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
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?”
Mary Campbell takes a call on her cell phone while cruising between
Arundel Lodge's headquarters and the residential home in Gambrills, Md.
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.
Yet another hurdle, Campbell added, was getting people living near the
program's residential homes to accept having seriously mentally ill seniors as
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.
Arundel Lodge's headquarters is located in Edgewater, Md. Joan
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
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.” ▪