According to research published in Medical Care Research and Review, it is estimated that 65% to 91% of nursing home residents are affected by a mental health disorder. Furthermore, studies tell us that decreased mental health can affect both cognitive and physical functioning and, ultimately, a resident’s quality of life. 

As CMS shines the spotlight on behavioral health in nursing homes with updated rules of participation and targeted audits to focus on the accurate assessment and coding of residents diagnosed with schizophrenia, there is no time like the present to discuss and promote the importance of mental health awareness in long-term care. 

CMS guidelines related to person-centered, non-pharmacological interventions for behaviors associated with mental illness such as schizophrenia mark a pivotal movement towards a growing body of evidence showing that alternative methods, such as therapy and lifestyle changes, can be just as effective, if not more so, at managing symptoms. As we pause to reflect on practical implementation, it is also a moment to begin laying the foundation for overall mental wellness within the facility. 

Listed below are some practical approaches for skilled nursing facilities to promote mental wellness among all residents:

  • Create a supportive and inclusive environment. Consider the implementation of empathy training for team members.
  • Promote a culture of trauma-informed care. Ensure each resident and his or her life experiences are understood and respected. Educate staff on signs or symptoms of trauma and include any known triggers in the resident’s care plan.
  • Ensure residents are physically functioning at their highest potential. Assess the effectiveness of therapy screening processes, timing and sensitivity in identifying needed interventions.
  • Assist residents in maintaining connections with friends and family. Provide accessibility to necessary devices for planning and interaction.
  • Increase opportunities for decision-making. Offer choices in meal options, leisure activities and daily routine. Integrate personal goals into therapy and care plans.
  • Provide activities to promote physical and mental exercise. Encourage residents to safely participate in memory games, puzzles and home exercise programs.
  • Encourage social interaction through group activities. Ensure every resident is invited to attend celebrations, group activities and community outings.
  • Implement resident-specific interests in daily life. Promote facility staff awareness of each resident’s motivation and activities of interest.
  • Provide access to counseling services and support groups. Collaborate with staff and mental health professionals.
  • Monitor and review current facility policies and procedures to ensure they adequately support the mental health needs of residents.

As an additional resource, the Substance Abuse and Mental Health Services Administration (SAMHSA) has established the Center of Excellence for Behavioral Health in Nursing Facilities (COE-NF). The COE-NF is a centralized hub offering CMS facilities a toolbox for assistance, training, and additional no-cost resources. 

Now is the time to check in on all residents and their mental well-being. Exploring strategies to promote mental wellness and engaging all departments will help facilities lay a foundation that fosters optimal wellness, outcomes, patient satisfaction and quality of life for your residents.  

Erin Johnson, OTR/L is a Clinical Services & Education Specialist for Reliant Rehabilitation. In her current role, she audits documentation, provides in-services to staff, and assists in the development of continuing education, policies and procedures and educational resources. Erin has presented on a variety of topics to therapists and staff at skilled nursing facilities across the country, including lectures at the 2021, 2022 and 2023 AOTA Conferences.

Annie Govea is a Speech and Language Pathologist and member of the Clinical Services & Education Specialist team for Reliant Rehabilitation. As a part of the clinical team, she provides training and collaborates on educational projects focused on enriching the rehabilitative care provided to patients. She has also presented at state and national-level conferences related to her field.

The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.

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