THE MULLER INSTITUTE FOR SENIOR HEALTH Rita Leinheiser, MA Social Gerontologist Elder Life Specialist OBJECTIVES 1. Discover the components of a comprehensive community wellness program for seniors and how they operate in an acute care hospital. 2. Identify both your organization s mission and the population they help to determine how you can best incorporate services to benefit everyone. 3. Raise your awareness of the various ways your organization can focus on helping the elderly both in your facility and in the community. Who We Are The Muller Institute encompasses many award-winning inpatient and outpatient services. It is dedicated to the treatment and wellness of older adults, as well as providing education, fellowships and internships to future healthcare providers. We offer education to our community through Interdisciplinary Geriatric Rounds, seminars and presentations. nicheprogram.org 2016 Annual NICHE Conference Care Across the Continuum 1
The Services OUTPATIENT Operation Reassurance Elder Med Geriatric Assessment Center Caregivers Support Groups Memory Fitness Center Stop Abuse in Later Life (SAILL) INPATIENT Hospital Elder Life Program (HELP) ADDITIONAL RESOURCES QUALITY RECOGNITION VISION C. John Muller s Personal Motto Do your giving while you are living, so you ll be knowing where it s going. In 2000 along with his wife, Sandy, the late C. John Muller, donated more than $2 million to Abington Memorial Hospital. Operation Reassurance This program enables seniors living in Montgomery, Bucks and parts of Philadelphia counties to live independently and feel confident and secure. Every morning, from 7 to 9:30 a.m., participants call a trained staff member of the Operation Reassurance team. The team member asks the participant how he/she is doing and if all is well. If a participant does not call in during those hours, the Operator will call the person at home. If there is no response, the Operator will call the emergency contact listed for each participant. If that person is unreachable, the Operator will call the participant s police department for help immediately. Operation Reassurance is a free service of Abington Hospital Jefferson Health. Trained staff members serve seniors seven days a week, including holidays. The program began in the 1970 s by a policeman in Upper Moreland Township who felt it was important to check up on the frail elderly living in his township. Responsibility for the program was eventually assumed by the County Aging and Adult Services. When their budget was cut, they approached Abington Memorial Hospital to house and underwrite the program. Two operators per day for 2 hours, 365 days per year are paid minimum wage for their services. This program is underwritten by a generous grant from the Genesis Corporation. nicheprogram.org 2016 Annual NICHE Conference Care Across the Continuum 2
ElderMed Free wellness program dedicated to helping people age 60 or older stay healthy, active and well-informed about medical topics. Program members enjoy Abington Hospital Jefferson Health events and services throughout the year. Currently 14,400 active community members are enrolled in our wellness program. Over 28,000 members have been served since its inception in the Fall of 1987. ElderMed began in 1989 within the Social Work Department. It originated as a franchise of ElderMed America. When ElderMed America went out of business, Abington Hospital continued with its own program. Health Information and Screenings Healthcare screenings for blood pressure, heart and stroke risk, memory, falls risk and others Walks and health fairs Educational programs on arthritis, prostate health, heart disease, exercise, diabetes prevention and more Social Activities Members connect with others through ElderMed group trips to theaters, museums, sporting events, book discussions, bowling and other special activities. Upcoming events are listed in the program s newsletter. Geriatric Assessment Center This service provides a comprehensive outpatient evaluation of older adults by our team of professionals with expertise in caring for seniors. Geriatric assessment team members include a geriatrician and/or a geriatric nurse practitioner and a geriatric social worker. An assessment includes a thorough medical history and physical examination. This evaluates both acute and chronic conditions as well as medication history. The center's geriatric nurse practitioner and social worker complete a functional evaluation to appraise physical and cognitive skills and measure the older adult s ability to perform activities of daily living. The team looks at how changes in health and function are affecting the patient as well as their caregivers. Financial aspects are considered in making appropriate recommendations. The geriatric team also may suggest referrals for consultations with other experts, such as a neurologist, neuropyschologist, physical therapist and/or geropsychiatrist. After completing the evaluations and testing, the team meets with the older adult and family members to review the findings and make specific recommendations. The team's geriatrician or nurse practitioner sends a medical summary to the senior's primary care physician. By receiving the results of the assessment, the doctor is able to help follow through with the recommendations. nicheprogram.org 2016 Annual NICHE Conference Care Across the Continuum 3
Caregivers Support Groups Participants in each type of group have the opportunity to talk with their peers about shared experiences. Alzheimer s Support Group Monthly Alzheimer s Association support group offering caregivers of persons with memory impairment the opportunity to meet with others in similar circumstances. Caregivers can discuss challenges, share best practices and knowledge about dementia, and find emotional support and empowerment from other group members. Most caregivers were given the opportunity to go through the Virtual Dementia Tour which is a simulation of what it would be like to have dementia. It was an eye opening and heartfelt experience for caregivers and awakened a sense of empathy for their loved ones. Care receivers can attend and participate in a separate group with their peers. Meetings are in a safe and confidential environment. General Support Group A monthly support group designed for people who are taking care of a friend or relative with any chronic illness. This group has been ongoing for over 25 years. Memory Fitness Center This program offers physical and social activities on an outpatient basis to sharpen the memory skills of older adults who are experiencing early memory loss or have been recently diagnosed with dementia. Seniors gain support and friendship from others attending the program, which helps them feel more comfortable and confident. Participants choose their own activities and the number of fourhour sessions they wish to attend. Began in the fall of 2007 by a Certified Therapeutic Recreation Specialist with the stipulation that the program cover its costs by the end of the first year. Program grew to an average attendance of 12 participants per day and now contributes a small profit to the hospital budget. For the second time, an additional Center has opened near another hospital in our system. Initially funded by the Brookdale Foundation, it failed to grow in it s first 2 years. It was restarted last May in a better space, so we are hoping for growth! 160 participants since inception (including both sites). Each participant can attend up to 5 days per week, making it a total of 200 patient days a month. Memory Fitness Center continued: By stimulating the mind, the Memory Fitness Center can help minimize memory loss and delay symptoms. Program Activities include: Physical exercise Games Puzzles Literature discussions Current events Guest speakers Music Support group Art Therapy Pet therapy Intergenerational readings of Shakepeare s works with local university drama class. nicheprogram.org 2016 Annual NICHE Conference Care Across the Continuum 4
Art Therapy at The Memory Fitness Center Stop Abuse in Later Life (SAILL) Began with a Innovator's Circle Grant, a program of Abington Health Foundation, increasing the role of the hospital s domestic violence counselor to serve the older adult population. Available to any senior admitted as an inpatient who may have endured neglect or abuse at home, in the community or in a long-term care facility. Elder abuse refers to any negligent act by a caregiver or loved one that causes harm or serious risk of injury to a vulnerable adult, age 60 or older. Men and women of all ethnic backgrounds and social status can be victims of elder abuse. Abuse comes in many forms: Physical abuse Sexual abuse Emotional abuse Exploitation Neglect Abandonment Through the SAILL program, a specially trained social worker meets with the patient who may have been abused. Anyone may report such possible abuse, including the victim. Services 24-hour medical treatment in the Emergency Trauma Center On-site elder abuse counseling Community resource referrals Support groups Affiliation with County Aging and Adult Protection Services Hospital Elder Life Program (HELP) HELP is designed to assist hospitalized older adults avoid the adverse effects of hospitalization including: Cognitive decline (hospital acquired delirium) and Functional decline Our site uses highly trained and supervised volunteer staff. This provides an effective system to consistently provide interventions that address the special needs of older patients, including: Daily Visitor Program: cognitive orientation, communication, and social support. Therapeutic Activities Program: cognitive stimulation and socialization Early Mobilization Program: daily exercise and walking assistance. Hearing and Vision Protocol: hearing and vision adaptations and equipment Feeding Assistance Program: assistance and companionship during meals. patients from declining Geriatric Interdisciplinary Care: nursing, medicine, rehabilitation therapies, pharmacy, and nutrition. Non-Pharmacologic Sleep Protocol: promotes relaxation and sufficient sleep Provider Education Program: geriatric education for professional staff Links with Community Services: assist with the transition from hospital to home nicheprogram.org 2016 Annual NICHE Conference Care Across the Continuum 5
HELP OUTCOMES The patient s mental status has consistently stayed the same or improved in 92% of the patients at Abington since 2004. The patient s physical status has consistently stayed the same or improved in 95.2% of the patients at Abington since 2004. Additional Resources Caregivers Resource Room Newsletter ElderMed Phoneline Healthcare Advance Directive Fellowship/Internship Opportunities Van Service Muller Lecture Series Interdisciplinary Geriatric Rounds Long-Term Care Quarterly Meetings Outpatient Geropsychiatry Program Apprise Free Health Insurance Counseling Quality Recognition The high quality of our geriatric medicine physicians, nurses and social workers, our involvement in clinical research and our geriatric fellowship program put us at the forefront of senior health care in the region. U.S. News and World Reports awarded Abington Memorial Hospital a commendation in geriatrics. The national Hospital Elder Life Program (HELP) honored our program as a HELP Center of Excellence. Our home care services consistently rank above other regional providers, and state and national averages, with better patient outcomes as tracked by Medicare s home health compare. Future Vision Collaboration with Neurology and Geropsychiatry to create a Memory Center including assessment, information and referral, medication management, counseling, case management, and clinical trials. Collaboration with local Aging at Home program (NORC) to establish a Memory Café. nicheprogram.org 2016 Annual NICHE Conference Care Across the Continuum 6
nicheprogram.org 2016 Annual NICHE Conference Care Across the Continuum 7