As the population ages, healthcare facilities are dealing with more and more elderly individuals.

 

This past summer, CentraCare Health - Monticello opened its new Geriatric Behavior Health unit - an innovative model designed to care specifically for the needs of the aging.

 

“We started on this journey almost two years ago,” says Chris Walker, director of the Geriatric Center. “We’ve always had a need for a geriatric unit.”

 

A steering committee looked at needs assessment in the community and found the area had the largest population of people who will be aging over the next 15 to 20 years.

 

“CentraCare Health Monticello was willing to try to open a 10-bed unit that would save the geriatric population with behavioral health needs,” says Walker.

 

What makes the 10-bed acute patient facility unique is that it is led by geriatricians - physicians who specialize in the geriatric population. 

 

“In all the research I’ve done, there’s never been a geriatrician-led behavioral health unit. It’s always been led by psychiatry,” says Walker. “We look at the whole person - mind, body and spirit. Here, the psychiatrist is a consultant.”

 

Patients go though a referral process before being admitted to the facility. They must meet criteria laid out by the Centers of Medicare and Medicaid CMS). 

 

“It could be a patient who is a danger to themselves or others, a patient who has had behavior problems in a care center, assisted living facility or the community,” says Walker. “We get a lot of patients from emergency rooms.”

 

A social worker takes the clinical information on each patient and reviews it with the inpatient nursing manager and the geriatric provider who is on call before admitting the patient. Every patient is seen by a geriatrician within 24 hours of admission.

 

“We look to make sure whether there are medications that might be causing some of the behaviors we’re seeing,” says Walker. “Are there underlying medical health issues that might be going on? We like to involve the family, so we ask what their loved one was like before they started to notice symptoms of dementia.”

 

Every patient is also seen by a psychiatrist within 60 hours of admission.

 

“We have people who are mentally ill, they just happen to be age 55 and up,” says Walker. “We’re working with them to make sure they’re not a danger to themselves or others and to make sure they have the correct psychiatric medications.” 

 

The typical stay at the facility is 10 to 14 days. During that time, providers are also looking at longer-term services.

 

“We’re working with facilities inside and outside the community to find the best fit for the patient, and a place where families can visit them,” says Walker. “We do a lot of placements to assisted living facilities and skilled nursing facilities, but we’ve also returned people back home to their loved ones, which has been very rewarding.”

 

The center recently admitted a patient who was taken to an emergency room by her family because of behavior issues.

 

“She’s been with us for almost two weeks. We discovered some medications that were causing some of the confusion, and worked with family to see how she was before,” says Walker. “Now she’s ready to go to a  rehabilitation facility before she goes back home.”

 

While at the center, patients have the opportunity to be involved in a number of activities, including pet therapy, baking and cooking, yoga, music therapy, aromatherapy and art therapy.

 

The center recently purchased a piano, and it has made an impact.

 

“I’ve found geriatric patients love music. Frequently, when they can’t remember a loved one they can still remember how to sing a hymn,” says Walker. “And sometimes a patient doesn’t remember what year it is but remembers how to roll out dough for baking.”

 

The center just received CMS certification by the Minnesota Dept. of Health (MDH) in October after a three-day evaluation.

 

“There are a number of standards we have to meet and safety is number one,” says Walker. 

 

The unit was built with safety in mind. There is special shatterproof glass in every window, tamper-resistant screws, locked ceiling tiles and a wandering path with video monitors in all public hallways. Each patient has to be seen visually every 15 minutes.

 

As part of their inspection, MDH also reviewed charts, nurses’ credentials and looked at how patients were treated.

 

“They make sure we have an interdisciplinary team approach - nursing, social workers, physicians, psychiatrist, family involvement, and that we always try the least restrictive alternative treatment options possible,” says Walker, “and that we always look at the holistic aspect of each patient.”

 

For more information on CentraCare Health – Monticello’s Geriatric Behavioral Health Unit, call 763-271-2885.