Behavioral Health for Older Adults - Geriatric Unit Helps Patients, Families Manage Severe Mental Health Issues

Behavioral Health Services for geriatric patients has been available for years at Henry Ford Macomb Hospital - Mt. Clemens Campus. As part of the expansion of Older Adult Services across the organization, the Geriatric Psychiatric Unit in Mt. Clemens has nearly doubled in size and brought in additional expertise.

The unit cares for patients 65 years of age or older who are exhibiting acute behavioral or emotional problems. In some cases, younger patients with similar needs may be placed on the unit. Patients may be depressed, have severe anxiety, bipolar disorder, schizophrenia, cognitive decline, changed mental status or may be suffering from dementia. It is not a long-term treatment option, but is meant to stabilize patients so they can return to the community for follow-up care.

"These are patients who are showing a very clear behavioral change such as severe agitation, disorientation or those who are suicidal," notes Henry Ford Macomb geriatric psychiatrist Prameela Baddigam, MD. "We can stabilize these patients in a number of ways, including changing the types or dosages of medication and initializing behavioral therapy and cognitive stimulation techniques."

Features that set the unit apart include:

• A board certified geriatric psychiatrist
• Nurses with specialized training in geriatrics
• A Coordinator of Geropsychiatric Services. This nurse helps outside providers such as nursing homes and assisted living centers understand what is available at Henry Ford Macomb, how it may benefit their patients and when a referral may be appropriate.
• Highly trained and experienced occupational, recreation and music therapists, mental health technicians, nursing assistants and social workers
• Family and/or caregiver education and support is an important part of the program. Coordination of care during the hospital stay and after the return home also is critical.

"We want patients and families to know there is help available. Just because someone grows older doesn't mean their mental health issues disappear and we need to have special care available to them," says Dr. Baddigam. "We can help patients and families understand and manage these problems."

Patients or families who think they may need Behavioral Health Services should see their primary care physician or call Henry Ford Macomb's Outpatient Behavioral Medicine at (586) 263-2760. If the situation is a medical emergency, they should go directly to the Emergency Center. Patients who are having a mental health emergency without related medical problems should go to the Emergency Psychiatric Evaluation (EPE) Access Center at the Mt. Clemens hospital. It is open 24/7 and can be reached at (586) 466-9895.

Persistent irritation, anger, sadness and anxiety are never normal

The crabby senior citizen has become a hallmark of sit-coms and television commercials. Looking at the general media, one might think irritable or depressed behavior is normal among older adults.

For many older adults, major life changes - illness, physical changes, retirement or losing a spouse, family member or friend - can be overwhelming.

Irritability, depression, anxiety or other behavioral symptoms are not normal for older adults, but they are all too common. Nearly 20 percent of people 55 years of age and up experience mental disorders that are not part of normal aging. Even more alarming, the rate of suicide is highest among older adults compared to other age groups.

While healthy aging requires habits that promote good physical health, mental health deserves equal attention. Fortunately, many of the things that keep our bodies fit are also good for our mental health. For instance:

Get regular exercise. It delivers oxygen-rich blood to our brains and helps prevent dementia, including Alzheimer's disease, alleviates depression and boosts energy.

Manage blood pressure. Nearly two-thirds of adults over age 65 have high blood pressure. A reading below 120/80 mmHg is considered normal and reduces your risk of stroke, which is tied to dementia. Keep your weight down, don't smoke, exercise regularly, eat a healthy diet, and limit salt, alcohol and caffeine.

Take medication correctly. Read labels and follow your physician's instructions. Remember that over-the-counter drugs and herbal remedies often include precautions such as avoiding alcohol or not taking them in combination with other medications. Harmful drug combinations and incorrect use can cause memory loss, dementia, and other brain problems.

Limit alcohol. If you don't drink, don't start. If you do drink, consume no more than one drink a day if you are over 65.

Care for your teeth. Brush, floss and see your dentist regularly. Recent studies have linked gum disease complications to Alzheimer's disease.

Beyond physical measures, these habits can also help promote healthy mental aging:

Exercise your brain. Use it or lose it. Read, do crossword and Sudoku puzzles, write, learn new things. Mentally stimulating activities help maintain brain function and ward off dementia.

Be connected. Studies show that people who are engaged with family, volunteering or community groups take longer to show the symptoms of Alzheimer's disease than individuals who are socially isolated.

What's not normal?

If you or a loved one experiences any of the following symptoms, see your physician.

• Occasional forgetfulness is normal; persistent memory loss is not
• Depressed mood or sadness lasting more than two weeks
• Unexplained crying spells
• Loss of interest or pleasure in the things you once enjoyed
• Persistent fatigue or low energy
• Anger or irritability
• Change in appetite or weight
• Change in sleep habits
• Feelings of worthlessness, guilt, hopelessness
• Decreased ability to concentrate or make decisions
• Repeated thoughts of death or suicide
• Unexplained aches, pains, constipation or other physical problems
• Confusion or disorientation
• Social withdrawal
• Trouble handling finances or paying bills
• Change in appearance, dress or cleanliness
• Problems maintaining the home