Treating the Emotional

Well-Being of Older Adults

Highline Geriatric Psychiatry Center

Highline’s Geriatric Psychiatry Center has expanded into a standalone specialty program called Cascade Behavioral Health. Click here to learn more.
24-hour admission
(206) 244-0180

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Click on the name below to read more about that practitioner.

Khurana, Rahul, MD
Jeanette, Michelle, MD
Trigg, Lisa, PhD, ARNP

Manager: Sarah Stover
Phone: (206) 901-8452

Geriatric psychiatry is the specialized field of psychiatry that treats older adults. Older adults often have complex needs and difficult life changes that can adversely affect their emotional well-being. The combination of medical and psychiatric issues can make the diagnosis, care and treatment of the older adult challenging. Geriatric Psychiatry Services at Highline was created in 1989 to address these special needs. We were the first specialized geriatric psychiatry program in Washington State.

Older adults experience many changes as they age, often losing a spouse, family members and friends. Added to that is retirement or illnesses that bring on major life changes that can easily overwhelm a person. These events can trigger depression and anxiety or mood disorders that are best treated by specially trained psychiatric physicians, nurses and therapists.

Highline's Geriatric Psychiatry Services program offers a continuum of care that includes individual appointments with the psychiatrist, outpatient group therapy and inpatient hospitalization, all directed by a board-certified geriatric psychiatrist.

An experienced geropsychiatric nurse is available to consult with family members about the mental, emotional and physical needs of their loved one. To speak with our intake and referral nurse, please call (206) 248-4713.

Range of Services

  • Inpatient treatment
  • Outpatient assessments and treatment
  • 24-hour admission access

Intake and Admissions

Initial screening is usually done through telephone contact. The admissions coordinator (during regular business hours) or the charge nurse on the unit (evenings and weekends) will gather information to determine if the client being referred meets Medicare criteria for acute inpatient hospital stay. If there is no recent medical workup, the client may be referred to his or her local emergency room for medical clearance prior to admission. Patients must be medically stable prior to admission.

Referrals or requests for evaluations can come from physicians, other healthcare providers, clergy, legal authorities and self-help groups as well as the patient, family and friends. There is always someone available to consult with the caller as to resources and options, even if an inpatient stay is not needed or appropriate. Admissions to our inpatient unit are available 24 hours a day, 7 days a week. For more information or to request an evaluation, please call the admissions coordinator at (206) 248-4713.

Inpatient Treatment

Our inpatient unit provides intensive medical-psychiatric treatment and medication stabilization in a homelike setting. Our patients are typically 55 years and older with a primary psychiatric problem. Inpatient treatment is often the best option for older adults suffering from severe anxiety, depression, agitation, paranoia, fearfulness or hallucinations.

Upon admission, patients undergo a comprehensive assessment that includes a thorough psychiatric and medical evaluation. Psychologists who specialize in testing the older adult (geriatric neuropsychologists) perform cognitive evaluations on appropriate patients.

Inpatients are treated by both a geriatric psychiatrist and a medical physician. The patient's psychiatrist leads a professional, multi disciplinary team that includes medical doctors, social workers, nurses, occupational therapists and psychologists. Physical therapy, nutritional consults, speech therapy, audiology and other specialty services are available depending upon the patient's needs.

The inpatient program is customized for each individual's particular needs. The length of stay will vary according to many factors, but is generally 12 to 16 days. Medicare and most private insurance plans cover inpatient treatment when certain criteria are met.

Outpatient Treatment

Most patients begin the outpatient program by attending group therapy one or more times per week (our groups meet  Monday through Thursday). Eventually, as patients progress toward their own individualized treatment goals, the schedule may be reduced to one or two groups per month. Many patients conclude their treatment after 10 to 15 sessions; some stay longer. The program is voluntary and decisions are collaborative between the patient and the patient's family or close support persons (if the patient wants this), the physician, the group therapists and the clinical coordinator.

In outpatient geriatric psychiatry, the group therapist works with patients who can be helped by the group experience and who can be learning partners for one another. In meetings, people are encouraged to talk with each other in a spontaneous and honest fashion. The therapist provides productive examination of the issues or concerns affecting the individuals and the group while guiding the discussion.

Outpatient Clinic

Our outpatient clinic involves one-to-one evaluation and follow-up treatment with a psychiatrist specializing in geriatrics. Appointments to see our psychiatrist can be made by calling (206) 248-4585.

Psychiatric Evaluation and Treatment

Patients are admitted for an acute psychiatric and/or behavioral issue; patients are evaluated for appropriate interventions to address each patient's needs.

Medical Evaluation and Treatment

A comprehensive medical evaluation is completed with each patient on admission. Any acute medical issue is addressed and each patient is followed by a medical doctor as well as a psychiatrist.

Psychological Testing

When the psychiatrist feels psychological testing is indicated, he or she will order neuro/psych testing by our consulting psychologist, who has worked with us for a number of years and whose expertise is invaluable.

Medication Management

Medications are reviewed for potential interactions; in some cases medication regimes are simplified and in other cases they are modified. Each patient is looked at individually.

Group Psychotherapy

Outpatient therapy groups provide a support network for specific problems or challenges. The psychotherapy group is different from support and self-help groups in that it not only helps people cope with their problems, but also provides for change and growth. Occasionally some of our inpatients will attend our group therapy for psychotherapy and group processing while they are staying on our unit.

Patient and Family Education

Ongoing assessment is made with each patient and family. Education is offered when requested or assessed as a need. Additional information is available through our Planetree Library upon request.

Continued Care Planning

Each person is evaluated as an individual and his or her needs and strengths are evaluated to determine the best individual care plan for prompt recovery.

Functional Assessments

Our occupational therapists, physical therapists and social workers work together with our nursing staff to evaluate each patient's strengths and areas of need and to offer suggestions and training to enhance his or her level of functioning to the highest level possible.

Nutritional Evaluation

Patients who have a nutritional need are monitored and appropriate diets are ordered by the medical physician. Education is provided to the patient and/or family. The dietitian is available to consult and provide additional interventions when indicated.

Dementia, Memory and Cognitive Functioning Evaluations

Each patient has a "Mini Mental Status Exam" on admission. This gives a general review of the patient's short-term memory impairment. When there are concerns identified about rapid changes or conflicting assessments, some patients are referred for additional psych testing by our consulting psychologist. The psych testing enhances our ability to solidify the diagnosis and to identify the patient's areas of need.