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Securing Proper Elder Care for Those with Mental Illnesses

In taking up residence at a nursing home or long-term care facility, a resident may be there for any of a variety of reasons, and possibly multiple reasons. Sometimes they are physical, as in the person is disabled from an injury or possibly a stroke, and requires round the clock attention and care. Other times, it is primarily mental, such as the person has severe emotional problems, or possibly suffers from dementia or Alzheimer’s. In any case, the Illinois Nursing Home Care Act is meant to address the quality of care for patients suffering from any injury or disability, and this includes patients with mental health needs.

After a growing and disturbing history of negligence and abuse occurring in nursing homes across the country and particularly in Illinois, the state government created a task force to assess issues of physical and sexual abuse, abuse of drugs, and other various problems that went on at facilities. The Illinois Nursing Home Safety Task Force issued a Final Report that noted particular deficiencies in nursing home care for those with mental illness. For example, the report stated that “many people currently admitted to nursing homes with serious mental illness would be better cared for in specially designed and monitored community residential settings.” To this end, the task force recommended that the process of assessing patients and referring them to community-based environments where appropriate for the best possible care. As the report also states, these community-based settings will typically be community housing where the patient’s needs can be addressed more directly. For nursing homes that still wish to be viable as a center of care for the mentally ill, the report indicated that those facilities obtain a special certification for dispensing that type of care. The report also recommended raising the general standard of care for the mentally ill.

The updated Nursing Home Care Act of 2010 adopted much of the task force’s recommendations, starting with the special certification for nursing homes to be able to offer care to those with mental health issues. Without the certification, these facilities cannot admit patients with serious mental illnesses. Under the law, patients with serious mental illnesses are screened by the right professional in order to determine if in fact that illness exists and how serious it is. This allows the Department of Human Services to properly refer a patient to the right facility. In addition to that initial screening, patients must be reassessed at intervals of 90 days, 6 months, and then annually after that. This frequency of screening allows for patients to have the proper assessment to determine if they require a different standard of care and if they must be referred to a different facility.

Another reform occurred in the area of drugs. As covered here previously, there has been controversy over the use of psychotropic drugs to chemically restrain patients from acting out or behaving violently. Much of the controversy regards the overuse of these drugs in unnecessary situations. The Nursing Home Care Act reforms responded to the task force’s recommendations by mandating that psychiatric services, including the use of drugs, be provided by qualified individuals employed by the approved, certified facility. The law also followed the task force recommendations by mandating greater standards of staff training and requiring greater staff volume to care for mentally ill patients.

Among many reforms, the Nursing Home Care Act followed the important recommendations of the state task force, with a particular eye toward enhancing the care of those with serious mentally illnesses. It remains to be seen whether care will improve, but continued monitoring by the state will be vital to this.

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