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Jewish Home Lifecare Launches Nursing Home-Based Geriatric Substance Abuse Program

New York City’s Jewish Home Lifecare, a large, diversified, not-for-profit geriatric health and rehabilitation institution, launched the country’s first nursing home-based recovery program for older adults dealing with alcohol and/or prescription drug addiction. The Jewish Home Lifecare Geriatric Substance Abuse Recovery Program, which will be located on Jewish Home’s Bronx campus, will start with a pilot expected to serve 720 patients over two years. At the end of the pilot, which is being underwritten by a $213,000 grant from The Fan Fox & Leslie R. Samuels Foundation, the program will become a full-fledged, self-sustaining operation expected to care for 480 patients annually.

The new initiative addresses the urgent need for a model of care that integrates addiction recovery into medical rehabilitation, also known as postacute care, for adults 60 and above. No facility in the country, including New York City, offers the twinned services, leaving hospitals struggling to find postacute locations willing to accept older patients with the dual need. Even facilities that accept these patients lack the expertise to tackle substance abuse. Patients ultimately return home with their physical problems resolved but their addictions intact, making relapse likely and creating an endless and costly cycle of rehospitalization (also known as readmission).

A Growing Crisis
Substance abuse among older adults is a complex and growing problem which often goes undiagnosed or is misdiagnosed. Even when correctly identified, it is insufficiently treated. In New York City, 17% of adults over 65 (170,000 people) suffer from alcohol abuse. In New York State, the fastest growth rate of substance abuse, 24% a year, is among older adults. It is estimated that, by 2020, approximately 5.7 million older adults in the United States will have a substance use problem.

Behind the numbers are the physical, psychological, and social changes that come with aging. Cognitive and medical conditions like dementia and bone fractures, common among older adults, are exacerbated by substance abuse. Older adults whose cognitive and/or medical problems have been compounded by addiction account for more than twice the number of hospital readmissions as adults without addiction issues.

Doctors often fail to identify substance abuse in this population because they are not trained to recognize it, they are embarrassed at having to screen older people for addiction, and they do not understand the role addiction plays in the medical problems of adults in this age group. To make matters worse, older adults dealing with addiction are much more resistant to treatment than their younger counterparts.

A Comprehensive Approach to Care
Each patient entering the Jewish Home Lifecare Geriatric Substance Abuse Recovery Program will receive an initial assessment to determine his or her medical rehabilitation needs and addiction-recovery needs. The resulting team-focused treatment plan will involve the family and will coordinate care among the physical and occupational therapy staff, mental health and addiction professionals, social services personnel, and organizations like Alcoholics Anonymous.

Similarly, when patients are ready to be discharged, the staff will work with each person and his or her family to make sure a support team is in place that draws on community recovery programs, thus giving the patient the greatest chance possible of long-term recovery.

Partnerships with local hospitals like Montefiore Medical Center and NewYork-Presbyterian, which often refer patients to Jewish Home for postacute care, will be essential to the success of the new program. Jewish Home has initiated outreach to other area hospitals as well, including Beth Israel Medical Center, Mount Sinai Roosevelt, and the VA Medical Center in the Bronx, and to Odyssey House, a program for older adults with substance abuse disorders.

“The Jewish Home Lifecare Geriatric Substance Abuse Recovery Program tackles a problem faced every day by our clinicians and by geriatric health care specialists around the country," says Gregory Poole-Dayan, associate administrator of Jewish Home Lifecare’s Bronx campus, where the program will be located. "With this integrated approach, we can offer truly comprehensive care to older patients dealing with both medical and substance abuse problems."

“We know from our own experience how acute the problem of alcohol and prescription drug abuse is among older adults," says Gary Kennedy, MD, director of the division of geriatric psychiatry at Montefiore Medical Center in the Bronx. "We also know that the kind of holistic approach being taken by Jewish Home offers the greatest chance of long-term success for these patients.”

The new program will be led by Steven Wollman, an addiction and mental health specialist who has worked with children, young people, and adults. Most recently, Wollman was the lead therapist and the creator and director of a substance abuse program for adolescents at Devereux Florida, part of the national Devereux Foundation, one of the country’s largest nonprofit providers of care for children and adolescents with emotional and behavioral disorders. Wollman holds master’s degrees in substance abuse counseling and education and in mental health counseling.

A History of Innovation
The Jewish Home Lifecare Geriatric Substance Abuse Recovery Program is just the latest in a long line of innovative Jewish Home programs.  In 2012, the organization launched Comfort First, a palliative care program for older adults with dementia based on a model pioneered by the Beatitudes organization in Arizona. A special unit to treat visually impaired older adults was created in 2007 in partnership with the Jewish Guild for the Blind, now the Lighthouse Guild. Earlier this year, Jewish Home and the Panasonic Corporation launched a telehealth pilot that turns home televisions into healthcare monitors, making it even easier for elders to age in place. And this coming fall, Jewish Home will break ground on New York City’s first long-term residence for seniors to be based on the GREEN HOUSE model of elder living, a revolutionary approach that emphasizes residents’ privacy, dignity, and autonomy.

Source: Jewish Home Lifecare