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Western North Dakota to get its first geriatric psych unit

St. Luke's Home will open a geropsychiatric unit in April. (Kayla Henson / The Dickinson Press)

St. Luke's Home in Dickinson is entering into a cooperative agreement with the North Dakota State Hospital to provide psychiatric care to geriatric patients. The new 20-bed geropsychiatric unit would be the only one in western North Dakota.

None of the current nursing home residents will occupy the unit, and those currently residing in that space will be relocated throughout the building. Current patients at the North Dakota State Hospital in Jamestown will fill the beds.

"(Patients) would always be referred by us," said Rosalie Etherington, superintendent of the State Hospital. "More often than not, if not all the time, they would come through the State Hospital for the purpose of us stabilizing them before placement in the nursing home."

Etherington said they may also make referrals for patients at other psychiatric hospitals.

She said the State Hospital currently has a similar arrangement with two other facilities—one in Valley City and one in Ellendale. Both arrangements were somewhat influenced by capacity—as was St. Luke's.

"We were continuously full, and we recognized that there were a set of folks that although could leave the hospital, they could not because we didn't have another specialized facility," she said.

Etherington said facilities like these are suited to people who no longer need the level of care that a hospital provides.

"The North Dakota State Hospital, which is a psychiatric rehabilitation facility, should not necessarily keep anybody who no longer needs to be at that level of care. ... We would surely like to place people as soon as reasonably possible, (and) ... based on the specialized needs of the geriatric individual, it is sometimes hard to find a suitable nursing home that can meet those needs," she said.

Being the only facility of its type in the area, it will be helpful to individuals who live near here.

"If someone meets the requirements of being (at St. Luke's) and they're on this side of the state, they can see their family members easier and not have to go to Valley City or Ellendale or Jamestown," said Amy Kreidt, administrator and CEO of St. Luke's.

It is unclear whether some of the incoming patients will have a history of substance abuse of violent behavior.

Etherington said many psychiatric patients also have substance use disorder, but Kreidt said they will not accept patients who are currently receiving detox treatment for substance abuse, and they will not be providing detox services.

"Typically, they're not acute hospital patients, so we're not doing detox or anything in that area. ... Anyone in the building could have a substance abuse issue. We don't necessarily know, and we don't decide based on that. ... (Incoming patients) could have past drug or alcohol abuse issues, but so could anyone else in the building," she said.

Etherington said that a demonstration of violence is often one of the reasons someone is admitted to the State Hospital, so it is possible some of St. Luke's incoming patients could have been violent in the past.

"Many of those individuals that are identified in need of specialized geropsychiatric care would have had a history of violence, would have demonstrated or exhibited violence," she said. "In part, that is often why they are not identified as able to go back to a regular, typical nursing home. They have that highly specialized need. They need individuals responding to them in a very specialized way, a very trained way, to try and prevent any episode of violence."

Etherington said that the likelihood of any incoming patients exhibiting violence at St. Luke's is low.

"The purpose of them coming to us first would be that we stabilize that mental illness and diminish the potential for violence—not to say that it can't occur, but that the likelihood of it occurring by the time we place them in a nursing home is very low," she said.

Kreidt said that violent patients would not qualify to be at St. Luke's.

"We still have to maintain everyone's safety, theirs as well as the employees' and the other residents', so if they're violent, they wouldn't even be here," she said.

The psychiatric patients will be housed in a separate unit, but some may interact with nursing home residents.

"They may, it just depends on what they are capable of doing ... or the care that they need or the ability that they have to be with other residents," Kreidt said.

Though the projected opening date of the unit is April 1, it will take more time than that to make space for the psychiatric patients, as St. Luke's must wait until beds elsewhere in the facility become available.

Their goal is to have all patients moved by July 1, per the agreement, but Etherington said that date is flexible, and they would not require that nursing home residents leave the facility to make room.

"We would never make a request to displace somebody," she said.