When Judy’s Parkinson’s disease * forced her to leave Colorado and move to Grand Rapids with her children, she was 57, was unable to sit up unaided, and used a walker to stand up. She couldn’t even go to the bathroom on her own. Her children have rearranged their family room to accommodate her.

But Judy ended up making a major turnaround with the help of a All-inclusive care program for the elderly (PACE). The PACE model provides comprehensive medical and social services at low cost or free to older people who live at home, including many services available in an adult day health center as well as home services.
Lacey Cole leads a seated aerobics class at the LifeCircles Center in Muskegon. PACE participants are encouraged to stay active and move their bodies with low impact exercise, keeping them mobile and independent for longer.
Veronica Horsley-Pettigrew is the Proximity Marketing Supervisor for PACE Care Resources, serving patients in Kent County and parts of Ottawa County. She says Judy’s condition was “heartbreaking” when she first became a Care Resources PACE client. But when Horsley-Pettigrew met Judy at the Care Resources Day Center gymnasium six months later, she was stunned.

“I couldn’t believe my eyes,” said Horsley-Pettigrew. “She went from a wheelchair to a walker to a cane to walk on her own. I just cried with happiness.”

Judy now lives independently in her own apartment. The PACE program has not worked miracles. Her multidisciplinary team simply addressed the different facets of Judy’s disease. Pharmacists determined that the main culprit in its decline was incorrect dosing of drugs. Once her medications were balanced, having unlimited access to physiotherapy helped her regain her strength. Transportation to the day center allowed Judy to connect with friends, participate in activities and get in a good mood. The centre’s on-site gymnasium gave her the space and equipment to continue the exercises prescribed by her physiotherapy team.

“We have 11 disciplines who come together and take care of that person. It’s a lot of love and expertise, ”says Horsley-Pettigrew. “We have medical specialists, a dietitian and social workers to help them navigate the process. Our support begins when the driver picks up the person. Every person on our team gets it. ”

All inclusive treatments

Launched nationwide in 1997, 131 PACE programs in 31 states serve more than 54,000 seniors. Managed by private or public not-for-profit entities, the programs can provide all of the services covered by Medicaid and Medicare as well as additional services needed to improve and maintain health. Because the Medicaid and Medicare Service Centers (CMS) restrict PACE’s marketing activities and providers don’t want to lose patients, many older people do not know that there are PACE programs. In Michigan, 14 independent PACE organizations serve 21 sites, covering more than 87% of the state. To verify eligibility, adults in Michigan aged 55 or older can call (877) 2MI-PACE from 9 a.m. to 5 p.m. Monday through Friday.
A PACE participant is helped to get on an exercise bike at the LifeCircles Center in Muskegon. PACE participants are encouraged to stay active and move their bodies with low impact exercise, keeping them mobile and independent for longer.
“It’s Michigan’s best kept secret,” says Stephanie Winslow, executive director of Michigan PACE Association. “We provide all-inclusive care for the elderly, all aspects of their care. Whether they need to go to a specialist or if they need hearing aids, personal care tasks or maybe a ramp, we provide everything for them to live safely. in their homes. We provide everything.

No PACE program works in the UP Winslow hopes that the recent changes to the CMS and the Affordable Care Act will change that.

“There is federal funding on the table and we would like to use some of that funding to provide PACE to Alpena, Mackinac, Marquette and Escanaba,” said Winslow. “The opportunities are there. Hopefully our legislature and administration will move forward on some of these demands.”

Healthier and happier at home

A recent AARP survey found this three in four people aged 50 and over want to age at home, not in a facility.

“It’s better to be able to stay at home because it’s heartwarming,” says Winslow. “Usually as you get older you start to lose a lot of things – family, friends, the ability to drive. Being at home gives you comfort that adds to your physical and mental health. … At the end of the day, even in the dark, you can navigate the terrain without a problem. Having your own things in your own space contributes to well-being.

PACE services allow seniors to age in place – and at a lower cost than living in an assisted living or retirement home.

“Most people want to live in their own homes as they get older. They want to live in their own community rather than in a facility or institution. That’s what people want, ”says Sarah Milanowski, Marketing and Communications Specialist at PACE LifeCircles. “We also know that the cost of institutional care is quite high. If we can provide services to keep someone safe in their own home, and less likely to run out of assets and use Medicaid, it costs too. less money in the system. “
Sarah Milanowski, Marketing and Communications Specialist at LifeCircles PACE, with one of the LifeCircles buses. LifeCircles provides accessible medical transportation to the LifeCircles Day Center and other specialist medical providers.
Seniors eligible for Medicaid receive all PACE services free of charge. The cost to seniors ineligible for Medicaid in Kent County, for example, is about $ 4,600 per month. the median cost of nursing home care in Michigan ranges from $ 8,300 to $ 9,400 per month. Problems with the way Medicare pays for services, especially Part D drug coverage, prevent PACE from serving Michiganders who hover above the poverty line until their savings, and often their health. , were unfortunately exhausted.

“There is more freedom in our funding model,” says Milanowski. “Our patients go out and around on bus tours of farmland, picnics at the lake, fishing, going to the Critter Barn. [in Zeeland], and enjoy boat rides. We make their experiences as dynamic as possible. It’s nice to have something to look forward to even when you are limited in terms of mobility and cognition. “

PACE programs also alleviate the growing number of family caregivers meet the needs of older people who can no longer take care of their own household or personal care. These caregivers often sacrifice their personal lives, career advancement, and even physical and mental health when caring for a declining family member. PACE transportation services mean they won’t have to take that day off to take mom to the doctor. Day centers allow them to keep their jobs away from home. And respite services preserve their health.
Angie Dill, LifeCircles PACE participant at home. CAPC participants like Dill have been allowed to stay at home thanks to the support of care partners from organizations like LifeCircles.
For example, a LifeCircles PACE patient with memory impairment showed signs of a blood clot. His wife looked after both him and their adult child with special needs at home. Instead of suggesting that she juggle a difficult trip to the emergency room, a PACE medical assistant used home diagnostic equipment and was able to prescribe the care the patient needed on the spot.

“It was a better outcome for the frail elderly person and the care partner who has other competing demands,” said Milanowski.

Pick up the pace

PACE National Association Studies have found that CAPC programs are effective and efficient in treating people with multiple and complex health care needs. Seniors enrolled in PACE programs report being healthier, happier and more independent than their counterparts in other care settings. The PACE model has been shown to reduce the need for expensive, long-term nursing home care and dramatically reduce avoidable hospital admissions and emergency room visits. Milanowski sees confirmation of these findings in the LifeCircles PACE service area in Muskegon County and parts of Ottawa and Allegan counties.

“While a hospital usually does an excellent job of correcting the reason for admission, other complex factors can be exacerbated there, particularly if the patient has dementia, memory loss or multiple chronic conditions. It can be as simple as not resting or being in an unfamiliar environment, ”says Milanowski. “Our traditional emergency rooms and hospital systems are not always the best place for frail elderly people. We are reducing these visits if we can.”
A LifeCircles PACE participant shows off her coloring. LifeCircles provides a day center and encourages participants to attend for socialization.
Studies have shown that when older people are hospitalized, they experience a decrease in their ability to function independently. So, in addition to the obvious cost savings, reducing hospital visits also increases a senior’s chances of aging in place.

“We are an aging population. People need services and there are staff shortages, not a lot of caregivers. We are here. We are ready, willing and able to serve Michigan seniors,” said Winslow . “My grandmother will be 94 in October. She lives in Alpena, where there is no PACE program. I will do my best to get a PACE program in her area so that she can stay home and don’t go to a nursing home like my grandfather did. “

A freelance writer and writer Estelle Slootmaker is happiest writing about social justice, wellness and the arts. She is the development news editor for Fast growing medium and L’Arbre Amigos chairs, Wyoming City Tree Commission. His greatest achievement is his five incredible adult children. You can contact Estelle at [email protected] or www.constellations.biz.

Photos by Pat ApPaul.