#58: Psychological input with treatment team in residential care

Show notes: Special edition

CASE STUDIES

Psychological input with treatment team in residential care

In this series of podcasts, we are exploring varies topics through case studies – and today we are looking at psychological inputs within the treatment team in aged care.

In this episode you will learn:

• Addressing myths associated with receiving psychological support
• When someone may require psychological support
• Case conferencing and collaboration
• The difference between having an in-house psychologist vs external provider
• Types of mental health conditions that a psychologist may be able to assist with

In this episode we’ll look at a case study of a client I supported who moved into an aged care facility after she had a fall and her mobility changed. She was still able to walk using a frame and she had no cognitive changes. There are a lot of myths around receiving psychological support, and especially with the older generation, there is so much stigma around if someone needs help. A telling sign when someone is in care and may need support is to look at the score on the Cornell Scale for depression, and for the lady in my case study, she scored quite high. She found it challenging managing her limited mobility and her transition into aged care was difficult for her.

I met her not long after she moved in, and she was sitting in her room, and she had her walker with her, and she displayed a mixture of relief that she could walk, but also disappointment that she needed it. From then on, I realised it wouldn’t be simple, and I needed to look at who else was there to support her. For residents in aged care, the treatment team or support team can include families, staff at the facility, support staff, and other allied health professionals. Connecting with the support team is so important, because in isolation, me talking to someone is not going to help them integrate into their environment. Support is needed to drive that behaviour in between session to promote those changes we are hoping to see.

‘Working alongside other health professionals, we will achieve better and more sustainable outcomes.’

Going back to my client, she would tell me how she saw her physiotherapist, and that her son was visiting, and I would think I need to speak to them to help us bring it all together. My first step was to make contact with her physiotherapist to find out what she could and couldn’t do and how we could avoid her sitting too long. He confirmed she could move around the facility with her walker, so we made a plan that got her moving a bit more to build her confidence in her mobility back up. What we did wasn’t rocket science, but we did it collaboratively.

I spoke to the nursing staff and attended her case conferencing to put all the pieces together. The risk with her was that she would become isolated in her room, and we know that if a person is not as active, their level of care needs can increase.

As psychologists, we really need to look at what we can do to support those in care to improve their quality of life, as so many people do experience depression. In the past the focus was just on giving them medication, but that’s not going to teach people skills in how to look at life differently, how to engage differently, how to feel differently, or to give them the option of being able to process what is going on for them.

There is certainly a lot of room to allow psychologist’s input into care plans, especially considering the high rate of depression in care residences, with 1 in 2 residents having symptoms of depression. This should not be surprising due to the many changes that are happening to their health and environment. There are many benefits to having a psychological assessment on admission conducted by a psychologist rather than a nurse, to help us gain a clearer picture of what is going on.

Working alongside other allied health professionals, psychologists will achieve better outcomes. We know that older people respond well to cognitive behaviour strategies, and that some elders won’t need too many sessions before they see some real benefits. Over the last 5 years there is much more awareness about the benefits of how psychologists can help elders in aged care settings and also around the importance of working together as a team.

Not everyone in aged care needs to see a psychologist, but there is an opportunity to look at non-pharmacological ways in how we help an older person in the later stages of their life to improve their engagement, improve their outlook and make those last years of their life in an aged care facility more enjoyable.

Resources:

Beyond the Reluctant Move, Dr Julie Bajic Smith

https://www.wisecare.com.au/book