Prime Time Living - Page 20 - Help during the day

Prime Time Living
- Page 20
Help during the day
Levindale’s Partial Hospitalization Program provides support

By Margit B. Weisgal, Contributing Writer

Sometimes those suffering from depression need more than someone to talk to or a pill to get through the bad days. They may be functioning, but it’s not at their best.

One such solution is the Levindale PHP. This Partial Hospitalization Program is specifically designed for the unique issues of older adults. Before depression becomes so serious it requires psychiatric hospitalization, PHP provides intensive therapy and daily in-depth treatment, but participants get to sleep in their own beds at night. It also acts as a transition program for those who did need in-patient treatments.

Levindale Hebrew Hospital & Nursing Center was founded in 1890 and has always been focused on the elderly, disabled and ill. It provides both medical and emotional solutions for both in- and outpatient clients; it also serves as a training site for health care professions students studying geriatric specialties. Levindale has units that focus on long-term, dementia, respiratory and rehabilitative care services. In the interest of full disclosure, I was a candy-striper there in high school.

Hannah Kilburg, LCSW-C, director of outpatient behavioral health services, says “Depression is the most common mental illness diagnosis among seniors, follow by anxiety. Much of it is undiagnosed since sufferers function on some level, but not their best. It will affect one’s mood, feeling hopeless and empty, with a negative outlook for the future. Causes are usually an aggregation of losses: loss of job and loss of home – such as moving to a new setting, loss of friends, loss of abilities, loss of independence and loss of purpose.”

Other emotions indicative of depression may be anxiety, a sense of panic. He or she may spend time worrying, afraid to go out and participate in activities. This results in a downward spiral so the person may become more isolated. In turn, that increases the adverse emotions.

“We help people in the community access our program, plus we get referrals from a variety of places,” says Bracha Poliakoff, LCSW-C, admissions liaison for partial hospitalization program. “I visit locations with a large senior population, such as assisted living homes, nursing homes and senior centers, to familiarize them with what we offer. Because of the increased oversight, staff at these places will often identify those with behavioral changes. Other times, people will talk with me themselves.”

What indicators signify a person needs help? It comes down to functionality. One signal is when a behavioral change sends up a red flag – and that’s different for everyone. When someone starts using phrases like “I used to …” or “I noticed a change in myself,” it means something isn’t right. Then, a friend or family member will refer them to the PHP.

“We had one patient,” says Kilburg, “who read the newspaper every day, cover to cover. It was a big part of her daily routine. When the papers started piling up unread, she knew it was time to call her psychiatrist.

“Another man who suffered from chronic pain due to injuries from an accident became depressed and wouldn’t leave the house because it caused so much anxiety. As he recovered, he participated in the PHP to transition from long-term care to returning home to live on his own. He took the coping mechanisms he learned here and ran with them. His pain is now under control and he’s returned to his old activities, so he hasn’t been back.”

PHP treatment emphasizes ways to cope with daily life, which is why it has a team approach. Every patient comes with a different perspective and varied needs, so the goal is always to improve their quality of life and to remain a functioning member of their community. New patients are assessed upon arrival and discharge, with 90% experiencing symptom improvement.

Team members consist of psychiatrists, clinical psychologists, licensed social workers and certified psychiatric nurses. Case managers help each individual figure out how to connect with new hobbies, senior centers, opportunities for socialization, and other community resources, so they continue feeling well. The mantra of the team is “Always have an eye on the future.”

The program runs from 10 a.m. to 3 p.m., five days a week, and is covered by insurance. Transportation, lunch and snacks are provided. Each day, patients follow an individualized plan based on his or her needs, challenges and goals. They attend various group sessions on an array of topics – dealing with loss, mindfulness techniques, anger management, relaxation, relationships, and even one on origami for stress relief. Since almost everyone is over 60, they support each other, acting as cheerleaders to improve their mental health. With improvement, there’s discharge planning designed to help each patient achieve realistic goals.

“One success story,” Kilburg relates, “was a highly functional woman whose husband died. She stopped taking care of herself, stopped communicating, stopped everything, so her family put her into assisted living, where she sat stone-faced, refusing to interact. She now volunteers at Levindale, and, having been through the program, she’s become our advocate, touting how well it works.”

“Losses can pile up. You don’t need to be mentally ill to need the program,” says Poliakoff. “When life becomes too much for you to handle, we provide the services you need to get though. Although PHP is mainly group-based, there’s individual counseling and case management services to set goals and figure out ways to reach them. You don’t have to do this on your own.”

Caring for those around us, the individual members of our community as they – and we – age is our charge. Recognizing when someone needs help is part of that, as is suggesting solutions. Whether it’s for yourself or a friend, it’s good to know there’s something that can be done. •