Organizing mental health care in nursing homes: How, by whom and what for?

Abstract

Though care should be provided in patients’ homes for as long as possible, it must be recognised that care in an alternative residential setting may be the only way of meeting some patients’ needs effectively or avoiding intolerable carer burden. Such care will always be necessary, for people who have no relatives available. The residential care may be useful for respite care including a range of time limited services, to support the carers. Residential care should also be available for those patients whose physical, psychological, and/or social dependencies make living at home no longer possible. This provision includes a range from supported accommodations with low level supervision, medium level care facilities and full nursing facilities. There is a high prevalence of mental disorders in nursing homes and very often the staff is not adequately educated, trained and supported to care these individuals. Psychiatric consultation liaison services should be provided not only for residents but also to support the staff of these facilities. The most recent international documents point out the necessity to offer the best available care [1] for these vulnerable persons in the deep respect of their dignity [2]. It becomes urgent to launch a deep debate on this subject in order to recommend to authorities the best guidelines to support policies to be adopted in this field.

Disclosure of interest

The author has not supplied his declaration of competing interest.