Here’s my latest article at McKnight’s Long-Term Care News:

6 common problems a shrink on staff can solve (and your consultant can’t)

As a psychologist consulting in long-term care facilities, I was paid through Medicare, Medicaid, and/or private insurance for only one task: direct contact with residents. That’s it. I provided a lot more because it was needed, but that’s all I was paid for.

There was much more help that I didn’t offer, not only because I wasn’t paid for it, but also because the organization wasn’t structured to accept this type of assistance. The facilities’ needs were the kinds of things that made me sigh and shake my shrinky head in frustration. Oh, what we psychologists could do for you if we were on staff!

Here are some examples:

Problem #1: Admissions decisions

As your admissions department scrambles to fill beds and wonders whether the facility can manage a new resident with a psych history and a recent diagnosis of cancer, imagine if they could ask the opinion of the psychologist likely to be treating the resident. Now imagine if they could do this for every questionable admission. Psychologists could set up mental health services upon the new resident’s arrival and you would have the support necessary to meet the mental health needs of the residents under your care.

As the number of residents with behavioral issues increases, this psychological screening becomes an increasingly important element of providing good care and preventing time-consuming problems on your units after admission.

Problem #2: Team Communication

Watching two aides argue about giving care to a resident over said resident’s head or observing an essential piece of information get lost between shifts, I’ve fantasized about offering in-service training to eliminate these destructive behaviors. Not half-hour meetings sandwiched in between resident care, but real training that allows time for examples and practice as well as observation and feedback on the floors.

Real training provides the opportunity for staff to turn to the psychologist for guidance in handling the sticky interpersonal dynamics that are inevitable as people work in groups.  It also offers assistance in designing and implementing procedures that facilitate written and oral communication.

Problem #3:  Interacting with residents

Improperly trained staff members frequently escalate tense situations, cause unintended distress in residents, or miss cognitive changes that signal physical illness. They aren’t doing this on purpose — they just haven’t been taught how to handle such situations.

For the entire article, visit:

6 common problems a shrink on staff can solve (and your consultant can’t)