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Screening for mental disorders in residential aged care facilities

Published online by Cambridge University Press:  06 April 2010

Nancy A. Pachana*
Affiliation:
School of Psychology, University of Queensland, Brisbane, Australia
Edward Helmes
Affiliation:
School of Psychology, James Cook University, Townsville, Australia
Gerard J. A. Byrne
Affiliation:
Discipline of Psychiatry, School of Medicine, University of Queensland, Brisbane, Australia Geriatric Psychiatry Service, Royal Brisbane and Women's Hospital, Brisbane, Australia
Barry A. Edelstein
Affiliation:
Department of Psychology, West Virginia University, Morgantown, West Virginia, U.S.A.
Candace A. Konnert
Affiliation:
Department of Psychology, University of Calgary, Calgary, Canada
Anne Margriet Pot
Affiliation:
Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands Department of Clinical Psychology, VU University, Amsterdam, The Netherlands
*
Correspondence should be addressed to: Nancy A Pachana, School of Psychology, University of Queensland, Brisbane, Australia. Phone: +617-3365-6832; Fax +617-3365-4466. Email: npachana@psy.uq.edu.au.

Abstract

Introduction: The International Psychogeriatric Association Task Force on Mental Health Services in Long-Term Care Facilities seeks to improve care of persons in residential aged care facilities (RACFs). As part of that effort the current authors have contributed an overview and discussion of the uses of brief screening instruments in RACFs.

Methods: While no current guidelines on the use of screening instruments in nursing homes were found, relevant extant guidelines were consulted. The literature on measurement development, testing standards, psychometric considerations and the nursing home environment were consulted.

Results: Cognitive, psychiatric, behavioral, functional and omnibus screening instruments are described at a category level, along with specifics about their use in a RACF environment. Issues surrounding the selection, administration, interpretation and uses of screening instruments in RACFs are discussed. Issues of international interest (such as translation of measures) or clinical concern (e.g. impact of severe cognitive decline on assessment) are addressed. Practical points surrounding who can administer, score and interpret such screens, as well as their psychometric and clinical strengths more broadly, are articulated.

Conclusions: Guidelines for use of screening instruments in the RACF environment are offered, together with broad recommendations concerning the appropriate use of brief screening instruments in RACFs. Directions for future research and policy directions are outlined, with particular reference to the international context.

Type
Focus on mental health issues in long-term-care homes
Copyright
Copyright © International Psychogeriatric Association 2010

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References

Alexopoulos, G. S., Abrams, R. C., Young, R. C. and Shamoian, C. A. (1988). Cornell Scale for Depression in Dementia. Biological Psychiatry, 23, 271284.CrossRefGoogle ScholarPubMed
American Psychological Association (1999). Standards for Educational and Psychological Testing. Washington, DC: American Psychological Association.Google Scholar
ABA and APA (2008). Assessment of Older Adults with Diminished Capacity: A Handbook for Psychologists. Washington, DC: American Bar Association Commission on Law and Aging and American Psychological Association.Google Scholar
Baltes, M. M. (1994). Aging well and institutional living: a paradox? In Ables, R. P., Gift, H. C., and Ory, M. G. (eds.), Aging and Quality of Life (pp. 185201). New York, NY: Springer.Google Scholar
Burns, A., Lawlor, B. and Craig, S. (2004). Assessment Scales in Old Age Psychiatry (2nd edn). London: Artin Dunitz.Google Scholar
Canadian Coalition for Seniors’ Mental Health (2006). National Guidelines for Seniors’ Mental Health: The Assessment and Treatment of Mental Health Issues in Long Term Care Homes (Focus on Mood and Behavior Symptoms). Toronto: Canadian Coalition for Seniors’ Mental Health.Google Scholar
Christensen, H. et al. (1999). Age differences in depression and anxiety symptoms: a structural equation modeling analysis of data from a general population sample. Psychological Medicine, 29, 325339.CrossRefGoogle Scholar
Chopra, M. P., Sullivan, J. R., Feldman, Z., Landes, R. D. and Beck, C. (2008). Self-, collateral- and clinician assessment of depression in persons with cognitive impairment. Aging and Mental Health, 12, 675683.CrossRefGoogle ScholarPubMed
Cronbach, L. J. (1960). Essentials of Psychological Testing (2nd edn). New York: Harper-Row.Google Scholar
Crum, R. M., Anthony, J. C., Bassett, S. S. and Folstein, M. F. (1993). Population-based norms for the Mini-mental State Examination by age and educational level. JAMA, 269, 23862391.CrossRefGoogle ScholarPubMed
Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A. and Gornbein, J. (1994). The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 23082314.CrossRefGoogle ScholarPubMed
de Vaus, D. A. (2002). Surveys in Social Research (5th edn). Crows Nest, NSW: Allen & Unwin.CrossRefGoogle Scholar
Dubois, B. et al. (2007). Research criteria for the diagnosis of Alzheimer's disease: revising the NINCDS-ADRDA criteria. Lancet Neurology, 6, 734746.CrossRefGoogle ScholarPubMed
Edelstein, B. A. et al. (2008). Older adult psychological assessment: current instrument status and related considerations. Clinical Gerontologist, 31, 135.CrossRefGoogle Scholar
Garb, H. N. (2005). Clinical judgment and decision making. Annual Review of Clinical Psychology, 1, 6789.CrossRefGoogle ScholarPubMed
Harper, G. J. (2000). Assessing older adults who cannot communicate. In Kane, R. L. and Kane, R. A. (eds.), Assessing Older Persons: Measures, Meaning, and Practical Applications (pp. 483515). New York: Oxford Press.Google Scholar
Hambleton, R. K., Merenda, P. F. and Spielberger, C. D. (2006). Adapting Educational and Psychological Tests for Cross-Cultural Assessment. Oxford: Routledge.Google Scholar
Hawes, C., Morris, J. N., Phillips, C. D., Mor, V., Fries, B. E. and Nonemaker, S. (1995). Reliability estimates for the Minimum Data Set for nursing home resident assessment and care screening (MDS). Gerontologist, 35, 172178.CrossRefGoogle ScholarPubMed
Koehler, M. et al. (2005). Measuring depression in nursing home residents with the MDS and GDS: an observational psychometric study. BMC Geriatrics, 5, 1.CrossRefGoogle ScholarPubMed
Lau, A., Edelstein, B. and Larkin, K. (2001). Psychophysiological responses of older adults: a critical review with implications for assessment of anxiety disorders. Clinical Psychology Review, 21, 609630.CrossRefGoogle Scholar
Lenze, E. J. et al. (2000). Comorbid anxiety disorders in depressed elderly patients. American Journal of Psychiatry, 157, 722728.CrossRefGoogle ScholarPubMed
Lichtenberg, P. A. et al. (1998). Standards for psychological services in long-term care facilities. Gerontologist, 39, 122127.Google Scholar
LoGiudice, D. et al. (2006). Kimberley Indigenous Cognitive Assessment tool (KICA): development of a cognitive assessment tool for older indigenous Australians. International Psychogeriatrics,18, 269280.CrossRefGoogle ScholarPubMed
McKhann, G. et al. (1984). Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology, 34, 939944.CrossRefGoogle ScholarPubMed
Mega, M. S., Cummings, J. L., Fiorello, T. and Gornbein, J. (1996). The spectrum of behavioral changes in Alzheimer's disease. Neurology, 46, 130135.CrossRefGoogle ScholarPubMed
Messick, S. (1988). The once and future issues of validity: assessing the meaning and consequences of measurement. In Wainer, H. and Braun, H. I. (eds.), Test Validity (pp. 3345). Hillsdale, NJ: Lawrence Erlbaum Associates.Google Scholar
Messick, S. (1991). Validity of test interpretation and use. In Atkin, M. C. (ed.), Encyclopedia of Educational Research. New York, NY: Macmillan.Google Scholar
Messick, S. (1998). Test validity: a matter of consequence. Social Indicators Research, 45, 3544.CrossRefGoogle Scholar
Meyer, G. J. et al. (2001). Psychological testing and psychological assessment: a review of evidence and issues. American Psychologist, 56, 128165.CrossRefGoogle ScholarPubMed
Murphy, G. T. and O'Brien-Pallas, L. (2004). The Development of a National Data Set for Health Human Resources in Canada: Beginning the Dialogue: Working Document. Ottawa: Canadian Institute for Health Information.Google Scholar
Peel, N. M., Bartlett, H. P. and Marshall, A. L. (2007). Measuring quality of life in older people: reliability and validity of WHOQOL:-OLD. Australasian Journal on Ageing, 26, 162167.CrossRefGoogle Scholar
Power, M., Quinn, K., Schmidt, S. and WHOQOL-OLD Group (2005). Development of the WHOQOL-OLD module. Quality of Life Research, 14, 21972214.CrossRefGoogle ScholarPubMed
Qualls, S. H. and Smyer, M. A. (2007). Changes in Decision-Making Capacity in Older Adults. Hoboken, NJ: John Wiley and Sons.Google Scholar
Reckase, M. D. (1996). Test construction in the 1990s: recent approaches every psychologist should know. Psychological Assessment, 8, 354359.CrossRefGoogle Scholar
Sansoni, J. et al. (2007). Final Report: Dementia Outcomes Measurement Suite Project. Wollongong: Centre for Health Services Development, University of Wollongong.Google Scholar
Shapiro, A. M., Roberts, J. E. and Beck, J. G. (1999). Differentiating symptoms of anxiety and depression in older adults: distinct cognitive and affective profiles? Cognitive Therapy and Research, 23, 5374.CrossRefGoogle Scholar
Silverman, M., Musa, D., Martin, D. C., Lave, J. R., Adams, J. and Ricci, E. M. (1995). Evaluation of outpatient geriatric assessment: a randomized multi-site trial. Journal of the American Geriatrics Society, 43, 733740.CrossRefGoogle ScholarPubMed
Snowden, M., Sato, K. and Roy-Byrne, P. (2003). Assessment and treatment of nursing home residents with depression and behavioral symptoms associated with dementia: a review of the literature. Journal of the American Geriatrics Society, 51, 13051317.CrossRefGoogle ScholarPubMed
Stewart, S. M. (2008). Methods in cross-cultural psychopathology. In McKay, D. (ed.), Handbook of Research Methods in Abnormal and Clinical Psychology (pp. 447462). Los Angeles, CA: Sage.Google Scholar
Streiner, D. L. (2003). Diagnosing tests: using and misusing diagnostic and screening tests. Journal of Personality Assessment, 81, 209219.CrossRefGoogle ScholarPubMed
Teresi, J. A., Lawton, M. P., Holmes, E. and Ory, M. (eds.) (1997). Measurement in Elderly Chronic Care Populations. New York: Springer.Google Scholar
Tweed, D., Blazer, D. and Ciarlo, J. (1992). Psychiatric epidemiology in elderly populations. In Wallace, R. B. and Woolson, R. F. (eds.), The Epidemiologic Study of the Elderly (pp. 213233). New York: Oxford University Press.Google Scholar
van de Vijver, F. J. R. and Tanaka-Matsumi, J. (2008). Multicultural research methods. In McKay, D. (ed.), Handbook of Research Methods in Abnormal and Clinical Psychology (pp. 463481). Los Angeles, CA: Sage.Google Scholar
World Health Organization (2007). Process of translation and adaptation of instruments. Available at: http://www.who.int/substance_abuse/research_tools/translation/en/.Last accessed 19 August 2009.Google Scholar