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Spring 2010: The Aging Population in Home Care


  • effects of ai Chi/Qigong among senior apartment residents

  • CHC’s Spring Education Spectacular

Volume 7, No.1 Spring 2010

Behavioral Health Challenges in Home Health Care

by Michael B. Friedman, LMSW

Michael B. Friedman, LMSW, is the Director of the Center for Policy, Advocacy, and Education of the Mental Health Association of New York City and Chair of the Geriatric Mental Health Alliance of New York. He can be reached at center@mhaonyc.org. For further information about geriatric mental health, visit www.mhaofnyc.org/gmhany.

Mrs. S appeared to have saved every newspaper and magazine that she had ever had. They were piled everywhere. Her apartment was beyond cluttered. There was a narrow passageway from her front door through her living room, just enough for a small, thin person walking sideways. Her kitchen appeared not to have been cleaned in months. Dirty dishes were piled in the sink and on the counter tops. Food was rotting. The smell had gotten so bad that her neighbors complained. A worker was sent to help he , but she adamantly refused to allow anything to be removed. She seemed, in fact, to be terrified of the idea. Reasoning with her had no impact. Eventually, the health department ordered the apartment cleaned. Mrs. S. screamed at them and then


ental and behavioral problems are among the greatest challenges faced by caregivers who go into the home to help people with disabilities—especially older people—live in the community, where almost everyone prefers to live. This became clear during focus groups we did a few years ago in which we asked, “What makes it most difficult for you to continue to provide care for people in their homes?” “Behavioral problems,” they

began to cry.

said. When we asked what they meant, they told us about people who refuse to follow their

treatment plan, or who are abusive to their caregivers, or who wander out of the home, or who have held onto all the stuff they have ever felt was important to them, or who forget or don’t care enough to eat food that is left for them, or who complain endlessly about the same thing, or who are paranoid, or who become acutely psychotic, or who sink into lethargic depressions, or who are painfully agitated, or—well, the stories went on and on.

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