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Community News
Community Program Crafted With Seniors in Mind
Psychiatric News
Volume 41 Number 21 page 15-15

A Maryland residential program for seniors who are both mentally and physically ill thrives on staff dedication. The staff, however, is not sure how much hands-on help is appropriate under Maryland law.

It is a crisp fall day in Maryland's Anne Arundel County. Mary Campbell, a dynamo who moves as fast as she speaks, is taking a call on her cell phone while cruising between the towns of Edgewater and Gambrills.

This is her turf, her domain. Campbell oversees four residential homes in the county for 24 seniors who have severe mental illness as well as high blood pressure, diabetes, cancer, or other medical problems.

She and her staff purchase food for the seniors and drive them to the doctor when they need medical attention. They also supervise the residents to make sure that they are doing well and carrying out their particular duties—washing clothes, fixing dinner, and other responsibilities.

Campbell's Senior/Somatic Program is one of the psychosocial rehabilitation programs offered by Arundel Lodge, a nonprofit organization, to Anne Arundel County residents with a serious mental illness. It is one of their most sought-after operations and appears to be cutting-edge from a national point of view (see article at right).

The idea for the Senior/Somatic Program originated in the 1990s under Arundel Lodge's then-executive director, Howard Eisenberg. In 1996, he hired Michelle Levy Croach, a psychiatric nurse practitioner, to help launch the program. He and others at Arundel Lodge also worked closely to identify patients living at the nearby state mental hospital, Crownsville Hospital Center, who would be good candidates for moving into the Senior/Somatic facilities. The first patient-turned-client arrived in December 1997. Also that month, Campbell, a former school principal, was hired as a direct-care worker for the program. She worked her way up to become manager of the program in 1999.

One of the challenges that Croach faced in developing the program, she explained during an interview, was that she knew a lot about psychiatric clients, but didn't have experience with rehabilitation. She noted that rehabilitation was developed to help people gain independence—to live independently and to work and become productive members of society.

“But working with an elderly population is different,” Croach says. “You are not planning on getting these people out into their own apartments and finding a job. So then we had to examine—and we are still struggling with this—what psychosocial rehab is for an elderly person. [Is it] a homelike environment rather than a nursing home or assisted living, and can they live out their days with us?”

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Mary Campbell takes a call on her cell phone while cruising between Arundel Lodge's headquarters and the residential home in Gambrills, Md.  Joan Arehart-Treichel

Also, how much hands-on help the program can give clients is not clear, Campbell pointed out, because the Senior/Somatic Program residential homes do not constitute assisted-living facilities under Maryland law.

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Yet another hurdle, Campbell added, was getting people living near the program's residential homes to accept having seriously mentally ill seniors as neighbors.

So she knocked on doors, introduced herself, and explained the program's mission before clients moved into the homes. She also attended homeowner association meetings in the communities to give people a chance to provide feedback about the program—“which was not always nice,” Campbell admitted. On the whole, however, these strategies and hard work paid off, she said.

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Arundel Lodge's headquarters is located in Edgewater, Md.  Joan Arehart-Treichel

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This home in Gambrills, Md., is one of the four residences for seniors with major mental illness in Arundel Lodge's Senior/Somatic Program.  Joan Arehart-Treichel

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Campbell said that a remaining obstacle is connecting the psychiatrists who care for the mental health needs of program participants with the specialists who tend to their other medical needs. Most of the individuals in the Senior/Somatic Program receive their psychiatric care from the same psychiatrist—Paul Giannakon, M.D., of Psychotherapeutic Services in Annapolis, Md.—which tends to ease that challenge. Giannakon is also Croach's collaborating psychiatrist, and they work closely together on patients' mental health needs.

Finally, Croach, Campbell, and their staff have to be creative at problem-solving. For example, what do you do when a manic program resident wants to cook at 3 a.m.? The answer: you surreptitiously turn off the stove before bedtime, Campbell said.

Despite the challenges, working with program participants has its recompense. “When we first started, it was so rewarding to see these people who had lived in institutions for a good part of their lives now live in a home,” Croach said.

Another outstanding aspect of the program, she added, is that when participants in other Arundel Lodge programs grow older and have medical problems, they can be transferred to the Senior/Somatic Program.

“One of our gentlemen developed a terminal cancer, and we loved him so much and had worked with him for so long that we didn't want to put him in a nursing home or hospice center,” Campbell recalled. “So we arranged for staff to volunteer their time and work off the clock to take care of him.... He was able to die at home with dignity in his own bed.”

She summed up, “I've worked with the Senior/Somatic Program for almost a decade now, and I enjoy it tremendously.” ▪

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Mary Campbell takes a call on her cell phone while cruising between Arundel Lodge's headquarters and the residential home in Gambrills, Md.  Joan Arehart-Treichel

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Arundel Lodge's headquarters is located in Edgewater, Md.  Joan Arehart-Treichel

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This home in Gambrills, Md., is one of the four residences for seniors with major mental illness in Arundel Lodge's Senior/Somatic Program.  Joan Arehart-Treichel

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