FROM OUR experts
Stroke and depression risk addiction continued from page 12
“You don’t want to chalk these symptoms up just to the brain injury, but you also don’t want to panic and assume that any symptom is severe depression, because a stroke is upsetting. I expect there to be a degree of sadness there, and that’s OK when you notice that in yourself or your loved one aer a stroke.” Stroke patients are grieving the loss of their abilities, Michelle Woogen, PsyD so some sadness is to be expected. Depression can start right aer the stroke or not show up for a year or more, she said, noting that stroke recovery typically takes one to two years.
treatment program partners Upstate with St. Camillus
coping When she visits with patients undergoing rehabilitation, “I am looking for something that shows me that they are also coping. So, l
are they also focused on the future, talking about wanting to get back to work, driving, being with their grandchildren?
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are they engaged in therapy, or do they just want to bury their heads in the covers all day and refuse therapy?
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are they able to focus on things other than the stroke, such as pleasant memories and how other people are doing, rather than being hyper-focused on the stroke?
THROUGH A $2.1 MILLION GRANT, Upstate University Hospital has partnered with e Centers at St. Camillus and others to create a new treatment program for those suffering from illness and addiction that is helping people recover and freeing up hundreds of beds per year.
what to do
e Collaborations for Health Program involves Upstate and St. Camillus with support from CNY Services and ACR Health. It has been operating since April. e program was created to help an increasing number of intravenous drug users who are admitted to Upstate with life-threatening infections. ey require IV antibiotics for up to six weeks at a time, says nurse Kelly Mussi, assistant director of transitional care at Upstate. “Aer about three weeks, they aren’t critically ill, and they are pretty bored,” she says.
If loved ones or caregivers see symptoms of depression aer a stroke, Woogen advises talking with the patient’s physiatrist — doctor of physical medicine and rehabilitation — or, if the patient doesn’t have one, with the primary care provider. ey can help figure out whether it’s depression and help recommend a treatment plan that might include a mood-stabilizing medication and/or seeing a mental health provider. “Sometimes, talk therapy is the best medication,” she said.
Mussi and others identified that time as an opportunity to help patients address their addiction and begin treatments to aid recovery. If patients agree to participate, once they are stabilized on antibiotics, they transfer to St. Camillus, where five beds are dedicated to the program.
As patients receive treatment and support, the depression oen lis.
St. Camillus employs full-time addiction treatment staff from CNY Services and social workers from ACR Health who help patients secure safe housing and clothing and help maintain a treatment plan aer discharge. Patients receive daily counseling sessions about substance abuse and addiction.
“If they are able to have other conversations, that is a sign that they are coping, so I look for those as well.” Post-stroke depression can limit a patient’s participation in rehabilitation, which is part of the process of the brain’s recovery; it interferes with people’s quality of life and their involvement in the community; it increases the need for medical visits; and it increases the risk of death and suicide, Woogen said.
Woogen also treats people in rehab for a variety of traumatic and other brain injuries and works with their family members and caregivers.
advice for caregivers Woogen noted the toll a stroke and post-stroke depression can take on family members and caregivers. “It’s hard to watch a loved one experience depressive symptoms, and it’s very easy to want to tell them that everything is going to be OK. at’s a good thing to say, and it’s also a good thing to sit with them and say, ‘I know this is hard, and I’m here with you, and you let me know if there is something that you need.’ Try not to just say everything is good again, because it’s not. ey’re grieving, and that’s appropriate.” ●
winter 2019 l upstate.edu
Sixteen patients joined the program during its first six months, and 14 were discharged during that time. Of those, 11 remain engaged with addiction treatment. ●
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