Darlene Taylor, director of the LifeBridge geriatric psychology unit at Jay County Hospital, takes a phone call during a recent interview. (The Commercial Review/Steve Garbacz)
Darlene Taylor, director of the LifeBridge geriatric psychology unit at Jay County Hospital, takes a phone call during a recent interview. (The Commercial Review/Steve Garbacz)
LifeBridge director Darlene Taylor is talking about the mission of the geriatric psychology unit when a patient strolls into the doorway.
He informs her that she just missed all the girls who passed through.
Taylor’s office sits just inside the entrance to the unit at Jay County Hospital, and a few people have come and gone within the past 30 minutes, but no large group of girls.
He is suffering from dementia — one of a few patients in the unit that day being treated for the condition marked by a lack of memory.
Taylor acknowledges the statement and then asks if he is in pain again, as his hands are resting on his lower back just behind his hips. He replies that he’s OK today, exchanges a few more words and then heads back toward the common room.
Observation, such as the short exchange, is a key component of LifeBridge as the staff works with senior patients who have psychological conditions. During short stays of typically no more than two weeks, the LifeBridge staff uses observation, therapy and medication to try to help manage the deteriorating minds of its patients.
“It’s a senior behavioral health unit for people 55 years and older, and it’s for people who have some behavioral disturbance due to either some kind of mental illness or dementia,” Taylor explains. “This is a community of older people. Half of the people 85 and older get dementia. We’re talking about a community that needs a place like LifeBridge.”
The unit is tucked in the back of the hospital behind secure doors to keep privacy intact as well as preventing patients from wandering away and keeping the potential for agitating influences to a minimum.
Although Taylor acknowledges there are some negative perceptions in the community about LifeBridge because of its isolation, the biggest goal for staff members is to return its patients to the most “normal” life they can continue to lead.
“I think maybe the hospital and the community got the impression, ‘It’s so secret back there and you can’t go back there and it’s something you can’t talk about,’” Taylor said. “It’s society’s perception of mental illness and aging.
“We try to do everything we can to send them home,” she continued, explaining that a trip to LifeBridge doesn’t mean a patient will need to go to a nursing home — a common fear among the elderly community and affected families.
“Sometimes a patient can return to their home, but with the help of home health agencies,” said LifeBridge social worker Carla Blankenship. “We try to find a placement for the patient that can help them achieve their highest level of functioning possible with the lowest restrictive environment.”
Taylor said many patients are able to return home by themselves with a home health nurse or home with family members, or into an assisted living complex.
Ideally patients are “one-timers” who come in for a short admission and receive therapy or medication or both and are able to resume typical life outside of LifeBridge. Other patients however, may be re-admitted a few times as their conditions worsen or medications are no longer effective.
“When you do have a person who is mentally ill and has been for years or has dementia and they’re on a downward spiral, their brain changes are such that the medicines may not work after a period of time,” Taylor said.
“Sometimes they have a hard time verbalizing their feelings … most of our patients are coming from an age group where they lived through (The Great Depression) so during those years you just had to be tough. You were taught you didn’t need to express your feelings,” Blankenship said. “It’s interesting to talk with these people and get their perspective on their own lives and sometimes they need help opening up about these issues.
“When we can get them to open up, they’re like walking history books.”
Although working directly with patients is the main operation, LifeBridge staff members perform equally important work with the patients’ families.
“Families will need help with dealing with the disease that’s going on with the patient,” Blankenship said. “The need for family therapy is here. A lot of families are dealing with denial of the disease … or maybe an issue of differing opinions of whether the patient needs to go to a nursing home or stay in a home environment.
“Possible placement into a nursing home, that’s always difficult, because most people will always want to keep that family member with them as long as possible. There’s a lot of guilt because, ‘We don’t want to put mom or dad into a nursing home.’
“We work to provide linkage with other services that can help them if the patient goes back into their home, and then try to help the family deal with the situation emotionally because that’s often an issue.”
Getting families to understand dementia is important too, as the disease progresses in strange ways in which a patient’s mental state can deteriorate quickly.
“Families will think ‘Yeah for 10 years I’ve been taking care of him. Why is he now in the advanced stages?’ Well, that’s the nature of it,” Taylor said. “Even though they’ve gone along really well for a number of years, something can happen to trigger (the disease) … that throws them into the later stages.
“Dementia is kind of a stepwise progress, it’s not really linear,” she said.
While in LifeBridge, patients receive highly supervised care as the unit boasts a high staff-to-patient ratio allowing for significant interaction to occur during the up to two-week admission period.
“I love my staff because they are committed and they work hard and they’ll hang right with them and give them that attention they need and the patience they have to have down here,” Taylor said. “It takes a fantastically committed staff to stay here.”
The LifeBridge unit only has 10 beds, but while other departments in the hospital may experience lulls, LifeBridge is typically occupied as the hospital attracts psych patients from neighboring counties and beyond.
“Many times we’ve had more patients than (medical-surgical) and (obstetrics) have together,” Taylor said. “Our unit is bursting at the seams a lot of times.”
Staff members also have to be prepared for patients who are struggling with paranoia or aggression that can lead to physical confrontations, making the job stressful. Despite the rigors of the job, Taylor said most employees hired to LifeBridge stay for long terms.
Aside from the normal job responsibilities, Taylor said she felt the most important part of the job is remembering that the patients are struggling with neurological problems and can’t be held accountable for their actions.
“The dignity and respect is absolutely the most essential to me,” she said. “They can’t help it.”
LifeBridge’s staff is formed to handle admitted patients, but in the future Taylor would like to see it working with former patients outside of the unit or working to try to identify potential disorders outside the hospital’s walls.
“I would like to see us have an IOP, which is an intensive outpatient unit,” she said. “Some of the patients they might go back home … they might start getting a little bit of a exacerbation of their symptoms again. If they could just come into an intensive outpatient, it is like three days a week maybe three hours in a morning.
“We’d have a clinician that could say ‘OK this person is not doing so well. They might need to come back in.’ Or ‘Maybe they need their meds adjusted.’ We could keep an eye on them it would almost be like a follow up.”
Taylor said she’d also like LifeBridge to have a clinician to do home visits to check on progress or a social worker available to do group work in local assisted living facilities or nursing homes to try to catch worsening symptoms early.
“That after care, to me, is really so important,” she said.
One other future development for LifeBridge will be happening and could potentially be started by the end of this summer. The Jay County Hospital Auxiliary is helping to raise funds for construction an outdoor garden for the LifeBridge unit that would allow patients to get outside for a bit within a securely fenced area.
“It’s something that the hospital, that they didn’t feel like they could do it at this time,” said JCH volunteer coordinator Betty Krieg. “We’re getting some bids in, so I look for maybe the 1st of July, we may be digging back there.”
The auxiliary adopted the LifeBridge garden as its new major project for its annual Celebration of Lights fundraiser now that the hospital isn’t managing the medical alert service Lifeline. Krieg said the new project maintains the senior-age demographic that the celebration aims to aid.
“I hope it brings a smile to their faces, something they can get out there and just be able to sit out there and feel the air and listen to the birds,” Krieg said of the garden.
Taylor, too, expects the garden to be an important addition to unit.
“I can’t think of any other place that a person would come to other than a hospital that a person could not get out and go for a walk,” she said. “People who cannot get out to even get a breath or fresh air or hear the birds or see the sun or sit out in the grass.
“If we have a garden, that would be so therapeutic for those people just to get out for a few minutes,” Taylor said. “I think it will decrease behavior and agitation as well. It will help distract them … and give them something to talk about.”
Cardboard boxes fill one corner of Taylor’s office as the staff is preparing to temporarily move out for some renovations starting Monday, one of the few times the unit will be empty.
LifeBridge has been helping the senior community for six and a half years and will get some new flooring and fresh paint and then will be back in business assisting area seniors.
Within the wall behind Taylor’s desk, a dark window has a saying written on it in golden script. It reads, “Every day holds the possibility of a miracle.”
She admits with a laugh that the script was put up to distract people from the window, which used to look outside but has since been boxed in with a room for an MRI machine, giving the glass the look for a two-way mirror. Decreasing agitation and paranoia are definitely important in LifeBridge.
But in a unit where the care doesn’t end in a cure, only management, the message holds some meaning to Taylor.
“We do see miracles back here, and you really have to hope for those.”