88. IMPLICATIONS OF INSTITUTIONALIZATION ON THE MENTAL HEALTH OF OLDER ADULTS: CASE-BASED ILLUSTRATIONS

Abstract

Introduction

Through this case series, we explore the implications of institutionalization on the mental health and well-being of older adults. Literature suggests this transition can create feelings of isolation, loss of independence, and other mental and physiological symptoms.

Methods

We conducted a retrospective chart review to explore the experiences of older adults who were identified by Cooper University Hospital faculty as having had extensive hospital stays due to unsecure disposition. This left them hospitalized until disposition was acquired. A literature review was conducted to explore the implications of this period of transition and subsequent institutionalization on the mental well-being of older adults.

Results

We identified seven older adults who had extensive hospital stays. This series includes patients whose hospitalization lengths range from two to ten months. Through our literature search we understood that Immediate institutionalization at the hospital while awaiting Long Term Care (LTC) placement for many months led to a loss of privacy and independence that likely made patients more vulnerable to feelings of stress, anxiety, and exacerbation of his depression. Increased risk of suicidal ideation can also present itself at the time of admission to the LTC. To mitigate the risk of suicide in older adults in LTC the following are some suggested ways to reduce the relocation stress for the residents of LTC: (1)Involving residents in decision-making (2) Adapting institutional routines to accommodate residents' preferences and practices (3) Assessing residents' adjustment and modifying the environment to enhance adjustment (4) Facilitating communication with residents' family and friends (5) Promoting residents' personal identity through productive activities and frank discussion about their relocation experience.

Conclusions

Through this case series, we discuss how older adults are mentally affected by the process of institutionalization. Older adults experience decreased independence and connection to loved ones. As institutionalization itself could increase mortality, we suspect that older adults with preexisting mental health conditions and prior suicide attempts have higher suicide risks. More extensive guidelines should be readily available for long-term care facilities to utilize to reduce relocation stress for older adults during their transition to institutionalization.