Mental help for seniors; St. Francis Hospital offers short-term program
For days, the old man's family urged him to come talk to the professionals at St. Francis Hospital in Jersey City. Family members had noted changes in him over the last few years, a moodiness that often eased into a depression he struggled to escape. Like many senior citizens suffering some level of mental illness, this man - a stubborn old Irishman as the family called him - rarely sought help until it became a crisis, when he needed to go to the Emergency Room for possible admission into an inpatient program. Because his family heard that St. Francis had a short-term program that might help him, they urged him to come, and after some reluctance, he agreed. Although aging is a part of life, some people may not always feel ready to cope with the changes that growing older brings. Declining health or the death of a loved one can often bring on feelings of sadness, nervousness, and uncertainty for the future. Some aging seniors struggle to deal with these feelings alone. Not until recently has the medical profession addressed some of the problems of emotionally-stressed or mentally ill seniors, said Rosemary Venter, coordinator for a new Partial Hospitalization Program on-going at St. Francis Hospital in Jersey City. The Partial Hospitalization Program is an outpatient mental health program serving patients who are sub-acute. Some patients are admitted after an inpatient hospitalization in order to prevent re-hospitalization; others are referred by their outpatient psychotherapists or primary medical doctors when they may be cared for in a less-acute setting than an inpatient unit, to avert inpatient hospitalization. "Most of the people we've had here come through an Emergency Room situation," Venter said, noting that St. Francis decided four years ago that it needed to better address senior citizens in this area. "We noticed that demographics show the older population is growing and incidents of depression and anxiety disorder also growing," she said. "This can be as high as 40 percent of the senior population." In the past, older people suffering mental illness had no specific programs geared towards their needs. Outpatient program is new
St. Francis started an inpatient program for seniors in 1996, and started this outpatient version last year. Partial Hospitalization is beneficial to individuals with serious emotional problems who do not require hospitalization but may require more intensive treatment than outpatient therapy. The program can also help individuals making the transition from inpatient hospital care to the home setting. The program is designed to reduce or control the patient's psychiatric symptoms to allow earlier discharge from an inpatient program than would otherwise be possible. The program also seeks to prevent relapse or hospitalization and improve and/or maintain the patient's level of function. In the past, people have been reluctant to come for help partly because of the stigma attached to mental illness, something, according to Venter, that has changed in recent years. "This program is based on a national model," she said. "We want to help people avoid being readmitted to the hospital, or avoid having them admitted in the first place." This is a voluntary program which people can attend up to four days during the week from 9 to 1 p.m. for 21 days, helping them get over the most acute portion of recovery. The program is usually structured around three areas a day, allowing patients to talk about what is going on with their life now, what their goals are, and how they can help reduce stress. Once a week, the patient meets with a psychiatrist. "It helps provide socialization and structure to seniors who might otherwise be all by themselves," she said. Venter and her fellow coordinator, Grace Magrini, are both Licensed Clinical Social Workers. Along with staff members, they seek to find services that can continue a person's recovery. The program also provides transportation in Hudson County to the hospital. "We try to find after care," Venter said. "We try to help a person find a psychiatrist and we can refer that person to a physician for medical management." A first in Hudson County
Treatment is covered by Medicare and most other insurance plans. According to national statistics, 5 million Medicare beneficiaries have mental disorders other than mental retardation, and 3.7 million of them are over the age of 65. In the late 1980s Congress authorized a hospital-based partial hospitalization benefit as an alternative to hospitalization. In 1990 Congress expanded the partial hospitalization benefit to allow community mental health centers (CMHCs) to deliver this benefit. St. Francis Hospital is the first in Hudson County to set up such a program. Medicare rules require that partial hospitalization services are services "reasonably expected to improve or maintain the individual's condition and functional level and to prevent relapse or hospitalization." Venter said the program is only 21 days long because Medicare rules require "active treatment." While the program is open to seniors throughout Hudson County, Venter said the staff is particularly interested in reaching the Latino population, where senior citizens may also be faced with a language barrier as well as the traditional stigmas associated with mental illness. "We all speak Spanish here," she said. "We want to reach these people to make certain that they get the services they need." Venter said she can be reached by calling 418-2252.