SAC details island healthcare resourcesFor the senior population
The Senior Advisory Committee sponsored a talk on July 22 on the availability of healthcare resources — both state and local — addressed to seniors and their caregivers. The meeting, which was held on a warm summer afternoon, drew an interested audience of islanders.
Senior Coordinator Anna Christina Rogers introduced the speaker, Jenny Miller, a social worker and president of Senior Care Concepts, a geriatric care management organization based in Warwick. Before Miller spoke, Rogers explained that her own role in the community was “to help build in more coordination of the health care system” to help make services available to island seniors.
Acknowledging that it was generally “difficult to access mainland agencies while [living] on island,” she said part of her work was looking into getting providers to come here. At the moment, she said she was looking into arranging for a physical therapist.
Having looked into whether it was possible to revive a blood pressure clinic offered at the medical center several years ago, Rogers recently learned that individuals can make an appointment to have their pressure checked without charge.
In her opening remarks, Miller said, “I want to tell you my story. I’m not just up here because I happen to have an education and a degree as a social worker.” She credited her close relationship with her grandmother for eventually leading her into social work and, specifically, work in geriatrics.
Because of physical limitations at the age of 86, her grandmother was about to move into an assisted living facility. Miller described her grandmother’s reaction. When looking at the other residents, she said, “These people are not my people.” Miller said at the time she learned how important it was to listen to her grandmother’s feelings, to understand the nature of the changes happening to her.
Several years later, Miller found herself in further disbelief when her grandmother was diagnosed with Alzheimer’s disease and moved to a nursing home. She said, “We had to work around her changes; she forced us to put ourselves in her place.”
The key, Miller said, was the willingness to listen, to learn how the individual needing services really felt and what was needed. This approach has been incorporated into the way she and her agency respond to their clients’ needs, she said.
Noting there are three companies in Rhode Island offering eldercare, Miller said she and her colleagues had discovered the best way to do an assessment of individuals’ needs was “to go into their homes” and directly evaluate the situation. “Only then,” she said, “can we put together a care plan,” which she noted was immediately developed.
With social workers and nurses on staff, each care management organization will then refer clients to agencies that might be a good match.
Another story Miller told was of a client with Parkinson’s, whose family asked for a care plan. The patient and her husband wanted to stay in their home. “The first thing we did was put a lifeline button in her home,” Miller said. After a while, when the woman could no longer do the stairs, the agency arranged for a stair lift to be installed.
Over time, as her needs grew, the patient received more and more relevant services, such as a cook and driver, which Miller explained, “lasted for about two years.” When more personal care was needed, adaptive equipment was brought into the patient’s home.
Eventually, as the patient’s needs advanced, Miller pointed out, “We knew [ahead of time] we would need hospice to the very end.” She added, “The best thing we taught her [the client] was to adapt.”
Miller noted, “If you’ve been in a skilled nursing facility and are going home, you’re entitled to skilled nursing care to continue at home. You can also have physical and occupational therapy. All are covered by Medicare if you’re homebound.”
Once an individual begins to recover, Miller said he or she is entitled to have a Certified Nursing Assistant (CNA), who will help with personal care.” An aid categorized as a companion is not allowed to touch the individual—not allowed to do personal care—but available to keep someone company or call upon others for appropriate care.
Miller described hospice services as two-fold: the first is doing palliative care, which offers such services as pain management; this is a somewhat longer-term service. The second is end-stage care, in which the comfort and pain management of the patient are the goals.
An individual may receive hospice care wherever he or she is living.
On recognizing when people need help, Miller cautioned members of the audience: “Don’t wait for a crisis.” She added, “People need a roadmap and [often] do not know when it is the right time to ask for help.”
She urged people to prepare a living will — to offer instructions to your family members and caregivers about “what you want to do while you’re alive.” Next, Miller said it was important to appoint a health care power of attorney. “You need someone to speak for you, if you can’t speak for yourself.”
She added that setting up a financial power of attorney ahead of time was very important as well. Miller stressed the importance of preparation.
She noted that other care management agencies, and her own, were available to do needs assessment and coordination, to put together an individualized care plan, to arrange for and go to appointments with individuals and generally to assist with transitional and crisis management.
Those wishing to learn more may contact Miller directly at firstname.lastname@example.org or at (401) 921-6100.
Rogers pointed out that she was distributing a survey and waiting to hear back from island seniors about what their needs might be. From those responses, she hoped to develop and coordinate a program making specific services available on island.