Spotlight: Magan Olson, Clinical Supervisor

Here I am, hoping to write a great blog post about Magan, one of HealthStar’s Mental Health department superstar Clinical Supervisors. She has this great HealthStar history that goes back to the beginning of the Mental Health program (spoiler alert – she was one of our first interns!). But I keep catching myself looking out the window and thinking about, well, lots of other stuff. It’s not that I don’t like what I’m doing, I just sometimes can’t get myself to buckle down and do one task at a time. My brain wants me to think about grocery shipping, what my kids are doing while I work, and a whole list of “other duties as assigned” when I’m trying to complete a task. Please tell me I’m not alone in this?

While writing the post that was published earlier this month, I talked with Magan about health and wellness ideas (she is a great resource for mental health wellness!). My conversation with Magan reintroduced me to mindfulness, which is basically paying more attention to where you are in the moment, instead of splitting your attention with all those other distractions. For me, this is a true exercise – it is very difficult at times. Some days, I swear my brain tries to purposely stop me from checking off my list. I’m still able to accomplish a lot, but just think of what I could do if this wasn’t happening!

Wait, what was that again?

Truth is, this distraction is normal to some degree. While it’s hard to overcome, we can learn to make peace with our distracted nature. Magan says that a focus on mindfulness has made a big difference for her – just taking those few minutes to breathe and be present has helped her to stay grounded. Magan also says that exercise has helped her with her personal health and wellness journey. A little extra energy and a boost in serotonin can go a long way to improving your mood and state of mind, especially in this long and snowy MN winter!

Here’s the thing – if I can learn these things from Magan by asking a few general questions, just imagine how amazing it could be if we knew all her secrets! Oh, OK, maybe not all of them, but at least a few? Well, I am lucky enough to tell you three amazing things about Magan right now! Magan, the HealthStar spotlight’s on you!

Responsibility, much?

Magan is one of those people who you just know will get back to you. Maybe it’ll take a day or two, but you never question that the response will be coming your way. She knows how to prioritize, and she absolutely understands responsibility and attentiveness. I assume that this comes at some cost to her, personally, because there are times when all of us are overwhelmed… but I don’t see her letting things go. To Magan, it is clearly important to meet the needs of others and to follow through on her commitments.

Her focus on responsibility makes Magan an amazing resource for her team. She has been a go-to on many projects, going back to her days as an intern! I won’t bore you with the details, but there are plenty of good reasons why Magan was hired as our first Mental Health Practitioner. We just couldn’t let her escape after her internship here! Tim Plant, former Executive Director at HealthStar, may not be here today, but his good hiring judgment still hangs around wherever Magan gets assigned. I’m sure Sherry Fridlund, current Director of Mental Health Services, would agree that this was one of Tim’s greatest decisions.

The eyes!

It happens so quickly – you might think you’re just shooting the breeze, and then, all the sudden, you get the look. If you’ve talked to Magan, you know what I’m talking about. It’s all in the eyes. It’s the look that says “I’m here for you, I’m listening to you, there is nothing else that matters right now, and I will help you fix all of your problems.” If you’ve never experienced this before, let me tell you, it’s quite the feeling. She listens like no one else I have ever known. No judgment, no unwanted advice, no interruptions. Just listening. It’s a kind of being heard that you might not realize you need until it happens. The kind that just validates you as a person and says “it will all work out OK.”

Honestly, this is the look that I want to see when I just have that “I want my mommy” feeling. Yes, I still get that even though I’m a mom, myself. I just want someone to calmly validate that my feelings are my own, and to tell me, in a soothing voice, that things will work out. I’ve never been Magan’s clinical patient, but I think this is exactly how it would feel.

Magan says that she feels honored to have someone tell her their story and to support them through whatever it is they’re going through. She considers it a privilege to connect with people and help them to find their strengths, whether they’re HealthStar team members or Clients in the field. I feel Magan’s honest commitment to as her co-worker, and I know the staff at the St. Paul office all feel it, too! If Magan is also serving warm milk to the Mental Health staff and Clients, I wouldn’t be surprised.

An object in motion

The rules of motion tell us that an object in motion stays in motion unless acted upon by an outside force. In Magan’s case, she can be both the moving object and the outside force, depending on the situation. If you need help getting motivated, Magan can apply a little force. But when Magan herself gets moving, she’s a force all her own. Magan says that she loves running, walking, hiking, and just generally being outdoors. It’s not hard to guess that she’s an active person – she looks great, and always has pep in her step!

Keeping physically active is just one of the ways that Magan stays healthy. I also mentioned earlier that she has a personal focus on mindfulness. Magan says that for her, this means concentrating on just being present in the moment throughout the day. She expressed the need for mindfulness really well:

“It’s easy to feel like you’re missing your own life… Take a few deep breaths and remind yourself to be present.”

Magan Olson

I know that feeling! Going home after a busy day, I just don’t want to engage. The problem is, the evening is the only time I have with my family. If I disengage, I’m missing out on that little bit of time which is the most important part of my day. Learning a little more about mindfulness from Magan has helped me to find that if I spend a “mindful moment” on the car ride home, I can re-center and be more present by the time I get back to my loved ones.

Each of us has different obstacles to wellness, but the goal is the same – continue moving towards our personal goals. This is why Magan is just the ticket – she can help you identify your unique obstacles and show you just the right force to apply to get those obstacles moving out of your way!

Magan, all wrapped up

There you have it – Magan Olson, in three parts. Responsible, attentive, engaged – she’s a triple threat! She’s a go-to when you’re in need, on so many levels! If you know someone who could use a little wellness help, check in with us and find out for yourself what Magan and the St. Paul staff have to offer!

Understanding Schizophrenia

HealthStar Home Health is presenting a series on various mental health and behavioral health topics. In this series of articles, we take a look at different subjects and provide information to help you know how best to care for your loved one.

The Mayo Clinic defines schizophrenia as a severe mental disorder in which people interpret reality abnormally. This chronic condition may present itself with a combination of hallucinations, delusions, and extremely disordered thinking and behavior that impairs the daily functioning of a person.

According to the National Alliance on Mental Illness (NAMI), schizophrenia affects about 1% of Americans. The illness can occur at any age, but the average onset typically is in a person’s late teenage years to early 20s for men and late 20s to early 30s for women. Due to its nature in that schizophrenia is a severe mental disorder that affects how a person thinks, feels, and behaves on a daily basis, people struggling with this may seem as though they have lost touch with reality.

Contrary to what many believe, schizophrenia is not multiple personalities or a split personality. Most who suffer from this illness are not violent towards others and do not pose a threat to others. Common misconceptions are that schizophrenia is brought on by childhood experiences, poor parenting is a driving factor, and that symptoms are the same for all. These simply are not true. In fact, research shows that a combination of genetics, brain chemistry, and environment are contributing factors to the development of this disorder. At HealthStar Home Health, our caregivers are educated in this disorder and support our clients by responding calmly, ensuring medications are taken as prescribed and understanding potential situations that may trigger symptoms or disrupt normal activities.

Here at HealthStar Home Health, we serve individuals in our adult and children’s mental health programs that are diagnosed with schizophrenia as well as other mental health disorders. When serving individuals with schizophrenia, we understand that coping with this illness is difficult. We have learned that our clients who suffer from any form of mental health disorder tend to have great insight into their symptoms and we support and use that insight when caring for them.

Symptoms and the severity can widely vary, but typically involve delusions, hallucinations, or disorganized communication as well as an impaired ability to function. Symptoms can include:

  • Delusions
  • Hallucinations
  • Disorganized thinking and speech
  • Abnormal motor behavior
  • Negative symptoms

To learn more about each symptom as well as risk factors, treatment options and more, visit:

We invite you to learn more about the mental health services offered by HealthStar Home Health. Both our Children’s Therapeutic Services and Supports (CTSS) and Adult Rehabilitative Mental Health Services (ARMHS) feature cultural sensitivity and are provided with empathy to the underserved members of the communities and regions we serve.

Our highly trained and culturally competent multi-disciplinary team of mental health professionals, practitioners and behavioral aides provide CTSS and ARMHS services in the home, school, and in the community.

HealthStar Home Health understands how overwhelming and challenging it can be to care for a loved one at home and also offer a variety of home health care services to help support your loved one to live a more independent and fulfilling life at home. To learn more about the various mental health and behavioral health topics being presented in this series, such as autism, seasonal affective disorder (SAD), and bipolar disorder, visit our blog.

With cultural care values as the foundation, our caregivers are able to provide quality service, delivering it with increased awareness and perspective. As we serve our clients and communities, we are motivated by our desire to bring services to everyone in need. Call us today at 651-633-7300 for more information or to schedule a no-charge consultation.

Understanding Autism and What is Covered Under the Spectrum Umbrella

HealthStar Home Health is presenting a series on various mental health and behavioral topics. In this series of articles, we take a look at different subjects and provide information to help you know how best to care for your loved one.

Autism Speaks defines autism, also referred to as autism spectrum disorder, as a range of conditions characterized by challenges with social skills, repetitive behaviors, speech and nonverbal communication, as well as by unique strengths and differences.

The Centers for Disease Control and Prevention (CDC) reports that an estimated one in 68 children in the United States has autism and considers autism a national public health crisis. Furthermore, approximately four out of five individuals with autism are male. With these dramatic numbers, more families than ever are affected by autism, and evidence shows that an early intervention has positive results.

Here at HealthStar Home Health, we serve individuals in our adult and children’s mental health programs that are diagnosed with autism. When serving individuals with autism, one of our main goals is to help treat the mental health condition that is often underlying such as depression, anxiety, or PTSD. Often times individuals who have a neurodevelopmental disorder tend to be “overlooked” by mental health professionals, thus the underlying mental health condition is missed and not treated at all. In turn, this becomes an important focus for the HealthStar Home Health mental health team of professionals. Our team is committed to helping these individuals reach their full capacity and achieve the highest level of independence while simultaneously improving their quality of life.

Research shows there is not just one autism but many types, each triggered by a combination of genetic and environmental factors. The term spectrum in autism spectrum disorder refers to the wide range of strengths and challenges each individual with autism lives with.

Typically, the symptoms begin to appear around the ages of 2 and 3 years, although sometimes even earlier. If your child exhibits symptoms of autism, it may be a good idea to follow up with further evaluation, but keep in mind that children without autism may also show some of the risk factors. The following are possible red flags to watch for in the development of babies and toddlers:

  • Limited eye contact
  • Lack of smiles or joyful expressions
  • Lack of nonverbal communication, including gestures such as reaching or pointing
  • No babbling or use of words
  • No response to name

As autism awareness has grown, many older children and even adults have been diagnosed. Similar risk factors may suggest autism at any age:

  • Struggles with emotions and other people’s feelings
  • Avoids eye contact as well as social settings
  • Remains nonverbal
  • Is affected by changes to routine
  • Performs repetitive behaviors, such as rocking, as well as repeats words or phrases

We invite you to learn more about the mental health services offered by HealthStar Home Health. Both our Children’s Therapeutic Services and Supports (CTSS) and Adult Rehabilitative Mental Health Services (ARMHS) feature cultural sensitivity and are provided with empathy to the underserved members of the communities and regions we serve.

Our highly trained and culturally competent multi-disciplinary team of mental health professionals, practitioners and behavioral aides provide CTSS and ARMHS services in the home, at school, and in the community.

HealthStar Home Health understands how overwhelming and challenging it can be to care for a loved one at home and also offer a variety of home health care services to help support your loved one to live a more independent and fulfilling life at home. To learn more about the various mental health and behavioral health topics being presented in this series, such as bipolar disorder, schizophrenia, and seasonal affective disorder (SAD) visit our blog.

With cultural care values as the foundation, our caregivers are able to provide quality service, delivering it with increased awareness and perspective. As we serve our clients and our communities, we are motivated by our desire to bring services to everyone in need. Call us today at 651-633-7300 for more information or to schedule a no-charge consultation.

Behavioral Health Home

HealthStar Home Health provides unparalleled public healthcare services through stewardship, honor-driven values, and a genuine desire to serve individuals in our community. We are a culturally sensitive healthcare team that provides services to individuals who are traditionally underserved. In an effort to expand the range of healthcare services offered to our clients, HealthStar Home Health now offers a Behavioral Health Home program.

What is Behavioral Health Home?

BHH (behavioral health home) refers to a model of care focused on integration of primary care, acute, behavioral health and social services and supports for adults with mental health conditions.  Delivered either in the patient’s home or in a group setting, such as an assisted living community, BHH services utilize a multidisciplinary team to provide person-centered services designed to support a person in coordinating care and services while reaching his or her health and wellness goals.

Who is eligible for BHH Care?

BHH is for adults, 18 years and older, who have a qualifying mental health condition and who are enrolled in medical assistance.  Qualifying mental health conditions include, but are not limited to:

  • Generalized Anxiety
  • Major Depression
  • PTSD
  • Bipolar Disorder
  • Borderline Personality Disorders
  • Schizophrenia Disorders

Individuals who do not have a formal diagnosis or who are not sure if their mental health condition will qualify them for services are encouraged to call our office at 651-633-7300.  A HealthStar Home Health BHH staff member can provide additional information.

What BHH services are available with HealthStar?

Behavioral health home services typically focus on delivering client-centered services designed to support an individual in coordinating care and services while reaching his or her health and wellness goals.  End goals of the HealthStar Home Health BHH program include:

  • Comprehensive Care Management – A collaborative process designed to manage medical, social, and mental health conditions more effectively
  • Care Coordination – Implementation and monitoring of holistic plan to help identify appropriate linkages, referrals, coordination and follow-up to needed services and supports
  • Health Promotion Services – Encourage and support healthy living concepts to motivate individuals to adopt healthy behaviors and promote better health management and wellness
  • Comprehensive Transitional Care – Specialized care coordination services that focus on the movement of individuals between different levels of care settings
  • Referral to Community and Social Support Services – Identify and provide referrals including but not limited to, medical and behavioral health care, entitlements and benefits, respite, housing, transportation, legal services, educational and employment, as well as many other specialized and supportive services
  • Individual and Family Support Services – Activities, materials, or services aimed to help reduce barriers to achieving goals, increase health literacy and self-efficacy skills as well as improving health outcomes

The behavioral health home program coordinates and integrates well with other services we offer individuals in the communities HealthStar Home Health serves. Services such as home health care, mental health services for children as well as adults, and personal care are how we help make strong communities and families and enable individuals of all ages to live more independent lives.

How do I get started?

HealthStar Home Health is proud to offer culturally-relevant services that address the unique needs of our population. Contact HealthStar Home Health directly by calling 651-633-7300 for more information or to schedule a no-charge consultation. Care coordinators, care managers, and health care professionals are also welcome to call for general information. To learn more about HealthStar Home Health and the range of services we offer, visit our website:

Common Causes of Depression in Older Adults

Are you or an older adult you care for suffering from more than a case of the winter blues? Winters in Minnesota can have an effect on some as well as the lack of sunlight, but if you or a loved one are experiencing loss of appetite, low energy, feelings of hopelessness, amongst other symptoms, then you may be experiencing depression. You are not alone. The National Alliance on Mental Illness (NAMI) reports an estimated 16 million American adults had at least one major depressive episode last year. That is over 7% of the US population.

According to the Mayo Clinic website, depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also known as major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems.


As a person ages, various life events such as the death of a loved one, retirement, or medical problems are experienced. It is common to be stressed or sad when managing these types of changes. When a person is suffering from depression, the feelings of stress and sadness do not go away after a normal adjustment period. The feelings are ongoing, worsen and interfere with daily life and normal functioning. As a branch of the U.S. Department of Health and Human Services, the National Institute of Mental Health (NIMH) is the lead federal agency for research on mental disorders. NIMH identifies 5 Common Causes of Depression in Older Adults:

  • Genes – People with a family history of depression are more likely to develop it. In older adults, those who had depression when they were younger are more at risk to develop depression later in life.
  • Brain Chemistry – People who have depression may have a different brain chemistry than those without the illness, leading them to be more likely to develop it.
  • Stress – the loss of a loved one, a difficult relationship, or any stressful situation can trigger depression.
  • Changes to the Body – Changes to the body and brain as we age can cause depression. Older adults who suffer from restricted blood flow may have blood vessels stiffen, which prevents blood from flowing correctly to the brain.
  • Other Illnesses – Depression can co-occur with other serious illnesses such as diabetes, cancer and heart disease. Sometimes medications taken for other illnesses may cause side effects that can contribute to depression.

Since many people think the various signs of depression is a normal part of the aging process and a natural reaction to illness or social transition, depression often goes untreated in seniors. Medication and psychotherapy are common treatment options for depression, but there are other options as well. People over the age of 65 must be careful when taking medications. Oftentimes seniors may be more sensitive to medications or are taking various prescriptions for other health conditions when they add a medication for depression. This can lead to several issues, including forgetting to take a dose, overdosing and even a bad drug interaction.

Psychotherapy is also a very effective way of treating depression and other forms of mental illness. Often referred to as talk therapy, psychotherapy teaches a person new ways of thinking, behaving and helps to change habits that are contributing to the depression. Many seniors would prefer psychotherapy rather than add more medications to take each day and studies show that for older adults, psychotherapy is as effective as taking an antidepressant.

At HealthStar Home Health, we understand that mental health disorders begin in the early years – for many as young as childhood or early teenage years. We recognize the alarming statistics surrounding mental health conditions and offer Children’s Therapeutic Services and Supports (CTSS) for the adolescent age. Services through our CTSS program include, but are not limited to, specialized skills training, behavioral aid services and individual, family and group psychotherapy. For those suffering from depression or other form of mental illness in the adult years, HealthStar Home Health offers services through the Adult Rehabilitative Mental Health Services (ARMHS) program. The clients we support are struggling with disorders such as:

  • Major depression
  • Schizophrenia
  • Bipolar disorder
  • Agoraphobia

Becoming educated and helping to raise awareness of mental health conditions can break down obstacles and improve the recovery of millions of Americans who suffer from a mental disorder. If you’re concerned about a senior loved one showing signs of depression, don’t wait to get help. HealthStar Home Health offers support to families dealing with mental health disorders, whether it is an adult in the family, a senior loved one you are caring for, or children and teenagers, we have a program to help you.

Spending quality time with family, friends and being active in your Minneapolis, Minnesota community will help you stay healthy, but sometimes you may need a little more support. Contact HealthStar Home Health directly by calling 651-293-1000 and ask to speak to a professional in the Adult Rehabilitative Mental Health Services (ARMHS) department or the Children’s Therapeutic Services and Supports (CTSS) department.

Feeling a Little Anxious?

We all feel anxious at times. In fact, occasional anxiety is a normal part of life. People may feel anxious when dealing with a problem at work or home; students feel anxious when preparing for a big test or interacting in a new social situation, and when important life decisions need to be made the anxiety level can grow for just about anyone. But for people who suffer from an anxiety disorder, their extreme feelings are not temporary and cause such distress that daily activities and the ability to lead a normal life is difficult to manage. This level of anxiety disorder is a serious mental illness. The constant and overwhelming worry and fear is disabling, but with proper treatment, people who struggle with this learn to manage their feelings and live a fulfilling life.

There are many different types of anxiety disorders, including the following:

Panic Disorder: recurrent, unexpected panic attacks including sudden feelings of terror. Common symptoms of a panic attack are heart palpitations, sweating, trembling, and a feeling of choking or difficulty breathing. Symptoms usually strike suddenly and without warning.

Generalized Anxiety Disorder: a person with this type of disorder will display excessive anxiety or worry for long periods of time and face symptoms such as muscle tension, problems sleeping (difficulty falling or staying asleep, or restless sleep), and constant restlessness or being on edge. This excessive, unrealistic worry and tension can go on for months, even if there is nothing to provoke the anxiety.

Social Anxiety Disorder: this worry centers around a fear of being judged by others and social situations where you may be embarrassed, rejected or ridiculed. Also known as social phobia, common symptoms include feeling highly anxious and self-conscious, feeling nauseous or sick to the stomach, blushing and sweating when around other people. This type of anxiety disorder involves extreme worry about everyday social situations and tends to make the person stay home instead of go in public.

Specific Phobias: these are extreme, intense fears of a particular thing or situation. Typically, the fear level is not proportionate to the situation and will cause a person to completely avoid everyday situations. Depending on the specific phobia, the symptoms will be similar to previously listed symptoms, such as heart palpitations, sweating, dizziness, and difficulty breathing.

If you or a loved one have a mental health condition, such as anxiety disorder, you are not alone. 1 in 5 Americans experience a form of mental illness in any given year, and world-wide 1 in every 20 adults is living with a serious mental health condition. Mental illness is not your fault, but there is still a widespread stigma surrounding mental illness largely due to misunderstandings or lack of education. Unfortunately, many people suffering from mental illness do not get help or seek treatment, but there is help available!

HealthStar Home Health offers therapeutic services to young people through our Children’s Therapeutic Services and Supports (CTSS) program. We also have a program focused on adults and their needs with our Adult Rehabilitative Mental Health Services (ARMHS) program. HealthStar Home Health is sensitive to the cultural needs of each person in our care and we offer culturally-relevant services to those suffering from mental health issues and teach a variety of skills that will help with independent living and social situations. We serve individuals and health care professionals in the Minneapolis and St. Paul area, as well as Duluth, Minnesota, Arizona and New Mexico.

At HealthStar Home Health, we believe if we join together as a society, people living with mental illnesses will be treated with respect and acceptance. We are here to help – contact us today!

Mental Health – How Can We Remove The Stigma?

The numbers are staggering. According to the National Alliance on Mental Illness (NAMI), 1 in every 5 adults in America live with a mental health condition. Approximately 13.6 million adults in America live with a serious mental illness, and one-half of all chronic mental illness begins by the age of 14; three-quarters by the age of 24. Recently, Yahoo News reported a study from 2014 by the American College Health Association finding there is an epidemic of depression and anxiety among college students. Almost 30% of college students reported feeling depressed at some point over the past year and 54% of students reported feeling overwhelming anxiety.

For those who live with mental illnesses, their conditions have been kept secret and often go untreated for fear of embarrassment. There is a stigma associated with mental illness that is furthered when one takes medication to treat the illness. Whether it is depression, anxiety, bipolar disorder, or another form of mental illness, it can be debilitating and should not go untreated. Help those suffering by learning what a mental illness is, the causes, and what you can do to ease the stigma surrounding this.

HealthStar posed this question on Facebook: “What do you think is the most misunderstood thing about mental illness?” Here are some of the top answers from our followers:

  • that it affects everyone differently and it comes in all forms and begins at any age
  • people don’t realize it can be treated
  • mentally ill people are potentially violent
  • society’s lack of information and education on mental illnesses cause the stigma to grow
  • talking about mental illness and being available to listen goes a long way – remove the awkward silence

“Make it OK” is a local campaign created to reduce the stigma of mental illness. Their mission is to get people to stop the silence, share stories, and dispel the myths surrounding mental illness. The people behind are changing the hearts and minds about the misconceptions of mental illness by encouraging open conversations and education on the topic, along with encouraging people to seek support when needed. Treatments for mental illnesses are available. The more everyone knows about mental illness, the more understanding and supportive we, as a society, can be.

The Make it OK website offers good, basic, information like what a mental illness is and is not, and what a mental illness can be caused by. They also offer great tips for talking to someone who struggles with mental illness. If a loved-one has told you they are suffering, ask questions, show concern, and most importantly, listen. Mental illnesses are treatable health conditions but people are still afraid to talk about it due to shame, misunderstanding and negativity, amongst other reasons. Help remove the stigma surrounding mental illness and its treatment by learning, listening and keeping the conversation moving.

At HealthStar Home Health, we recognize the alarming numbers of adolescent and young adult depression and offer Children’s Therapeutic Services and Supports (CTSS) that focuses on cultural sensitivity and we provide these services with empathy to the underserved people in the communities and regions we serve. Some of the services we offer through this program are:

  • Individual, family and group psychotherapy
  • Specialized skills training
  • Crisis assistance
  • Behavioral aide services

For the adult years, we offer services through our Adult Rehabilitative Mental Health Services (ARMHS) program. The clients we support are dealing with these and other issues and disorders:

  • Major depression
  • Schizophrenia
  • Bipolar Disorder
  • Agoraphobia

HealthStar looks at how the individual’s mental illness affects their functioning in various aspects of their lives. They may have depressive symptoms that interfere with independent living, self-care, school, housing and even transportation. The services we provide are community based. This allows our caregivers to go out into the community and meet the individual where they are so they can be as independent and functional as possible within their communities. HealthStar strives to remove the stigma by teaching those living with mental illnesses and their family members a variety of skills that can help with independent living and social situations.

Getting educated and helping to raise awareness of mental health conditions can break down obstacles and improve the recovery for the millions of Americans who suffer from a mental illness. If we join together as a society, people living with mental illnesses will be treated with respect and acceptance.

A Day in the Life of a Psychiatric Field Nurse

7:00 am: Amelia Muir, psychiatric home care nurse begins her day by logging into her laptop. After checking e-mails and confirming appointment times with patients, Amelia is ready to enter the field for her four scheduled home visits in Queens, New York. Queens, a borough of New York City, is home to more than 2 million residents and is considered one of the most diverse areas in the country.

8:00 am: Amelia’s first visit is to see Ms. A., a 62-year-old woman who has been living with HIV for the past 25 years. Ms. A. was referred to Amelia by her caseworker, who noticed signs of depression and anxiety following a recent hospital admission. For the first 30 minutes of the visit, Amelia provides counseling to Ms. A. using cognitive behavioral therapy techniques, which aim to help her reframe negative thought patterns and begin to change ineffective coping mechanisms. After her patient has had the opportunity to express her feelings openly, Amelia shifts the visit to focus on specific symptoms she and Ms. A’s doctors have been closely monitoring. The home care visit is a vital way to keep doctors updated on a patient’s condition as many patients feel certain symptoms are either not important enough to call their doctors or nurses about.

The last 15 minutes of Amelia’s visit with her patient focuses on goal setting and educating the patient about her recommendations for whatever issue they had been discussing. In addition to patient-centered goal setting, Amelia also adds her own suggestions, such as taking a walk around the neighborhood with the home health aide for exercise and stress relief, calling an old friend, or taking time to sit down with a good book. “Many of my depressed patients are in need of more joy in their lives. It may seem overly simple but with the right frame of mind, escaping into a novel or a hobby can have noticeable effect on someone’s mood.” To close the visit, Amelia reviews a list of important symptoms to report to her nurse or doctor with Ms. A. Establishing good communication between patient, nurse, and doctor helps prevent hospitalizations by addressing issues at the earliest appearance. Ms. A. tearfully hugs Amelia at the end of most visits and thanks her for her support. The authentic relationship established between clinician and patient after weeks or months of working together cannot be understated.

Back in her car and mobile office, Amelia checks voicemails and e-mails from other clinicians and patients. Between every visit, arise that require careful coordination. It is often said in the office that being in the patient’s home is the easy part, meaning the real work is often done by clinicians behind the scenes. The case management aspect of home care nursing can drive the stress level up in this specialty.

10:00 am: Amelia’s next patient is Ms. G., a 74-year-old who is experiencing a high level of anxiety because of her progressing amyotrophic lateral sclerosis disease. Amelia has been coming for several weeks after Ms. G.’s daughter begged her to accept psychiatric treatment when she noticed her mother’s motivation to care for herself significantly declined. The first half of the visit is again focused on allowing the patient to have time to express her feelings openly to her nurse. Ms. G. describes how her breathing has become more difficult. One of the interventions Amelia teaches her is how to preform deep abdominal breathing exercises to decrease anxiety and improve lung expansion. She also recommends that Ms. G. play classical music during this exercise to give an added stress-relieving quality. After reviewing goals for the week and target symptoms to report, Amelia begins a short relaxation exercise with the help of aromatherapy oils and acupressure. “I love home care because I have more flexibility to try different strategies with my patients.” Using a simple acupressure technique on both hands creates a calming sensation for Ms. G. She teachers her how to use this technique on her own.

Technology is also an important part of Amelia’s teaching strategies for patients who have access to computers or tablets. Ms. G. was an accountant before she retired 3 years ago and is part of a growing group of tech-savvy seniors. On and earlier visit, Amelia helped Ms. G. explore Web sites, such as YouTube, that provide free instructional videos on topics relevant to the wellness teaching she provides including guided meditation, chair yoga for seniors, and breathing exercises. Ms. G. is also learning to use her tablet for recreation, “I love the videos of the New York City Ballet. It brings me back to when I could move like that!”

1:00 pm: At a nearby apartment complex, Amelia greets her next patient’s wife, who is the primary caregiver for her husband. Mr. C. is in the middle stages of Alzheimer’s disease and has been experiencing many behavioral changes that have caused great stress for his wife. Amelia sits down with the couple in their brightly lit kitchen and reviews symptoms over the past week. During her visits, Amelia explains the different stages of his illness, communication techniques, safety precautions, tips for managing insomnia, and encourages Ms. C. to keep her husband’s mind stimulated with structured activities and recreation. Another important topic Amelia covers is caregiver burnout and she encourages Ms. C. to take time for herself whenever possible.

3:00 pm: For her last visit, Amelia visits Mr. B., a man in his late 50s who is now homebound as a result of Parkinson’s disease. Despite increasing physical challenges, Mr. B. is determined to stay as independent as possible and spends 3 days per week doing intensive treatments with a physical therapist. Amelia visits this patient every 2 weeks to fill his medication box as muscle weakness in his hands prevents him from doing this for himself. Mr. B. updates Amelia on symptoms over the past week and excitedly discusses his progress with his rehabilitation program. Amelia finishes the visit with a quick check on his vital signs.

At the end of her visit, Amelia returns back to her car to make the trek back to her home where she will complete her visit notes and make some final calls to doctors. After another emotion-filled day, Amelia tries a breathing exercise of her own. “Helping patients with depression and anxiety can take an emotional toll on clinicians and it’s vital for me to have self-care rituals so that I don’t become burned out,” adding “I want to do this work for the rest of my career and my goal is to take good care of myself along the way.”

Written by Amelia Muir, BSN, RN-BC

Amelia Muir is a Psychiatric Field Nurse, Behavioral Helath, Visiting Nurse Service of New York, New York City, New York.

Managing Holiday Stress

For some, the holiday season is “the most wonderful time of the year” but for those with mental health issues, seniors and caregivers, it’s also a time that manifests hopelessness and loss. People often get caught up in the commotion the holidays bring with all the extra commitments, emotions and expectations, making it easy to lose focus. Before you know it, stress and depression have taken over and it’s tough to dig yourself out, especially for those already dealing with mental health issues. It may sound simple, but what can help is to remember what matters most in life.

Here are some reminders to keep you focused on what’s important this holiday season in order to stay healthy both mentally and physically.

Keep it Real. As much as you may want the holidays to be perfect for you and your family, let’s be realistic… they aren’t. And that is ok! When life throws you a curve ball in the way of travel delays from the icy Minnesota roads, poor health or an unfortunate accident, try to adjust and go with the flow. Even your long-standing holiday traditions over the years may need to adjust to accommodate changes that come your way. Who knows, you just may find a new favorite tradition!

Plan ahead. Schedule time to do your shopping, baking and extra activities. If you don’t plan out your day, it will easily get away from you and then you’ll be rushing to get things done or end up forgetting something important. If you’re unable to leave a senior or someone with mental health issues that you’re caring for, consider respite.

It’s ok to say no. Decide in advance what is important to you, your family and the seniors in your life, then stick to your plan. You are not a superhero with more hours in your day as your secret weapon so instead, attend the events that are important to you. Spend time with the people you love most and who feed your soul, paying careful attention to avoid those that bring negativity into your life. Your spirit will thank you.

Be Healthy. Daily exercise, good sleep and healthy eating habits will keep you feeling your best this holiday season. It’s ok to treat yourself to the cookies and indulgent meals, but don’t over do it. Weight gain will lead to depression and low self-esteem, which in turn will prevent you from feeling your best. Don’t forget to carve out some time for yourself – take care of yourself first.

Set a Budget and Stick to It. The joy of gift giving will fade quickly if you know you will be buried in debt when the holidays end. Instead, determine a budget that works for you and stick to it. If money is tight, be creative with your gift giving. You can make a donation or volunteer your time to a charity in someone’s name, give the gift of spending time together or give homemade gifts. Your loved ones will appreciate this too, especially homebound seniors.

Volunteer. Volunteering your time is a great way to help those who are less fortunate. There are so many great non-profit organizations in Minnesota that need a little extra help during the holiday season. Volunteering teaches your children the invaluable lesson to give back to their church and Minnesota community. It makes you feel good inside and keeps the holiday spirit alive.

Seek Support If You Need It. Don’t be ashamed or afraid to ask for help if you need it. Spending time with family, friends and your community is helpful in staying healthy, but sometimes you need a little more support. At Healthstar Home Health, we offer Adult Rehabilitative Mental Health Services (ARMHS) for adults 18 years and older who have a qualifying mental illness and are eligible for medical assistance that want to improve their life. ARMHS is not case management or traditional therapy, but instead is mental health services aimed at teaching you skills for managing your mental health symptoms and can get your through the busy, unpredictable holiday season. Contact HealthStar directly by calling 651-633-7300 and ask to speak to a professional in the ARMHS department.