Caring for the Whole Person: Inside Riverside’s Senior Behavioral Health Unit

After more than two decades at Riverside—first as a mental health tech, then a bedside nurse in pediatrics and the ED, and now a nurse leader—Heather Lee, RN, manages Riverside’s Senior Behavioral Health Unit with a mix of experience and heart. “I’ve actually worked at Riverside for over twenty-three years,” she says. “About a year and a half ago, I became the manager of our senior behavioral health unit.”

What the Unit Is—and Who It’s For

Riverside’s Senior Behavioral Health Unit is a 13-bed inpatient program dedicated to older adults living with conditions such as major depression, bipolar disorder, schizophrenia, and dementia with behavioral disturbances. “Not every patient who has dementia needs a behavioral health unit,” Lee explains. “But, those patients who have disturbing behaviors such as violent outbursts qualify for our unit.”

Just as important is knowing what isn’t “normal aging.” As Lee puts it: “Normal aging does not include depression and sadness and loneliness. It doesn’t include confusion and wandering. It doesn’t include hallucinations and delusions. Those are symptoms that could warrant a stay on a behavioral health unit.”

Whenever possible, the team tries to help patients stay out of the hospital. “We want to start outpatient first,” she says. “But if our patients are to the point that they can’t take care of themselves safely, or if they’re at risk of harming themselves or somebody else, then they can use our care on an inpatient unit.”

Why a Specialized Unit Matters

Lee has worked on mixed-age behavioral health units and knows the difference. “Anybody from eighteen all the way up to someone in their eighties or nineties could be on the unit,” she recalls. “It was an interesting mix, but it was a lot.” With a smaller, senior-focused space, patients can get more individualized care. “It’s a quieter unit with more individual attention,” adds Lee.

Older adults often have medical comorbidities—diabetes, heart failure, stroke—that require close coordination. “My nurses are well versed not only in behavioral health, but also medical conditions,” Lee assures. “They are very creative in working together to figure out how do we make things better for this patient because every patient is different.”

A Structured Day that Adapts to Each Patient

Riverside’s unit opened on January 1, 2015, and its programming has steadily grown. “We set a structure to our day. Then, we edit that structure based on the needs of the patient,” Lee explains. Patients aren’t jolted awake at dawn, but the morning brings vitals, breakfast, medications, nursing assessments, and 9:00 a.m. group programming led by activity therapists, recreational therapists, nurses, and techs.

Some days take on a theme. “We have Music Monday and that’s really probably one of our most popular days,” Lee says. “It’s not just for fun. We tie it into the therapeutic part of the programming.” Discussions explore meaning, memories, coping skills, resources, and practical topics like finances—always tailored to current patient needs. For those unable to join groups, one-to-one sessions are implemented. Built-in rest time recognizes that recovery requires downtime, too.

“I love the fact that every day is different, even though there’s a structure,” Lee notes. “The structure helps people feel safe, but every day is different because it’s based on what the patient needs individually, but also as a whole.”

Supporting Families—Especially the “Sandwich Generation”

Lee brings a pediatric nurse’s mindset to geriatric care: the family is part of the patient. And many families are stretched. “A lot of times, family members are surprised this is their life.” Her message? You’re not alone—and it’s okay to seek help.

One practical resource she highlights is adult day care. A patient’s spouse told her, “It allowed me to continue to work. I get the break that I need.” Lee also urges caregivers to share the load—ask siblings, aunts, and others to help—and to connect early with primary care and support groups (including Riverside’s Alzheimer’s support group). “You can’t be one person’s caregiver twenty-four-seven,” she cautions, adding that caregiver health often suffers without support.

If you’re second-guessing choices, Lee offers reassurance: “You make the best decision with the information that you have at the time. Be okay with that.”

How to Access Care

If you think a loved one might benefit from inpatient senior behavioral health care, start with Riverside’s centralized intake department. “They’re wonderful experts in behavioral health who can guide the process,” Lee says. Many patients also enter the unit through the Emergency Department, which is appropriate when safety is a concern.

Above all, Lee doesn’t want families to hesitate. “We can make a difference. We can improve the quality of people’s lives, not only for our patient, but also for their family members,” she says. “It’s an invaluable resource, a gift we can give to the community to take care of our patients.”

For more information about behavioral health services at Riverside visit myrhc.net/behavioralhealth.