Integrating Psychotherapy into Elderly Care: Improving Mental Health and Reducing Hospitalizations in Nursing Homes
Keywords:
psychotherapy in older adults, nursing homes, mental health, preventable hospitalizations, integrated care, dementia, Treat-in-Place model, care planning, quality of life, health economics.Abstract
Long-term care facilities face a dual systemic strain: widespread comorbidity of mental disorders among residents and a high volume of preventable hospitalizations, which collectively imposes an excessive burden on healthcare. The aim of the study is to provide a theoretical rationale and present a comprehensive modular program that integrates psychotherapeutic and psychosocial interventions into the routine practice of nursing homes, focusing on improving residents’ mental well-being and reducing hospitalization rates. The research methodology is based on a systematic literature review with analysis of results from large clinical programs (OPTIMISTIC, WHELD), as well as a descriptive analysis of a case study reflecting the practical implementation of the authors’ model across diverse contexts — from nursing homes in the United States to centers for elderly refugees in humanitarian crisis settings. The data obtained indicate that the integration of psychotherapy, personalized dementia care, proactive care pathway planning, and the Treat-in-Place model reduces the severity of anxiety and depressive symptoms (by 30–40% in pilot samples) while simultaneously decreasing the proportion of preventable hospitalizations by 19–25%. In conclusion, the proposed model is a scientifically validated and practically tested solution capable of transforming the long-term care system, improving the quality of life of older adults, and rationalizing healthcare expenditures. The material is intended for leaders of long-term care institutions, clinical psychologists, geriatricians, and healthcare organization specialists.
References
‘We did not want to take this guy’: Abuse rates higher at nursing homes with more mental illness [Electronic resource]. - Access mode:https://www.apmreports.org/story/2025/08/07/abuse-rates-higher-at-nursing-homes-with-more-mental-illness (date accessed: 09.09.2025).
Mental Health in Nursing Homes | Learn Why it is Important [Electronic resource]. - Access mode: https://www.nursinghomeabusecenter.com/resources/mental-health-in-nursing-homes/ (date accessed: 11.09.2025).
MOST HOSPITAL VISITS OF VULNERABLE NURSING HOME RESIDENTS AVOIDABLE [Electronic resource]. - Access mode: https://www.fau.edu/newsdesk/articles/hospital-transfers-nursing-home-residents.php (date accessed: 11.09.2025).
Ouslander J. G. et al. Potentially Avoidable Hospitalizations of Nursing Home Residents: Frequency, Causes, and Costs: [See editorial comments by Drs. Jean F. Wyman and William R. Hazzard, pp 760–761] //Journal of the American Geriatrics Society. – 2010. – Vol. 58 (4). – pp. 627-635.
Bohnet-Joschko S. et al. Nursing home-sensitive conditions: analysis of routine health insurance data and modified Delphi analysis of potentially avoidable hospitalizations //F1000Research. – 2022. – Vol. 10. https://doi.org/10.12688/f1000research.73875.2.
The projected costs and economic impact of mental health inequities in the United States [Electronic resource]. - Access mode: https://meharryglobal.org/wp-content/uploads/2024/05/DI_CHS_Cost-of-MH-inequities.pdf (date accessed: 12.09.2025).
Vogelsmeier A. et al. Results of the Missouri quality initiative in sustaining changes in nursing home care: six-year trends of reducing hospitalizations of nursing home residents //The journal of nutrition, health & aging. – 2021. – Vol. 25 (1). – pp. 5-12. https://doi.org/10.1007/s12603-020-1552-8.
Gramaglia C. et al. Non-pharmacological approaches to depressed elderly with no or mild cognitive impairment in long-term care facilities. A systematic review of the literature //Frontiers in public health. – 2021. – Vol. 9. https://doi.org/10.3389/fpubh.2021.685860.
Lyons T. L., Champion J. D. Nonpharmacological interventions for management of behavioral and psychological symptoms of dementia in long-term care facilities by direct caregivers: A systematic review //Journal of Gerontological Nursing. – 2022. – Vol. 48 (7). – pp. 18-23. https://doi.org/10.3928/00989134-20220606-03.
OPTIMISTIC program reduces avoidable hospitalizations [Electronic resource]. - Access mode: https://healthjournalism.org/blog/2018/03/optimistic-program-reduces-avoidable-hospitalizations/ (date accessed: 14.09.2025).
The WHELD programme for people with dementia helps care home staff deliver person-centred care [Electronic resource]. - Access mode: https://evidence.nihr.ac.uk/alert/wheld-dementia-care-homes-person-centred-care/ (date accessed: 14.09.2025).
Blackburn J. et al. Reducing the risk of hospitalization for nursing home residents: effects and facility variation from OPTIMISTIC //Journal of the American Medical Directors Association. – 2020. – Vol. 21 (4). – pp. 545-549. https://doi.org/10.1016/j.jamda.2020.02.002.
Whitaker R. et al. Improving Well-being and Health for People with Dementia (WHELD): study protocol for a randomised controlled trial //Trials. – 2014. – Vol. 15 (1). - pp.1-14.
Searle B. et al. Which interventions are effective at decreasing or increasing emergency department attendances or hospital admissions from long-term care facilities? A systematic review //BMJ open. – 2023. – Vol. 13 (2). https://doi.org/10.1136/bmjopen-2022-064914.
Martin R. S. et al. The effects of advance care planning interventions on nursing home residents: a systematic review //Journal of the American Medical Directors Association. – 2016. – Vol. 17 (4). – pp. 284-293. https://doi.org/10.1016/j.jamda.2015.12.017.
Over a billion people living with mental health conditions – services require urgent scale-up [Electronic resource]. - Access mode: https://www.who.int/news/item/02-09-2025-over-a-billion-people-living-with-mental-health-conditions-services-require-urgent-scale-up (date accessed: 17.09.2025).
The projected costs and economic impact of mental health inequities in the United States [Electronic resource]. - Access mode: https://www.deloitte.com/us/en/insights/industry/health-care/economic-burden-mental-health-inequities.html (date accessed: 17.09.2025).
Morgado B. et al. Psychotherapeutic interventions for depressive symptoms in older adults in a community setting: a systematic review protocol //Frontiers in Psychiatry. – 2024. – Vol. 15. https://doi.org/10.3389/fpsyt.2024.1448771.
Davison T. E. et al. Psychological therapies for depression in older adults residing in long‐term care settings //Cochrane Database of Systematic Reviews. – 2024. – Vol.3. https://doi.org/10.1002/14651858.CD013059.pub2.
Quinn E. A., Millard E., Jones J. M. Group arts interventions for depression and anxiety among older adults: a systematic review and meta-analysis //Nature Mental Health. – 2025. – pp. 1-13.
The WHELD programme for people with dementia helps care home staff deliver person-centred care - NIHR Evidence [Electronic resource]. - Access mode: https://evidence.nihr.ac.uk/alert/wheld-dementia-care-homes-person-centred-care/ (date accessed: 19.09.2025).
Mayor S. Person centred care that includes antipsychotic review reduces agitation in dementia patients, finds study. – 2018. https://doi.org/10.1136/bmj.k4899.
Alnaimat F., Dabbah Y. A., AlSamhori A. R. F. Psychological interventions for mental health in aging populations //Anti-Aging Eastern Europe. – 2024. – Vol. 3 (2). – pp. 66-73.
Advance Care Planning for Older Adults - American Geriatrics Society [Electronic resource]. - Access mode: https://www.americangeriatrics.org/sites/default/files/inline-files/AGS%20Statement%20on%20Advance%20Care%20Planning_FINAL%20%28August%202017%29.pdf (date accessed: 20.09.2025).
Oteniya V. Standardized education on physician orders for life sustaining treatment (POLST) conversations. – 2021. - pp.1-27.
Effectiveness of Community Nurse-Led Intervention in Managing Older Adults with Multimorbidity: A Systematic Review of Randomized Controlled Trials [Electronic resource]. - Access mode: https://www.dovepress.com/effectiveness-of-community-nurse-led-intervention-in-managing-older-ad-peer-reviewed-fulltext-article-JMDH (date accessed: 04.10.2025).
Uhr C. et al. Psychological interventions for refugees with depression: a systematic literature review //BMC psychiatry. – 2025. – Vol. 25 (1). pp.1-32. https://doi.org/10.1186/s12888-024-06447-y.
Due C., Gartley T., Ziersch A. A systematic review of psychological group interventions for adult refugees in resettlement countries: development of a stepped care approach to mental health treatment //Australian Psychologist. – 2024. – Vol. 59 (3). – pp. 167-184. https://doi.org/10.1080/00050067.2024.2343745.
Ibekaku M. C. et al. Barriers and facilitators to providing rehabilitation for long-term care residents with dementia: a qualitative study //BMC geriatrics. – 2024. – Vol. 24 (1). - pp.1-22. https://doi.org/10.1186/s12877-024-05433-z.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Korovitskyi Rostyslav
This work is licensed under a Creative Commons Attribution 4.0 International License.
