Elderly mentally retarded in nursing homes: Analysis of health care needs and critical nursing interventions

Increased life expectancy of the mentally retarded and the deinstitutionalization policies of the 60's and 70's have resulted in placement of increasing numbers of elderly mentally retarded in nursing homes. Nursing research, however, has not addressed the health care needs and effective nursing interventions for the care of these individuals.; The purpose of this study was to describe nursing interventions that were effective in meeting the health care needs of the elderly mentally retarded in nursing homes. Interviews were conducted with 52 nurses in 52 general nursing homes licensed as intermediate care facilities and/or skilled nursing facilities (ICF & SNF) and 7 nurses in 3 nursing homes specialized in the care of the mentally retarded and licensed as intermediate care facilities for the mentally retarded (ICF/MR). During the interviews the participants were asked to describe a health care need of an elderly mentally retarded resident in their facility. Participants were then asked to describe nursing interventions that were either particularly effective or ineffective in meeting the identified need.; Interviews were transcribed and analyzed using Flannigan's (1954) process for analysis of critical incident reports. Maslow's hierarchy of needs was used as the framework for identification of health care needs. Health care needs were identified that related to the basic human needs of physical needs, safety and security, love and belonging, and self esteem. Nursing interventions were then classified according to the related health care need. Summaries of health care needs and related interventions were presented.; Nurses in general nursing homes and nursing homes licensed for the care of the mentally retarded identified that each elderly mentally retarded person is an individual with specific needs. Nurses in nursing homes licensed for the care of the elderly mentally retarded identified lack of understanding and fear of the mentally retarded as one of the primary reasons nurses have difficulty providing care to the elderly mentally retarded.; Unsolicited findings included concerns regarding public policies related to placement of the elderly mentally retarded. Nurses identified the need for regulating agencies to consider individual characteristics and needs before determining placement of the elderly mentally retarded.; The conclusions of the study included a listing of common health care needs and related effective nursing interventions. This study provides a basis for future investigation and analysis of appropriate health care goals and nursing care of the elderly mentally retarded. Similarly, the results raise questions regarding health care delivery and public policies regulating the placement and care of the elderly mentally retarded.