By Sue Sveum | Photo from Shutterstock
The vast offerings of our health care system can often make it challenging to understand what is available and how to access it.
Several local health care providers have specialized senior care programs — some of which have been around for decades, and others are recent additions that aim to make everyday living easier for you and your loved ones.
We spoke with Stoughton Health, Sienna Crest, SSM Health at Home and Agrace to learn more about what they provide for seniors and their families — with options that focus on mind, body and end-of-life care.
ADDRESSING MENTAL HEALTH WITH AN INPATIENT CLINIC
This is likely one of the best programs you’ve probably never heard of: Stoughton Health’s Inpatient Geriatric Inpatient Psychiatry Program. The program has been a godsend for many seniors suffering from mental health issues ranging from depression and anxiety to Alzheimer’s disease and other dementias. The program, which began in 1997, is the oldest and largest in Wisconsin and receives referrals from throughout the state — and some as far away as Florida.
Designed to meet the unique needs of those 55 and older with psychiatric disorders, the short-term program treats patients with the goal of helping them return home or find a living arrangement better suited to their current needs.
“There’s a greater need for geriatric services like this today,” explains Heather Kleinbrook, Inpatient Services Manager. “With our population aging, we’re seeing more dementia as well as increased awareness of mental health issues like depression and anxiety.”
According to program psychiatrist Dr. Amy Connell, targeting the service to the needs of those 55 and older has been beneficial to the patients and the program. “They’re all from a similar age group so there’s a common thread,” she explains. “Activities and therapies, even music, can be geared toward that population.”
The age commonality also helps build relationships. The environment is homey, with patients generally out of their rooms, involved in an activity or socializing. “Increased socialization is important because people tend to open up more with other people around them,” says Connell.
“Some patients may initially just want to shut down, but once they become engaged, they begin to build friendships,” adds Kleinbrook. “And that social support goes a long way toward their success.”
Although the majority of the patients have some form of dementia, unlike a typical memory care facility, the 10-bed inpatient unit within Stoughton Hospital is unique in that it is licensed by the state to treat acute needs rather than provide long-term care.
Referrals can come from patients themselves, their family or a physician. But note that a health care power of attorney (POA) does not give a POA the ability to admit someone to a licensed acute inpatient psychiatric unit. Admission must be voluntary or court ordered.
Kleinbrook says while there’s no “typical patient,” many come in with similar issues. Those with depression or anxiety may be struggling with medications or dosing. And dementia patients are often admitted due to hallucinations, paranoia or agitation.
The first order of business is neuro- psych testing and the creation of a personalized care plan for treatment. Older patients often experience more medication side effects, so dosing is conservative, starting out with smaller doses.
Since patients are in various stages of treatment, activities and supportive therapies are geared to each person’s ability to engage. Aromatherapy, art therapy, and coping and life skills education are among the options — with some one-on-one sessions and others involving groups or families. Connell has even brought in her dog — a definite hit among patients. “Dogs tend to have a calming effect,” she says, “and their presence leads to patients sharing stories about their own pets.”
Another essential element of the program includes educating the patient’s family or senior community so they can understand the diagnosis, therapies or medication used in treatment and what to expect when the patient leaves. “We really rely on family support,” says Kleinbrook, “but sometimes that means encouraging them to stay away — so they get a break, and the patient has time to adjust.”
A typical stay in the unit is 15-18 days, and success takes many forms. Folks with depression are more hopeful. Those with dementia are sleeping better, less agitated and more cooperative. Overall, their lives are more manageable.
“No one stays here forever,” says Connell. “But some do ask if they can.”
ADDITIONAL SUPPORT AT AN ADULT DAY CENTER
As loved ones age, many of us find ourselves caring for family members, and respite services can really help when this is the case. This is where Agrace comes in.
Agrace has made it their business to care for people in need for more than 40 years, beginning with hospice care. Now they’ve expanded their services — opening an Adult Day Center.
“We saw a need in the community for families and caregivers needing respite,” explains Kewana Jamison, RN Adult Day Center manager. “[Families] want to keep their loved ones home, but can’t risk leaving them alone.”
The center fulfills that need by offering a place for seniors needing extra support to be safe. “It’s twofold,” says Jamison. “To provide caregivers a break, and [it gives] a chance for clients to socialize and get out of the house.”
The center can disburse medications and provides two meals and snacks daily. Activities are designed to meet each person’s unique cognitive and emotional needs, from brain exercises to physical exercises. The staff is also specially trained in dementia care.
The Adult Day Center is open weekdays from 7:30 a.m. to 5:30 p.m.
PEACE OF MIND WITH MEMORY CARE
For elderly adults that need more specialized care, Sienna Crest and Sienna Meadows have created exceptional facilities that take mental and physical wellness into account.
A lot goes into creating and operating a memory care community, says Sue White, president and owner of Sienna Crest Assisted Living, Inc. It’s not just an assisted living facility with locked doors. It’s a safe and homey environment with specially trained and caring staff, appropriate activities and food prepared to accommodate individual needs.
“It’s a higher level of care,” says White. “But our philosophy is to let residents be as independent as possible, fostering and encouraging independence, while watching out for their safety.”
It begins with staff training, understanding dementia and how best to interact with residents on their level. Activities are then geared to residents’ interests and abilities.
The building layout at each of the four, 15- to 20-bed Sienna Crest and Sienna Meadows memory care communities features a continuous indoor “walking path” with no dead ends. Residents can walk the path for both exercise and enrichment. Because of the community’s small size, a resident can be at the end of a hallway and staff can easily see them. And themed activity niches in most of the facilities along the hallway offer points of interest for residents to see and touch while providing stimulation — and evoking memories.
Each resident has a private room and most facilities have a private bath with an open door, affording them privacy while allowing staff to assist when needed. Several common areas also encourage residents to drop by and sit for a spell, rather than spending all of their time in their rooms.
“And we get to know our residents’ background and interests, so we can meet them at their reality,” explains White, adding staff may go along with what a resident is saying or redirect them, but they always make residents feel heard.
“We also feel it’s important to educate families, especially those in denial about a loved one needing memory care,” adds White. “After an assessment, we’re always upfront. We want Sienna Crest and Sienna Meadows to be a good fit — for the resident, their family and our community.”
BRINGING END-OF-LIFE CARE TO THE HOME
Talking about the end of life is difficult. No one wants to think about dying or about the death of a loved one. But when it becomes clear that you or a loved one may be reaching that time, it’s important that you do talk about it, to prepare for the best end-of-life journey possible. And that’s where hospice comes in — helping patients and their families do just that.
To be eligible, a physician must determine that they anticipate the patient has a life expectancy of six months or less. And patients choosing hospice services must be receptive to receiving end-of-life care, which includes stopping curative treatments.
“There are just so many benefits to having hospice on board,” says Janet Bollig, MSSW, of SSM Health at Home Hospice. “We focus on the patient’s quality of life, along with goals and wishes for their end-of-life journey.”
A patient’s care team may include the hospice medical director, nurse practitioner, registered nurses and licensed practical nurses, along with medical social workers, spiritual support/chaplains, home health aides and volunteers. Together they develop a unique care plan for each patient that covers pain and symptom management.
“Our team focuses on making sure our patients are treated with dignity and respect,” says Bollig. “Managing physical symptoms is obviously an essential part of hospice care, but quality of life is also impacted by mental and spiritual wellbeing. Hospice supports the whole person — physically, mentally and spiritually.”
Hospice is also unique in that the team provides care, not only to patients, but also to their family and loved ones. They’ll receive ongoing education, guidance, and emotional and spiritual support so they can prepare for the loss of their loved one, knowing what to expect and how to best care for them. This support continues for 13 months after the patient passes.
“Patients and families are encouraged to address unresolved issues, complete a life review and plan for the future,” explains Bollig. “This helps everyone to focus on comfort and peace as the end-of-life approaches.”
Most patients want to remain at home in a familiar environment, surrounded by the people and things they love most. Hospice allows people to do that, knowing they can receive all the care they need right in the comfort of their home. And as long as they meet eligibility requirements, it’s never too early to bring in hospice.
“Sooner is always better,” stresses Bollig. “The earlier a patient is admitted, the sooner our care
team can begin managing pain and providing the support needed to improve the patient’s quality of life, so they can live their best life to the end. We repeatedly hear from families that tell us they wish they would’ve started hospice services sooner.”