Senior
Care Center
By Christa Hedrick
Randolph County Medical Center in
Pocahontas is one of a handful of hospitals in Arkansas to have a facility
within its walls devoted to the special care needs of older adults.
Run by Horizon Mental Health, the
Senior Care Center offers help for a number of emotional and behavioral health
needs that befall the elderly. Stroke,
Parkinson’s, Alzheimer’s and depression are a few of the conditions suffered by
older patients which may leave them confused, anxious, and frightened, with
feelings of hopelessness that make them unable to cope with daily
responsibilities. The Senior Care Center
is designed and staffed to lead its patients out of this fog and into a world
in which each of them can achieve the highest possible quality of life for
themselves.
Just as we know that infants and
children have specialized medical needs, we now know that adults over the age
of 55 have specialized needs as well. As
our metabolism decreases, medications work differently. Certain health problems, such as diabetes,
hypertension and pulmonary disease often worsen as we grow older and add to the
losses associated with aging, making it increasingly difficult to cope with
daily living. At a time when our energy
and strength is lessening, we can find ourselves facing the monumental task of
caring for a loved one who is no longer able to care for himself.
Primary care physicians who often
see a patient for a few minutes and only when she presents with specific
symptoms are forced to rely on the patient to supply information regarding her
feelings and needs. Those who are not
trained in geriatric needs may overlook certain signals and fail to properly
diagnose because of insufficient data from the patient, leaving a patient even
more bewildered. Just as there is a need
for children to be seen by pediatric specialists, there is a need for the aging
to be seen by geriatric specialists.
The Senior Care Center, heartily
staffed and small, by design, provides an environment where assessment of a
patient’s needs is the top priority.
With a maximum of 12 beds on a secure unit, there are four to six
registered nurses, licensed practical nurses and nurse’s aids on the ward at
all times. They log all medications and
monitor and log patient responses, interactions, moods and physical
abilities. They are available 24 hours a
day to speak with family members about their loved ones who are in their
care.
Augmenting that staff are
Psychiatric social workers, the Program Director and a psychiatrist, who review
the logs constantly and tweak medications while providing counseling and
therapy sessions. In addition, the ward
has the availability of the entire hospital medical staff, including primary
care physicians, specialists, occupational therapists, psychologists,
activities therapists and pharmacists.
They employ a team approach to the
treatment. Everyone involved in the patient’s care becomes a member of
Treatment Team and is in almost constant communication with each other. Informal discussions about patient care occur
daily and a formal team meeting, which includes the participating family
members, are conducted each Wednesday.
The program is structured for
intense short-term, overall care with an emphasis on regulating the patient’s
medications and providing a continuing treatment plan and counseling as
necessary. With this end in mind, the
medical specialists at Randolph County Hospital are actively involved as
needed. Patients are observed closely
and all affects of medications are monitored so dosages can be adjusted
quickly. The average stay is 10-14
days.
The Treatment Team leader is Dr.
Debra Williams of Jonesboro. Dr. Williams is the staff psychiatrist at the
Senior Care Center. She visits the site
daily, talking with patients and reviewing charts. With the help of the staff pharmacist and
medical specialists, she reviews the patient’s medicines and eliminates as many
as possible. A common instance is that,
as a patient ages, he manifests more symptoms and may see more than one
physician or specialist. Medications are prescribed and changed and more are
added. He may have his prescriptions
filled by more than one pharmacy or by mail order. Drug interactions can be missed,
misunderstandings about dosages occur and often a medication that should have
been dropped as another was introduced is continued.
The constant monitoring at Senior
Care enables Dr. Williams to watch closely for changes in the patient, and the
close relationship with the resident pharmacist allows her to order an adjustment
in medication immediately when the patient’s condition calls for it. She believes in using the minimum medication
needed. “Start low, go slow” is her
motto when it comes to medicating her patients.
Doctor Williams interned at Mayo
and Menninger clinics and specializes in both geriatric psychiatry and
pediatric psychiatry. She continues her
education at a rate in excess of 75 hours per year to be sure she is giving her
patients the best treatment she can. She
became interested in geriatrics during her internship at Menninger. One of her responsibilities involved nursing
home work. “Older patients are still
human,” she says. “They deserve a good
quality of life as much as the rest of us.
That’s what I try to give them.
The best they can have.”
When asked what would help her do a
better job, she replied, “Earlier diagnosis. If we can diagnose some conditions
earlier and begin treatment, we can give patients 3-4 more good years with
their families. Sometimes that can mean
the rest of their lives.”
There are barriers, however. It is still difficult to get people to ask
for psychiatric help. People still think
of “crazy” when psychiatric help is
mentioned. They don’t realize that
mental health is like other health.
There are many different problems and greatly varying degrees of health
needs. They have no problem asking a
physician for “something for stress” or “something to calm my nerves”, but to
many, the idea of seeking the help of a psychiatrist is like asking to be
ridiculed or locked away. Still others
simply do not realize that help is attainable.
The irony is that emotional
problems are shared by a vast majority of the population and almost all mental
illnesses can be cured or controlled with proper medications. This is not a statement that can be made
about physical illnesses.
Dolly Coke, previously the Program
Director of the Senior Care Center, says, “People think of a psychiatric unit
as being someplace where we will lock them up and throw away the key. That is
not true. It is true, this is a secure
area. It has to be because we have
patients who wander, but we take patients off the unit to smoke and to take
walks. It is really a gentle
environment. We try hard to make our
guests as comfortable as we can within our constraints. Our goal is to get them as ready as possible
to meet the outside world with as little stress as possible.”
Patient referrals to the Senior
Care Center can come from their physician or other health care
professionals. Some patients are sent
from a nursing care center when behavioral problems become severe enough to
endanger the patient or his family.
Concerned family members or the patient, himself can also call and ask
for an assessment. A qualified
professional will immediately be sent to the home and interview the potential
patient before giving a recommendation.
Some of the problems, which qualify a person for admission to Senior
Care are: depression, confusion,
agitation, paranoia, hallucinations, combativeness or suicidal tendencies. These are symptoms of conditions such as Post
Traumatic Stress Syndrome, anxiety disorders or addictive disorders.
Kay Huggins of Rector learned about
the Senior Care Center after her husband suffered a series of strokes, which
left him confused, agitated and unable to sleep. “They did a good job with my husband’s
medications”, Kay says. “He was unable to sleep even with sedatives. He wanted to get up but wasn’t able to walk
without help. I was having to hold him
in bed or hold him down in a chair to keep him from hurting himself. Within a few days they had his medications
regulated to the point that he could sleep regularly and he could be moved to a
rehabilitation center. It was the kind
of help he could not have gotten in a hospital.”
Geriatric health care needs have
only recently been identified and many healthcare professionals do not believe
they are being adequately addressed.
Facilities like the Senior Care Center in Pocahontas are unique in their
specialized, total care approach. You
will not find a facility like this in most larger cities where resources are
more plentiful, but they are not concentrated like they are in Senior
Care.
All of Horizon’s facilities of this
sort are found in rural communities.
This is a tremendous resource to have with the population aging as it
is. This is a facility that can address
behavior problems and return one to the community in many cases, in a condition
that will allow them to lead an enjoyable life.
In other cases, when further treatment is needed, the facility can help
them establish a medication routine that will allow them to feel safe and
comfortable.
There are several other Horizon
owned facilities in Arkansas and more in the mid south. Care in these facilities is covered by
Medicare and by most major health insurance plans. Anyone who feels they or someone they care
about would benefit from the Senior Care Center can ask for a referral from
their physician or they can call Senior Care directly. The daytime phone number is 800
892-6013. The local number is 870
892-6292. In the case of an emergency,
870 892-6293 answered 24 hours a day at the nurses station.