Pre-admission Screening of Older Adults with Cognitive Impairment: Considerations for Emergency Services Staff

Live event held May 17, 2012, 1:30 pm Eastern Time (Third in the series Mental Health and Aging Training Initiative)

Learning Objectives

  • At the end of this one-hour presentation participants would have learned:
  • What unique characteristics of the LTC environment (e.g., frail elders at risk – safety/ liability concerns, staffing issues) need to be considered.
  • Special challenges involved in treating older adults with acute mental health issues in the LTC environment (e.g., risk of possible harm or death to elders with dementia when certain psychotropic medications are used; psychiatric consultants/ providers may not be available to the facility or not available within a reasonable time period).
  • Issues regarding diagnoses and behaviors relevant to older adults that psychiatric units must consider in their admissions decisions, in order for insurance to cover the hospitalization.

Learning Materials

The live event was recorded and its recording posted on this site (below).

This event was made possible through a grant from the Virginia Center on Aging’s Geriatric Training Education Initiative and supported by the  Center for Excellence in Aging and Lifelong Health., the Virginia Geriatric Mental Health Partnership* and the VCU’s Department of Gerontology.


Elizabeth Kirkland, LCSW, has over 11 years experience in a community mental health clinic, where she provided case management to adults with serious mental illness, and later managed the Emergency Services unit. This unit is responsible for providing 24/7 coverage of psychiatric crises for Virginia two counties.

Elizabeth served one year as Chair of the Emergency Services Council, the statewide group of Emergency Services managers. Currently, she is the Director of Behavioral Health & Community Relations at Mature Options, which is a care management practice and licensed home care agency, owned and operated by professional nurses. Founded in 1991 in Richmond, VA, Mature Options provides services for private pay clients located throughout central Virginia.

Elizabeth holds a Bachelor of Visual Arts from Winthrop University, as well as a Master of Social Work and Certificate in Aging Studies from Virginia Commonwealth University. She provides several trainings on responding to psychiatric crises, with a focus on geriatric crises specifically, and is deeply committed to providing older adults with the best care possible.

Amy S. Powell, MS, LNHA received a Master of Science degree in Human Development with a concentration in Gerontology to include a Graduate Certificate in Gerontology from Virginia Tech in Blacksburg, Virginia.

After spending lots of hours volunteering as a child in a long term care facility with her Great Grandmother, Amy dedicated her studies and career goals to become a Long Term Care Administrator.  Amy’s eight year experience as a Long Term Care Administrator ranges from opening a 120-bed, for-profit, Skilled Nursing Facility in rural Virginia to include a 30-bed secured dementia unit, the growth and development of a ventilator and skilled nursing unit of a 60-bed non-profit facility and a 120 bed, hospital owned, Skilled Nursing Facility with extensive renovations and culture change activities throughout.

Currently she holds the position as Health Services Administrator for an urban, non-profit CCRC managing their Health Care Unit, Assisted Living Unit, secured Memory Support Unit and their Wellness Center.  Amy is also licensed in the state of North Carolina as a Long Term Care Administrator as well as a Licensed Preceptor in Virginia.  Amy is member of the Geriatric Planning Partnership which is a partnership developed with the assistance of the Virginia Health Care Association for the coordination of care amongst the elderly population with challenging behaviors, mental illness and developmental disabilities.  Amy is an annual supporter of the Alzheimer’s Association Memory Walk and is certified in EssentiALZ, a dementia caregiver’s certification provided by the Alzheimer’s Association.


E.  Ayn Welleford, PhD, received her BA in Management/Psychology from Averett College, MS in Gerontology and PhD in Developmental Psychology from Virginia Commonwealth University. She has taught extensively in the areas of Lifespan Development, and Adult Development and Aging, Geropsychology, and Aging and Human Values.

As an educator, researcher, and previously as a practitioner she has worked with a broad spectrum of individuals across the caregiving and long term care continuum. As Associate Professor and Chair of VCU’s Department of Gerontology, she currently works to “Improve Elder Care through Education” through her Teaching, Scholarship, and Community Engagement.

Outside of the classroom, Dr. Welleford provides community education and serves on several boards and committees. She is the Immediate Past Chair of the Governor’s Commonwealth of Virginia Alzheimer’s and Related Disorders Commission. Dr. Welleford is the proud recipient of the 2008 AGHE Distinguished Teacher Award.



Webinar May 2012 5 17 final

To download the slides, click here.


The Geriatric Mental Health Partnership (GMHP) is an informal, voluntary group which focuses on geriatric mental/ behavioral health care. The group began in 2007 in response to the challenges of difficult behaviors of elderly residents in long-term care (LTC) facilities. Participants of the GMHP include representatives from mental/ behavioral health, aging services, and long-term care professionals representing the private, public and academic sectors. Organizations represented include the Virginia Health Care Association; the Virginia Hospital and Healthcare Association; the Virginia Association of Nonprofit Homes for the Aging; various Community Services Boards (CSB); State agencies including the Department of Medical Assistance Services; Department of Social Services Department of Health; Department for the Aging Long-Term Care Ombudsman; Department of Corrections; Department of Behavioral Health and Developmental Services; Piedmont Geriatric Hospital; Eastern State Hospital; the Center for Excellence in Aging and Geriatric Health (CEAGH), the College of William & Mary; Eastern Virginia Medical School; Virginia Commonwealth University (VCU) Department of Gerontology; Long-Term Care Facility Providers (e.g., nursing homes); and Behavioral Health Consultants.

The GMHP has worked tirelessly to improve communication and service coordination between the mental/ behavioral health and long-term care systems, so that older adults are able to receive needed care in a timely manner in the most appropriate setting. One of the key obstacles the group has identified is a lack of relevant training for facility and community staff. In order for seniors in long-term care facilities to receive timely and appropriate mental health treatment, staff members need to understand the issues involved and the procedures necessary to address and implement appropriate treatment. Traditionally, staff persons in long-term care facilities have received training which was more focused on the daily care and clinical needs of residents. Meanwhile, the staff at the local CSBs (individuals usually involved in psychiatric hospitalization of these older adults) have traditionally focused on behavioral health issues common to adults and children, without specialized training regarding the geriatric mental health issues more common to seniors residing in long term care facilities. The GMHP has identified six key training issues important for developing a workforce prepared to effectively address the behavioral health needs of the growing aging population.  Three of them are part of the current series titled “Mental Health and Aging Training Initiative”:

  1. “Community Partnerships: Ethical and Communication Issues for LTC Facility/ Hospital Transitions and Effective Care Coordination”
  2. “Psychiatric Emergencies: a Practical Guide for LTC facility staff”
  3. “Pre-admission Screening of Older Adults with Cognitive Impairment: Considerations for Emergency Services Staff”.

The current webinar is the last in the series of three described above.