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Evaluation

Behavioral Health

(SA18) Make Hard Patients Easier: Manage Treatment Refusals by Integrating Medical/Behavioral Care

Saturday, March 9, 2024
2:15 PM – 3:45 PM CT
Room: 301
CMD Clinical Credit Recording
CME: (1.5) MOC: (1.5) CMD Clinical: (1.5) NP Pharmacology Hours (.5)
Disclosure(s):
Kendra Toodle-Register, LCSW: No financial relationships to disclose.
Karl M. Dauphinais, MD, MSS, FACP, CMD: No financial relationships to disclose.
Long-term care residents exhibit refusals of care and medications for many reasons. Refusals may be due to an attempt at manipulation, delusions and psychosis, or even an expression of an underlying medical need or concern. Past traumas and interactions with staff or residents may contribute. Ultimately the refusals may worsen both the mental illness and the medical conditions. We present an integrated, team-based system for evaluating refusals. We'll present initial considerations for the medical practitioner who then collaborates with a behavioral health team including psychiatric providers and social workers. This integrated team works together with facility staff to elucidate reasons for refusals and implement best approaches for successful patient-centered care.

Learning Objectives:

At the completion of this session, learners will be able to:
  • Recognize how mental health and medical health outcomes are dependent upon one another in long term care and recognize the value of integrating the behavioral and medical health team to establish treatment goals and behavioral health care plans.
  • Provide a framework to assess and identify a complex patient's physical and behavioral health needs to help prevent treatment refusals and improve overall outcomes.
  • Explore key points to recognizing and managing personality disorders and mental health reasons for treatment refusals in order to enact appropriate treatment and care plans that unite the staff and medical and behavioral teams for the greatest potential for success in managing the most challenging patients.
  • Establish an approach to understanding, managing, and minimizing treatment refusals to improve patient outcomes, reducing hospitalizations, polypharmacy, and exacerbations of chronic medical conditions.