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What is the Role of the Psychologist in Long-Term Care (LTC) Settings?

CHE Behavioral Health Services has been providing psychological services in skilled, rehabilitation, and other long-term care facilities for over 25 years. At CHE, we recognize that best practices in behavioral health in LTC settings requires a "systems-level" approach. To that end, CHE psychologists, clinical social workers, and other qualified mental health specialists work to support not only the resident, but those invested in the resident's care and quality of life, including staff and family caregivers. By working as an essential and integral part of the interdisciplinary care team, the psychologist supports person-centered, individualized treatment recommendations that help maximize positive outcomes and improve the resident's emotional and physical well-being.

CHE psychological services provided in the nursing home reflect a comprehensive behavioral health practice that include initial diagnostic assessments, individual psychotherapy, group psychotherapy, family/couples therapy, cognitive/neuropsychological assessments, participation in interdisciplinary care plan meetings, and staff training.

Why are Residents Referred to the Psychologist?

Most residents admitted to LTC or rehabilitation setting experience difficult emotional and/or behavioral symptoms at some point during their admission. If we take a minute to put ourselves in the shoes of a persons admitted to a LTC or rehabilitation facility, we quickly appreciate the emotional challenges they face. Common reasons for referrals include:

  • Recent traumatic medical events (e.g. falls, fractures, serious illness) that impact independent functioning and increase health related anxieties
  • Chronic pain or difficulty coping with chronic illnesses that impact emotional and physical well-being
  • Difficult emotions related to a change in living environment, family support, routines, or other significant changes
  • Persons struggling with significant losses and complicated grief reactions or feeling overwhelmed by a life stressor or difficult situation
  • Persons with a pre-existing history of clinically significant depression, anxiety, trauma, or other mental health conditions, which may me exacerbated by recent and ongoing medical and psychosocial stressors.

When the resident, family, or staff caregiver identify clinically significant indicators of emotional distress, the patient's physician will often make a referral to the CHE psychologist for a more comprehensive assessment and follow-up treatment if indicated.

What are Signs of Emotional Distress?

While some people verbalize feeling depressed or anxious, others report different symptoms when experiencing emotional distress. These include feeling more irritable, chronic fatigue, emotional exhaustion, worsening experience of body aches and pains or other physical symptoms, and difficulty sleeping and eating. Further, residents in older cohorts or members of different ethnic and cultural groups may not use words like "depression" or "anxiety," Rather you may here statements such as: "I am in poor spirits," or "I do not feel like myself," "or my nerves are acting up."