A dangerous combination at too many nursing homes

John O'Connor
John O'Connor

A new report chronicling a 21% drop in antipsychotic use among residents drew a quick and happy response from the field. Rightfully so.

For as anyone who has spent any time in a nursing home can tell you, such meds have often been used in the past to turn misbehaving residents into zombies.

But what really caught my eye after reading the story on the McKnight's site was the lively discussion stream that followed.

If the half-dozen or so postings are indicative, it would appear facilities are becoming more reluctant to admit younger people with mental illnesses. At the risk of sounding like an insensitive jerk, that's a good thing.

Now before you send me a nasty note pointing out my numerous shortcomings as a human being, hold on a second.

For the record, I happen to believe that mental illness is a largely undiagnosed and massively under-treated problem in this country. Rare is the family that has been completely spared its grip. I also believe that the way local, state and federal support for community-based mental health services has eroded in recent years is, well, unconscionable.

But as the saying goes, two wrongs don't make a right. It's bad for governments to under- or non-fund mental health services. It's catastrophic to use nursing homes as spackle. Yet that is exactly the scenario that frequently plays out, often with devastating consequences for all involved.

It's not too hard to imagine what can happen when younger, stronger residents with depression, schizophrenia or bipolar disorder suddenly find themselves rooming with frail, often demented seniors. Actually, no imagination is required. Simply Google “nursing home resident attacks

But be warned: What you'll see won't be pleasant.

Yet by all indications, this deadly mixing and matching appears to be anything but rare. When the Chicago Tribune examined the issue in Illinois, the paper found that people with mental illness represent about 15% of the state's total nursing home population. That's more than 10,000 people in the Land of Lincoln alone.

So what's to be done? The best scenario would be if those with mental illnesses hadn't been kicked to the proverbial curb. And it would be better if the response hadn't been to put many of those unfortunate souls in nursing homes. But as the saying goes, that ship has sailed.

My strong recommendation is that at a minimum, the two populations should be kept in separate buildings. That is the only foolproof way to prevent punishment and other crimes.

Does that step sound extreme? Is it a solution you cannot support? Well then, let me ask you this: Would you be okay with your frail, demented mother living in a nursing home with younger residents suffering from mental illnesses?

I didn't think so.

John O'Connor is McKnight's Editorial Director.

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Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Emily Mongan.

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