Category Medicare

Nursing Homes Are Turning Away Patients with Mental Health Issues

Daniel D. Sewell Photo

Daniel D. Sewell, MD, Director, Senior Behavioral Health, UC San Diego Medical Center

Care For Your Mind acknowledges and appreciates the collaboration of the National Network of Depression Centers and the American Association for Geriatric Psychiatry in developing this post.

Chemical restraint is a serious problem in nursing homes. History has shown that psychotropic medications tend to be overused in order to keep residents with problem behaviors such as wandering or combativeness subdued or “under control.”

In other words, there are documented instances when serious psychiatric drugs are given to people who might not have needed them.

To address this and other nursing home quality issues, the Centers for Medicare & Medicaid Services (CMS) created a Five-Star Quality Rating System. One of the rating criteria is the number of residents at the facility who are receiving antipsychotic medications: the larger the number, the lower the score the facility receives.

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Putting Profits Over Patients: Medicare Part D Changes Mean Disaster for People with Depression

Daniel D. Sewell Photo

Care For Your Mind acknowledges and appreciates the collaboration of the National Network of Depression Centers and the American Association for Geriatric Psychiatry in developing this post.

Putting Profits Over Patients: Medicare Part D Changes Mean Disaster for People with Depression
Daniel D. Sewell, MD, Director, Senior Behavioral Health, UC San Diego Medical Center

In older adults, depression can have severe consequences. It’s associated with an increased risk of suicide; decreased physical, cognitive and social functioning; and greater self-neglect; all of which are associated with increased mortality. This is a vulnerable population that needs effective, affordable access to mental health care.

Unfortunately, proposed changes to the Medicare Part D drug program would put older patients living with depression at even greater risk.

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Older Adults Are Being Overlooked When it Comes to Mental Health Care

Daniel D. Sewell Photo

Care For Your Mind acknowledges and appreciates the collaboration of the National Network of Depression Centers and the American Association for Geriatric Psychiatry in developing this post.

Daniel D. Sewell, MD, Director, Senior Behavioral Health, UC San Diego Medical Center

For most individuals in the U.S., accessing mental health care is a struggle, but older adults may have it worst of all. Due to stigma, misinformation, and false beliefs about aging, they frequently go without adequate care for depression and other psychiatric illnesses and psychological problems. Too often, doctors offer prescription drugs as a cure-all solution, and fail to address the overall mental health and well-being of the older patient.

The truth is, addressing mental health issues in older populations requires paying more attention, not less. In aging adults, depressive symptoms can point to a physical illness, while physical pain or other physical complaints can often be a sign of mental health issues.

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Medicare Part D Users are Feeling the Squeeze

If concerns about being able to retain access to the correct medications to treat their mood disorders was not enough, individuals utilizing Medicare Part D must also be concerned about whether or not they can even afford to take their prescribed medications.

When Medicare Part D took effect in 2006, it arrived with mixed reviews. Today, according to a survey conducted by Medicare Today, 86% of seniors say they are satisfied with their prescription drug plan. One reason they site for the satisfaction is that the costs are reasonable. Given the way things are trending however, the Center for Medicaid and Medicare Services (CMS) may see satisfaction dip.

Cost related non-adherence to medication protocols is growing. The inability to pay for costly medicines causes patients to stretch out their prescriptions by skipping or taking smaller doses than prescribed. In in a recent Health Affairs study, (Medication Affordability Gains Following Medicare Part D Are Eroding Among Elderly with Multiple Chronic Conditions) seniors experiencing four or more chronic conditions reported a cost-related non-adherence rise from a low of 14.4% in 2009 to 17% in 2011.

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