HARTFORD INSTITUTE FOR GERIATRIC NURSING |
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Dear Friends,
As COVID-19 rates continue to fall, many of us are looking ahead to the future. As we begin to move away from crisis mode, we can begin to reflect on the lessons we have learned and envision how we can provide better care to older adults in the future.
The vast majority of older adults want to remain living in their homes for as long as possible, but there are times when the care and services needed are too much to be provided at home. Loss of independence can be devastating and can contribute to depression and lower quality of life. Assisted living facilities provide needed services that promote independence and socialization, but they also come with a price tag that is out of reach for most low-income adults.
Our feature this month is by HIGN-affiliated faculty Prof. Dan David. Prof. David illustrates the benefits of providing affordable access to assisted living facilities to low-income older adults through the story of Dorothy, a woman who lived independently until she was hospitalized. Dorothy’s placement in a Medicaid-funded assisted living facility provided support while allowing her to maintain her independence.
Warmly,
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Tara A. Cortes, PhD, RN, FAAN |
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Supporting Independence: Dorothy's Story
Daniel David, PhD, RN
To age successfully everyone needs a place to live. Dorothy Brown is one of these individuals.
Her backstory demonstrates how low-income adults with a little support can avoid less desirable housing placements. Without functional support many older adults end up in places that are expensive and compromise autonomy. Independence is especially valued by older adults. Pain, anxiety, depression, breathing challenges, frequent hospitalization, poor nutrition, inability to navigate outpatient care are all factors which push individuals to higher levels of care. While the price of independence is unmeasurable, the cost of living in facilities with skilled care is not negligible. These places include nursing home care ($100K/year), out of pocket assisted living ($60K/year), hospital stays ($5-10K/visit), homeless shelters ($40K/year for barracks style accommodation).
A few years ago, Dorothy Brown was dealt an unfair blow. After living independently, she contracted double pneumonia, got really sick, was hospitalized, intubated, and had a small stroke. She was discharged after a full month of being kept in a medically induced coma while her lungs healed. Recovery was challenging. Her lungs returned to normal function but cognitively she was initially not the same. Temporary confusion resulted in questionable risky behavior and poor choices which to this day she states that she cannot fathom why she did them. The family rallied and she cleared all symptoms except for forgetfulness that resulted in her taking too much medication sometimes or not enough other times. Her daughter provided her with a room in her home and asked her to not smoke. While her daughter was at work, Dorothy went into the fire stairwell to sneak a cigarette. She doesn’t remember falling but found herself upside down, against the wall, at the bottom of the stairs with a broken hip. It was decided that Dorothy could not live there safely.
Recovery has been hard but Dorothy is an optimist and on-the-mend following a stint in a rehab facility. With no financial reserves and care needs exceeding what her family could provide she was fortunate to find placement in a Medicaid-funded assisted living facility. There, they provide support for low-income older adults with functional needs. The support provided to Dorothy allows her to live independently. She maintains a tastefully decorated single room apartment adorned with crayon-colored pictures from grandchildren and polaroid pictures of herself from the 70’s when she was a younger, stylish, and hip African American woman. She attends physical therapy and medical appointments as an outpatient. While at her home she does extra work to build strength and heal. She is a regular at chair aerobics and music appreciation/dancing in the community dining hall. It’s been challenging since she moved in due to social distancing and other COVID measures. With the improvement of COVID vaccination in the city, newly opened recreational opportunities are allowing her the ability to socialize with other individuals who found themselves in this unique lower cost environment in the Bronx. Aside from the administration of scheduled medications, Dorothy continues to live an independent and active life. Each day of independent living is a bonus to her and a financial savings to society that does not need to pay for higher levels of care.
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The Conundrum of Minimal Staffing Plans
HIGN's Executive Director Tara Cortes penned a guest column for McKnight's Long-Term Care News on the marginalization of long-term care in the healthcare system and its impact on recruitment and retention of staff, as well as the need for a systematic strategy with an appropriate financial model and education to develop a well-prepared workforce.
Click here to read the full column.
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Family Caregiving and People with Dementia |
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HIGN convened a panel of experts to discuss the challenges and rewards experienced by family caregivers of people with dementia.
Presentations:
Ab Brody, PhD, RN, FAAN: Liberalizing Access to Person-centered Care for Persons Living with Dementia and their Family Care Partners
Kalisha Bonds Johnson, PhD, RN, PMHNP-BC: Understanding Decision Making in African American Dementia Dyads
Tia Powell, MD: Challenges in Family Caregiving
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2021 HIGN Virtual Interprofessional Summer Research Scholars Program
July 14th - 20th
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Applications are now being accepted for HIGN's Annual Interprofessional Summer Research Scholars Program.
The 5-day intensive virtual program is open to doctorally prepared healthcare professionals who are interested in conducting research in aging related fields.
NYU faculty mentors will guide you on advancing your career through building grant writing and research skills.
Deadline: June 15th
Click here to learn more and download the 2021 application.
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The Interprofessional Education (IPEP)
Case Studies
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The Interprofessional Education and Practice (IPEP) online case studies will prepare healthcare practitioners to effectively and efficiently collaborate in providing quality primary care to adults with chronic conditions
Click here to learn more.
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IPEP Case Study Series:
Alcohol
Oral Health and Dementia
Depression
COPD
Heart Failure
Dizziness
Transitional Care
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HIGN Highlights
HIGN's Executive Director Tara Cortes, RN, PhD, FAAN has been selected as a 2021 Fellow of the Gerontological Society of America in the Health Sciences Section.
Prof. Tina Sadarangani has been named a Rising Star by McKnights's Long-term Care News.
Prof. Bei Wu made an invited keynote presentation titled "Improving Long-term Care Quality in China" at the Symposium on Chronic Illness Care, 7th Pan-Pacific Nursing Conference, organized by the University of Hong Kong School of Nursing
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