Focus on mental health issues in long-term-care homes

Principles of good care for long-term care facilities

Maggie C. Gibson^a1 c1, Mary W. Carter^a2, Edward Helmes^a3 and Anna-Karin Edberg^a4

^a1 St. Joseph's Health Care and Lawson Health Research Institute, London, Ontario, Canada

^a2 Center on Aging, Department of Community Medicine, West Virginia University, Morgantown, West Virginia, U.S.A.

^a3 Department of Psychology, James Cook University, Townsville, Queensland, Australia

^a4 Department of Health Sciences, Lund University, Lund, Sweden

ABSTRACT

Background: The International Psychogeriatric Association Task Force on Mental Health Services in Long-Term Care Facilities aims to support and strengthen mental health services in the long-term care sector. The purpose of this paper is to identify broad principles that may underpin the drive towards meeting the mental health needs of residents of long-term care facilities and their families, as well as to enhance the overall delivery of residential care services.

Methods: Principles of good care are extrapolated from an analysis of international consensus documents and existing guidelines and discussed in relation to the research and practice literature.

Results: Although the attention to principles is limited, this review reveals an emerging consensus that: (1) residential care should be situated within a continuum of services which are accessible on the basis of need; (2) there should be an explicit focus on quality of care in long-term care facilities; and (3) quality of life for the residents of these facilities should be a primary objective. We take a broad perspective on the challenges associated with actualizing each of these principles, taking into consideration key issues for families, facilities, systems and societies.

Conclusions: Recommendations for practice, policy and advocacy to establish an internationally endorsed principles-based framework for the evolution and development of good mental health care within long-term care facilities are provided.

(Received November 17 2009)

(Revised March 04 2010)

(Revised April 01 2010)

(Accepted April 08 2010)

(Online publication July 02 2010)

Key words:

• aged;
• institutionalized;
• continuum of care;
• quality of care;
• quality of life;
• residential care;
• mental health;
• philosophy of care

Correspondence:

^c1 Correspondence should be addressed to: Dr. Maggie Gibson, Veterans Care Program, Parkwood Hospital, St. Joseph's Health Care London, 801 Commissioners Road East, London, Ontario, Canada, N6C 5J1. Phone: 519-685-4292 ext. 42708; Fax: 519-685-4031. Email: maggie.gibson@sjhc.london.on.ca.