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At least 5.6 million to 8 million-nearly one in five-older adults in America have one or more mental health and substance use conditions, which present unique challenges for their care. With the number of adults age 65 and older projected to soar from 40.3 million in 2010 to 72.1 million by 2030, the aging of America holds profound consequences for the nation. For decades, policymakers have been warned that the nation's health care workforce is ill-equipped to care for a rapidly growing and increasingly diverse population. In the specific disciplines of mental health and substance use, there have been similar warnings about serious workforce shortages, insufficient workforce diversity, and lack of basic competence and core knowledge in key areas. Following its 2008 report highlighting the urgency of expanding and strengthening the geriatric health care workforce, the IOM was asked by the Department of Health and Human Services to undertake a complementary study on the geriatric mental health and substance use workforce. The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands? assesses the needs of this population and the workforce that serves it. The breadth and magnitude of inadequate workforce training and personnel shortages have grown to such proportions, says the committee, that no single approach, nor a few isolated changes in disparate federal agencies or programs, can adequately address the issue. Overcoming these challenges will require focused and coordinated action by all.
There have always been homeless people in the United States, but their plight has only recently stirred widespread public reaction and concern. Part of this new recognition stems from the problem's prevalence: the number of homeless individuals, while hard to pin down exactly, is rising. In light of this, Congress asked the Institute of Medicine to find out whether existing health care programs were ignoring the homeless or delivering care to them inefficiently. This book is the report prepared by a committee of experts who examined these problems through visits to city slums and impoverished rural areas, and through an analysis of papers written by leading scholars in the field.
"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/
Written by leading international experts, this book discusses the latest advances in the field of dementia in nursing homes. The topics and findings covered are based on their survey and on a scientific literature review. Dementia is spreading worldwide, placing a growing burden on healthcare systems and caregivers, as well as those affected. With increasing and complex care needs, nursing home admission is often necessary. Globally, over half of nursing home residents suffer from dementia. The book provides essential information on the most important issues in dementia in nursing homes today, including meaningful activities, patient-/person-centered care, psychosocial interventions, challenging behavior, inclusion and support of family members, pain, staff training and education, communication, polypharmacy, quality of life, end-of-life care and advanced care planning, depression, delirium, multidisciplinary approaches, physical restraints and care dependency. Each topic is covered by an international expert in dementia. As such, the book will appeal to professional nurses, nursing scientists, nursing students, other healthcare professionals, and to a broad readership, and will provide a valuable resource for those working in nursing homes, as well as researchers in the field.
Among the issues confronting America is long-term care for frail, older persons and others with chronic conditions and functional limitations that limit their ability to care for themselves. Improving the Quality of Long-Term Care takes a comprehensive look at the quality of care and quality of life in long-term care, including nursing homes, home health agencies, residential care facilities, family members and a variety of others. This book describes the current state of long-term care, identifying problem areas and offering recommendations for federal and state policymakers. Who uses long-term care? How have the characteristics of this population changed over time? What paths do people follow in long term care? The committee provides the latest information on these and other key questions. This book explores strengths and limitations of available data and research literature especially for settings other than nursing homes, on methods to measure, oversee, and improve the quality of long-term care. The committee makes recommendations on setting and enforcing standards of care, strengthening the caregiving workforce, reimbursement issues, and expanding the knowledge base to guide organizational and individual caregivers in improving the quality of care.
Approximately 4 million U.S. service members took part in the wars in Afghanistan and Iraq. Shortly after troops started returning from their deployments, some active-duty service members and veterans began experiencing mental health problems. Given the stressors associated with war, it is not surprising that some service members developed such mental health conditions as posttraumatic stress disorder, depression, and substance use disorder. Subsequent epidemiologic studies conducted on military and veteran populations that served in the operations in Afghanistan and Iraq provided scientific evidence that those who fought were in fact being diagnosed with mental illnesses and experiencing mental healthâ€"related outcomesâ€"in particular, suicideâ€"at a higher rate than the general population. This report provides a comprehensive assessment of the quality, capacity, and access to mental health care services for veterans who served in the Armed Forces in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn. It includes an analysis of not only the quality and capacity of mental health care services within the Department of Veterans Affairs, but also barriers faced by patients in utilizing those services.
Artificial Intelligence in Behavioral and Mental Health Care summarizes recent advances in artificial intelligence as it applies to mental health clinical practice. Each chapter provides a technical description of the advance, review of application in clinical practice, and empirical data on clinical efficacy. In addition, each chapter includes a discussion of practical issues in clinical settings, ethical considerations, and limitations of use. The book encompasses AI based advances in decision-making, in assessment and treatment, in providing education to clients, robot assisted task completion, and the use of AI for research and data gathering. This book will be of use to mental health practitioners interested in learning about, or incorporating AI advances into their practice and for researchers interested in a comprehensive review of these advances in one source. - Summarizes AI advances for use in mental health practice - Includes advances in AI based decision-making and consultation - Describes AI applications for assessment and treatment - Details AI advances in robots for clinical settings - Provides empirical data on clinical efficacy - Explores practical issues of use in clinical settings
Chronic homelessness is a highly complex social problem of national importance. The problem has elicited a variety of societal and public policy responses over the years, concomitant with fluctuations in the economy and changes in the demographics of and attitudes toward poor and disenfranchised citizens. In recent decades, federal agencies, nonprofit organizations, and the philanthropic community have worked hard to develop and implement programs to solve the challenges of homelessness, and progress has been made. However, much more remains to be done. Importantly, the results of various efforts, and especially the efforts to reduce homelessness among veterans in recent years, have shown that the problem of homelessness can be successfully addressed. Although a number of programs have been developed to meet the needs of persons experiencing homelessness, this report focuses on one particular type of intervention: permanent supportive housing (PSH). Permanent Supportive Housing focuses on the impact of PSH on health care outcomes and its cost-effectiveness. The report also addresses policy and program barriers that affect the ability to bring the PSH and other housing models to scale to address housing and health care needs.
The Health Survey for England 2000 presents a number of reports which consider the health of older people, aged 65 years and over, both in private households and, for the first time, in residential and nursing homes. This report focuses on the issue of disability among older people. Findings include: that there are marked differences between residents in care homes and private households; disability levels are higher among those aged 80 and over, than among the 65-79 age group; the most commonly reported type of disability, for both men and women aged 65 and over, is locomotor disability, with personal care issues the second highest.; in care homes, multiple disability is more prevalent than private households, with 40 per cent of men and 45 per cent of women having three or more disabilities.
The care home sector is large, with over 400 000 residents in the UK and a similar number employed within the homes. It is therefore an area of considerable economic importance. Care home residents are often very old, and many have multiple physical and mental health needs, meaning that their care poses particular challenges. They are also a distinctly and profoundly marginalised group who are often invisible in the wider debates on quality of care including those about care homes. Mental Health and Care Homes is a coherent and evidence-based text exploring these issues. Bringing together both clinical and research perspectives it will help those working in the care home sector to deliver high quality care and support to both residents and staff. This important, yet neglected, area is thoroughly reviewed by a range of experts including residents, family carers, staff, researchers, and clinicians. The book has four sections: 'the inside view' which includes several first-hand accounts of care home life; 'the outside view' which discusses the regulatory, funding, and legislative context in which care homes operate; 'mental health and care', a detailed review of the major mental and other health issues that arise in care homes, as well as interventions and services to offer support; and a section exploring the 'promotion of health and wellbeing' including examples of good practice. It concludes by synthesising key themes and setting an agenda for further enquiry. The book is written in a style that encourages engagement, with the inclusion of contemporary case studies and examples, making it topical and readable. It will be valuable for a broad professional and vocational audience across both health and social care, as well as students and researchers.