St. Louis’ STLToday.com had an interesting article about the change in demographics at today’s nursing homes including healthy mentally ill patients sharing homes with elderly vulnerable residents.   The conventional wisdom is that nursing home residents are frail and elderly. That’s not the reality.   Increasingly, adults with serious mental illness are being housed and cared for in  nursing homes.  Nationally, the number of mentally ill nursing home patients has jumped by 41 percent since 2002, an analysis by the Associated Press showed. In Missouri, it climbed by 76 percent. 

The article discusses the recent forced closure of Whispering Oaks after a well that supplied water froze, causing toilets to overflow. The facility had a history of fire and safety violations. State nursing home regulators tried to suspend its license last June. Whispering Oaks housed a number of patients with serious mental illness.   Several were relocated to another nursing home in St. Louis — owned by a psychiatrist — that also has been cited for safety violations in the past two years.

In theory, no one is supposed to be admitted to a nursing home unless he has disabilities that require extra care or supervision. That requirement is contained in the 1980s-era federal Nursing Home Reform Act.   But state officials estimate that about 2,500 people are in Missouri nursing homes primarily because they are mentally ill. They could be treated in a less restrictive — and less expensive — setting.  Missouri consistently has failed to fulfill its responsibilities to people with mental illness. The share of state funding for treating the mentally ill has been shrinking for decades.

Missouri could get federal money to help provide housing and treatment to patients with serious mental illness — but only if it came up with matching state funds, which the Legislature has refused to do.  The result of this neglect isn’t just tragedy for the mentally ill. In Illinois and other states, it’s also a tragedy for elderly nursing home patients and their families.

When the state budget is tight and elderly people are increasingly opting for home care, it’s tempting to see nursing homes as a short-term solution to the chronic lack of care for the mentally ill. It may be tempting, but it is wrong.

People with mental illness deserve housing and care in the communities where they live, not in facilities designed for the frail elderly.
 

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