Psychological Transitions


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· Regulation Compliance
· Survey Assistance
· Knowledgeable Support (PPS & Consolidated Billing)
· Organizational Development
· Clinical Direction
· Quality Improvement
· Policy Consultation

The well being of facilities is as important to us as our patients. Our services must be integrated into interdisciplinary care in an emotionally healthy environment for both staff and residents. Because communication is critical we have several unique features to our service. We provide a written log as well as a face to face exit conference at the end of each day to enhance continuity of care. area clinical psychologist with networked access to all case notes is available 24 hours a day by pager/cell phone. We ask that each facility designate a clinical liaison staff so that we begin each day with a brief update on new referrals and residents under our care.
Frequently Asked Questions
Residents' behavioral/emotional problems seem worse in certain situatons. How will you help?
After we have assessed the resident and established a plan of treatment, we establish a close working relationship with the nursing staff and direct care staff and encourage them to discuss their concerns and ask for suggestions. We provide case management information to encourage follow through on interventions and strategies. We assess environmental factors to determine irritants and reinforcers which could impact on a resident. Interventions such as altering a noise level or changing a meal seating arrangement may eliminate a maladaptive behavior and are far preferable to a restraining intervention.
We will also consult with facility quality assurance and medical staff to identify patterns and trends which affect residents psychosocial well being and will participate in the development and monitoring of solutions.
Do you help with surveys?
The clinical documentation requirements of the regulations are carefully and uniformly met through the forms and educational materials developed and used by PSYCHOLOGICAL TRANSITIONS. We have participated in many state and federal surveys and are available 24/7 to explain our services to surveyors.
Can you help with residents who are aggressive to each other or staff?
When requested, we will review incident reports, assess the resident,, and help develop individual clinical interventions and behavior management strategies. We will address the underlying reasons for maladaptive behaviors such as frustration, depression, inadequate coping skills, medications reactions, comorbid physical conditions, etc.
How do you handle restraints?
Every alternative intervention should be attempted to manage behavior. These include environmental, changes in staff interventions, counseling, behavior management plans, etc. We are committed to an integrated approach to management of residents' behavior and emotional health which uses all interventions possible prior to medications and during the course of use of pharmacological treatment to minimize and/or eliminate the need. We are never proponents of physical restraints to manage behaviors.
We will review psychotropic medication trends and offer suggestions for behavioral, environmental, and other interventions which may allow reduction strategies.
We have some residents with Alzheimer's Disease who wander or become upset especially during ADLs. Can they benefit from psychological services?
Psychosocial interventions are extremely important and effective. We have worked in facilities where aggressive incidents have been reduced significantly. Although Alzheimer's Disease is progressive and irreversible, and the victims have cognitive, communication and perceptual losses, there is still a great deal of emotional stress which does respond to treatment. We have extensive experience and special training in the treatment of residents with Alzheimer's Disease and related dementias. We will work with residents to increase effective self expression, to decrease frustration, to minimize effects of change or transfer trauma, and to assist with management of catastrophic reactions.
We will also work with families or support groups to increase understanding of Alzheimer's Disease.
How do you communicate with the facility staff?
We ask each facility to designate a contact person or persons and we give them a brief exit interview after each day. We also leave contact information for the MDS nurse to assist in accurate case mix scores.
We will also arrange with the facility to provide training sessions with the staff if the facility wishes this or when the resident might benefit from changes in staff conduct or environmental changes.
We will also attend care plan meetings when there are issues relating to the resident's behavior or psychosocial well being. We will meet with the treatment team when it is needed to coordinate care or communicate goals and objectives.
What type of documentation do you provide?
We always leave written notes covering each session. Our services are based on a goal and measurable objective. We monitor progress with performance based outcomes. Our documentation coordinates with the care plan. All documentation is HIPAA compliant.
What will your relationship be with our physicians?
We try to meet or talk by phone to attending physician to introduce ourselves and our services. Our services are provided only with a physician's order so effective communication is essential. We also work with psychiatrists to make sure that psychological services interface well with psychiatric interventions.
When will you be at our facility?
We can come to the facility on a regularly scheduled day, usually weekly. We are available by phone 24/7 to help with an emergency situation or behavioral crisis.
Will the facility always have the same psychologist?
Absolutely. In addition to the doctoral level psychologist providing services. Additionally, we have substitute coverage available for vacations and illness.
Do you have experience with the legislation governing Long Term Care Facilities?
We provide consultation regarding staff practice and compliance with OBRA and state regulations. We have been involved with OBRA since its promulgation and prior to that with the ICF-MR legislation upon which OBRA was modeled.
Do you have references whom we can call?
Yes. We will gladly provide you with the names and phone numbers of administrators, directors of nursing, and other relevant clinicians with who we currently provide services.
Who does the billing?
We do. We bill the appropriate responsible parties or the insurance carriers such as Medicare, Medicaid, Blue Cross, Travelers, etc.
How do you decide which residents to see?
We see only residents who are referred by the designated clinician or care team. We discuss the clinical reasons for the referral and goals, and we terminate services when the goal is met or when it seems likely that the resident has attained maximum benefit from services.