• 2019 Senior Report Senior Report: Older Americans have more options for home care, but still struggling.

    The United Health Foundation has released results of a sweeping new study benchmarking the health of older adults. The America's Health Rankings® Senior Report was created in partnership with GAPNA to improve the health of America's seniors.

    The data will help advanced practice nurses and other providers deliver quality care.

    Find out about it!

  • 38th Annual GAPNA Conference

    October 3-5, 2019 at the Paris Hotel, Las Vegas, NV.

    Focused education; lasting connections, networking, free access to the GAPNA Online Library.

    Earn up to 22 contact hours (including pre-conference workshops).

    Get more information and register now!

  • AwardCall for Excellence Award Nominations

    The awards are: Emerging Chapter Award, Established Chapter Excellence Award, Special Interest Group Excellence Award, Excellence in Clinical Practice Award, Excellence in Community Service Award, Excellence in Education Award, Excellence in Leadership Award, and Excellence in Research Award.

    The nominations are tallied in July and the winners are announced every year during the Awards Celebration at the GAPNA Annual Conference.

    Now is the time to nominate a colleague or yourself - DEADLINE is June 1, 2019.

    Get started... nominate today!

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

    "Contemporary Heart Failure Management"

    (session captured at the GAPNA 2018 Annual Conference)

    For May/June 2019 - Get Your Free CNE Now!

  • AwardNew for GAPNA members: MCM Education

    GAPNA has partnered with a MCM Education to offer a series of CNE programs available to GAPNA members. "Alzheimer’s Disease Today and Tomorrow: Optimal Treatment and Collaborative Care," is the first program offered.

    What are the state-of-the-art strategies for managing the symptoms of Alzheimer’s disease? How can the multidisciplinary team work together to ensure timely intervention and optimal outcomes?

    Find out about it!

  • Meet the Candidates for the 2019-2020 BOD!
    The time to vote is right now: May 6 - 31, 2019!

    Please take a moment to read about this year’s candidates and why they feel they should be chosen for the position noted.


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.


Melodee Harris, PhD, APRN, GNP-B

Chair, Geropsychiatric Nursing Special Interest Group