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Emerging Trends in Psychological Practice in Long-Term Care

Authors

  • Roy J. Goldberg MD, FACP, CMD,

    1. From the *Kings Harbor Multicare Center, Bronx, New York; Albert Einstein College of Medicine, Bronx, New York; and PsychAssociates, Inc., United Oddfellow and Rebekah Home, Bronx, New York.
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  • Jeanne M. Devine PhD

    1. From the *Kings Harbor Multicare Center, Bronx, New York; Albert Einstein College of Medicine, Bronx, New York; and PsychAssociates, Inc., United Oddfellow and Rebekah Home, Bronx, New York.
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Address correspondence to Roy Goldberg, MD, Kings Harbor Multicare Center, 2000 East Gun Hill Road, Bronx, NY 10469. E-mail: Rgoldberg@kingsharbor.com

Abstract

Review of: Norris MP, Molinari V, Ogland-Hand S, eds. Trends in Psychological Practice in Long-Term Care, Copublished Clinical Gerontologist (Vol. 25, nos. 1/2/3/4, 2002), Binghamton, NY: The Haworth Press, 2002, pp 303.

Purpose: To bring geropsychologists up to date on the ever-evolving field of geriatric mental health in long-term care settings.

Background: Over the last 25 years, the number of older adults with mental disorders in nursing homes has surpassed the number in state mental health facilities as these facilities have closed down. This has made skilled nursing homes often times de facto inpatient psychiatric care units for older adults using a large amount of psychotropic and neuroleptic medications. In addition, many older adults with no premorbid history of mental illness develop a range of psychiatric, psychological, and behavioral disorders in response to the losses experienced through aging, illness, and subsequent placement in long-term care (LTC) settings. The balance between appropriate therapeutic usage of psychoactive medications and overmedication resulting in usage as chemical restraint has always been a difficult one. With the institution of the Omnibus Budget Reconciliation Act of 1987, which restricted use of physical and chemical restraints in nursing homes, opting instead for psychological and behavioral interventions, the role of the psychologist has become more important in the LTC setting. Not only are there far fewer iatrogenic effects, but also nursing home residents' quality of life has improved, enabling each of them to achieve the highest practical, physical, mental, and psychosocial well-being.

Emerging Trends in Psychological Practice in Long-Term Care has been copublished as Clinical Gerontologist, Volume 25, Numbers 1/2/3/4, 2002. Margaret P. Norris, PhD, president, Psychologists in Long-Term Care, Victor Molinari, PhD, president-elect, American Psychological Association section on clinical geropsychology, and Suzann Ogland-Hand, PhD, geropsychologist and former secretary for Psychologists in Long-Term Care, edited it. Each editor is also a contributor of a chapter in the book.

Contents: The book is divided into three sections.

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