Whether referred by a physician or taking their own initiative, those entering the Bariatric Program at Hillcrest Commons are in for much more than weight loss assistance.
Aimed at “overweight residents who are unsuccessful in conventional weight programs,” services based in the Berkshire Healthcare Systems-affiliated facility in Pittsfield range from consultations with a nutritionist and group meetings, to learning to manage lifestyle alterations.
Skilled nurses provide 24-hour comprehensive medical care. According to Carlette McDaniels, director of the Bariatric Program, they help patients manage things like their blood sugar levels and working on the physical ailments that commonly plague people who are overweight. Nurses also assist those who may enter the program after undergoing gastric bypass or other weight-loss surgeries.
Physical and occupational therapists assist in conjunction with medical staff. Physical therapists work with patients to improve walking and mobility, as well as minor strength training. As they lose weight, increased movement and exercise are very important components, McDaniels said.
Work with occupational therapists is equally important, because a broad lifestyle change is underway during patients’ time at Hillcrest. Dealing with the “more functional stuff,” they help patients re-learn things like showering, cooking and using the bathroom, yet now in a much different way. Coping skills and dealing with stress are also a focus, McDaniels said, as group meetings help patients deal with issues of depression, grief, and loss.
“We deal with how these issues and feelings relate to food in that particular patient’s life,” she said.
Behavioral services are offered for patients as well. Sometimes when patients enter the Bariatric Program they additionally require some type of psychiatric care, such as for dementia.
They deal with issues of co-dependency. According to McDaniels, sometimes a patient’s family or friends add to the problem by directing their support in the wrong way. She said it is crucial, particularly for those who are severely overweight, to come to the program armed with the support of their loved ones.
“We had one woman here once whose family would cry on the phone to her, telling her that they missed her and wanted her to come home,” McDaniels said. “That wasn’t helping her at all. She needed to stay here or she was going to die.”
Taking the First Step
Patients in the program are typically referred by a primary care physician, or they enter on their own. Referral by a health care provider gives staff at Hillcrest more initial information, as a consultation with that provider offers a look at what the patient’s needs are. According to McDaniels, those who are ‘self-referred’ meet with staff to determine what their goals are, whether surgery is an option, types of weight-loss programs they’re interested in, and ways to continue the work through services available in the community.
The Bariatric Program is equipped to handle varied length stays. Those enlisting in the short-term program stay for a period of 90 days. Short-term patients are typically those who are preparing for weight-loss surgery such as gastric bypass; a person must be at or below a certain weight in order for the procedure to be safe and successful. Those who have recently undergone such surgery and are now looking for additional therapy, whether physical, occupational or behavioral, are also typical in this shorter program.
The longer-term program is most often utilized by patients who have decided that weight-loss surgery is not for them. McDaniels said that while some simply need this longer period of time through the weight loss process, often those who choose this route are looking to lose weight naturally through diet and exercise changes.
Either way, she noted, they need to be willing to make a commitment to the program and to the improvement of their own health.
Learning a New Way of Life
Another major part of the program is accountability. McDaniels noted that it is often too easy for people to blame others for their situation, a pattern that enables patients to go into ‘emotional retirement.’
“The risk in this program is having to take a look at yourself and take responsibility for yourself,” she told The Healthcare News. “Taking ownership for yourself is a big component.”
The program focuses, too, on independence and helping patients take better care of themselves. Everyday activities like reaching a towel in the bathroom or tying shoes seem mundane, she said, but can be quite difficult for someone who is severely overweight. She added, though, that it sometimes takes an individual time to learn that they can, in fact, perform such tasks on their own. That’s where the bariatric program’s lessons in independence come in.
“It’s about independence,” she explained. “I worked with one man who would ask me to get things for him. I’d say, ‘you can reach your towels here, because when you’re back at home there won’t be anyone there to do it for you. We deal with taking care of themselves and how to address difficulties they may have.”
Staff at Hillcrest want patients to leave the facility with the skills and confidence needed to be part of the community, said McDaniels. Such confidence is built in a number of ways, she continued, listing part-time work in the Hillcrest Commons gift shop or participating in fun activites as just some of the ways patients can begin to feel better about themselves.
“We help patients take healthy risks, and do things that they normally would be too self-conscious to do,” she told The Healthcare News.
Overall, McDaniels believes the supportive environment at Hillcrest Commons’ Bariatric Program allows people to not only work on and maintain their physical health, but their equally important emotional health as well.
“I really enjoy being able to help people, this is a great place,” she said. “We give people hope and that’s so great.”
More information about the program is available online at www.hillcrestcommons.org, or by calling (413) 445-2300.