Transplant Behavioral Health Team

The Transplant Behavioral Health Team at Hartford Hospital consists of licensed clinical social workers, psychologists and psychiatrists. This team supports transplant candidates, recipients and living donors.

The transplant journey can be challenging for patients and caregivers. It is common to experience distressing emotions before and after transplant. The Transplant Behavioral Health team can help! Our services include assessment, support, coordination of care, and counseling related to the transplant or living donation. We also can assist in referrals to community behavioral health services for caregiver, transplant patients and living donors.


Our Role

Transplant Social Work

As Transplant Social Workers, our primary goal is to promote the well-being of patients & their caregivers.  We also strive to respect and promote the rights of patients and self-determination.

Transplant social workers assess factors that relate to readiness for transplantation and living donation.

The assessment includes a review of patients’:

  • Financial and Social history
  • Support system
  • Understanding of transplant process
  • Motivation for transplant
  • Self-management with medical treatment
  • Psychiatric history
  • Substance Use history
  • Location & Lodging

Transplant Social Workers can assist with:

  • Referral to community resources
  • Housing, Transportation, Immigration, Disability, and other financial concerns.
  • Safe hospital discharge planning
  • Counseling for post-transplant and living donation adjustment concerns.
  • Finding a Transplant Mentor

Transplant Psychology

As Transplant Psychologists, our primary goals are to focus on how biological, social, and psychological factors influence health and illness, address barriers to transplant and living donation, and optimizing your health prior to surgery.

The Transplant Psychologist’s role is consultative, evaluative, and intervention-focused. The transplant psychologist will evaluate patients to determine barriers to transplant and living donation and provide recommendations on how to optimize your health prior to surgery. Transplant Psychologists also serve as a liaison for physicians and other medical staff.

Transplant Psychiatry

As Transplant Psychiatrist, our primary goals are to increase access to psychiatric services within the transplant program and treat common psychiatric disorders experienced by transplant patients and living donors.

The Transplant Psychiatrist’s role is consultative and evaluative.  The Transplant Psychiatrist will assist with short-term medication and behavioral health management to improve candidacy and manage behavioral health challenges post-transplant or living donation. 

Relapse Prevention Program

To be eligible for a transplant, you will be required to make changes in your lifestyle and document the lasting impact of these changes. There are not enough donated organs for every person who could benefit from a transplant. Transplant programs, such as the Hartford Hospital Transplant Program, try to make sure that a transplant will benefit each recipient and that the organs donated by others are used responsibly.

Patients with a history of substance use disorder, whether or not this was the cause of their organ failure, must show their commitment to a healthy lifestyle by following the recommendations of the Transplant Team both before and after transplantation.

Download the Relapse Prevention Agreement

What to expect and how to prepare for your Transplant Behavioral Health appointment:

During your Behavioral Health Assessment we will review your health status, readiness for transplant and post-transplant support plan. You will also be asked questions about your employment, substance use and psychiatric history.

Bring:

  • At least one support person.
  • A list of medications you are currently taking and any past psychiatric medications you have taken.
  • A list of past and present psychiatric or addiction services you have uses, including counselors, therapists and support groups.

Self-report Tools:

  • You may be provided with self-report tools to fill our before or during your appointment. These tools give us feedback on your current mood and other health symptoms.

Appointment Length:

  • First appointments typically take 60-90 minutes.
  • Follow-up appointments take 30-60 minutes.

Financial Planning

In order to be eligible for transplant at Hartford Hospital, patients are required to have adequate medical insurance coverage.  Prior to being evaluated for transplant, the transplant financial coordinators will check with your insurance provider to confirm your transplant benefits.  They will also confirm with your insurance provider whether or not the care you would receive at Hartford Hospital is covered. 

During your transplant evaluation you will meet with a financial coordinator who will review with you how your insurance covers your transplant and post-transplant medications.  It is important to note that insurance coverage within the same plan can change from year to year.  Maintaining full insurance coverage is vitally important due to the ongoing costs associated with transplant.  We rely on you to notify your financial coordinator if you experience a lapse in coverage or change in insurance providers.

Things to consider:

  • If you are working at the time of transplant, it is important to talk to your employer about policies that may be in place to help alleviate the financial strain taking the necessary time off may cause.  The amount of time out of work will be determined by the medical team and take many factors into account.  Your transplant team is available to help assist with any information that may be required to obtain these benefits (FMLA, SSDI, etc.).  
  • If you are receiving Social Security Disability Income (SSDI) at time of transplant you will continue to be eligible for this benefit for at least 3 years following transplant.  After this time, to continue receiving this benefit, you will need to have an alternate provider complete the documentation for a qualifying diagnosis. 
  • If you are receiving assistance paying for insurance premiums through the American Kidney Fund (AKF), this coverage will be limited after transplant.  This coverage will continue through the end of the calendar year following your transplant surgery.  For example, if you undergo transplant surgery in June, your this assistance will expire the end of December the same year.  Please let your social worker or financial coordinator know if you are receiving any assistance paying for insurance prior to transplant.
  • Travel expenses to/from the transplant center should be assessed if this is required for your transplant.  Also, if your transplant center is not close to your home, lodging close to the center before and after surgery should be considered as well.
  • Parking and food costs for family may be necessary.  Parking is available for a fee at Hartford Hospital parking garages or through valet (additional fees apply for valet).
  • If you have young children, additional childcare may be needed.

Resources:


Life after Transplant

For many people, getting a transplant can feel like getting another chance at life. There are many great things that come with getting a transplant, like having more time in the day and more freedom. There are also many things you should consider in your life after transplant that involve taking care of your new organ.

Getting a transplant is usually an exciting event, but because it is also a major life change, it’s normal to have all kinds of emotions afterward. If you’re experiencing feelings of anxiety, depression or guilt, please know that you are not alone; many transplant patients experience these feelings at first, for many reasons.

  • Mood changes may be a side effect of the immunosuppressant medicines you are taking.
  • You may feel stressed or anxious about your new lifestyle.
  • You may feel guilty about getting a kidney from a living or deceased donor.
  • If you have been on dialysis for a long time, you may feel guilty about leaving other dialysis patients ‘behind’ once you get your transplant.
  • Your family members may also have emotional changes as they adjust to your new lifestyle.

You do not have to deal with these feelings alone. Getting a transplant is a major life change, and it is normal to feel stressed and anxious about big life changes.

Reach out to your family and friends for support. Also, let your transplant team know about your emotional changes so they can help support you and adjust your medicines if needed.

Your transplant team can also refer you to a mental health specialist.

If you are planning on going back to work, the transplant team will advise you when it is safe to return.  You may be given limits on what you can do at work at least in the beginning (for example you should not lift objects that weigh more than 10 pounds).  If you need to find a new job, ask your social worker to connect you with a career counselor.


Keeping your transplanted organ healthy

To keep yourself healthy, and to make sure your organ works well, the following are extremely important:

  • Take your immunosuppressant and other medicines exactly how your doctor told you.
  • Know the signs of infection or possible rejection, then contact your transplant team right away if this ever happens.
  • Avoid being around people who are sick.
  • Drink plenty of water to stay hydrated.
  • Eat foods low in salt, fat, and cholesterol.
  • After you are cleared by your doctor, start an exercise routine such as walking, or biking.
  • Eliminate tobacco use
  • Avoid use of alcohol, drugs and other substances that are habit forming.

Behavioral Health

As is the case with many chronic medical conditions, transplant recipients are at increased risk of developing psychiatric disorders. The cause may be reactivation of a preexisting mental health problems or the development of a new symptoms because of the illness process or side effects from medications.  

The Transplant Behavioral Health Team can help you navigate your mental health by assessing and managing these disorders. It is very important to obtain proper behavioral health care because there is mounting evidence that suggests psychiatric disorders can affects patients health and outcomes after organ transplant.

Depression

It is important to receive treatment for depression, because these symptoms interfere with patients’ quality of life and can limit patients’ ability or motivation or adhere to their post-transplant medical regiment including taking medication, making appointments, self-monitoring, and exercise. 

Patients with depression may experience:

  • Sadness
  • Irritability
  • Loss of interest in usually pleasurable activities
  • Changes in appetite
  • Changes in sleep
  • Feeling slowed down
  • Poor memory and concentration
  • Feeling worthless or guilty
  • Morbid thoughts of death or suicidal ideation

Anxiety

Many transplant candidates and recipients experience anxiety symptoms. Prior to surgery patients often worry about their health, if they will get a transplant, and what the outcome of surgery will be. After surgery, patients and families are anxious about complications, medication side effects, rejection, and if transplant will actually improve their quality of life. Oftentimes, patients are in denial with the potential stressors that can occur after transplant and are caught off guard with the complexity of the transplant after care.

Patients with anxiety may experience:

  • Feeling nervous, restless, or tense
  • Having a sense of impending danger, panic or doom
  • Having an increased heart rate
  • Breathing rapidly
  • Sweating
  • Trembling
  • Feeling weak or tired
  • Trouble concentration or thinking about anything other than the present worry

Anxiety symptoms may increase with:

  • The stress of an ICU stay
  • Medical complications
  • Sleep deprivation
  • Post-operative complications
  • Graft rejection and/or medication side effects

Cognitive impairment

Immediately after transplant, some patients experience cognitive impairment including difficulty concentrating, memory troubles and confusion. Oftentimes these changes are reversible or managed with continued medical care.   

Addiction

All transplant candidates will be evaluated for past or present addiction.  Patients with a history of substance use disorders, whether or not this was the cause of their organ failure, must show their commitment to a healthy lifestyle by following the recommendations of the Transplant Team both before and after transplantation.  There are recovery support networks and treatment programs to help you achieve this goal. The Transplant Behavioral health team will partner with you to get the care you need.


Resources

Video:

Community recovery supports:

Hartford HealthCare Behavioral Health Network:

Behavioral Health Network