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CHE Memory Centers
Our Services: We serve Skilled Nursing Homes, Rehabilitation Centers, Community-Based Adult Homes,
Assisted-Living Centers and Adult Day Care

Overview
Each of the above settings have distinct needs and pressures. Thus, our services are conceptualized within a framework of viewing the �facility as client. � In addition to providing psychological services to the individual resident, we address staff needs through in-service training programs --- such as personal stress management, dealing with difficult residents, and facility-wide behavior modification programs.

In recognition of the changing client base of nursing facilities, our services have become more diverse in scope � while individualized to the needs of the sub-populations of our client facilities. As noted below, these services range from individual and group psychotherapies for chronic mental health problems to behavioral health interventions for pain and other medical conditions .

The Need
The frail and elderly as well as the younger sub acute populations create a host of challenges that require advanced staff skills. For example, eighty-five percent of nursing home residents have a psychiatric diagnosis.  Over fifty percent are clinically depressed.  Nursing facilities are serving a changing geriatric population that has more acute illness-both physical and emotional.

In addition to the above-mentioned problems, facilities are now faced with the challenge of implementing the OBRA REGULATIONS. These regulations require nursing facilities to provide alternatives to the use of psychotropic medication and physical restraints.  This represents a significant challenge to administrators and D.O.N.’s who are already quite taxed with other responsibilities.

The Solution
CHE provides Behavioral Health services to residents of long-term care and rehabilitation centers in a caring and cost effective manner.  Seniors can have a better quality of life for a longer period of time.  Studies have shown that good mental health can result in better physical health and a longer, fuller life.

It is often assumed that the elderly are not good candidates for psychological intervention.  This is not true.  The elderly can be very effectively treated for psychological problems.  It is the nature of the psychiatric disorder and not the age of the resident, which is the crucial issue in whether an individual will respond to treatment.

Additionally, seniors and their families are becoming more educated, more psychologically sophisticated and more likely to have had some contact with psychotherapy.  Those factors lead to greater acceptance and, therefore, a higher success rate.

Psychological Services
CHE has carefully developed a program of psychological services to meet the specific needs of residents in nursing and rehabilitation facilities. These include the following:

  1. Diagnostic Assessment of patients’ psychological functioning, with specific recommendations for rehabilitation and treatment.

  2. Individual Psychotherapy to address the patient’s emotional and cognitive difficulties.  We also maintain consistent communication with staff through feedback and charting.

  3. Group Psychotherapy to address a variety of psychological issues such as depression, anxiety, coping with a disability, or cognitive impairment.

  4. Family Therapy utilizes a family member (child, spouse, or sibling) in the therapeutic process.  Placement of a family member in a nursing home can be very trying for the whole family.  Family sessions allow individuals to find more effective ways of responding to their family member's concern, dealing with their own reactions and ultimately improving the resident’s psychological functioning.

  5. Staff Training on a variety of psychological issues is provided free of charge. These include managing difficult patients, stress management, and so forth.

  6. Behavior Management to address common behavior problems, such as wandering, personal care difficulties, and sexual acting out.

  7. Health and Behavioral Services these services address a wide range of physical health issues, such as patient adherence to medical treatment, symptom management of chronic diseases, including: pain management, diabetes, COPD, as well as treatment of post stroke and cardiac patients.

  8. Pain Management Programs thru multi-modal psychological interventions such as relaxation training, imagery, and psychosocial support.

  9. Alzheimer's Screening through a multi-modal neurobehavioral assessment.

  10. Neuropsychological Testing to assess cognitive deficits in the domains of attention, memory, and executive function.

  11. Cognitive Assessment neuropsychological and neurocognitive assessment that assist in differential diagnosis, treatment planning and identifying cognitive functioning that impact memory, attention and problem solving to improve overall cognitive functioning.

  12. Development of Cognitive Skills cognitive rehabilitation, such as development of cognitive skills that address strengths and deficits identified by neuropsychological assessment that utilize cognitive exercises to improve attention, memory and problem solving to help better manage mood and behavior.

Costs
Medicare and Medicaid generally pay for the costs of these services.  CHE’s billing department processes all claims for professional services directly to third party payers. The facility bears no responsibility for claims processing or payment.

At times the resident has private insurance of which authorization must be received prior to providing services.  This authorization is requested by CHE.  Upon receiving an approval, CHE performs the psychological services and directly bills the appropriate payer.

The Process
When a facility selects CHE Senior Psychological Services to manage their psychological services, the following steps will occur:

  1. CHE will train the Facility Staff to identify residents who are in need of psychological services. Specifically, they will be taught to detect the following symptoms/disorders:

         a) Confusion                              
         b) Inappropriate sexuality         
         c) Paranoia                                
         d) Refusal to eat                         
         e) Frequent mention of death     
         f) Depression
         g) Aggressive behavior
         h) Anxiety
         i) Extreme mood swings
         j) Post-traumatic shock
         k) Non-compliance with medical treatments

  2. When these behaviors are observed, the staff member will request a referral for an initial psychological assessment by a CHE psychologist.

  3. Upon completion of the initial assessment of the resident, the psychologist will recommend a treatment plan compatible with the facility’s  “Care Plan”. The psychologist will see the patient on a weekly basis for individual psychotherapy, group therapy, or family therapy as warranted.  He/she will also provide clear and thorough communication to the staff through charting, staff discussions, and participation in meetings.

CHE is committed to working with the facility staff to provide comprehensive quality behavioral services.  Our aim is to create a program that will improve residents’ functional capacity, and help staff in their role of caregivers.

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CHE MEMORY CENTERS

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