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Nursing home research I'd like to see: An open letter to researchers

October 13, 2010
by ebarbera
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Dear Researchers,

I've been a nursing home psychologist for the last 14 years and, while there are many fascinating areas to be studied in the field of geropsychology, I'm writing to you with the hope that we'll see more research on the medical cost offset of psychological services.

One type of study could look at archival data from Medicare/Medicaid or private insurance companies comparing the medical costs of beneficiaries receiving psychological services with those who do not. I'd expect to see decreased use of medications, and possibly reduced use of aggressive end-of-life treatments. Studies showing reduced medical expenditures could result in changing regulations to require psychological consults upon nursing home admission, much like therapeutic recreation and dental service evaluations are required, and would increase the likelihood that insurers would promote mental health services in physical health environments.

Another type of study would take place within individual nursing homes, comparing floors or units receiving psychological interventions with those that don't. Such studies could examine the effectiveness of psychotherapy provided to residents on measures of resident, staff, and family satisfaction, absenteeism, incidents, turnover, etc. Other studies could measure the effects on those variables of a broader application of psychological services, such as team-building on a unit, communication skills training, conflict resolution, establishment of a therapeutic milieu, etc. If research indicated that providing psychological interventions to residents and staff decreased overall costs within individual nursing homes, perhaps we'd begin to see psychologists funded as part of the nursing home budget and able to provide a greater range of services.

If you're a researcher who's been working on medical cost offset studies, please contact me if you'd like a blog post about your research. Let's get the word out.

Sincerely,

Dr. El

Dr. Barbera is an author and a licensed psychologist consulting in long-term care facilities in the New York City area. She frequently lectures on subjects related to psychology, aging, and nursing homes. Dr. Barbera is available for private consulting with organizations, institutions, and individuals around eldercare issues. Visit her personal blog at www.mybetternursinghome.blogspot.com.

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My facility has a high percentage of residents with psychiatric illnesses. We have a team of clinicians to help us deal with these complex people. We are careful about room assignment and have an entire floor dedicated to residents with various psychiatric problems. We have just started a therapeutic psych/behavior program on that unit. The residents are very pleased with it and we have seen a decline in behaviors. Now if only we could get Medicaid to reimburse for all the time we spend dealing with these residents and their behaviors.

ebarbera

Dr. Barbera is an author and a licensed...