Issues of Care in Long-Term Settings

Abstract

Edelson and Lyons (1985), in the introduction to their excellent book Institutional Care of the Mentally Impaired Elderly, describe basic principles of working in institutional settings. They begin by admonishing readers not to confuse mental disease with “excess disability” that can be treated, particularly visual and auditory deficits. Care, they state must be “rehabilitative whenever possible, prosthetic whenever necessary, and at all times humane, identity-preserving, and ego-supporting” (p.XIX). They suggest that institutional arrangements “that support direct care staff (ie nursing staff) in establishing a supportive relationship with impaired residents focuses attention on how interdisciplinary teams work” (p. XXI). Indeed, their message here is that the main purpose of teams, and mental health practitioners is to help in the structuring of ongoing supportive relationships between nursing staff and individual residents. The usefulness of sophisticated practitioners they say, is less in their one-to-one interaction with residents than in their educating and structuring of interaction between staff and residents.