PACE Programs Keep Seniors at Home
Monday June 21, 2010
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On a typical workday, Mark Borrego, OT, hits the road to help frail or disabled seniors in the sprawling Denver metropolitan region maintain the basic skills needed to live independently.
Borrego is one of eight OTs on a multidisciplinary healthcare team who “float” to health centers where they are most needed by frail seniors 55 and older in the federally funded Program of All-Inclusive Care for the Elderly, or PACE.
“We call ourselves the cavalry,” Borrego says of the OTs who spring into action at Denver-based Total Longterm Care, a PACE provider that helps about 1,200 participants maintain essential functions for daily living that keeps them out of nursing homes.
“It’s different for everyone,” he says of baseline standards, adding that more than half of the regional participants live in their own homes with various degrees of independence. Others reside with relatives or in a shared or assisted living arrangement, and about 5% are in nursing homes under PACE sponsorship.
“A senior may not even need therapy sessions but can use help with house cleaning, cooking or shopping,” Borrego says.
Borrego typically attends an early morning team meeting, provides one-hour therapy sessions at health centers from 10 a.m. to 2:30 p.m., and then visits and evaluates participant homes. He recently went directly from an early team meeting to help evaluate and install a ramp for a woman who was having difficulty going to and from her home.
Holistic Senior Care
On the edge of downtown San Diego, Fera Piran, OT, is enthusiastic about her daily challenges at a PACE center for 105 frail seniors operated by nonprofit St. Paul’s Senior Homes & Services.
“What I like about working at PACE is the holistic and interdisciplinary approach to care,” Piran says. “We make therapy fun for participants, and they look forward to coming to sessions.”
Under PACE, OTs have the flexibility to do what is appropriate to help frail seniors maintain activities for daily living that keep them out of nursing homes, says Piran, a senior clinical specialist with Sun Healthcare Group of Irvine, Calif., which provides therapy services for St. Paul’s PACE.
In morning strategy meetings, OT recommendations are reviewed and occasionally revised by the PACE healthcare team, she adds. “We don’t deny any services to participants who need them,” says Piran, a lymphedema specialist who also is certified in hand therapy and pain management. “If someone needs a splint for their hand, or a compression stocking for edema, we get it for them.”
Piran also makes home calls to assess participants’ needs and helps them adapt techniques for cooking meals, showering safely or sleeping comfortably.
Positive Feedback
The PACE team makes life easier for seniors by setting all therapy appointments, providing transportation to and from checkups or center activities, and eliminating clinic waiting rooms. Members scheduled for OT sessions can bide their time in a setting that offers music, painting, games, educational classes and a nutritious lunch in a healing atmosphere that encourages socialization.
“The health center is an all-in-one shop that takes care of any healthcare need of a participant,” says Borrego, who graduated in 1996 from the OT program at Colorado State University in Fort Collins and interned at Denver’s Craig Hospital.
“I’ve practiced in many settings, and PACE is one of the best and most satisfying programs I’ve ever worked in,” says Piran, who earned a BA degree in OT from Mount Mary College in Milwaukee, and an MS in adult education and administrative leadership from the University of Wisconsin-Milwaukee.
“You cannot believe how participants’ lives are changed and improved, both cognitively and physically, in the PACE model — and I sincerely mean that,” says Piran, who has been with the program since it started nearly two years ago.
Benefits include lowering cholesterol, blood pressure and sugar levels to improving muscle strength and cognitive skills for everyday tasks.
PACE Grows Nationally
Nationally, PACE programs have grown to encompass about 17,000 frail seniors — a small fraction of the 70 million Americans who are 55 or older and are on the leading edge of a large and graying baby boomer generation known for its independence.
PACE was started in the early 1970s in San Francisco’s Chinatown as a Medicare demonstration project. The On Lok model was adopted elsewhere, and since gaining permanent federal status in 1990, the number of providers operating a PACE option has grown to 70 in 30 states. Pennsylvania has the most programs with 10, followed by Massachusetts (six), New York (six), Virginia (five) and California (five).
Under the Balanced Budget Act of 1997, PACE is a capitated benefit that uses Medicare and Medicaid financing to create a pool that pays for all services needed by nursing-home eligible participants who want to live independently.
The PACE program also is being launched in rural areas through Medicare grants for pilot projects, the most recent going to the VA Montana Healthcare System. The VA partnered with two organizations in early January to provide community-based and home services for 40 veterans.
In San Diego, 15 PACE members formed an action committee and wrote a letter to President Barack Obama. “We are offered a full range of services from transportation to medical service, social services, drug coverage, home care and nutritious meals ... our basic needs are being met, and we have a new lease on life,” the letter says. “We want to see PACE expanded to reach all who can benefit by it.”
John Leighty is a freelance writer.
Borrego is one of eight OTs on a multidisciplinary healthcare team who “float” to health centers where they are most needed by frail seniors 55 and older in the federally funded Program of All-Inclusive Care for the Elderly, or PACE.
“We call ourselves the cavalry,” Borrego says of the OTs who spring into action at Denver-based Total Longterm Care, a PACE provider that helps about 1,200 participants maintain essential functions for daily living that keeps them out of nursing homes.
“It’s different for everyone,” he says of baseline standards, adding that more than half of the regional participants live in their own homes with various degrees of independence. Others reside with relatives or in a shared or assisted living arrangement, and about 5% are in nursing homes under PACE sponsorship.
“A senior may not even need therapy sessions but can use help with house cleaning, cooking or shopping,” Borrego says.
Borrego typically attends an early morning team meeting, provides one-hour therapy sessions at health centers from 10 a.m. to 2:30 p.m., and then visits and evaluates participant homes. He recently went directly from an early team meeting to help evaluate and install a ramp for a woman who was having difficulty going to and from her home.
Holistic Senior Care
On the edge of downtown San Diego, Fera Piran, OT, is enthusiastic about her daily challenges at a PACE center for 105 frail seniors operated by nonprofit St. Paul’s Senior Homes & Services.
“What I like about working at PACE is the holistic and interdisciplinary approach to care,” Piran says. “We make therapy fun for participants, and they look forward to coming to sessions.”
Under PACE, OTs have the flexibility to do what is appropriate to help frail seniors maintain activities for daily living that keep them out of nursing homes, says Piran, a senior clinical specialist with Sun Healthcare Group of Irvine, Calif., which provides therapy services for St. Paul’s PACE.
In morning strategy meetings, OT recommendations are reviewed and occasionally revised by the PACE healthcare team, she adds. “We don’t deny any services to participants who need them,” says Piran, a lymphedema specialist who also is certified in hand therapy and pain management. “If someone needs a splint for their hand, or a compression stocking for edema, we get it for them.”
Piran also makes home calls to assess participants’ needs and helps them adapt techniques for cooking meals, showering safely or sleeping comfortably.
Positive Feedback
The PACE team makes life easier for seniors by setting all therapy appointments, providing transportation to and from checkups or center activities, and eliminating clinic waiting rooms. Members scheduled for OT sessions can bide their time in a setting that offers music, painting, games, educational classes and a nutritious lunch in a healing atmosphere that encourages socialization.
“The health center is an all-in-one shop that takes care of any healthcare need of a participant,” says Borrego, who graduated in 1996 from the OT program at Colorado State University in Fort Collins and interned at Denver’s Craig Hospital.
“I’ve practiced in many settings, and PACE is one of the best and most satisfying programs I’ve ever worked in,” says Piran, who earned a BA degree in OT from Mount Mary College in Milwaukee, and an MS in adult education and administrative leadership from the University of Wisconsin-Milwaukee.
“You cannot believe how participants’ lives are changed and improved, both cognitively and physically, in the PACE model — and I sincerely mean that,” says Piran, who has been with the program since it started nearly two years ago.
Benefits include lowering cholesterol, blood pressure and sugar levels to improving muscle strength and cognitive skills for everyday tasks.
PACE Grows Nationally
Nationally, PACE programs have grown to encompass about 17,000 frail seniors — a small fraction of the 70 million Americans who are 55 or older and are on the leading edge of a large and graying baby boomer generation known for its independence.
PACE was started in the early 1970s in San Francisco’s Chinatown as a Medicare demonstration project. The On Lok model was adopted elsewhere, and since gaining permanent federal status in 1990, the number of providers operating a PACE option has grown to 70 in 30 states. Pennsylvania has the most programs with 10, followed by Massachusetts (six), New York (six), Virginia (five) and California (five).
Under the Balanced Budget Act of 1997, PACE is a capitated benefit that uses Medicare and Medicaid financing to create a pool that pays for all services needed by nursing-home eligible participants who want to live independently.
The PACE program also is being launched in rural areas through Medicare grants for pilot projects, the most recent going to the VA Montana Healthcare System. The VA partnered with two organizations in early January to provide community-based and home services for 40 veterans.
In San Diego, 15 PACE members formed an action committee and wrote a letter to President Barack Obama. “We are offered a full range of services from transportation to medical service, social services, drug coverage, home care and nutritious meals ... our basic needs are being met, and we have a new lease on life,” the letter says. “We want to see PACE expanded to reach all who can benefit by it.”
John Leighty is a freelance writer.
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Monday June 21, 2010
