The role of mental morbidity in the nursing home experience.

The history of a newly admitted cohort to eight nursing homes (N = 454) was studied prospectively over the first year of residence. Data were gathered at admission, 2 months, and 1 year, and included full psychiatric examination and staff reports of behavior. Chart reviews collected additional data on preadmission and postdischarge information. At admission, 80% of the population had mental illnesses, 60% of which were dementia, and about half of demented patients had other complicating mental illnesses. Use of mixed-effects linear model analysis revealed significant associations of mental morbidity, restraints, and psychotropic medication with behaviors indicative of noncoping and nonadaptation to the nursing home settings.