Introduction
Meeting the psychosocial needs of geriatric residents is a vital part of nursing home care. Psychosocial well-being effects the resident’s life, health, and potential to thrive at the highest level of functioning. The importance of comprehensive Social Services care plans is emphasized by the new Psychosocial Outcome Severity Guide.
At least half of all nursing home residents have a dementing illness, most commonly Alzheimer’s disease or vascular dementia. The prevalence of depression in nursing homes is 20% - 25% (compared with 3% in the community). 13% of nursing home residents develop a new episode of major depression within a one year period. In a study conducted over 12 months, residents with depression had a 59% increase in mortality.
The Nursing Home Resident Assessment - Quality of Care Study, performed by the Department of Health and Human Services in December, 2000 revealed many crucial discrepancies in psychosocial assessments. In 14 percent of the records, the RAP was triggered by the reviewer but not by the nursing home. The RAPs with the greatest differences were Psychosocial Well-Being (38%) and Mood State (37%).
The Data Assessment and Verification Project (DAVE) Discrepancy Report, published by CMS in June, 2003 listed many discrepancies in Psychosocial areas:
Section B, Cognitive Patterns:
Contradictory information
Full look back period not used
Section E, Mood and Behavior Patterns:
Indicators of depression, anxiety, sad moods that occur only one or twice in the past thirty days – not coded
Contradictory information
Section F, Psychosocial Well-Being:
Contradictory information
This manual provides information and tools to improve assessments and interventions for meeting psychosocial needs. Regulations, survey protocols, and excerpts from the RAI User’s Manual give the basis of industry standards and quality of care. Care plans are provided for every possible problem generated from the MDS assessment entries.
Assessment forms and Quality Assurance audits are included, as well as a complete advance copy of the new Psychosocial Outcome Severity Guide.
The CD-ROM contains all of the forms and care plans from the book, and these can easily be made resident and facility specific using a word processor.