• W A N T E D   G A P N A   L E A D E R S!
    Call for Nominations!

    Have you ever considered stepping forward, accepting the challenge and volunteering for a position on the 2019 National Board of Directors? Register online NOW by April 1, 2019!

    Step Up - NOW is the Time! Register Here>

  • 2019 GAPNA Pharmacology Conference: Contemporary Pharmacology and Prescribing in Older AdultsJoin us in Chicago for our 5th conference!

    2019 GAPNA Pharmacology Conference:
    Contemporary Pharmacology and Prescribing in Older Adults

    March 28-30, 2019, Chicago Hilton, Chicago, IL

    Earn up to 11.5 CNE hours

    Register Now

  • Gerontology Resources for APRNs in Acute and Emergent Care Settings ToolkitCareer Center

     
    NEW! The goal of the Gerontology Resources for APRNs in Acute and Emergent Care Settings (“Acute Care Resource Guide”) is to make geriatric and gerontological content easily accessible to those caring for older adults in higher acuity care settings.

    Learn more about the toolkit

  • FREE continuing education credit is available for the following session:

    "Diastolic Heart Failure Management"

    (session captured at the GAPNA 2017 Annual Conference)


    For November/December 2018 - Get Your Free CNE Now!

  • Poster PresentationONLINE NOW:

    2018 GAPNA Conference Poster Presentations

    Note the latest trends in the care, education, and research of the older adult population.

     

    View the 2018 Poster Presentations from the Annual Conference!

  • The GAPNA Clinical Resource Corner

    Designed Especially
    for the Gerontological Advanced Practice Registered Nurse

    With over 106+ categories, the short features/articles contain valuable information tailored especially for Gerontological APRN's that will help them with patients, as well as increase their knowledge of this field of nursing. All of the articles directly affect, involve, and impact the elderly.

    Go to the GAPNA Clinical Resource Corner

Clinical Pearls

What Is a Serious and Persistent Mental Illness (SPMI) in Older Persons?

by Melodee Harris

The Social Security Administration is revising the rules for SPMI that were published in the Federal Register in 2010. The rules are used to evaluate claims for mental disorders. This is a brief overview of rules for SPMI effective January 17, 2017.

SPMI is a documented mental illness over the past 2 years that:

  1. Requires ongoing treatment that diminishes symptoms and
  2. Treatment that results in marginal adjustment or decreased capacity to adapt to the home environment.

Some examples of SPMI: neurocognitive disorders, schizophrenia, depressive bipolar disorder, anxiety, and obsessive compulsive disorder.

SPMI was used in the Revised Medical Criteria for Evaluating Mental Disorders: Proposed Rule published in 2010 in the Federal Register. SPMI provided an alternative to old terminology in an effort to decrease stigma. Although SPMI can be found in government documents, each state may have its own interpretation.

SPMI replaced these terms:

  • ŸSerious and persistent mental disorder.
  • ŸSeriously and persistently mental illness.
  • ŸChronic mental impairment.
  • ŸChronic mentally ill.

Changes for SPMI in the new Revised Medical Criteria for Evaluating Mental Disorders Final Rule (2016) from the previous 2010 document include a longer time interval for documented mental illness and some updates to provide consistency with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.

View the Revised Medical Criteria for Evaluating Mental Disorders Final Rule.


References

Melodee Harris, PhD, APRN, GNP-B

Chair, Geropsychiatric Nursing Special Interest Group
t2mharris@aol.com