Psychiatric Consultation in Long-Term Care: A Guide for Health Care Professionals

Preface

P r e f a c e A coauthored text such as this, unlike edited texts, gives the authors a unique opportunity to present state-of-the-art information regarding biopsychosocial and environmental interventions in long-term care (LTC) together with our philosophy of caring for older adults who live in LTC settings. Our philosophy of care is that “there is life in the nursing home” and other LTC facilities and that health care professionals in many disciplines—physicians , nurses, administrators, nurse aides, social workers, various rehabilitative therapists, pharmacists, psychologists, clergy, recreational therapists, music therapists, and others—all have a lot to offer in improving the quality of life for LTC residents and their families. Every health care provider has an important role to play as a member of the health care team. Our philosophy of care places the needs and dignity of the LTC resident at its center. It promotes the notion that, to some degree, we can help every LTC resident and his or her family. A caring attitude on the part of all health care professionals in LTC is vital in meeting this goal. Our philosophy sees the LTC environment as warm, nurturing, and supportive. For residents, it is their extended family, or, at times, their only family. Achieving excellence in the care of LTC residents will require physicians not only to be responsible to each individual resident, but also to promote the well-being of family members and other professional caregivers, as well as to understand the systems of care. This means a team approach—in addition to individual assessments—to determine what intervention strategies are most effective, to standardize care where possible, and to eliminate errors. Our philosophy of care promulgates the use not only of biological therapies , when appropriate, but also of psychosocial, behavioral, and environmental interventions. In fact, one of the longest chapters in this text is de- viii P R E FA C E voted to psychosocial-environmental (i.e., nonpharmacologic) treatments of behavioral problems in LTC. This guide is written to be user-friendly and is targeted to physicians, physician assistants, nurse practitioners, nurses, social workers, administrators, and other health care professionals involved or interested in behavioral and psychosocial issues in LTC. It can also be useful for students and trainees who desire to learn more about behavior, aging, and LTC. We hope our book will further education and training regarding LTC by providing evidence-based, state-of-the-science approaches to improving the well-being of all residents in LTC. We would like to thank our spouses and families for their support of this project. We also appreciate the high-quality editorial work of Ms. Wendy Harris of the Johns Hopkins University Press. Without her unfailing support, this project would not have been realized. Lastly, we have learned a great deal from our patients, their families, and the staff of the outstanding LTC facilities with which we have been affiliated. We hope you enjoy reading this book and find it helpful in your work with LTC residents. Psychiatric Consultation in Long-Term Care This page intentionally left blank ...