Within a month, an elderly south suburban man’s wife died, then his sister. He went into a deep depression for several weeks, then after visiting his doctor he was hospitalized and put on an antidepressant.
After he stopped taking his medication, he became depressed again and had a difficult time making it through the day. His doctor told him to restart his medication and referred him to the Older Adult Partial Hospitalization program, which opened last November at Christ Hospital and Medical Center in Oak Lawn.
The program, located in the hospital’s outpatient center, offers counseling and support for older patients with depression, anxiety disorders, psychological disorders or intense bereavement reaction.
The latter brings many of the patients into the program, say those who run it.
“Older adults suffer from a lot more losses than younger adults do,” Donna Curley, RN, said. “Older adults also require an intensive therapeutic psychiatric community. They’re not sick enough to be in the hospital but some require monitoring to help them get through the day.”
Zivile McPolin, RN, a clinical nurse specialist, noted that most patients in the program think it’s normal to be depressed because they are old.
“We’re saying old age is not a disability or a disorder, so we are sort of shaping their opinions about what is going on in their lives,” McPolin said.
Health providers need to meet the needs of elderly people who face emotional crises because they often lack support, said Karen Taylor-Crawford, MD, chairwoman and medical director of Christ Hospital’s Department of Psychiatry and Substance Abuse.
The partial hospitalization program was started because the hospital determined there was a need for such support for the elderly.
“With an aging population and so many seniors continuing to have relatively active lives, such issues as loss of a loved one and changing lifestyles deserve attention,” Taylor-Crawford said.
“We found that when a patient age 65 or older came into our medical psychiatry unit, they needed care after that acute period,” McPolin said. “Once the medical condition had been stabilized, these patients needed more time in recovery primarily because of their medications. You have to watch any changes with their medication much more carefully because of their senior status.”
Once in the program, patients continue the type of recovery they experienced during inpatient care.
After reviewing the patients’ records and familiarizing themselves with the previous treatment approach, the staff continues to explore the situations that may have put the individual in the hospital, McPolin said.
The patients receive group counseling, individual counseling, activity and occupational therapy and after-care support–which directs patients to resources such as support groups.
“Most of the patients benefit from the group setting,” McPolin said. “Most of the program is a group approach, with some individual intervention. This means they must have some comprehension of what they’re facing.”
Patients also attend education seminars on such topics as medication effects, communications skills and relaxation exercises. This helps them to understand a specific topic.
“We’re offering support during a time when their medication is becoming more effective,” McPolin said. “But the medication is also being titrated and adjusted, perhaps, so this period is a learning time. For example, if a patient is having a problem with non-compliance, the staff would look at the root cause.”
The group of outpatients in the program usually includes no more than 12. Most patients stay with the program for a period between one to four weeks. Then, they move on to the support groups in their communities.
“We’ve helped many people avoid hospitalization,” Taylor-Crawford said. “One of the phenomenons we’ve seen in this program is the number of individuals with substance abuse–mostly alcohol–problems.”
She said there are very few programs out that deal with alcoholism among older adults.
Although it’s too early to judge the effectiveness of the program, those associated with it with it have noted positive results.
“The patients seem to feel better, and they’re having a reasonably stimulating time,” McPolin said.
Curley said that when patients are ready to leave, they say they’re less anxious and they are willing to try new things.
“You would be surprised by how many go on to do volunteer (work) because they have a more positive outlook on life,” she said.
