Community mental health service use by older adults with dementia.

We considered the role of community-based public mental health services in providing care to older persons with Alzheimer's disease and other forms of dementia, and examined service outcomes within California's county-based public mental health system over a 3-year period. Treated prevalence rates, repeat service use rates, and service mix patterns were regressed onto individual, market, and contextual variables across 25 counties over 12 observation periods. The number of older adults with dementia who used community mental health services increased slightly over the observation periods, and service use was associated with age and Medicaid status. Service outcomes also were affected by complementary mental health and aging service systems within each county, as well as the poverty rate and location of the county. Future research is needed to clarify how administrative policies and service management practices contribute to increasing community mental health service use by persons with dementia. In the meantime, these findings can help program administrators and service providers understand the role of community-based mental health services in providing care to persons with dementia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Local Medicare policies: A pathway for providing mental health services to older adults.

Inconsistent local Medicare service coverage policies constitute one of the most prominent barriers encountered by mental health professionals who provide services to older adults. In this study, the authors analyzed the scope and delineation of local Medicare policies for 19 types of psychiatric and psychological services in 2003 and again in 2006. Results indicated policies now exist for all Medicare services in all the states, and many of the local policies provide definitive statements to guide practice. However, some policies lacked delineation and variability persists from one region to the next. While researchers ascertain how local policies can impact service outcomes, providers should form issue networks and resolve current problems such as the inequities surrounding service documentation requirements and the lack of guidance in providing mental health care to older persons with dementia. Given that the Medicare administrative structure will undergo substantive changes in the next five years, there is an exceptional opportunity for providers to address these problems successfully and pave a pathway for providing specialty mental health services to older adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Temporal memory for remote events in healthy aging and dementia.

Memory for the temporal order of term of office of 7 past U.S. presidents was examined in healthy older adults and individuals in the early stages of dementia of the Alzheimer type (DAT). Among those individuals who recognized all 7 presidents, bow-shaped serial-position effects for temporal order similar to those seen in studies of short-term memory were observed for both the healthy group and the groups of individuals with dementia. Accuracy of temporal ordering decreased with increasing dementia severity. Thus, DAT affects 1 aspect of "old" memory (i.e., temporal information) even in the very early stages of the disease. Theoretical models of serial-position effects need to address remote memory as well as short-term memory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)