If I were suffering from clinical depression and needed in-patient medical treatment for a short time, my choice would be the newly opened Wyman Center, a geriatric psychiatry unit at Mount Auburn Hospital in Cambridge. A visit last week and an extended conversation with three of the unit’s staff members left me with favorable impressions of the mental health services available there to people over age 65.
Advocates for elders have long complained about the way older people are shortchanged by the mental health care system. In my own family, I remember my mother, when she was still in middle age, reporting how a psychiatrist told her that she was too old for psychotherapy.
The United States Surgeon General, Dr. David Satcher, recently issued a report with an extensive chapter to the mental health of older adults. He takes note of the way many older people burdened with depressive symptoms are told that these problems “are to be expected at your age.” But the Surgeon General rejects this pseudo folk wisdom and insists that the symptoms often indicate disease that can be successfully treated by modern medicine.
Entering the Wyman Center, a visitor finds the physical space brightly painted and decorated with photos and other attractive objects. A large scheduling board posts the events of each week. Rooms of patients are simple but well equipped and another section features common rooms for social activities and dining.
The medical director, Dr. Joseph D’Afflitti, psychiatric nurse and co-director Rose Netzer, and chief social worker Anthony Piro talked with me at length about their work. What I most liked about the new center is the way these professionals work together in attending to the various needs of their patients.
The center’s publicity says it provides “comprehensive medical services that are integrated into each patient’s individualized care plan.” This means that psychiatrists, nurses, social workers, physical and occupational therapists, and others attend to whatever can improve the patient’s functioning.
To my satisfaction, team members also feel a concern about spiritual issues. Though a chaplain pays special attention to these questions, she can count on the interest of the other team members as well. As Rose Netzer reports, “We treat patients holistically: we dance with our patients, we sing with our patients, we pray with our patients.”
I labeled “justifiable pride” the staff leaders’ confidence about providing top-of-the-line health care. These professionals obviously care a lot about their patients and work hard to respond to a wide range of needs.
At the same time, they are realistic about the work setting. “I think inpatient hospitalization is hard on patients,” Rose Netzer frankly admits. “It’s very debilitating; you have to see to it that people do not become sicker when they come in. We want people back where they belong and treated there.”
The center staff works cooperatively with other institutions. Nursing homes, for example, benefit from consultation whenever a patient is to return to such residences. Also, of course, they keep the patient’s primary care physician informed about the treatments the center has provided.
Staff members confer extensively with the family members of patients. In this way they provide some “case management” enabling the family to support the patient after discharge from the hospital. This crucial service can give the healing that has taken place in the hospital a chance to take hold. And staff members will be glad to receive follow-up contact from the patients whom they have discharged.
Jeanette Clough, president and CEO of the hospital, conceived the idea of the Wyman Center. She expresses strong support for its work over the past two months and considers it an important addition to Mt. Auburn’s array of services. Of the center she says, “We hope it will be a real bridge among medication, medical, and psychological issues that will help keep elders functional, in their homes, and enjoying their lives.”
To be eligible for admission to the Wyman Center, a person does not have to live in Cambridge or adjoining towns. People can come from outside of Greater Boston. Financing, however, may be a problem for some. Though the basic source of payment is Medicare, not all health care plans do have arrangements with the center.
At the beginning I mentioned depression as a cause for admittance but there are many other reasons why a person would choose this center. There may be some cognitive problems, for example, issues connected with memory. These problems receive thorough evaluation by the staff, in connection with whatever other health issues may be discovered.
The center boasts easy access at (617) 499-5780, 24 hours a day, 7 days a week. The admissions coordinator promises to return calls within 10 minutes.
One can hope that this new service represents a move toward greater responsiveness of the mental health system to the needs of older people. Perhaps it can become a model for other institutions so that we elders will be better served.
Richard Griffin