Aging is not only hard on the body, it can also be very difficult emotionally. Clinical depression is an illness that’s related to an imbalance of substances in the brain called neurotransmitters. It effects more than two million of the 34 million Americans age 65 and older, according to the National Institute of Mental Health, and is considered a major public health problem. For those seniors who are dealing with a health challenge, the percentage of depression more than doubles. Chronic pain and drugs to relieve it may contribute to depression as well as some cardiac, blood pressure and other medications. Unfortunately, signs of depression are often overlooked, under-diagnosed and untreated when they coincide with other medical illnesses such as diabetes, heart disease or stroke and life events like the loss of loved ones.
The emotional health picture for seniors has been improving significantly in Douglas County since 2010 when Vitality for Life was launched at Carson Valley Medical Center in Gardnerville. An intensive outpatient mental health wellness program, it has transformed, and literally saved the lives of older adults for the past five years.
Frank Jacobelli, LCSW, is one of a team of four licensed therapists who work at Vitality for Life with psychiatrist Dr. D. Vuppalapati and a nursing staff under the direction of Andrea Highfill. Together they design, implement and evaluate a plan for each patient who typically spends three months in the program.
“The often misunderstood disease of depression is not a result of weakness, poor life-choices, or morale failings,” Jacobelli stresses. “Like diabetes, depression is an illness that’s totally treatable.” Untreated depression can lead to serious consequences including increased social withdrawal, worsening physical health problems such as cardiac disease and even suicide.
Depression is also not “just the blues.” Seniors “suffer more loss than the general population—loss of spouse and friends, independence, activities or work they can no longer do,” Jacobelli explains. “Healthy grief is a normal response, a way to process this loss.”
But when a person is depressed, they experience “periods of profound sadness, isolation, chronic pain, they might have lost a sense of purpose, lost a sense of pleasure in the things they used to enjoy, have low energy, and find it hard to concentrate,” he says. Patients may also be sleeping excessively or having a lot of insomnia and can be preoccupied with death and dying, including having suicidal thoughts or plans.
When a patient comes to Vitality (typically referred by their physician), the first step is a confidential and comprehensive intake interview with a therapist to gain a full medical and emotional history. “We identify the problems and then develop an individual treatment plan for each patient that includes their medical, medication and psychological needs,“ Jacobelli says. Once a patient enters the program (which is usually covered by Medicare and supplemental insurance), they are expected to participate fully, from 9 a.m. to 1:30 p.m., four days a week for 50 days. There are 15 to 20 patients in the program at any given time.
Although group therapy three times a day is the foundation, Jacobelli says regular individual therapy, along with programs on nutritional training, Tai Chi, sleep hygiene, exercise, family and couples counseling are also offered. Patients receive a healthy lunch and snacks each day. Transportation can be arranged through the local DART bus system, if needed.
“In 30 years as a mental health professional, I’ve never seen people get better faster than they do in Vitality for Life,” Jacobelli says. Some enter the program having become very withdrawn, anxious, distrusting or unable to ask for help. In Vitality, patients are given a safe, secure, supportive, place to explore the challenges faced every day and gain, as well as practice, new coping skills to so they can lead fuller, more meaningful lives.
One patient he remembers is an example of how life-changing the program can be. “The woman had been abused her entire life verbally, sexually, emotionally — she had depression, PTSD, flashbacks, was totally isolated and had finally made a suicide plan,” he recalls. “At the end of three months she was so improved she could be social again, she was working and doing really well.”
The positive changes happening at Vitality for Life are inspiring for staff as well as patients. Graduates, (who leave with an aftercare plan to follow and may come back once a month for a year afterward), typically find new social outlets such as those offered at local senior centers or even find a new purpose by sharing their time and expertise as volunteers.
For more information on Vitality for Life, call 775-782-1599.
