Changing SNF population & mental health challenges

[LaGrandeRN]

Longterm care facilities seem to be exploding with homeless alcoholics unprepared for early onset chronic health disease associated with poor lifestyle choices. Additionally, mental health services are also poor and patients in acute care settings also transfer to SNFs...thus our nursing home population beds fill with more that just grandmas and grandpas. How does one keep care staff trained to serve these challenging populations under one roof. Where is our nursing home elderly population going? (this is also including transitional type rehab care for hips, knees, cardiac, etc..) I have also noticed that there seems to be a younger age creeping in as well of Meth users as possible admissions too. How does one pick and choose...Will we ever get (again?) to facility specific elderly care. Will my parents be next door to a poor in health young meth user or a homeless 50 year old with liver failure? Where are our longterm skilled facilities headed? Are we going to scare away care providers related to an overload of untreated mental health--do we need to require an intense mental health training with RN licensure--to also include other direct care staff to meet the needs of our mixed populations? Anybody with comments on skilled nursing facility populations?

[JZ_RN]

I worked with many encephalopathy and end-stage alcoholic disease patients, who were elderly, but with issues the facility did not have resources or staff to address. Their needs were great and they pushed them in with grandpa jones who was just too frail to care for himself. I dealt with BPD and many other mental health issues, including abuse and violence towards staff. But since we are LTC and a SNF it didn't matter, they still had the same ratios as if it were just sweet old grandma who needed some pills and some help with her walker. It was ridiculous. The behaviors. I have been assaulted more times working LTC?SNF than most police officers in their careers. It was sad and frustrating. Why I left LTC. All the facilities cared about was the medicare or medicaid reimbursements for the admission, not the patient with special needs or the staff who had to deal with them.