Does the Person-Centered Care Model Support the Needs of Long-Term Care Residents With Serious Mental Illness and Intellectual and Developmental Disabilities?

Abstract

Person-centered care approaches continue to evolve in long-term care (LTC). At the same time, these settings have faced increased challenges due to a more diverse and complex population, including persons with intellectual and developmental disabilities (IDD) and serious mental illness (SMI). This study examined the mental, social, and physical wellbeing of residents with different diagnoses, within a person-centered care model. It was hypothesized that individual wellbeing would be comparable among all residents, regardless of primary diagnosis. The study cohort was drawn from all admissions to long-term care facilities in the USA from 2011 to 2013. Data are based on admission, 3 and 6 month follow-up Minimum Data Set (MDS) 3.0 assessments. The groups examined included: schizophrenia, other psychotic disorders, IDD, dementia, and all others (i.e., none of the above diagnoses). The wellbeing outcomes were depression (mental), pain (physical), and behaviors (social). All residents experienced improvements in pain and depression, though the group without the examined diagnoses experienced the greatest gains. Behaviors were most prevalent among those with psychotic disorders; though marked improvements were noted over time. Improvement also was noted among persons with dementia. Behavior worsened over time for the three other groups. In particular, those with IDD experienced the highest level of worsening at 3-month follow-up, and continued to worsen. The results suggest person-centered care in US nursing homes provides the necessary foundation to promote mental and physical wellbeing in persons with complex needs, but less so for social wellbeing.

Utilization and performance of long-term care system for older people with disabilities and dementia in Zhejiang Province, China

“…The Program of All-Inclusive Care for the Older (PACE) has been in place since the 1970's to address challenges with the LTC service system. PACE programs have been proven to be effective and beneficial (43)(44)(45).…”

Effects of person‐centred planning and practices on the health and well‐being of adults with intellectual and developmental disabilities: a multilevel analysis of linked administrative and survey data

“…In the USA, publicly funded HCBS for people with intellectual and developmental disabilities (IDD) are managed by state developmental disability (DD) service systems with funding from a combination of state and federal sources. Although DD systems have moved towards person-centred approaches, recent evidence suggests that the IDD population has been less well supported by person-centred service approaches compared with LTSS recipients without IDD (Howard et al 2021). In recognition of this gap, the US Department of Health and Human Services (DHHS) has called for increased attention to patient-centred research and development in this area, with efforts underway to expand data infrastructure for outcomes research specific to the IDD population.…”