SENIOR CARE Adding Life to Years

People are living longer, more fulfilling lives than ever before. Modern medical advances have contributed to the emphasis on preventative care, which has prompted Americans to take their health seriously. People now keep a closer watch on blood pressure and cholesterol. They recognize the increased risk of heart disease and cancer associated with smoking cigarettes. And people are more likely to stay current on immunizations, physical exams and diagnostic screenings such as checking bone density for osteoporosis. Science, healthcare and technological innovations have extended life expectancy by almost 20 years.

Extended life spans have increased the amount of time people will spend in retirement. In 1900, the average man spent 2.2 years retired: in 1987, the average time spent in retirement was 17.4 years. This effectively divides the older population into two categories: seniors and advanced seniors. Seniors are baby boomers who are retiring earlier, choosing to spend their time pursuing recreational interests rather than working. This relatively new category includes individuals who have already had careers and families and still have a lot of living to do. Their parents are at the advanced senior stage, so most are being confronted with healthcare issues and concerns on a familial level. Questions like “What services are available?” and “How much will this cost?” suddenly arise about long-term healthcare of those advanced seniors.

Because families are less centrally located and extended generations rarely live in the same home, families are often strained when it comes time to decide the best arrangement for an elderly relative’s quality of care. Still the question remains: Are our loved ones living better or just longer?

Seven million Americans help older family members with tasks .such as daily household chores, doctor visits and paying bills, Family members are the only source of care tor older people 70 percent of the time. Changes in the structure of caring for the aged have led new industries of elder-care alternatives to the forefront of healthcare, These options can prove invaluable when deciding what to do when elderly relatives need assistance to continue living in the manner in which they are accustomed.

Sorting through the various alternatives in caring for advanced seniors requires diligence and patience, If the situation has escalated to a point where the individual can no longer care for him or herself, the most obvious decision that has to be made is whether the senior will stay at home or move into a specialized facility.



Home Base

Living at home may require different levels of care and because of this, there are different services available. Private caregivers provide a range of support, from part-time assistance to live-it) medical aid, for people who continue to live at home.

A geriatric care manager can provide detailed information about caregiving sources. By using a geriatric care manager, the family is assured that the elderly man or woman’s affairs are looked after, This saves the family members’ time for love and support instead of spending it running errands and visiting doctors. The number of geriatric care managers nationwide rose from 225 in 1990 to 800 in 19%. Using a geriatric care manager has become an increasingly popular alternative for families that are separated by long distances. While this is the most thorough and convenient method, it is also the most expensive. A geriatric care manager costs $60 to $100 an hour.

There are less expensive options that provide aid to advanced seniors who may not be entirely independent but do not need full-time assistance. A home companion does not provide medical help but does light housekeeping and prepares meals. This type of service costs between $6 and $15 per hour.

A home health aide is slightly more expensive, about $16 an hour, but is helpful in cases where the woman or man needs help bathing and dressing and with other day-to-day activities around the house.

A registered nurse or licensed vocational nurse is able to help people with serious illnesses, such as long-term cancer treatments or Alzheimer’s disease. While these nurses do not administer all aspects of treatment, they are sometimes necessary to monitor patients with serious medical needs who choose to live at home. An RN or LVN costs $20 to $40 an hour.



Providing a Healthier Life

Area hospitals and doctors offer a variety of healthcare options designed specifically for older patients. Outpatient clinics for seniors are opening up across North Texas, signaling a new trend in advanced senior care. These facilities have evolved out of the growing concern that advanced seniors are not receiving the appropriate care due to gaps in insurance procedures, physical limitations and locational restrictions. The best facilities offer primary care that is easily accessible, meet a variety of health related needs, and have a solid reputation and a friendly environment.



Columbia

Columbia Senior Health Centers are part of Columbia, which gives seniors the benefit of a worldwide knowledge base associated with this large medical conglomerate. Center branches are located in Dallas, Denton, Fort Worth, Garland, McKin-ney, Piano and Sherman-areas where a large number of seniors can receive treatment in convenient locations. Computers at all locations are linked so medical records can be transferred between centers if necessary.

The involvement and quality of care at Columbia Senior Health Center is comparable to that of a traditional family doctor, with the additional benefits of expanded services such as nutritional counseling, hearing tests, wellness screenings, pharmacies, physical therapists and health educators. As with a family doctor, the same primary-care physician is always used.

The doctors and staff have specialized training in dealing with the concerns, health problems and challenges seniors face. If a hospital stay is necessary, the health center doctor admits the senior and serves as a liaison among hospital staff, the patient and the family, The same doctor will also recommend a specialist if the need arises. A social worker is also available to coordinate community resources, a home health program and social services.

Greg Layman, director of Senior Health Centers for the North Texas Division, says, “Our strategy is to provide high-quality, cost-effective healthcare to the areas we serve. Medicare recipients often have trouble finding a physician who takes Medicare, and we are filling this need for them.”

Columbia recognizes that the mental health needs of the senior population deserve special attention, and Columbia Green Oaks Behavioral Health Care Services address that need. Seniors 55 and older can visit geropsychiatric units in Denton, Lancaster, McKinney and Sherman. These facilities provide services and treatments that address the learning and therapeutic needs of seniors suffering from serious emotional or behavioral problems. A psychiatric medical director works with group, family and individual therapists, recreational therapists and social workers to customize a treatment plan that alleviates or manages the patient s issues.

“We’re proud of the level of care and the quality of personnel we have at our geropsychiatric units,” says Alan Leavitt, Ph.D., director of Geropsychiatric Services, “Our units serve the mental health needs of people 55 and older, and are located in hospitals that provide the immediate care needed by many seniors. “



Baylor University Medical Center

In August 1996, U.S. News & World Report ranked Dallas’ Baylor University Medical Center as one of the top 30 geriatric programs in the country. As pioneers of the Senior Health Centers in the Dallas-Fort Worth area, the Baylor team focuses on an interdisciplinary approach that integrates the primary care services of a geriatric nurse practitioner, pharmacist, dietitian, home health nurse and social worker with the staffs internist. There are 11 centers located in the city, and they emphasize the special needs of the advanced senior population.

The facilities are all elder-friendly with handrails in the hallways, private changing rooms, individual heaters above exam tables and non-glare lighting. If a specialist is needed, the doctor is either brought to the neighborhood center or van transportation is provided to the patient from the center to another Baylor facility. The branches of Baylor Senior Health Centers accept Medicare, most Medicare supplemental policies, Medicare assignment and Medicaid, and provide assistance with insurance filing.

The goal of the Senior Health Centers is prevention. New patients are given a prescription analysis, which often determines that the individual is taking too many medications or that the drugs being taken are incompatible. Distinguishing counteractive drugs and reducing the number of prescriptions usually results in a better-feeling patient as well as a cost reduction to that patient- Wilson Weatherford, M.D., medical director of Baylor Senior Health Centers, says, “We’ve found if patients understand why they’re taking this medicine, they take it as directed.” Many drug companies participate in programs that provide some needed prescriptions to seniors at reduced cost. Baylor staff members also counsel seniors about making their homes safer-installing nightlights in bedrooms, hallways and bathrooms, and removing throw rugs from slippery surfaces.

In response to requests from Baylor patients, a pool was installed at the Hillside Village center at Mockingbird and Abrams. According to Shirley Shofner, registered nurse and executive director of Baylor Senior Health Centers, “Seniors are interested in fitness, exercise and receiving specialized therapy for geriatrics. “

Ten years ago, Baylor implemented 55PLUS, a senior membership program that provides seniors with free benefits. Currently, it has more than 135,00 members, which makes it one of the most popular programs of its kind. Members of 55PLUS have access to informative seminars, health screenings, travel opportunities and tips to help manage incidental costs related to healthcare that are not usually covered by insurance plans. Also included among the benefits is a subscription to The Advisor, a publication from Baylor hospital that gives seniors information about health, fitness, nutrition and finance to help build a secure and active lifestyle,



RHD Memorial Medical Center and Trinity Medical Center

RHD and Trinity have Senior Healthcare Centers on-site at the hospitals to provide primary care such as annual check-ups, flu vaccinations, and regular blood pressure and cholesterol screenings. Visits are scheduled with a personal physician so a patient-doctor relationship can be established. If a specialist is needed, the doctors provide the referral, A clinical social worker helps the patient and his or her family with services and benefits. Insurance counseling helps patients keep files and payments up to date.

Prestige Care is a benefit program offered by RHD Memorial Medical Center and Trinity Medical Center. There are no annual fees or dues, and the program is not an insurance plan or supplement. It provides privileges for seniors such as private-room upgrades, free meals for guests, and discounts at hospital cafeterias and gift shops. Cholesterol, diabetes and blood pressure screenings are available at the Senior Health Fair free of charge to Prestige Care members.

Carter Eye Center

The Carter Eye Center, located on Greenville Avenue in Dallas, offers services that are helpful in the prevention and treatment of senior eye problems such as free cataract screenings and candidate evaluation for refractive procedures. Dr. Harvey Carter, founder of the center says, “We provide patients with state-of-the-art technology, and we continue to lead our profession by performing the most innovative procedures available.”

Dr. Carter’s specialties include cataract surgery, refractive procedures, glaucoma laser surgery and corneal transplant surgery. He says, “Education does not stop with a degree-it’s an ongoing process. Throughout my 10 years of practice, I’ve stayed abreast of the latest technology in the ophthalmology field.” The Carter Eye Center provides total eye care, has a complete optical dispensary on site and will provide courtesy transportation if needed.



Help from the Community

Social service agencies such as Senior Citizens of Greater Dallas and the Alzheimer’s Association are available to help family members coordinate aspects of caring for the aged. These organizations, and ones like them, serve the area with programs that are beneficial to elderly people, their caregivers and loved ones.

The SCGD provides programs that assist senior adults who want to return to work, and the AGE, addresses healthcare via informative seminars on topics such as long-term care insurance.

The Alzheimer’s Association focuses on helping patients and their families deal with this debilitating form of dementia that has claimed more than 4 million Americans. Support groups, caregiver classes, respite care assistance and a help line are some of the services available.



Facilities to Fit Various Lifestyles

While living at home is often preferred, there are several reasons why advanced seniors choose to move into retirement communities. Maintaining a home often can be a chore, especially when repairs and maintenance get bothersome and expensive. Safety is also a concern. The isolation caused by the death of a mate can lead to a lonely, sedentary lifestyle for the surviving partner.

Future health concerns can make living alone impractical, in which case a community environment can become an attractive option. Or it may be that the current home no longer meets the needs of the resident due to the location, which may be far away from family members. Something simple like the obstacle of getting up and down stairs may pose a problem. Concerns such as this lead seniors and their families to consider the benefits of moving into a retirement community.

Retirement facilities offer a range of care. There are facilities available for most situations-those for healthy and active seniors who choose to live in a community full of friends and activities, and those for seniors with medical needs. Some specialize in personal care for people who just need assistance with daily tasks; others have doctors and nurses on staff for those who require medical attention. Certain facilities have units for people with specific illnesses, like Alzheimer’s, where the staff is especially skilled in dealing with patients whose memories often fail them.

The terminology used to describe retirement facilities can be confusing. A “retirement community” is usually an independent living community for healthy and active older adults. In Piano, Preston Place offers self-reliant living arrangements designed for the agile senior. Although it is not a healthcare facility, it offers accommodations and activities to keep residents’ quality of life high. Monthly rent-one-bedroom units start at $870-includes health and wellness programs, planned social and educational activities, scheduled transportation, car wash, 24-hour emergency maintenance and door-to-door garbage pick-up. Taking advantage of more amenities increases costs, but gives residents access to dining service, guest suites, housekeeping, salon visits, tours and garages. Services are priced separately, so residents only pay for what they use. Preston Place has one- and two-bedroom apartment homes in a variety of floor plans. Gladys Cottrill, a resident at Preston Place, says, “It is like having that part of our family around that has been lost.”

An “assisted living community” provides residential facilities for those in need of more personal assistance. Joyce Residence Hall at Presbyterian Village North in North Dallas is a licensed personal care center. Attendant care is provided by the staff 24 hours a day for residents who live in individual apartments. Personal assistance, housekeeping, laundry, medication supervision and meals are included in the monthly fee, which starts at $2,000. Construction began in May on the Adult Day Care Center that will provide advanced seniors with activities and care during the day.

A “continuing care retirement community” refers to a facility that offers varying levels of care. Presbyterian Village North offers this type of variety, which combines the types of elderly care and makes them available in one establishment. En addition to Joyce Residence Hall, Presbyterian Village North offers an independent living area and the Health Unit. The independent living area offers maintenance-free housing for active and highly mobile seniors. The Health Unit provides nursing care foi-patients that need medical supervision, which can cost as much as $4,460 per month. Specialized facilities allow residents to graduate to more care-intensive parts of the complexes as their needs change.

One resident said that moving into Presbyterian Village North was the best gift she could give her children. PVN is a non-denominational part of Presbyterian Healthcare System and just minutes away from its affiliate, Presbyterian Hospital of Dallas. Presbyterian Village North is a nonprofit organization that accepts either monthly payments or prepaid leasing at a reduced rate. PVN does not accept Medicare, but will work with residents to find an optional arrangement.

Individual needs have created a variety of healthcare options. As medical advances keep extending life expectancy, the challenge to modern healthcare providers will be to continue increasing the quality of life for seniors.