THE VIRGINIAN-PILOT
Copyright (c) 1996, Landmark Communications, Inc.
DATE: Friday, April 26, 1996 TAG: 9604250192
SECTION: VIRGINIA BEACH BEACON PAGE: 36 EDITION: FINAL
SOURCE: Pam Starr
LENGTH: Medium: 72 lines
Seventy-six-year-old Frances Dixon was being treated for depression earlier this year when she accidentally took too many antidepressants.
A two-week stint in a psychiatric hospital helped to stabilize her, but Dixon is now receiving a specialized kind of treatment. One that costs a fraction of hospitalization.
A psychiatric nurse visits Dixon twice a week to check her medications, talk to her and makes sure she's OK. Psychiatric home care, as it's called, has enabled Dixon to stay safely in her Pungo area home and has taken a load off her son's mind.
``I never knew that the hospital has people who handle things like home care,'' said Sonny Dixon. ``They give you someone to lead you around to what your options are. I had no idea what to do. They led me in the right direction.
``Mom's fine now.''
Psychiatric home care is the new kid on the mental health block, although the treatment has been around since about 1979. That's when Medicare started reimbursing providers for psychiatric home care. But few insurance providers today cover the cost of psychiatric home care, even though recent studies show that cost savings are enormous.
According to Verna Carson, the national director of behavioral health at Staff Builders, a home health agency, patients receiving psychiatric care in the home save the provider nearly 70 percent of what hospitalization costs. Patients normally hospitalized are those with bipolar disorder, schizophrenia, clinical depression and other mental illnesses.
``One inpatient day in a psychiatric hospital, with room and board, will cost between $400 and $1,000,'' said Carson, who was in town last week heading up a forum on this topic at Virginia Beach Psychiatric Center. ``The fee for home care service runs between $70 and $100 a visit.''
The concept is pretty straightforward. After hospitalization or doctor's services, a psychiatric nurse visits the patient at home to teach him or her about managing the mental illness. The nurse is responsible for educating the patient by providing information, helping the patient make up a behavioral plan, identifying stressors which may increase symptoms, checking medications and simply listening to the patient.
Carson said that by receiving psychiatric care in the home, the patient is less threatened, more comfortable and more in control.
``Patients tend to do better in their own home rather than in a hospital,'' said Carson, who was recognized in 1995 by the American Psychiatric Nurses Association for her work in psychiatric home care. She has also been a faculty member at the University of Maryland School of Nursing. ``But psychiatric patients tend to be the underdogs of the health care system. People tell them to `just pull yourself together' or blame them for their illness.
``There are some real inequities in the system.''
But Carson said that psychiatric home care is going to be a trend for the next century. Cost containment is the driving force for this kind of treatment, she said. Medicaid paid for home health care, including psychiatric care, for 4 million people this past year - twice as many as five years ago.
``Our goal is always short-term care and stabilization,'' said Carson. ``Health care is moving away from institutionalized care and into the home. Home care makes patients full partners in their recovery. It's a healing benefit.
``I think patients in general get better with home care.''
Intense, one-on-one treatment is the mainstay of psychiatric home care. The nurse will provide facts, remove blame and guilt, add compassion, teach coping skills and have a generous amount of patience, said Carson.
``We have to love these patients. Kindness is not enough by itself but it's a good foundation,'' Carson said. ``The home care model is not a therapy model but a teaching one. It's a very empowering way of working with people.'' by CNB