mental health

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Bringing-together-Kings-Fund-March-2016_1

Bringing together physical and mental health

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Priority 10: Supporting the mental health needs of people in

residential homes

The problem

Mental health problems are not a normal or inevitable part of the ageing process

– the majority of older people enjoy good mental health and make valuable

contributions to society (Age UK 2006). Nonetheless, depression, dementia and

other conditions are common in residential homes. Two-thirds of people living in

care homes have dementia and are usually at a more advanced stage of the illness

(Personal Social Services Research Unit 2007). Many homes are not equipped to provide

the one-to-one, person-centred care that people with dementia need, and access

to support from external specialist services is variable (Joint Commissioning Panel

for Mental Health 2013a). Depression occurs in 40 per cent of people in care homes

and often goes undetected (Chew-Graham et al 2014), with many carers seeing

depression as a normal phenomenon among older people (Ayalon et al 2008).

Very few care homes cater explicitly for residents’ mental health needs other than

dementia, and the extent of mental health training provided to care home staff is

often limited (Levenson and Joule 2007).

Impact on people

Mental health problems significantly affect the physical, psychological and social

wellbeing of people in care homes. Confusion related to dementia or delirium

can be highly distressing for residents and their families. Depression among care

home residents with dementia has been associated with poor nutrition and excess

mortality rates (Katz and Parmelee 1994). Depression is also a risk factor for suicide

in care homes (Suominen et al 2003). Although depression can seriously affect

the quality of life of older people, many do not receive adequate treatment, with

symptoms frequently being misunderstood as an inevitable part of ageing (Eisses

et al 2005).

The case for change: 10 areas where integration is needed most 40

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