Long-term care and assisted living homes need to focus more on supporting their residents' mental health, a Canadian organization that develops quality and safety standards said on Tuesday.
The new standard released by CSA Group provides guidance for facility administrators and staff on how to promote good for all residents while also screening and providing treatment for dementia and mental illnesses.
鈥淗istorically, mental health has not been prioritized in these settings," said Dr. Julia Kirkham, a geriatric psychiatrist and a clinician-researcher in Ontario, Saskatchewan and Alberta who led the development of the standard.
"When it comes to potentially going to long-term care ... people are not worrying that they're going to have a fall and break their hip," Kirkham said at a virtual news conference on Tuesday.
"What people worry about, what people tell me ... is that you're going to be miserable, that you're going to be isolated, that you're going to have no quality of life," she said.
The majority of people living in long-term care have a diagnosis of either dementia or a mental health condition, Kirkham said, noting that rates of depression and anxiety are high.
One of the key recommendations for mental well-being is to make sure staff are able to develop meaningful relationships with residents, their family members and other "care partners."
The guidelines also include making long-term care environments more home-like and less institutional through measures such as better lighting, less noise, choosing artwork with the input of residents, incorporating plants and ensuring access to outdoor space while still maintaining safety.
Promoting social interactions among residents and recreational programs 鈥 including outings when possible 鈥 is also essential, the standard says.
If it's not already available, access to technology and the internet should be provided so residents can participate in activities ranging from watching movies to virtual visits, the guidelines say.
Privacy is also important for emotional well-being, the standard says, so long-term care homes should eliminate rooms with more than two residents and prioritize single-occupancy rooms with their own bathrooms in new buildings, renovations or additions.
Staff should also consider requests from spouses, siblings or close friends who want to share a double room, it adds.
In addition to promoting mental wellness for all residents, the standard emphasizes that long-term care homes also need to screen for and get treatment for residents with mental health issues.
If a resident was already receiving mental health care before moving into the LTC home, the home should try to facilitate the resident seeing that same care provider whenever possible to provide continuity of care, the standard says.
When in-person care isn't possible, virtual care might be an option, it says.
Mental health care should be included in residents' care plans, the recommendations say, and social workers, therapists and others who provide care should be considered "essential workers."
Long-term care workers should receive training in basic mental health knowledge and skills to help them recognize symptoms that could indicate a mental health issue that needs to be assessed, the standard says.
Although CSA Group standards are voluntary, the association is speaking with government decision-makers and policymakers with the hope that the mental health standard will be incorporated into long-term care and assisted living regulations, said Kay Penn, CSA Group's director of health and safety standards.
Kirkham, the geriatric psychiatrist, acknowledged she has "concerns" about whether private companies that own long-term care homes will be willing to invest the money needed for things like increased staffing to meet the mental health standard.
But she's "optimistic."
The standard lets prospective long-term care residents and family members know what kind of environment, programs and mental health care they should be asking for, Kirkham said.
She's hopeful that will create a "culture shift" where mental health becomes a non-negotiable priority for both for-profit and government-funded homes.
Providers haven't had the "tangible guidance" on how to do that up until now, Kirkham said.
"What does it look like to support mental health in these settings, to prioritize it?" she said.
"I'm optimistic that this (standard) will provide some of those more clear guidelines for that.鈥
This report by The Canadian Press was first published July 23, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
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