Professor of Psychiatry and Community and Family Medicine, Dartmouth Medical School, Lebanon, New Hampshire, USA.
J Aging Soc Policy. 2011 Jul-Sep;23(3):244-57. doi: 10.1080/08959420.2011.579497.
Older adults with serious mental illness disproportionately reside in nursing homes despite the U.S. Supreme Court Olmstead decision supporting the rights of persons with disabilities to benefit from integrated services in the community. This commentary addresses the neglected policy debate on implementing Olmstead for this rapidly growing, older population with special needs. First, the author describes research findings on older adults with serious mental illness living in nursing homes who might more appropriately reside and receive services in the community. Second, the author summarizes the evidence base for effective psychosocial rehabilitation interventions and services facilitating independent living in community settings for this subgroup. Finally, he concludes with seven policy recommendations aimed at advancing the promise of the Olmstead decision with respect to older adults with serious mental illness.
尽管美国最高法院奥姆斯特德裁决支持残疾人士在社区中获得综合服务的权利，但患有严重精神疾病的老年人仍不成比例地居住在养老院中。本评论探讨了在实施奥姆斯特德法案方面被忽视的政策辩论，该法案旨在为这一快速增长的、有特殊需求的老年人群体提供服务。首先，作者描述了居住在养老院中的患有严重精神疾病的老年人的研究结果，他们可能更适合在社区居住并接受服务。其次，作者总结了针对这一亚组人群在社区环境中促进独立生活的有效心理社会康复干预措施和服务的证据基础。最后，他提出了七点政策建议，旨在推进奥姆斯特德裁决对患有严重精神疾病的老年人的承诺。
