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One-on-one with...Montgomery (Monte) Ostrander.

From student to psychotherapist to administrator, Montgomery (Monte) Ostrander has followed a calling to address issues of depression, dementia and dying in senior care facilities by integrating therapeutic mental health services into a senior residential care program. As founder of Tree of Life Elder Care in El Cajon, Calif., Ostrander has created an integrative, therapeutic and holistic program for his residents. He shared his philosophy on eldercare in an interview with Long-Term Living Managing Editor Sandra Hoban.

How--and why--did your career transition from social work to senior residential care?

During my final semester at University of Southern California's online Masters in Social Work program, MSW@USC, 1 interned at different locations, serving the needs of different populations from a mental health standpoint. I was working with foster children, which was difficult for me. The foster care model extended my practice of psychotherapy to informal residential settings. This "take the couch to the streets" philosophy made me rethink how to use my new therapy skills. I took a course with Thanatologist Professor Cynthia Rollo-Carson and noticed a massive need for mental health professionals in eldercare facilities.

I opened Tree of Life Elder Care to provide free informal psychotherapy to the elderly residents of my four care homes and their families, integrating holistic support for the Bio-Psycho-Social-Spiritual needs of this population.

How does the Tree of Life differ from traditional nursing home care?

The idea of integrating psychotherapy into Tree of Life has been rewarding, but also challenging. It's very difficult to build a therapeutic alliance with someone suffering from cognitive impairment. Aging and dying are difficult topics for most people to discuss. My mental health practice has been helpful for family members to cope with the dying process.

Realizing that residents with dementia respond more to less external stimuli, my therapeutic approach focuses on anxiety relief, mindfulness and stress reduction. My original idea was to engage with each client one-on-one and begin addressing psychodynamic or case management issues, but as things usually go, the residents taught me how to treat them. Building new bonds, relationships or trust can improve their quality of life, make them feel more connected to the world.

In the first six months, all of my residents were able to discontinue antidepressant medication. I believe the most important change that affected their well-being was a change in diet.

Why such a strong emphasis on specialized diets?

I researched diet change and learned that gluten and sugars in processed food create free radicals that create inflammation, the source of all disease. Of course, no one is going to send their elderly parent to a gluten-free raw, vegan board and care, so we implemented these changes subtly. Spinach infused orange juice, fruit smoothies with fresh kale, ground turmeric on eggs; many of these are hardly noticeable, but they represent radical changes.

Memory is cellular, it exists as chemicals inside the brain. Until recently, we believed that brain cells were gone forever once destroyed. Now we know about neurogenesis. New brain cells can actually be formed and certain foods assist in this process: antioxidants, fresh whole fruits and vegetables. For example, a hospice patient was put on a total anti-inflammatory diet; he recovered and moved out. Food is medicine, without question.

What results have you witnessed? What are your future plans?

I've observed the struggle each person has in coping with death. Dying is a major life event; when it happens in Tree of Life homes everything sort of stops for a few hours, the energy in the room shifts. The loss of a loved one still has the power to traumatize.

With the Affordable Care Act, millions of Americans now have access to medical care for the first time. Imagine those who have lived their lives in poverty finally receiving proper care at the end. Hospice for the Homeless is my future plan.

Any advice for organizations that want to adopt your care philosophies?

Absolutely! I encourage other care facilities to do some research to find the holistic program that works best for their residents. Every facility should research diet change, which has had a positive impact on Tree of Life residents.
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Title Annotation:Q & A Boardroom
Publication:Long-Term Living
Article Type:Interview
Date:Sep 1, 2015
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