Mental Health Series

/Mental Health Series
Mental Health Series 2017-09-27T22:25:57+00:00

Note: Sessions can be  taken individually and credited to the 5-Day Mental Health Recovery Care Certificate Program.

Session One:
Supporting Residents with Mental Disorders in LTC (MHMD) – An overview of many common mental disorders and how they may present in a LTC setting towards building a specialized mental health care plan.

Recovery and harm reduction are fundamentally different ways of caring for residents with mental disorders.

Full-day Training Session (6-hours)

Much of the training in long term care over recent years has been focused on care of individuals with dementia and related disorders. However, there are other types of residents in LTC homes that pose behavioral challenges. Those individuals include a growing demographic of older adults coming into LTC from hospital and community with psychiatric disorders. The needs of these individuals are unique. Their care plan interventions have a different focus than that of the dementia resident. Unlike the resident with dementia, who steadily declines due to neurodegeneration, many residents with mental disorders are actually capable of achieving some level of recovery for themselves. If we are to be truly resident-centered then we must now focus efforts and resources to this unique population as well.

This workshop is focused on the management of complex residents with longstanding psychiatric disorders that often present with risk, and strain resources in long term care homes. The goal of this session is to help participants discover the critical components of a comprehensive RecoveryCare plan for residents suffering with mental disorders. Participants will learn important criteria for pre-admission screening for risk of violence. The nuances of a therapeutic staff-resident relationship will be explored as a starting point for planning care and treatment. Specialized interviews such as the Mental Status Assessment serve as foundational skill sets for measuring severity of psychiatric symptoms. Selecting the appropriate therapeutic intervention often includes combinations of psychotropic medications, dialogue-based therapies, recovery-based programming and behavior plans. With these skills and knowledge participants can serve key roles in facilitating between the LTC home and hospital-based outreach to ensure continuity of care for the resident.

The session is suitable for all levels of staff, from all departments.

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Session Two:
Residents with Anxiety & Depression in LTC (MHAD) – Explores the bio-psychosocial factors which contribute to the presentation of disorders such as anxiety and depression with special focus on managing suicide risk Linked to individual session description

Perceived threat, doom and gloom characterizes the world of the resident suffering with anxiety and mood disorders.

Full-day Training Session (6-hours)

Both anxiety and mood disorders are accounted for by genetic, neurochemical and environmental factors. These factors combined with the resident’s personal history and physical disability, create a complicated presentation. Anxiety has many presentations in the older adult; such as phobias, obsessive-compulsive disorder and post-traumatic stress, that are not always visible to the non-clinically discerning eye. These disorders require specialized training in order to better detect problems before the resident begins a downward spiral that could manifest into episodes of panic. Mood disorders are also highly prevalent in institutionalized older adults and the disorders typically range between Major Depressive Disorder and Bipolar Affective Disorder. Additionally, suicide risk and the behaviors associated with mania can prove extremely challenging in a long term care home environment.

This interactive and insightful workshop explores the complex world of anxiety and mood disorders through the lens of the RecoveryCare Model and philosophy of Harm Reduction. Specific assessment tools will be presented as well as fundamental skills relative to assessing mental status, establishing therapeutic relationships, employing behavioral activation and drug therapies such as antidepressants, mood stabilizers and anxiolytics. Participants will be introduced to the fundamentals of the cognitive behavioral therapy, which has a strong empirical basis in the successful treatment of anxiety and mood problems. Additionally, participants will gain insights into the benefits of electroconvulsive therapy (ECT) in cases of treatment refractory depression, with special emphasis on suicide prevention and intervention.

The session is suitable for all levels of staff, from all departments.

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Session Three:
Residents with Psychotic & Substance-Use Disorders in LTC (MHPS) – Assessment and stabilization of residents with perceptual disturbance in the form of hallucination and delusions, as well as motivational interviewing for substance use disorders/addictions. Linked to individual session description

My distorted reality and self-medicating my suffering.

Full-day Training Session (6-hours)

What happens to a resident who can no longer tell the difference between what is real and unreal? How do care staff respond to a residents distorted view of reality? Do they go along with the resident’s perception or should they attempt to correct it? Fixed false beliefs (delusions), false visual and auditory perceptions (hallucinations) are common hallmarks of psychosis. LTC staff are challenged on how to accurately assess perceptual disturbances and respond appropriately when the resident experiences something that is not real to us but real to them. Often those with psychosis and other mental health conditions self-medicate through the use of substances to try and alleviate their symptoms. However, this often leads to addiction and serves to further exacerbate their condition. Traditional approaches such as abstinence can be helpful but harm reduction can be another effective option.

This interactive and insightful workshop explores psychosis and substance use disorders through the lens of the RecoveryCare Model and philosophy of Harm Reduction. Specific assessment tools will be presented as well as fundamental skills relative to assessing mental status, establishing therapeutic relationships, employing specific dialogue to engage, re-orient and refocus the distracted mind of the psychotic resident. Drug therapies such as antipsychotics will also be covered. Participants will be introduced to the fundamentals of the trans-theoretical model of change and it’s relation to the skill of motivational interviewing which has a strong empirical basis in the successful treatment of addictions.

The session is suitable for all levels of staff, from all departments.

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Session Four:
Maladaptive Personalities: Verbal Abuse & Manipulation among Residents in LTC (MHMP) – Designing a behavioral program that provides stability to the resident and support to the staff. Linked to individual session description

“When staff feel helpless or demeaned, when nothing they do for a resident is ever enough, or if they find themselves consistently doing things the resident could do independently then the question of a personality disorder should be raised.” Robinson & Schogt

Full-day Training Session (6-hours)

Personality disorders in long term care homes are a relatively misunderstood and under-researched topic. Unlike the resident with dementia whose behavior is driven by a neurodegenerative process, or the resident with schizophrenia, who has an underlying organic cause for their psychosis, the resident with a personality disorder often displays cleverly calculated yet maladaptive behaviors that are driven more by past life experiences and conditioning. Manipulation, splitting of staff, help-seeking/help rejecting behaviors and emotional dysregulation are the hallmarks of personality disorders. Some of the available research shows that institutionalizing these individuals is often problematic as they will frequently respond by attempting to control their environment. However, for older adults with medical co-morbidities and disability, they are not appropriate for independent living in the community due to the high level of risk. Once admitted to long term care, their negative coping behaviors emerge and can be highly disruptive for staff, families and co-residents.

This interactive and insightful workshop explores the problem behaviors of residents with personality disorders in long term care. The psychodynamic model forms the foundation for better understanding how unconscious defense mechanisms form in early development which then produce maladaptive coping skills and pathological behaviors. Behavioral planning based on the principles of operant conditioning will be presented in depth to give participants a solid understanding of how to properly modify their approach, prevent countertransference and empower the resident to set goals.

The session is suitable for all levels of staff, from all departments.

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Session Five:
Ethical Issues in Long Term Care Mental Health & Crisis Management (MHEI) – Management of ethical dilemmas and crisis response skills.

“Chance favours the prepared mind.” Louis Pasteur

Full-day Training Session (6-hours)

Moral Distress is defined as knowing the ethically correct action to take but feeling powerless to take that action. The field of mental health is full of ethical dilemmas where solutions are grey instead of black or white. Outcomes are not clear cut and sometimes the consequences of decisions made by care teams or the resident/client are difficult to bear, particularly if they go against our own values and convictions. This workshop outlines a framework for ethical problem solving based on the core principles of ethics: respect for client/resident autonomy; self determination; integrity; quality of life; dignity; advocacy; professionalism; due diligence; beneficence and nonmaleficence.

No crisis ever goes the way you plan no matter how much you practice. However planning for crisis is still critical. Lack of crisis planning results in disorganization, poor communication, conflict and lack of trust creating a potentially dangerous situation. During a code white, team roles need to be clear, documentation must be thorough and the outcome must be such where the client and the team are made safe with the least amount of harm possible. This workshop is focused on a team approach to crisis, as well as developing individual skills of verbal de-escalation and debriefing.

The session is suitable for all levels of staff, from all departments.