SSH gero-psych unit celebrates first anniversary

By Greg Miller

New Leaf Senior Care, Sycamore Shoals Hospital's 12-bed, inpatient gero-psychiatric unit, celebrated its first anniversary of service on July 1, according to Ron Bowman, LPC, program director.
   "This is a partnership between a company called New Day, Inc. in Nashville and Sycamore Shoals Hospital," Bowman said. "New Day is a company that specializes in setting up psychiatric units, helping hospitals get them up and going and managing them. The theme for Sycamore Shoals is that leaf. The name sort of came about as a combination of New Day, Inc. and the symbol for Sycamore Shoals Hospital, the Sycamore leaf."
   The average length of stay at New Leaf is averaging a little more than 10 days, according to Bowman. Patients come to New Leaf from both nursing homes and assisted living centers. "We have more folks come from home where they are living with relatives, and they are able to return back to that situation." Family and caretakers are reporting to New Leaf that the patients "are in much better spirits" than when they are admitted to the facility."
   New Leaf, which serves those age 65 and over, offers a variety of services, including individual and group therapies, occupational therapy, and psychological testing.
   The goal at New Leaf is to get the patient "back to the highest level of functioning possible," said Bowman.
   "There are lots of issues that we deal with, but the primary thing is depression," Bowman said. "That comes from loss of function, things that happen with change of life, things like that."
   The depression may be caused by losing a spouse, social status, the ability to drive an automobile, difficulty in walking or other restrictions or problems. "They have all of these other problems, but then the depression starts to take away their energy and their motivation, as far as being able to cope or work on a problem. The depression then becomes a big problem within itself."
   Typically, those who are admitted to New Leaf experience a loss of activities of daily living (ADL). "Somebody has become withdrawn and isolated, maybe even to the point of staying in a particular room in the house; they won't leave the house. Their appetite has changed. They're either overeating or not eating. Their sleeping habits have changed. They're either sleeping all the time, or they can't sleep. Their normal daily routine is just gone. They can't perform on the level that they are accustomed to performing on or should be able to perform on."
   Depression, along with a combination of other factors, Bowman said, "can lead to confusion, your mind can play tricks on you, you can see things, you can hear things. There are a lot of things that can happen if it goes untreated, and it keeps getting worse."
   Managing the medicine, dealing with reactions that come from taking too little or too much medication, or interactions between the medications can present problems, too, according to Bowman. "One of the first things we do when assessing someone is to make a list of all their medicines and run a pharmacy review to make sure that there is nothing happening with the medicines that is causing them to be confused," he said.
   Reminiscing is one of several types of sessions used to help someone deal with depression, Bowman said. "Research is showing there is a lot of therapeutic value in reminiscing and telling good stories, telling pleasant stories," Bowman said. "It affects and helps people with their mood. It also gives them a chance to talk about and reveal times when they were active and when they were doing things in earlier parts of their lives."
   The gero-psych field has experienced an influx of new medicines, according to Bowman. "There's a whole new family of anti-depressants that's come out in the last 10 or 12 years," he said. "And there's less side effects, less interference. There's a little more respect for the older system. The impact on taking them is not quite as difficult as far as the dry mouth or some of the other things that come with some of the other medications.
   "We have a whole new family of medicines, and it's easier to find a safe dosage range for an older person, where their metabolism is slow and their absorption rate is slow and all of those things are different."
   Some people think that psychiatric-related problems are associated with aging, Bowman said. "A lot of people just associate all this with being old, and they needlessly suffer. They think that depression and the side effects of depression -- not eating right, not sleeping, not being social -- are just a part of being old."
   Focus groups can help people deal with orientation, Bowman said. These sessions "help people keep track of the time, the day, month, any world event, who the President is, what's going on, just some basic orientation and reality kinds of things."
   When necessary, one-on-one attention is available. "Then we might step back and put them on some kind of system where we check them every 15 minutes," Bowman said.