Thriving in place pursued for elderly

The fear of failing a loved one with healthcare needs is very real. A man is knocked unconscious from a bad fall while out walking the dogs at night. He is discovered, and an ambulance whisks him away to a hospital. While he remains unconscious or seriously incapacitated, no one is the wiser that his wife is at home, left alone with a serious health condition that makes it impossible for her to seek help. In another scenario a family member or friend decides that dying at home is preferable to driving long distances for cancer treatment, as is required by those living in Washington County. Aging in place is nothing new in Maine, but thriving while aging in place both as caregiver and the person cared for is something else entirely and dependent on strong social networks and resources ranging from specialized healthcare to easily accessible transportation.
A group of Eastport caregivers, interested residents and healthcare representatives met the morning of April 5 to discuss the future of "thriving in place" for Eastport's elderly population. The Caregiver Community Circle was started by two residents who each care for a family member and found that as caregivers they needed support and access to information about resources. Holly Gartmayer‑DeYoung, CEO of Eastport Health Care, facilitates the group, as she does with a number of other health‑related community circles.
At the April 5 meeting the group gathered to discuss issues about aging in place with Director of Development Joe Perkins of Washington Hancock Community Agency and Co‑Director Charlie Martin‑Berry of the Community Caring Collaborative. Citing a planning grant from the Maine Access Health Foundation that is funding similar discussions around the state, Martin‑Berry noted that those conversations are beginning in Washington County as well, with the Eastport gathering the third so far. The caregivers group is a natural fit as part of the information gathering.
Gartmayer‑DeYoung noted that an online resource list is being developed for caregivers, a collection of music CDs is available to help with relaxation and sets of "Graceful Passages" CDs are also available that are helpful with the palliative care journey. Books are in the process of being reviewed by members for usefulness, and the Peavey Memorial Library is gathering a list of books in its stacks on the subject, including a recent donation of about 10 books from a representative of AARP. In addition, she is planning on inviting an attorney who specializes in senior legal matters to attend an event in the summer. She is pushing to remove barriers to using POLST (physician order life sustaining treatment), as it is a more useful tool than the commonly used and known advance directive.
The strong social networks of a place like Eastport certainly help, especially with those who have long family ties to the area. But there are still people who are alone, lonely and often isolated from lack of transportation and immediate family in the area. Church groups, neighbors and a culture of "adopting‑a‑senior" can build safety nets, and more senior housing that is flexible in design and built close to the city center rather than out in rural and isolated areas can also help. However, healthcare professionals have a critical role to play in all such networks in providing advice and skill sharing for such tasks as: rolling and lifting a bed‑bound invalid; navigating purchases such as adult diapers that may qualify for prescription status and thus are at least partially reimbursable through insurance; navigating healthcare options and knowing many of the resources available.
Technology may play an increasingly important role for the baby boomer generation, as information technology capacity improves and telehealth and telemedicine become more mainstream. The current gaps may be filled by a more technology-savvy generation. But meanwhile the "transition of care" is still full of potential mine fields for the caregiver and the one cared for upon discharge from a hospital, said Gartmayer‑DeYoung. Infrastructure around the city could use a friendly eye towards accessibility with more ramps built into sidewalks and some businesses and railings for stairs.
And then there are the basics that the aging homeowner begins to need, such as help with shoveling, plowing, mowing and other yard work, grocery shopping and cooking healthy meals, house maintenance and cleaning and exercise and social stimulation. What the aging person needs to thrive in place, so does the caregiver, said one such person at the meeting. "One compelling theme of caregivers is the unanticipated loneliness or an event that can derail a day's routine," Gartmayer‑DeYoung said. While for some it may be as simple as a neighbor bringing over an occasional meal and sitting down for a visit, for others it will always be more complicated.