Older adults with severe mental illness: Characteristics and levels of care

Kristin J. Levine (1999)

This study explored characteristics and needs of older adults with severe mental illness (SMI) across the range of community-based settings in which they live. Based on a sample of 417 individuals, principal components analyses and logistic regressions were utilized to determine variables that differentiated between individuals who lived independently, in the community with support, and in nursing homes. Analyses were repeated for the subsample receiving appropriate levels of care. Results indicated that 39 percent of those in nursing homes were inappropriately institutionalized and that those with schizophrenia were especially vulnerable to inappropriate placement. Community living skills and self-care were most highly predictive at all levels; social skills were important for those living independently; and behavior and social support were significant predictors of higher level of care for those living in the community with support. Suggestions were made for directing policy development, future research, and planning psychosocial interventions to meet the needs of this vulnerable group.