Medical center offers counseling for seniors

KELLOGG – The need was apparent in 2003 even though no senior citizen stood in Shoshone Medical Center’s lobby and asked for mental health counseling.

Everywhere hospital administrators looked, they saw the faces of grandparents. Statistics backed up their observations. North Idaho’s senior population – people older than 59 – had grown by 43 percent since 1990. And it is expected to explode by 200 percent by 2020.

Even more serious was the news about senior citizens’ mental health. Statistics showed that senior men in Idaho commit suicide at six times the national rate and the state ranks second in the nation for its inadequate access to mental health care.

“There was a definite need,” said Paul Lewis, Shoshone Medical Center’s assistant administrator. “The elderly population is highly valued, and we need to show our support in clinical health and mental health.”

Now, the medical center runs the state’s only mental health program specifically for senior citizens. It’s called Journeys, and it makes no money for the hospital. But it doesn’t cost the hospital money either, thanks to Medicare. Seniors didn’t flock to the program when it started, but now some patients say it has changed their lives.

“I felt I left it a new person,” said a woman who was referred to Journeys because of panic attacks. She agreed to share her experience if her name wasn’t used. “They gave me the tools I needed. I’ve been so enthused, I tell everyone.”

SMC was able to start the program because it’s a critical-access hospital – a special Medicare category. Critical-access hospitals are so small and rural that Medicare’s standard reimbursements, sometimes as little as 60 percent of cost to the hospital, aren’t enough to keep them operating. Medicare reimburses critical-access hospitals for the amount procedures cost them.

That added amount persuaded SMC Administrator Gary Moore to launch Journeys, said Kristina Nicholas, program director. “He said if we could break even and provide the service, great,” she said. “That speaks to his commitment to the community.”

A consulting firm in Virginia verified the need by finding no mental health programs for seniors in Sho-shone County even though the number of seniors was growing rapidly. Moore recruited Dr. David Wait, a Coeur d’Alene psychiatrist, as medical director and two clinical social workers as therapists.

That Journeys wasn’t an immediate attraction didn’t surprise Pearl Bouchard, director of Aging and Adult Services’ North Idaho office.

“That’s not a population drawn to using that type of service,” she said. Seniors never stop in her office to ask for mental health services, she said.

For its first six months, Journeys existed on life support. A few seniors came for individual counseling, but the program’s emphasis was on group therapy. Then, Nicholas, a licensed social worker, was hired to direct Journeys. She had no doubt about the need.

“I see seniors who’ve lost their identities. They’re no longer husbands or fathers, they’re alone, their health is deteriorating, their friends are dying,” she said. “They don’t think of those problems as mental health issues.”

Nicholas spread the word about Journeys to nursing homes, doctors, clubs and senior centers. Doctors began referring patients to the program.

The woman suffering panic attacks was referred.

“I was so panicky I would have done anything,” she said. “But when I listened to the other women in the program, I wondered how it would help me. No one else had panic attacks.”

She joined one of the two groups that meet five days each week and met with Wait every week for a year.

“After I finished, I understood about myself and how to deal with things,” the woman said. Medicare covered her costs. “I wish I had done this at 40 instead of when I’m almost 70. I recommend this a thousand times over for everyone.”

About 15 seniors are in the Journeys program now. Some drive from Coeur d’Alene and St. Maries, Nicholas said. Coeur d’Alene’s Dirne Community Clinic has applied for a grant to start a mental health program for seniors. Even nursing home residents in Kellogg attend Journeys therapy sessions.

“I’ve seen folks not eating or sleeping when they start, or they’ll cry,” Nicholas said. “When they leave, they’re in church or golf or gardening groups. They resume hobbies. I can’t tell you the joy I feel when I see the difference.”