Since losing her husband two years ago, 88-year-old Jean* has struggled with depression. Suzette S., a behavioral health nurse with VNSNY, had cared for the Nassau resident previously, and when she was reassigned to Jean’s case last August she could see that things had gotten worse.
“Jean had lost 20 pounds, wasn’t sleeping well, and had no interest in eating,” Suzette recalls. “Hospitalization was a real possibility.” While Suzette had made only limited progress before in treating Jean’s depression, this time was different: In recent months, VNSNY Home Care has introduced a new set of behavioral health protocols, including “triggers” that alert the home care team when behavioral health care is needed, new evidence-based clinical pathways, and a psychoeducation technique in which patients are encouraged to become involved in their own care.
In another important shift, VNSNY’s behavioral health nurses are now more pro-active in making recommendations to physicians about their patient’s psychiatric medications. Picking up on this, Suzette observed that Jean’s multiple medications were causing more problems than they were solving. “Their combined side effects were upsetting her more,” she says. Realizing the drug Remeron would address all of Jean’s symptoms, Suzette suggested substituting this medication for the others, and Jean’s primary care physician readily agreed.
Following the new care model, Suzette also explained to Jean about the new medication and the importance of taking it daily, and got her buy-in. “Within three weeks Jean was doing much better,” reports Suzette. “Today, her medication compliance is one hundred percent and she is a different person. She’s re-gained her weight, is talking and eating more, and has started cooking again. Now, during my weekly visits, she asks what she can make for me!”
“Without Suzette, I wouldn’t be in the good condition I am,” adds Jean. “She’s my soul mate.”
* The patient’s name has been changed for privacy.