Although we continue to hear about the graying American and the increase in the number of the “oldest old,” there is another demographic trend in play which is filling our nursing homes with another group—younger disabled people. Nursing home facilities, regulations and activities are designed to care for elderly frail women. When caring for younger residents, staff identify different care needs, expectations and approaches and little guidance on what to do. In response, AMDA set up a task force of experts from around the United States who are for larger populations of younger residents in long term care and asked them to develop a resource to help the nursing home community cope with this influx. The result is “The Younger Adult in the Long Term Care Setting,” AMDA’s newest addition to its LTC Information Series.

A San Diego Medical Director, Rebecca Ferrini, MD, CMD, AMDA’s 2010 Medical Director of the Year chaired the committee. She directs a 192-bed county-run  LTC facility in a suburb of San Diego which has many younger residents.  The committee members including doctors, nurses, psychologists and even some younger LTC residents,  hailing from across the U.S., shared their experiences, challenges, solutions, policies, educational resources and opinions in a collaborative effort.

Although the goal was to make a tool that was evidence-based, we found a dearth of information on the younger population in long term care.  The committee pulled from the groups’ diverse experience, sharing stories of challenging and rewarding patient encounters in an attempt to accumulate the experience and wisdom and the best practices of those who feel they are successful in caring for this population. The kit reads like a story—taking us through the case of a young man with a spinal cord injury named Martin and talks about his developmental needs, medical issues, behaviors, financial challenges and coping strategies. Then, subsequent case studies outline various usual situations  and how to approach them. Look for stories about  people with developmental disabilities and their parents, transgender patients, drug seeking habits, aggressive tendencies, Huntington’s disease, Multiple sclerosis,  substance abuse, boredom, marriage or relationship issues, technology troubles, hoarding, bariatric residents and more. The booklet is less than 100 pages but is packed full of good ideas. Purchasing this item also entitles you to a website where the authors all donated sample policies and procedures, informational handouts and in-services that are free to take and modify.

The main themes in the book are that the key to success is to develop healing relationships, understand that the perspective of the younger resident is different than for older people due to life stages, align expectations and understand how to deal with cognitive loss and behavioral challenges. For more information or to order the kit, go to: http://www.amda.com/resources/ltcis.cfm#LTCYA13.