The Challenge of Integrating Behavioral Health Care in Assisted Living Facilities

Abstract

Residents of Assisted Living Facilities (ALFs) often experience a range of psychiatric disorders and behavioral symptoms, the usual care for which is marked by fragmentation from medical care, overreliance on Emergency Department visits and psychiatric hospitalizations, and variable collaboration between clinical and facility staff. Given the high and increasing burden of mental illness and cognitive disorders among ALF residents and the growth of Assisted Living industry, there is a considerable need for the integration of high-quality behavioral health care into Assisted Living and Memory Care facility settings. Geriatric mental health workforce shortages demand innovative solutions in order to embed and scale this clinical expertise in communities whose design may lack clinical infrastructure. Existing attempts to address these challenges are marked by heterogeneity and a lack of high-quality evidence.This presentation will describe two different models of the integration of behavioral health care into Assisted Living Facilities and the strategic planning approaches to their development. First, we will present the development and implementation of a Behavioral Health program for ALF-residing patients of ConcertoCare, an innovative risk-bearing in-home and virtual healthcare provider offering interdisciplinary care to geriatric patients across the US. Next, we will discuss a model of embedding a geriatric psychiatrist and neuropsychologist from an academic medical center into a for-profit memory care facility, including the process of forming the business and care models. Both presentations will address challenges and strategies of approaches to clinical care, management of staff, patients, and families, and implementation of behavioral assessments and interventions. Also discussed will be future opportunities including scalability and need for further research into best practices.