Jan. 15-21, 2004
By Eileen Jevis/ SUN staff writer
SUN photo(s) Paul Finch
Elderly Care Strives to Help Maintain Independence as Long as Possible
Independent Living Services of Central New York is a comprehensive program that provides an alternative to nursing home placement among the elderly. The PACE model, (Program of All-inclusive Care for the Elderly) is the collaborative effort of Loretto and St. Joseph’s Health Care. The program was designed to consolidate care and financing to meet the needs of nursing home eligible persons. PACE is a managed-care program that provides services to its clients through contracts with a variety of health care providers including therapy services, medical services, socialization and respite relief for caregivers. “We are the provider of the services as well as the payer of the services,” said Penny Abulencia, executive director of PACE CNY. Abulencia explained that because PACE is a managed-care program, clients are sometimes reluctant to give up their own primary care physicians and transition to the physicians on staff. “We offer a lot of protection for our clients. Worries that we are managed-care program are unfounded,” she said.
While PACE offers day care programs for the elderly, its purpose is to offer a wide range of services that will help clients remain as independent as possible in their own homes. In cooperation with the caregiver, PACE develops and coordinates a complete range of health related services designed to serve the geriatric patients in the community. “It’s important that people realize that PACE is a cooperative effort between us and the caregiver,” said Ruth Ann Kirk, director of operations at the Loretto PACE site.
The PACE site at Loretto continues to function as a diagnostic and treatment center, offering podiatry, vision and dental services along with socialization, recreational and physical therapy, nutrition education, exercise programs and comprehensive medical treatment. “The enrollment process is complicated,” said Abulencia. “Those accepted into the program must be nursing home eligible, 55 years of age or older and live in Onondaga County.” An interdisciplinary team that must meet New York State’s criteria assesses each client. The long-term care resource center of Onondaga County must concur with the state on the eligibility of the clients.
Once a client is enrolled, PACE not only provides all the services the client needs in order to remain independent but also pays all the medical bills as well. PACE is funded through Medicaid and Medicare or those willing to pay privately. Before enrollment into the program, each client is evaluated by a team of professionals –– a primary care physician or nurse practitioner, day care supervisor, registered nurse, physical, occupational and recreational therapists, social worker, registered dietician, personal care attendants, and drivers to determine their needs and level of functionality. The client’s social and emotional needs are also assessed. In the initial meeting, the team discusses how PACE can meet the client’s needs and develops a care plan for the patient. Patients are re-assessed every six months or whenever there is a noticeable change in their functioning. In addition to primary medical care, outpatient health services, hospital impatient services, nursing home services and others, PACE also provides home health services. Included in these services are transportation services to outside appointments, skilled nursing and home health aide visits, homemaker/chore services and physician visits. “PACE has a medical on-call staff available 24 hours a day, seven days a week in the event a client needs emergency care,” said Kirk. “The services we provide are very individualized.”
Kirk said that the day care program is based on the needs of the clients and their living situation. “Some clients attend five days per week while others may attend only once a month,” she said. “We want the caregiver to stay well, so it’s important that they receive respite.” The day care facility provides a variety of activities that promote socialization, while providing restorative therapies, nutrition counseling, recreation and meals. When entering the facility, visitors see a beehive of activity as clients play bingo, cards, work on craft projects or socialize. The staff is skilled and attentive. PACE is one of only 29 such programs in existence across the country. It took Loretto at St. Joseph’s eight years to develop the model that was pioneered by On Lok, a community-based non-profit agency in California. Currently in Onondaga County, PACE is serving 282 older adults at two different sites and is close to full capacity. Therefore, Loretto is conducting a $950,000 capital campaign to raise funds for expansion of the program. “Our renovation will include small group rooms where clients can go for spiritual gatherings or to knit or do crafts,” said Kirk. “We will also have quiet rooms available for those who would like to rest.” The expansion will also include walking paths where clients can meander and explore within the confines of the facility. “Some of our patients with dementia often feel the need to wander and to touch things,” said Kirk. “The walking paths will allow them to do that in a safe environment.”
The elderly population in the U.S. continues to grow and the baby boomer generation will dramatically affect the size of the aging population over the next 10 years. According to information published by Loretto and Life Wise, “The number of people 65 years of age and over will grow to 40 million by 2010, an increase of more than 6 million seniors in just seven years.” In order to serve the increasing population of the elderly, PACE’s goal is to continue to provide the services necessary that will allow the elderly to stay at home, live independently and maintain quality of life in a more cost-effect manner. By providing quality care and by working in cooperation with caregivers, PACE and other services will help decrease the number of persons prematurely placed in nursing homes.