Psychiatric disturbances of aged patients in skilled nursing homes.

The authors found that 85% of 74 patients supported by Medicaid in two skilled nursing facilities had significant psychiatric disorders in addition to serious multiple medical illnesses. Almost two-thirds of the psychiatric disturbances had not been diagnosed. Although staff were more concerned with the psychosocial than the physical aspects of patients' problems in more than half of the cases, they often had difficulty recognizing the legitimacy of psychological complaints and relating to patients with psychological disturbances. Staff were not clear about the orders for psychotropic medications that were prescribed for more than half of the patients. The authors point out that more psychiatric consultation is needed to ensure appropriate and effective care for psychiatric patients in such facilities.