Psychologists in Long-Term Care (PLTC) Guidelines for Psychological and Behavioral Health Services in Long-Term Care Settings.

Abstract

To address concerns about limited training of psychologists working in long-term care (LTC) facilities, the Psychologists in Long-Term Care (PLTC) organization published Standards for Psychological Services in Long-Term Care Facilities (Lichtenberg et al., 1998). The expanding evidence base for knowledge and skills, the increasing diversity of LTC residents, and the complexity of presenting problems have compounded the guidance psychologists need when providing services in this setting. In this article, the PLTC Guidelines Revision Task Force presents PLTC guidelines based on the original prescriptive PLTC Standards. The content of the PLTC Standards was updated and the format changed from prescriptive standards to aspirational guidelines. We begin with general guidelines regarding knowledge and skills in LTC (education and training. understanding of LTC systems. end-of-life care), followed by specific guidelines covering the basic psychological service activities in LTC (referral, assessment, treatment, ethical issues, and advocacy). The PLTC Guidelines are designed to provide direction for psychologists who work, or plan to work, in LTC and to guide continuing education pursuits. Public Significance StatementIt has been 25 years since the publication of the PLTC Standards of Practice for Psychologists in Long-Term Care. The composition of the long-term care (LTC) population has changed, and the need for aspirational guidelines for psychologists to enter the LTC field has grown in increasing importance. The authors hope that these guidelines will serve as a guide to training needs and optimal mental health practice in LTC settings.

Intervention, consultation, and other service provision: A foundational geropsychology knowledge competency.

“…Although there is strong overlap between the skills of psychologists working in long-term care (LTC) and those working in other settings, there are unique aspects of the provision of care in LTC settings. To address concerns about limited training of psychologists working in LTC facilities, the Psychologists in Long-Term Care (PLTC) organization published Standards for Psychological Services in Long-Term Care Facilities (Lichtenberg et al, 1998) that were recently updated (Molinari et al, 2021). The guidelines supplement the recommendations of the Pikes Peak model specific to LTC, and highlight aspirations for training, knowledge, and skills needed for psychologists to competently serve the diversity of clients residing in LTC settings.…”

“…IDTs are made up of numerous professionals and disciplines depending on the setting, often including some combination of the primary care physician, psychiatrist, nursing, social work, case managers, members of the rehabilitation team (physical therapists, occupational therapists, speech-language pathologists), dietitians, recreations/activities directors, chaplains, the psychologist or other mental health professionals, family caregivers, and the client. Psychologists are encouraged to be active members of interdisciplinary teams and honor the contributions of the major health care disciplines, skillfully communicate with members of the team, and work collaboratively with them (Molinari et al, 2021). Competency areas for psychologists related to their role on the IDTs are outlined in the Pikes Peak Geropsychology Knowledge and Skill Assessment Tool, which include: (a) Recognizing the value of IDTs in geriatric settings to address the varied biopsychosocial needs of older adults and modeling respect for all team members, (b) Educating team members about the roles and responsibilities of psychology and how behavioral health approaches are optimally integrated, (c) Communicating in a concise and timely manner, (d) Being visible and responsive, and (e) Supporting and facilitating appropriate informal bonding.…”

“…With regard to cognitive impairment, having a dementia diagnosis does not necessarily preclude an older adult from having capacity to give consent for psychological services. Informed consent for psychological services is based on the legal competency of the client to make informed decisions regarding mental health care, their decision-making capacity regarding consent to psychological services, and the availability of family members or other potential surrogates should the client have diminished capacity (Molinari et al, 2021).…”

“…When an older adult is cognitively compromised, receiving treatment where they reside, or having others (e.g., family members or an IDT) actively involved in treatment, psychologists should thoroughly discuss limits of confidentiality, including who has the authority to release and access information (e.g., designated health care agent, guardian, or conservator), and exceptions to confidentiality (Molinari et al, 2021). Older adults in medical or LTC setting are often seen by multiple healthcare providers who have access to their medical records.…”

Healthcare Quality Improvement Competency: A Clinical and Training Imperative for Geropsychology

“…gov/ nursi nghom ecomp are). Though they may often work in a consultation role, psychologists working in LTC settings should understand how the MDS is used to inform resident care (Molinari et al, 2020). In addition to LTC, QI occurs across the spectrum of geriatric care settings and is often driven by the six dimensions of the IOM QI framework.…”