Prevalence of psychiatric vulnerability and neurocognitive disorders in nursing homes: impact on care levels

TL;DR

This study finds that nearly 1 in 5 nursing home residents in Belgium have psychiatric vulnerabilities, leading to higher care needs and behavioral issues.

Contribution

The study provides new insights into the prevalence of psychiatric vulnerability in nursing homes and its impact on care levels in Belgium.

Findings

17.5% of residents had a psychiatric diagnosis and 41.8% had a neurocognitive disorder.

Residents with psychiatric diagnoses had higher behavioral and symptom scores compared to those with only neurocognitive disorders.

Abstract

To gain insight on the prevalence of psychiatric vulnerability in Belgian nursing homes and its impact on care levels.

Seventeen and a half percent of the residents have at least one documented lifetime psychiatric diagnosis and in 41.8% a neurocognitive disorder was documented. Residents with a psychiatric vulnerability scored higher on symptoms and behavioural problems compared to older adults with only a neurodegenerative disorder.

It is crucial to invest in nursing home staff training and education to enhance their competencies in the care of psychiatric vulnerable older adults.

There is an increasing number of residents with more complex needs in nursing homes. Due to the deinstitutionalisation of mental health care, more individuals with psychiatric vulnerabilities are being referred to nursing homes. The aim of this study is to gain insight into the prevalence of psychiatric vulnerability in Belgian nursing homes and its impact on care levels.

After screening 3238 patient files of residents in twenty-four Belgian nursing homes, informed consent was obtained from 1155 of the 1608 residents or their legal representatives with a neurocognitive and/or psychiatric diagnosis. Residents were classified into three groups: residents with only a psychiatric diagnosis, with only a neurocognitive diagnosis, and both a psychiatric and neurocognitive diagnosis. The Health of Nations Outcome Scale 65 + was used to assess residents’ behaviour, limitations, symptoms, and functioning.

Of all residents, 17.5% had a lifetime psychiatric diagnosis and 41.8% had a neurocognitive disorder. Most prevalent were depressive disorder (8.2%) and Alzheimer’s disease (19.3%). Scores for behavioural problems (1.4 and 1.4 versus 0.9, p < 0.0001) and symptoms (5.5 and 5.1 versus 4.4, p < 0,0001) were higher in residents with only a psychiatric or both diagnoses compared to those with only neurocognitive disorders. Conversely, scores for limitations were higher in residents with only a neurocognitive disorder (3.6 versus 2.2 and 3.1, p < 0.0001).

With almost 1 in 5 nursing home residents having a psychiatric vulnerability with higher levels of symptoms and behavioural problems, more attention towards improving nursing home caregivers’ competence in psychiatric care is recommended.

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