Needs assessment : identifying the barriers to admission and supports in long-term care facilities for the mentally ill elderly in the region of London-Middlesex, Ontario

Abstract

There are increasing demands for long-term care (LTC) homes to admit elderly persons with mental health illness who are unable to be cared for within the community. This project examined the barriers to admission to LTC homes and supports required in these homes for the elderly who experience mental health illness. No longer is LTC simply for the frail elderly population, but current trends now include a younger population with mental health needs, an increased male population, residents with dementia and difficult-to-manage behaviours, developmentally challenged residents, and other residents with a variety of mental health diagnosis that may also include concurrent substance abuse and medical issues. These facilities face unique challenges when providing care for the geriatric mentally ill population not only because of these trends but also because of issues with staffing recruitment and retention; a need for appropriately trained staff in mental health; and unmet interdisciplinary staffing needs, inadequate psychiatric supports, environmental needs, and fiscal constraints. Older adults who suffer with mental health illness are at an increased risk for experiencing the inequalities within our health care system. This is a very vulnerable population because their medical and psychological needs related to aging are more complex than those of the youth and adult populations. Older adults with serious mental illness face discrimination and stigma both for their mental health disorders and for their age. These facts, in turn, are just some of the barriers facing admission to LTC homes for this population. The increasing senior population, especially in the 85 and older age category, gives precedence to the urgency of assessing the community resources available to meet their needs. The statistics show an alarming incidence of mental health illness within the geriatric population, with the frequency being as high as one in five being affected over the age of 65 (Jeste et al., 1999, as cited in Bartels, Dums, et al., 2002). It is anticipated that the number of people over the age of 65 who will suffer with a mental health illness will “more than double by the year 2030, from 7 million in 2000 to 15 million” (Jeste et al., as cited in Bartels, Dums, et al.).