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September 12, 2002

Media Contact: Sue Pondrom 619-543-6163 spondrom@ucsd.edu

The newly designed unit includes mood-enhancing bright light, soothing wall colors, hand-picked paintings that show seniors in positive activities, and specially designed furniture geared to older mental-health patients.

An inpatient, outpatient, and community-based program, Senior Behavioral Health offers a combined psychiatric and medical approach for seniors age 65 and older. The number of Americans 65 and older is expected to double from 35 million today to about 70 million by 2030. In recent years, primary care physicians and geriatric specialists have seen an increase in the number of elderly patients with mental health problems, and expect this number to grow as the nation's baby boomers age.

Since UCSD's Senior Behavioral Health Program began five years ago, the number of inpatient stays has doubled. Nearly 300 individuals were hospitalized in the past year for disorders such as depression, dementia with agitation or psychosis, delirium, schizophrenia, bipolar disease, or substance abuse. Outpatient visits and consultations have grown, as well.

The patients admitted to the inpatient unit are evaluated for any underlying medical or biochemical problems, as well as their mental health disorders. Each patient receives a comprehensive assessment by a number or professionals including a geriatric internist, a registered nurse, a social worker, an occupational therapist and a board-certified geriatric psychiatrist. In addition, a neuropsychologist evaluates those patients who have concerns about memory. Treatment in the inpatient unit also includes daily participation in a diverse array of therapeutic activities designed to increase physical, mental, emotional and spiritual health.

Dilip Jeste, M.D., Estelle and Edgar Levi Chair in Aging, professor of psychiatry and neurosciences, and chief of the Division of Geriatric Psychiatry, notes that the new inpatient unit has been constructed with considerable thought about the general health care and welfare of the patients.

The program staff spent more than 18 months working with architects and interior designers to create a state-of-the-art environment for older patients who are experiencing a combination of acute psychiatric and medical problems. Design ideas were obtained from recent scientific and professional publications as well as from visits to recently constructed residential facilities in the community.

Daniel D. Sewell, M.D., the program's medical director, worked with several program staff members to select and frame museum quality posters depicting a cultural mix of older people in positive, active interactions.

Sonia Ancoli-Israel, Ph.D., a UCSD expert in sleep disorders and light therapy, provided input regarding light levels. For safety reasons, the hallways, central living room area and dining room are illuminated to a level of 2000 lux, which is sufficient to have a physiological effect and to help treat depression and circadian rhythm disturbances.

Additional design elements include:

• A walking loop, which allows patients to walk off feelings of restlessness or anxiety;
• Wall and floor colors in soothing shades of sage, cream, and taupe;
• Dark green floor segments are used in front of exit doors to discourage patients from going into areas not intended for their use. The dark green flooring serves as a natural cue to patients with cognitive impairment to avoid the area - it is believed that patients interpret these dark regions as shadows or holes, which could be dangerous;
  
• Exits not to be used by patients are painted the same color as the walls to camouflage the doors;
  
• Chair seats are covered in a dark print fabric, with chair backs in a lighter solid color, which helps patients with visual problems identify the chair seat more quickly and accurately. Table edges are made more visible with the use of a dark color that contrasts with the light surface.
  
• Soothing music in patient rooms is designed to facilitate sleep and relaxation;
  
• Patient beds can be lowered close to the floor, significantly reducing injuries from falling out of bed. Pressure sensors on the beds alert staff if a patient who is at risk of falling is attempting to get out of bed without assistance. To make patients more comfortable, the mattresses are constructed of a high-tech material that has been shown to reduce the occurrence of pressure sores and musculoskeletal pain. The beds also have the capability to weigh patients.

For more information about UCSD's Senior Behavioral Health Program, call (619) 543-3741.