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Preparing Long-Term Care Staff to Meet the Needs of Aging Persons With Serious Mental Illness.

Muralidharan A, Mills WL, Evans DR, Fujii D, Molinari V. Preparing Long-Term Care Staff to Meet the Needs of Aging Persons With Serious Mental Illness. Journal of The American Medical Directors Association. 2019 Jun 1; 20(6):683-688.

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OBJECTIVES: Individuals with serious mental illness (SMI; schizophrenia spectrum disorders and affective psychoses) are increasingly aging into older adulthood and are overrepresented in residential long-term care settings. The present study aimed to examine the preparedness of staff in these settings to care for individuals with SMI. DESIGN: A multidisciplinary US Department of Veterans Affairs (VA) workgroup of professionals with expertise in geriatric mental health collected voluntary feedback via online questionnaire as part of a quality improvement project. SETTING AND PARTICIPANTS: Respondents were mental health providers (N = 51) embedded in VA nursing homes called Community Living Centers (CLCs). MEASURES: The questionnaire contained multiple-choice, Likert-type scale, and open-ended questions regarding the opportunities and challenges associated with caring for Veterans with SMI in CLCs. RESULTS: Respondents identified a lack of training of front-line staff as a key challenge in providing high-quality care to residents with SMI. Specifically, respondents indicated a need to increase staff knowledge about SMI symptoms and diagnoses, to improve staff communication and interactions with residents with SMI, and to decrease mental illness stigma among staff. CONCLUSIONS/IMPLICATIONS: The present study revealed significant areas of training need for front-line staff in nursing homes. Many perceived staff training needs overlap with the knowledge and skill set required to provide high-quality dementia care. Integrating training regarding the care of residents with SMI into dementia care training efforts may be a fruitful future direction. Strategies for this and a suggested curriculum are provided.

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