Psychiatric ailments treated without hospitalization

January 19, 1995|By Dolly Merritt | Dolly Merritt,Special to the Sun

Though clinical depression can be a major problem among older adults, long hospital stays aren't necessarily the best way to help them cope with day-to-day life, mental health professionals say.

That's why Taylor Manor Hospital in Ellicott City has started an outpatient treatment program for people 50 and older with such serious psychiatric problems as depression and anxiety disorders.

"It is as intensive as inpatient treatment, but the program allows the person to stay in the community," said Barbara Merke, who coordinates the program for the private psychiatric hospital. "It can be either an alternative to inpatient hospitalization or it can be a transitional service that can shorten a hospital stay."

Called the Older Adults Partial Hospitalization Program, it provides 6 1/2 hours a day of treatment up to four times a week for as many as 10 people at the hospital's Taylor Manor campus.

The program, which began last month, is aimed at those whose psychiatric problems are not severe enough to require 24-hour supervision but whose behavior might make it difficult for them to live normally at home or in the community.

Depression is among the most common problems for older people, said Tracy Forte, clinical coordinator for the program.

"They are dealing with a lot of losses: bereavement and grief, loss of status, physical limitations, among others," she said.

The partial hospitalization program, which is similar to one already offered for adolescents, provides psychiatric treatment without the isolation that can result from extended hospital stays, Taylor Manor officials say.

Most people enter the program through a referral from a mental health worker, a social service agency, a family member or an inpatient psychiatric facility. The average time spent in the program is a few weeks, but the length varies with each patient's need.

The costs, which can range up to $154 a day, plus fees for medical evaluations and some individual therapy sessions, are covered by most insurance plans, Medicare and Medicaid, Ms. Merke said.

Participants take part in a variety of therapies, including group sessions and art. They also learn strategies for coping with such illnesses as depression, including recreation that focuses on how the mind and body work together.

Each week's treatment schedule is structured to make the therapy useful to the patient's daily life, program organizers say.

Monday morning sessions, for example, begin with a review of the weekend in which patients are encouraged to talk about medical problems or situations that might have come up at home.

Tuesdays and Thursdays feature community meetings, at which participants are kept informed about current events.

Wednesdays are set aside for staff and family meetings and for patients to tend to personal errands, although there is no formal treatment those days.

On Fridays, therapists help outpatients prepare for two days of independence from the program -- a preview of what they will face when they leave the program.

"We try to train people to think about what's in store for the weekend," said Mrs. Forte. "We want them to work on what they can look forward to. The program is not forever; it's a transitional period. Patients should leave when they reach their goals."

Participants say the program provides a sense of community, along with the psychiatric care.

"You learn that you are not here alone," said a 71-year-old patient who asked not to be identified.

The patient, who is clinically depressed and has been in the program for three weeks, said, "You are with other people, and you are sharing the same feelings with them. You make comparisons; you meet new friends. . . . Now I'm joking and getting a sense of humor."

For further information, call Barbara Merke at 465-3322, Ext. 372.

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