December 2023 Newsletter
The Center of Excellence for Behavioral Health in Nursing Facilities (COE-NF) provides mental health and substance use evidence-based training, customized technical assistance, and resources to certified Medicare and Medicaid nursing facilities who care for residents with a variety of behavioral health conditions at absolutely no cost. To submit a request for assistance, complete the online request form by clicking HERE.
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In This Issue
- Holiday Blues: An In-depth Look
- Tips To Eliminate the Holiday Blues in Nursing Facilities
- National Helpline: Substance Abuse and Mental Health Services Administration
- Centers for Medicare and Medicaid Services (CMS) Expands the Behavioral Health Workforce
- Regulatory Guidance: Visitation and Leaves of Absence for Residents with Substance Use Disorders
- COE-NF Resources
- Holiday Blues
- Bite-Sized Learning: Schizophrenia and Antipsychotics
- Learning Module: Recognizing and Treating Schizophrenia in Nursing Facilities
- Schizophrenia Fact Sheet
- Ways to Support a Resident with a Schizophrenia Diagnosis
- Did You Know?
- Register for Upcoming COE-NF Training Sessions
- You Matter: Self-Care for Health Care Providers
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The holiday blues is a feeling of sadness, anxiety and depression that lasts throughout the holidays. It typically begins around November or December and lifts shortly after the new year. People with a mental health condition may be more prone to experiencing holiday blues.
According to the National Alliance on Mental Illness (NAMI), 64% of people with an existing mental illness report that the holidays make their condition worse.
For nursing facility residents coping with mental health conditions, the holiday season can magnify feelings of loneliness, isolation, depression, and separation from family and familiar traditions. The holidays can also remind them of loved ones who are no longer present. Grief may resurface, intensifying feelings of sadness and longing.
The holiday season also disrupts the daily routines in nursing facilities. The decorations, festive activities and special events can create a sense of disorientation and confusion for residents with behavioral health disorders who thrive on structure and predictability. In addition, the bright lights, loud music, and fragrances may trigger anxiety or discomfort in residents with and without a mental health condition.
For residents with mental health conditions, holiday stressors may cause symptoms to worsen. For example, a person with schizophrenia may have an increase in hallucinations or delusional thoughts, while a person diagnosed with bipolar disorder may experience episodes of mania and depression.
Some signs of holiday blues may include:
- Feeling depressed or sad
- Feeling more tired than usual
- Feeling tense, worried or anxious
- Being irritable or more easily agitated
- Losing pleasure in things and/or trying to isolate
As nursing facilities navigate the holidays, take steps to support the emotional well-being of residents and staff. Engaging in open communication, fostering choices, and providing individualized care will go a long way in creating a positive and meaningful holiday experience for all. Use the COE-NF Comfort Menu to help residents identify strategies to help manage symptoms during the holidays and beyond. Report all changes in a resident’s mood to the clinical team.
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Tips to Eliminate the Holiday Blues in Nursing Facilities
Article contributed by Dr. Taunya Lowe
Here are some practical tips to help nursing facilities navigate the holiday blues and create a positive and festive atmosphere.
- Encourage regular communication between residents and their loved ones. Utilize video calls, emails or “snail mail” to bridge the physical gap.
- Decorate common areas with colorful lights, ornaments and seasonal decorations. Consider involving residents in crafting activities to create handmade ornaments or decorations, fostering a sense of accomplishment and holiday spirit. Invite carolers and other local groups to participate.
- Organize various holiday-themed activities to keep residents engaged and uplifted. This could include movie nights featuring classic holiday films, carol singing or crafting sessions to make personalized holiday cards. Invite students from local schools to conduct a play, have the chorus do a sing-along, or bring in pets to love on the residents.
- Encourage residents to take a trip down memory lane and share their favorite holiday memories. This can be done through storytelling sessions or by creating a holiday memory board where residents can display photos and mementos from past celebrations. Sharing stories fosters a sense of community and connection among residents.
- Engage residents in volunteer activities. Whether it's making holiday cards for local charities, knitting blankets for those in need, or participating in fundraising events, giving back can bring a sense of purpose and fulfillment during the holiday season.
- Ensure that mental health support services are available and accessible. Provide counseling or support groups for those who may be experiencing heightened feelings of loneliness or sadness.
- Encourage staff members to actively participate in holiday celebrations. Staff involvement creates a positive and inclusive atmosphere and fosters a sense of camaraderie among residents and staff.
- Create a calm and soothing environment, allowing residents to retreat to quieter spaces to help reduce sensory overload and promote a sense of well-being.
Taunya A. Lowe, Ph.D., is an international speaker, trainer and consultant.
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National Helpline: Substance Abuse and Mental Health Services Administration
If a resident or a loved one is struggling with feelings of depression this holiday season, contact SAMHSA’s National Helpline at 1-800-662-HELP (4357) to locate a treatment provider, obtain resources, or find a support group in your area.
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Centers for Medicare and Medicaid Services (CMS) Expands the Behavioral Health Workforce
Effective January 1, 2024, following congressional action, marriage and family therapists and mental health counselors (including addiction counselors or alcohol and drug counselors who meet all the requirements to be a mental health counselor) can treat Medicare beneficiaries and bill services to CMS. This new ruling makes it possible for more than 400,000 additional counselors to provide behavioral health services.
What does this mean for nursing facilities?
- Behavioral health provider choices for residents are increased
- Appointment availability is improved
- Barriers to mental health and substance use treatment are reduced
- Access to treatment levels of care is expanded
To assist interested counselors in this process, the CMS Center for Program Integrity developed the comprehensive Marriage and Family Therapists (MFT) and Mental Health Counselors (MHC) Provider Enrollment Frequently Asked Questions (FAQs) September 2023 document.
Share this information with mental health and substance use treatment providers in your area to help expand effective behavioral health systems in your local community.
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Regulatory Guidance: Visitation and Leaves of Absence for Residents with Substance Use Disorders
For residents with substance use disorders (SUD), there may be triggers around the holidays that increase the risk of substance use. Facility staff must be mindful of this and plan to mitigate the risks while maintaining residents' rights to visit and take leave from the facility.
Before facility outings, provide support to the resident by offering appropriate interventions such as substance use counseling, encouragement to attend a support group (Alcoholics /Narcotics Anonymous), diversional activities, engaging family, and attempting to work with the resident on planning for safety.
Upon return from an outing, facility staff should monitor the resident for any signs of substance use and provide appropriate levels of support, intervention, or supervision to mitigate any negative outcomes of the substance use (such as overdose, injuries, or falls).
CMS guidance (Appendix PP, pg. 338) reminds facilities and surveyors that relapse (substance use) and overdose is a common part of the disease process of SUDs and is not always preventable. While facilities are not expected to fully cure individuals of their underlying SUD, they are expected to develop a care plan that identifies appropriate interventions to help support the residents with substance use recovery. Also, facilities are expected to be prepared to identify and address emergencies around substance use, like overdoses.
Keys to Compliance and Quality Care:
- Allow visitation and leaves of absence for residents, including those with a SUD or history of SUD.
- Visitation may be restricted or supervised if it is determined that the visitor is a danger to the resident, other residents or staff.
- Ensure the facility has a safety plan for emergencies such as overdoses or impairment due to substance use.
- Evaluate each resident’s needs related to substance use history and identify appropriate interventions in their care plan.
- Ensure that interventions are attempted when appropriate.
- Ensure staff are trained to identify symptoms of substance use and watch for symptoms after a resident returns from a facility absence or after having visitors.
- F563 Resident Right to Visitation has a section that addresses “Visitation and Illegal Substance Use” (Appendix PP, Pg. 30). F689 “Accidents” has a section on “Safety for Residents with Substance Use Disorders (SUD)” (Appendix PP, Pg. 336-338)
The COE-NF is available to support your facility in any of these guidance areas. Contact the COE-NF today:
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COE-NF Resources
The COE-NF developed the following resources related to MDD and co-occurring disorders. Nursing facilities can use these resources to educate the team about these mental illnesses.
Bite-Sized Learning: Schizophrenia and Antipsychotics:
Discover practical ways to support residents living with schizophrenia. Learn about common symptoms of schizophrenia and the risks and benefits of antipsychotic medications. WATCH VIDEO
Discover practical ways to support residents living with schizophrenia. Learn about common symptoms of schizophrenia and the risks and benefits of antipsychotic medications. WATCH VIDEO
Learning Module: Recognizing and Treating Schizophrenia in Nursing Facilities:
This 15-minute module will give you the tools needed to support residents living with the complex disorder of schizophrenia. You’ll learn how to identify symptoms of schizophrenia, conditions that can be mistaken as schizophrenia, and treatment strategies. COMPLETE PRE-TEST TO WATCH MODULE
This 15-minute module will give you the tools needed to support residents living with the complex disorder of schizophrenia. You’ll learn how to identify symptoms of schizophrenia, conditions that can be mistaken as schizophrenia, and treatment strategies. COMPLETE PRE-TEST TO WATCH MODULE
Schizophrenia Fact Sheet
Schizophrenia is a complicated brain disorder with a range of symptoms. Learn the facts about schizophrenia. DOWNLOAD RESOURCE
Schizophrenia is a complicated brain disorder with a range of symptoms. Learn the facts about schizophrenia. DOWNLOAD RESOURCE
Ways to Support a Resident with a Schizophrenia Diagnosis
Here are 10 tips for supporting a resident diagnosed with schizophrenia. DOWNLOAD RESOURCE.
Here are 10 tips for supporting a resident diagnosed with schizophrenia. DOWNLOAD RESOURCE.
Interested in accessing additional COE-NF resources for your facility?
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Did you know that drinking alcohol can worsen symptoms of depression and cause antidepressants to be less effective?
Source: Mayo Clinic: Antidepressants and Alcohol: What’s the Concern?
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The Center of Excellence for Behavioral Health in Nursing Facilities (COE-NF) has four (4) training opportunities in December.
These sessions are being held at no cost to you.
Click the REGISTER HERE buttons below each training to sign up.
See you there!
- EVENT TITLE CHANGE -
Previously, "Good Grief: Helping Nursing Facility Residents Cope with Loss"
Wednesday, December 13, 2023
2-3 p.m. EST
Grief and loss symptoms from resident death are often similar to those experienced from family or friend loss. This webinar session will provide an overview of the bereavement concerns that can arise when nursing home residents and staff experience the death of a resident. Content will review the emotional and psychological responses to loss through the five stages of grief. The discussion will further inform on postvention activities to support self-care and healing for residents and nursing home staff.
Learning Objectives:
- List types of grief and symptoms.
- Define the five stages of grief and potential impacts.
- List strategies for self-support and healing.
- Identify ‘postvention’ opportunities to support nursing home staff and residents after a patient death.
Thursday, December 14, 2023
2-3:30 p.m. EST
- ACCME & NAB credits will be offered. -
2-3:30 p.m. EST
- ACCME & NAB credits will be offered. -
*** SESSION FULL ***
Wednesday, December 20, 2023
11 am. - 4:30 p.m. EST
- ACCME & NAB credits will be offered. -
11 am. - 4:30 p.m. EST
- ACCME & NAB credits will be offered. -
*** SESSION FULL ***
Wednesday, December 20, 2023
2-2:30 p.m. EST
Duration: 30 minutes
The fundamentals of Seasonal Affective Disorder (SAD) and its effects on holiday depression will be discussed. This training is designed to provide participants with a basic understanding of depression, seasonal onset, symptoms, and treatments to support residents experiencing challenges from SAD.
Learning Objectives:
- Participants will gain a basic understanding of seasonal depression during the holidays.
- Participants will be able to recognize and understand signs, symptoms, and triggers of seasonal depression.
- Participants will learn helpful responses to engage with residents.
You Matter - Self-care for Health Care Providers
Working in a nursing facility can be incredibly rewarding, but it can also be physically and emotionally demanding.
It is important to recognize the importance of self-care as a component of your overall well-being.
Take a moment to relax by viewing this two-minute video, “Self-Care for Health Care Providers,” created by Alliant Health Solutions’ Quality Improvement and Innovation Organization (QIN-QIO).
WATCH VIDEO.
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Contact us:
For more information, please call 1-844-314-1433 or email coeinfo@allianthealth.org.
To submit a request to inquire about substance use and/or mental health training options for your facility, complete the inquiry form.
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Alliant Health Solutions (AHS) was awarded a three-year cooperative agreement from the Substance Abuse and Mental Health Services Administration (SAMHSA), in collaboration with the Centers for Medicare & Medicaid Services (CMS), to create a COE-NF. AHS has over 50 years of experience working with nursing homes and behavioral health in nursing homes.
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This newsletter was made possible by grant number 1H79SM087155 from the Substance Abuse and Mental Health Services Administration (SAMHSA). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Substance Abuse and Mental Health Services Administration.
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