The
coming geriatric age:
How we care
Part
Three of Four
by Susan Brinkmann
CS&T Correspondent
Baby boomers have very definite ideas about how and where they want their
parents — and eventually themselves — to age. And it’s
not within the typical nursing home paradigm.
“They want choices,” said Joseph J. Sweeney, Jr., deputy secretary
and chief executive officer for Catholic Health Care Services (CHCS).
“Bricks and mortar are only part of the future. The future must
include a mobile, responsive, long-term health-care system extending into
senior years where CHCS will be out there reaching out to people in parishes.”
Within the industry, it’s called “aging in place,” which
means keeping the elderly in their own homes as long as possible.
“I’m a baby boomer myself,” said Sweeney, who was born
in 1946. “Our organization recognizes there is going to be a sea
change in the health-care environment. Right now, we’re operating
beautiful nursing homes rendering quality care, but we know in 10 years
it’s going to look a lot different as we expand our service continuum
outward to the community.”
At present, CHCS offers short and long-term nursing care at six skilled
nursing homes, an independent living facility and three assisted living
facilities throughout the area, in addition to overseeing a treatment
center for Catholic religious and priests.
“Within the city limits of Philadelphia alone, we operate almost
eight percent of the nursing home beds,” Sweeney said.
A massive organization employing more than 1,700 people, CHCS is already
planning and implementing new ways to meet the needs of the coming geriatric
age.
“We’re at the halfway mark in the process of developing a
new strategic plan which is looking toward how we can most effectively
care for those who are going to need healthcare in the future, and how
to do it in a cost-effective and appropriate manner,” Sweeney said.
One way is to help safely maintain people in their homes for as long as
possible, which means developing a community-based support system to handle
those needs.
“We are currently doing something called a NORC, a Naturally Occurring
Retirement Community,” said Kenneth P. Lewis, Director of Administrative
Support and Community Services for the Archdiocese.
“It could occur anywhere, in a high rise or in a physical area in
a neighborhood, where there are a lot of people over the age of 60. We
partner with other entities in the community to give people help with
winterization, spring cleanup, doctors’ appointments or church services,
[and] minor home repair such as installing smoke alarms or fixing leaky
faucets.”
The first NORC was officially initiated last year in Rhawnhurst in Northeast
Philadelphia. It is the result of a partnership with Catholic Human Services
of the Archdiocese, the Jewish Federation of Greater Philadelphia and
United Way of Southeastern Pennsylvania.
Funded by a grant from Mellon Mid-Atlantic Charitable Trusts and in-kind
support by the partners, a network of volunteers serve older residents
under the direction of a program coordinator and two part-time staff,
both seniors themselves. Seniors are provided with comprehensive information
and referral services, socialization opportunities and other direct services.
Volunteers include students from Stern Hebrew High School, Northeast High
School and the Orleans Technical Institute. These young volunteers provide
valuable inter-generational contact, and some direct services —
and keep alive a sense of community.
“We also have a no-fee, case management program called CCOPE, the
Catholic Care Options Program for the Elderly, which helps seniors who
have been referred because they have been unable, for whatever reason,
to gain admission to a Catholic facility,” Lewis said. “Let’s
face it, with over one million Catholics in the five county area,and CHCS
facilities managing 1,200 nursing beds, there just may not be an appropriate
bed available.”
The CCOPE program follows a case until the person is safely settled in
either a CHCS or other Catholic or secular nursing home, or connected
with the at-home care they need.
“Anything that a geriatric patient could potentially need, I try
to provide them with,” said Shiela MacMaster, R.N., case management
supervisor for the CCOPE program. “My job is to help people enter
the system and get set up with the care they need. A lot of times that’s
all the family needs — some help getting their loved one into the
system.”
MacMaster also helps oversee the archdiocesan parish nurse program, which
consists of a program coordinator and six full-time nurses who assist
pastors in creating parish nurse programs or health ministry teams within
their parishes. These programs can provide a vital outreach service to
increasing numbers of elderly who live at home and often become isolated.
“Parishes nurses are health educators and health counselors who
provide resource information,” MacMaster said. “They can go
into a home and make a determination of what a person needs, such as whether
they need help with medications, and they diligently try to get them the
help they need.
“Sometimes, it’s a referral to a visiting nurse agency. Sometimes,
it’s finding a neighbor to help out.”
The Community Model Project (CMP) goes into parishes and helps to educate
the elderly and their families on how to manage life-threatening health
challenges while remaining in the community.
“We try to reach people in the early stages when they’ve been
diagnosed with a long term chronic illness,” MacMaster said. “We
try to help them have the best possible quality of life while helping
them know what they should be paying attention to, such as advanced directives.”
The 61-year-old MacMaster, who started working as a volunteer with the
elderly when she was 10, assisted more than 300 people in the CCOPE program
last year. The program coordinator and the six nurses in partnership with
parish volunteers made 1,500 parishioner visits last quarter alone.
However, there will still be large numbers of persons needing long- term
nursing care, and archdiocesan facilities are already making adjustments
to accommodate the needs of a new generation of elderly.
“We know that life choices and interaction with others is a critical
need in the nursing home,” Sweeney said. “That’s why
we started the transformational model project (TMP).”
That model allows residents to wake up when they’re ready, take
a bath when they want, even cook their favorite meals in supervised kitchens.
The first home in the CHCS system to implement the change is St. Mary’s
Manor in Lansdale.
“The next generation of elderly are going to be healthier, wealthier
and wiser than previous generations,” said Allen Glicksman, director
of research and evaluation at the Philadelphia Corporation on Aging. “There
will be an increasing diversity in terms of race, religion, ethnicity
and language, and in terms of greater ranges of income from very wealthy
to extremely poor.”
The PCA recently published a report on the subject, “Looking Ahead:
Philadelphia’s Aging Population in 2015,” which takes a comprehensive
look at all the facets of this issue, from gender and marital status to
civic engagement and volunteerism.
However, the bottom line for handling the coming geriatric age will be
increased collaboration and cooperation between the various area providers,
Glicksman said.
“We have to think more regionally,” Glicksman said. “Strategically,
we must also collaborate on lobbying at the local, state and federal level
for appropriate funding for these kinds of needs. And the other divide
we have to work on is the divide between healthcare and social services.
They both exist but we have to find better ways to work together.”
For instance, if three different agencies are caring for the same elderly
person, who’s in charge?
“In theory it’s all wonderful,” Glicksman said, “but
the devil is always in the details.”
In part four of this series, the CS&T will take a look at the baby-
boom generation’s take in end-of-life care issues.
Contact Susan Brinkmann at fiat723@aol.com or (215) 965-4615.