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Managing Behavioral Problems in the Nursing Home
I am a nursing home administrator struggling with many residents who are having altercations with other residents (e.g., striking, throwing water, struggles). We have previously sent these individuals to geri-psych facilities for evaluation but to no avail. They return on the same meds with the same behavior. At this point we are going to try to manage their behaviors and med regimes with our own primary care physicians and psychiatrist. Unfortunately, I don't feel we have enough information to really enlighten our MDs in the psychiatric issues of the geriatric population. I would appreciate any information you could provide to us. Thank you so much for your time and consideration.
Thank you for your question.

This is a difficult question, but I believe that the situation you describe is shared by all nursing homes and chronic care facilities. I can only tell you how we handle it at Amsterdam Nursing Home in NYC, where I am the psychiatric consultant. We feature monthly multi-disciplinary case conferences that focus on residents who pose the greatest behavioral problems. The conference is always led by a geriatric psychiatrist. It is mostly attended by full-time nursing, recreational, physical therapy, and social work staff, but physicians are also encouraged to participate because key to the discussion is use of psychotropic medication, as well as management in the milieu. I find that even if the featured problem cannot be completely resolved, the conference itself covers important material educationally and contributes to improved staff morale since individual staff members' observations tend to be validated.

 
 
 
 
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