By Jill Draper
The majority of patients admitted to the Senior Behavioral Health Unit at St. Joseph Medical Center first come through the doors of the emergency room. They’re frightened, depressed or delusional. Some are hearing voices or think people are stealing things from them. Others are violent and out of control. But the right medication offers a quick turnaround.
“That probably is my favorite thing about this profession,” says Helen Miller, a clinical social worker who directs the Behavioral Health Unit. “You can really change the disease process in a short amount of time.”
Miller says the medications used for senior mental health have improved dramatically in the last 20 to 30 years. “People think it resembles the movie ‘One Flew Over the Cuckoo’s Nest.’ Nothing could be further from the truth. The difference is night and day.”
In the past, psychiatric drugs often were linked to weight gain, impotency, hair loss and cancer, she says. “If you took Thorazine in the old days, the voices would go away, but you’d wind up 30 pounds heavier with a case of diabetes.” Today the side effects are much fewer and the impact much more rapid.
St. Joseph’s 22-bed care unit for psychiatric patients ages 55 years or older opened in December 2018, and is one of only four in the metro area, Miller says. The $1.6 million unit, located on the 5th floor of the Patient Towers at 1000 Carondelet Drive, typically has 16 to 17 patients at a time who stay for one or two weeks. The staff includes psychiatrists, internal medicine physicians, psychiatric nurses, social workers and physical therapists.
During their stay, the patients take part in individual and group talk therapy.
“We talk about how to have fun and what’s appropriate recreation. Some people never drank before, and now they’ve started to drink a little too much,” Miller says. “And some have become dependent on sleeping medication from other doctors.” It’s important to find social activities and be able to reach out to others and not keep feelings bottled up, she adds.
Miller says talk therapy can help people avoid the need for psychiatric drugs, “but that’s more of an outpatient approach.” Administering the proper dose of pharmaceuticals is tricky, however, because older adults may process drugs differently or take longer to respond. “You want folks trained in this,” she emphasizes. What’s not different among seniors, according to Miller, is the percentage of people who will have significant mental health issues in their lifetime—about one in ten, or perhaps one in eight.
Still, the senior years are when issues often arise after patients suffer the loss of a spouse, friends, independence and physical health. “You can become extremely depressed and you don’t see any way out of that,” Miller says. Seniors with chronic pain also are at high risk for mental health issues, especially suicidal thoughts. She notes that men over the age of 40 have the highest suicide rate.
“Chronic pain is very frustrating. It wears you down,” says Miller, who says these patients are referred to a pain clinic.
Occasionally a delirious emergency room patient requires neither pain nor psychiatric medication. “Someone with a severe urinary tract infection, and this is common in women, looks just like a person who’s psychotic because of all the toxins in their body. You give them antibiotics, and within 12 hours they’re back to their normal self,” Miller says.
To avoid a visit to the Senior Behavioral Health Unit, concentrate on good habits such as exercise, nutrition, staying social and wearing glasses and hearing aids, if prescribed. But realize that genetics, including a family history of dementia, is also a main factor.
“Take care of yourself, but [realize] you’ll have little dribs and drabs of dementia by the time you’re 90 or 95,” Miller says. “This is a disease. It’s no different than hypertension or diabetes.”
For more information regarding senior mental health, contact 816-943-5800 or go to st.josephkc.com.