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June 13, 1990

Medical Care in the Nursing Home

Author Affiliations

Cornell University Medical Center New York, NY

Cornell University Medical Center New York, NY

JAMA. 1990;263(22):3023-3024. doi:10.1001/jama.1990.03440220045022

To the Editor.—  Dr Ouslander's1 review of medical care in the nursing home is the finest of its kind I have seen. I would just like to underscore some of the points made in his section on the need for more mental health professionals to work with patients in nursing homes. As the author notes, unless a greater degree of attention is paid in residency and fellowship programs to the training of geriatric psychiatrists, it is unlikely that any substantial changes will occur in the underdiagnosing and treatment of depression or the overprescription of antipsychotic, sedative, and hypnotic medications to patients in nursing homes described by the author.To attract a greater number of applicants to such programs, however, one must pay attention to the various resistances younger therapists have to embarking on such training. These include ambivalent feelings about one's own parents or grandparents, unwarranted assumptions about the