November 2024 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 that 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
- National Native American Heritage Month
- Veteran's Day Training: Supporting Veterans in Nursing Facilities
- Nursing Facility Guidance: Ensuring Excellence: Best Practices for Nursing Home Facility Assessments
- New Podcast: Easing Transitions of Care for Patients with Serious Mental Illness
- Subject Matter Expert Article: Promoting Behavioral Health Equity for American Indian and Alaska Native Facility Residents
- Office Hours
- Managing Substance Use Disorders in Nursing Facilities
- COE-NF Resources
- Comfort Menu
- Stop Smile Go
- Did You Know?
- Save the Date: Upcoming Training
- You Matter
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November is National Native American Heritage Month, also referred to as American Indian and Alaska Native Heritage Month. To honor this significant month, consider practical ways your nursing facility can promote equity for residents from this community. Review the subject matter expert article "Promoting Behavioral Health Equity for American Indian and Alaska Native Facility Residents" below for examples of actionable steps you can take.
The American Indian and Alaska Native Behavioral Health Center of Excellence (AIAN CoE) is also a great resource for nursing facilities all year round. The Center of Excellence supports behavioral health professionals in providing culturally responsive care for AI/AN individuals and their families.
The American Indian and Alaska Native Behavioral Health Center of Excellence (AIAN CoE) is also a great resource for nursing facilities all year round. The Center of Excellence supports behavioral health professionals in providing culturally responsive care for AI/AN individuals and their families.
November 11 is Veterans Day, a time to honor our military veterans for their service in the U.S. Armed Forces. The COE-NF is offering training focused on the specific needs of veterans. This training provides nursing facilities with knowledge and strategies to help address the behavioral health needs of veterans in their care. By focusing on a person-centered care approach, the training aims to reflect the unique experiences of each veteran and promote a more holistic understanding of their specific needs related to their service.
Register your team today: The VA created the Older Veteran Behavioral Health Resource Inventory to collect resources to help health and social services professionals support older veterans who are at risk for behavioral health conditions.
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Nursing Facility Guidance:
Ensuring Excellence: Best Practices for Nursing Home Facility Assessments
Recent updates to §483.71 on facility assessments highlight using evidence-based, data-driven methods to evaluate the resident population’s needs, including diseases, conditions, and cognitive limitations, to determine necessary care and staff competencies. It should also consider the physical environment, equipment, and services required, including the addition of behavioral health services, as well as any cultural or religious factors affecting care. Additionally, the assessment requirement should account for the facility’s resources, such as buildings, equipment, services, personnel, and health information technology (Center for Clinical Standards and Quality: Revised Guidance for Long-Term Care Facility Assessment Requirements, 2024).
To ensure residents receive the best care possible, nursing home leaders can utilize their facility assessment through several best practices:
- Implement Evidence-Based Practices (EBP): Integrate EBP by combining clinical expertise with the best available research and resident preferences. This approach helps address complex conditions and improve overall care quality (Brennan-Cook, 2020). Quality Improvement Organizations (QIOs) are great resources for supporting the implementation of EBP in nursing facilities.
- Quality Assurance and Performance Improvement (QAPI): Use QAPI principles to continuously assess and improve care processes. This involves setting measurable goals, collecting data, and implementing changes based on findings. By committing to a strong QAPI program, nursing facility leaders are fostering a collaborative environment where staff and resident input is valued and continuous efforts for improvement are embraced (Leadership, Management, and Safe Operations, 2022).
- Staff Education and Training: Routine staff training on geriatric care and EBP is crucial to providing quality care for all residents. This includes ongoing education initiatives to keep staff updated on the latest care techniques and protocols (Brennan-Cook, 2020).
- Use the COE-NF's Behavioral Health Needs Assessment here to identify training needs and behavioral health service gaps at your facility. Your Regional Behavioral Specialist from the COE-NF can use this assessment to help tailor your facility’s training and education plans to ensure nursing facility staff have the skills and knowledge to provide resident-centered care for all, even in the most difficult situations.
- Resident-Centered Care: A comprehensive admission assessment that allows for focused and personalized care plans is important to understand each resident’s unique needs and preferences. It’s crucial to understand that life’s challenges and hardships significantly shape an individual’s journey and identity over time. The resident population is a vulnerable group that has encountered various disparities throughout their lives, stemming from environmental, sociocultural, behavioral, and biological factors. Regularly review and update these plans based on assessments, changes in condition, and feedback.
References:
- Brennan-Cook, J. (2020, September 4). American Nurse: The Official Journal of the American Nurses Association (ANA). American Nurse. https://www.myamericannurse.com/implementing-evidence-based-practice-in-long-term-care/
- Leadership, Management, and Safe Operations. (2022). AHRQ.gov. https://www.ahrq.gov/nursing-home/materials/leadership/index.html
- Center for Clinical Standards and Quality: Revised Guidance for Long-Term Care Facility Assessment Requirements. (2024). https://www.cms.gov/files/document/qso-24-13-nh.pdf
The COE-NF stands ready to support your facility in these guidance areas. Contact us today:
Effective transitions of care are instrumental in improving the efficiency and quality of care while improving outcomes. Click below for the COE-NF's most recent collaboration, where industry experts explore special considerations when patients diagnosed with SMI transition through different care settings across the post-acute long-term care continuum.
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Keeping you up to date with the latest research, advancements and best practices in managing and addressing behavioral health conditions in nursing facilities.
Promoting Behavioral Health Equity for American Indian and Alaska Native Facility Residents
By Whitney O’Donnell, MBA, BSN, RN, CPHQ
Behavioral health equity ensures that all individuals have fair and just access to mental health services, regardless of their race, age, ethnicity, gender, disability, socioeconomic status, sexual orientation, or geographical location,. In long-term care settings, it is crucial to recognize and address the unique trauma-related needs of American Indian and Alaska Native (AI/AN) residents. For AI/AN residents, this involves acknowledging the historical and cultural contexts that impact their mental health.
These communities have historically faced significant challenges, including forced relocation, cultural suppression, and systemic discrimination, which have contributed to intergenerational trauma. Understanding and addressing these needs can greatly enhance the quality of care provided in nursing facilities.
Here are a few best practice recommendations for addressing behavioral health equity for the AI/AN resident population:
Incorporate Traditional Healing Practices
Many AI/AN individuals prefer to integrate traditional healing practices with conventional medical treatments. Collaborate with AI/AN healers and incorporate traditional practices, such as talking circles, sweat lodges, and herbal remedies, into the care plan when appropriate and desired by the resident, (NIHB, 2023)
Holistic Approach to Care
AI/AN communities often view health holistically, encompassing physical, mental, emotional, and spiritual well-being. Spirituality is often a central component of AI/AN life. Facilitating access to spiritual practices, such as smudging or prayer, and providing spaces for these activities can be very important for residents’ spiritual health.
Community and Family Involvement
Family and community play a significant role in the lives of AI/AN individuals. Involving family members in care decisions and ensuring that residents can maintain strong community ties can enhance their sense of support and belonging. This is especially true for the elder population. Providing care that honors their wisdom and experience and ensuring they are treated with the utmost respect is essential. This can include involving them in decision-making processes and respecting their autonomy (Kaldy, 2022, NIHB, 2023)
Communication Styles
AI/AN individuals may prefer indirect communication styles and may value listening over speaking. Care providers should be patient, attentive listeners and avoid interrupting (NIHB, 2024).
By integrating these practices, nursing facilities can create a supportive and healing environment for American Indian and Alaska Native residents, honoring their history and promoting their health and well-being.
These communities have historically faced significant challenges, including forced relocation, cultural suppression, and systemic discrimination, which have contributed to intergenerational trauma. Understanding and addressing these needs can greatly enhance the quality of care provided in nursing facilities.
Here are a few best practice recommendations for addressing behavioral health equity for the AI/AN resident population:
Incorporate Traditional Healing Practices
Many AI/AN individuals prefer to integrate traditional healing practices with conventional medical treatments. Collaborate with AI/AN healers and incorporate traditional practices, such as talking circles, sweat lodges, and herbal remedies, into the care plan when appropriate and desired by the resident, (NIHB, 2023)
Holistic Approach to Care
AI/AN communities often view health holistically, encompassing physical, mental, emotional, and spiritual well-being. Spirituality is often a central component of AI/AN life. Facilitating access to spiritual practices, such as smudging or prayer, and providing spaces for these activities can be very important for residents’ spiritual health.
Community and Family Involvement
Family and community play a significant role in the lives of AI/AN individuals. Involving family members in care decisions and ensuring that residents can maintain strong community ties can enhance their sense of support and belonging. This is especially true for the elder population. Providing care that honors their wisdom and experience and ensuring they are treated with the utmost respect is essential. This can include involving them in decision-making processes and respecting their autonomy (Kaldy, 2022, NIHB, 2023)
Communication Styles
AI/AN individuals may prefer indirect communication styles and may value listening over speaking. Care providers should be patient, attentive listeners and avoid interrupting (NIHB, 2024).
By integrating these practices, nursing facilities can create a supportive and healing environment for American Indian and Alaska Native residents, honoring their history and promoting their health and well-being.
References:
- National Indian Health Board (NIHB) (March 2023) Rethinking How the Centers of Medicare and Medicaid Services Approaches Health Equity for American Indians and Alaska Natives. Retrieved September 17 2024, from Health Equity in Indian Country (nihb.org)
- Kaldy, J. (2022). The Unique Needs, Challenges of Native American Long-Term Care Residents. Caring for the Ages, 23(7), 1–7. https://doi.org/10.1016/j.carage.2022.09.016
- National Indian Health Board (NIHB) (January 2024) Advancing Health Equity with Tribal Perspectives on Data. Retrieved September 17, 2024 from THEDS Final Report (nihb.org)
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Have mental illness and substance use questions? We have the answers! Join us for office hours to talk with the experts.
Managing Substance Use Disorders in Nursing Facilities
Interested in receiving expert answers to substance use challenges you are facing in your nursing facility? Join Dr. Jen Azen and Dr. Swati Gaur, subject matter experts, as they answer questions related to your complex cases. No question is too big or too small!
Join our monthly office hours on the third Friday of each month from 1-1:30 p.m. ET to get answers directly from the experts working in nursing facilities!
Audience: Appropriate for clinicians, nurses, administrators, and social workers.
Interested in receiving expert answers to substance use challenges you are facing in your nursing facility? Join Dr. Jen Azen and Dr. Swati Gaur, subject matter experts, as they answer questions related to your complex cases. No question is too big or too small!
Join our monthly office hours on the third Friday of each month from 1-1:30 p.m. ET to get answers directly from the experts working in nursing facilities!
Audience: Appropriate for clinicians, nurses, administrators, and social workers.
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Comfort Menu
The COE-NF's Comfort Menu is a resource that facilities can use with their residents to identify ways to reduce anxiety, discomfort, and pain without using medications. Residents can choose from items in different categories, including relaxation, comfort, and entertainment. Download Resource
Stop Smile Go
The STOP SMILE GO technique offers a natural way to promote relaxation, reduce stress, and enhance overall well-being. Download Resource
Interested in accessing additional COE-NF resources for your facility?
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The Indian Health Service and its Division of Behavioral Health focus on providing integrated health and wellness services that are culturally appropriate for the American Indian and Alaska Native communities. Click Here to learn more about the Division of Behavioral Health and access further resources.
Reference:
Reference:
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Join us this November for our impactful training sessions designed to support nursing facility staff, with a special focus on self-care and mental health. In honor of Veterans Day, we invite you to participate in the Question, Persuade, Refer (QPR) suicide prevention training on November 19, where you'll learn techniques to help support veterans and others facing mental health crises. These sessions offer valuable strategies for building resilience, preventing burnout and providing compassionate care to residents.
Don't miss out on these learning opportunities!
Register Today!
Don't miss out on these learning opportunities!
Register Today!
Understanding Post-Traumatic Stress Disorder (PTSD): A Brief Overview
Tuesday, November 12, 2024
2-2:30 p.m. ET
2-2:30 p.m. ET
0.5 ACCME & 0.5 NAB credits will be offered.
This training is designed to give a brief overview of post-traumatic stress disorder (PTSD), its symptoms, and how this can manifest in nursing facility residents. We will review ways for supporting and treating PTSD.
Learning Objectives:
- What is PTSD?
- What are the symptoms of PTSD?
- What are ways to support individuals with PTSD?
Tools for Creating Calm in Time of Distress: Part 1
Thursday, November 14, 2024
2-3 p.m. ET
2-3 p.m. ET
1.0 ACCME & 1.0 NAB credits will be offered.
This two-part training series is designed to provide information, strategies, and engagement tools that can be used to create calm for the distressed resident while ensuring the delivery of effective care. Participants will improve their self-awareness regarding their own reactions to distress, in addition to discussing risk, safety factors and concrete tools for creating calm.
Learning objectives:
- Develop greater empathy and understanding related to distress.
- Gain insight into personal reactions to distressed residents.
- Review tools for responding to distress that will improve staff and resident engagement.
- Identify risk and safety boundaries.
Question, Persuade, Refer (QPR)
Suicide Prevention Training
(Recognition of Veterans Day)
**Registration Closed: This session is now full**
**Registration Closed: This session is now full**
Tuesday, November 19, 2024
2-3:30 p.m. ET
2-3:30 p.m. ET
1.5 ACCME & 1.5 NAB credits will be offered.
Key components covered in the training:
- How to Question, Persuade and Refer someone who may be suicidal.
- How to get help for yourself or learn more about preventing suicide.
- The common causes of suicidal behavior.
- The warning signs of suicide.
- How to get help for someone in crisis.
Tools for Creating Calm in Times of Distress: Part 2
Thursday, November 21, 2024
2-3 p.m. ET
2-3 p.m. ET
1.0 ACCME & 1.0 NAB credits will be offered.
Part 2 of this training series is designed to provide information, strategies, and engagement tools that can be used to create calm for the distressed resident, while ensuring the delivery of effective care. Participants will improve their self-awareness regarding their own reactions to distress, in addition to discussing risk, safety factors and concrete tools for creating calm.
Learning objectives:
- Develop greater empathy and understanding related to distress.
- Gain insight into personal reactions to distressed residents.
- Review tools for responding to distress that will improve staff and resident engagement.
- Identify risk and safety boundaries.
Mental Health First Aid (MHFA)
**Registration Closed: This session is now full**
Friday, November 22, 2024
11 a.m.-4:30 p.m. ET
7.75 NAB credits and 5.5 ACCME credits will be offered after completing the live training.
11 a.m.-4:30 p.m. ET
7.75 NAB credits and 5.5 ACCME credits will be offered after completing the live training.
Mental Health First Aid (MHFA) training provides skills to engage and provide initial help and support to someone developing a mental health or substance use challenge or experiencing a crisis.
This session provides a MHFA certification for three years.
The training covers:
- Common signs and symptoms of mental health and substance use challenges.
- How to interact with a person in crisis.
- How to connect a person with help.
- Expanded content on trauma, substance use and self-care.
Part 1 starts AFTER initial registration has been APPROVED by the instructor. Approved registrants will be emailed instructions on how to create an online profile using MHFA Connect and complete a pre-survey/quiz followed by a two-hour self-paced online course. Registrants MUST complete Part 1 no less than 48 hours (two business days) prior to the scheduled Part 2 session.
Part 2 is a 5.5-hour live instructor-led virtual training. Participants are required to be on camera the entire time.
Part 3 participants will return to MHFA Connect to complete the post-test and evaluation, which is required to receive a certificate of participation.
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Working in a high-paced long-term care setting can present many challenges, including heightened stress. Have you ever considered the healing benefits of humor and laughter? Laughter has many physiological effects; it can actually change body chemistry and brain function.
Here are a few examples:
Take notice of the humor and laughter in your life.
- Laughter increases heart and respiratory rates as well as oxygen consumption over a short period
- After intense laughter, muscle tone relaxes
- Laughter lowers levels of the stress hormone cortisol
- Laughter activates the reward system of the brain
Take notice of the humor and laughter in your life.
- Notice when you laugh
- Who/what makes you laugh
- Notice when you make others laugh
- Practice intentionally bringing the use of laughter and humor into your daily practice and your life in general
References
- https://www.va.gov/WHOLEHEALTHLIBRARY/tools/healing-benefits-humor-laughter.asp
- Bennett MP, Lengacher C. Humor and laughter may influence health IV. Humor and immune function. Evid Based Complement Alternat Med. 2009;6(2):159-164.
- Mora-Ripoll R. The therapeutic value of laughter in medicine. Altern Ther Health Med. 2010;16(6):56-64.
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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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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.
Was this email forwarded to you? If so, please subscribe HERE.
Want to opt-out from receiving news from us? Click HEREto unsubscribe.
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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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