N.J. Medical Center Program Seeks to Better Diagnose Patients Referred to Psychiatric Facilities

With the elderly population of the United States living longer, the rate of dementia in nursing homes and other eldercare facilities is also steadily rising.  Dementia, a gradual deterioration of cognitive skills, is not a mental illness.  But understaffed facilities and undereducated workforces can often confuse it as mental illness in patients.  Moreover, these facilities are seeing increased admissions in general.  And—with the symptoms of aging that accompany this population—the potential for confusing such symptoms with psychiatric difficulties has also risen.

A recent article in the New Jersey Star-Ledger cited the example of one 62-year-old patient of a nursing home.  He would regularly strike out at workers in the facility and was summarily sent to a psych ward.  But, it turned out that the patient was just blind.  He was startled when these staffers entered his room.

What occurred in that room—and in others like it—wasn’t figured out until a geriatric specialist was sent to resolve the problem.  The specialist was a member of a relatively new program designed to help curb the unnecessary flow of “hard-to-manage” seniors from nursing homes to psychiatric hospitals.

The program, run by Trinitas Regional Medical Center in Elizabeth, NJ, sends members around the state to help determine whether difficult patients are actually mentally ill.  Last year, the first year of the program, the nine-members visited 650 patients—and prevented 137 seniors from being incorrectly sent to psychiatric institutions.  This program, added to a statewide Department of Human Services training program for nursing home workers, has seen real successes.  Patient referrals to psychiatric hospitals were down 16% last year.

“Any assistance is helpful,” said Paul Langevin, president of the New Jersey Association of Health Care Facilities.  “In general, people are staying in their homes longer, so by the time you get folks to a nursing facility, you have the sickest of the sick, the frailest of the frail and the oldest of the old.  There may be behavior issues, and (workers) are glad to have the expertise and help.”