Psychological Services in Long-term Care Resource Guide Introduction

With the “graying” of the American population, the number of older adults, and particularly the number of the “oldest-old” adults over the age of 85, has grown exponentially. Moreover, because individuals are more likely to develop multiple physical and mental health co-morbidities with advancing age, long-term care providers are increasingly responsible for meeting very complex needs in the individuals they serve. While long-term care settings were specifically designed to meet the medical needs of older adults, their capacity to address the psychological, social and behavioral needs of their residents has traditionally been less developed. Fortunately, a growing number of clinical/counseling psychologists, geropsychologists, rehabilitation psychologists, and neuropsychologists have stepped forward to assist long-term care providers in addressing the behavioral health needs of their residents. Psychologists from a variety of specialty areas are well equipped to support their colleagues in long-term care in the care of residents struggling with depression, anxiety, dementia, delirium and/or lifelong mental health conditions. The Omnibus Budget Reconciliation Act of 1987, which provides reimbursement to psychologists for providing psychological services under Medicare and mandates that non-psychopharmacological care be attempted prior to trials of psychoactive medication, opened the door to this important collaboration between long-term care providers and psychologists.