After polling a few colleagues, I am unconvinced that there is one single issue that stands out above the rest for seniors in Vermont. But one response in particular really caught my attention. When PACE’s Nurse Practitioner, Rosemary Dale, responded with “isolation,” I immediately thought of my neighbor who stays inside her house alone, all day, every day; and who, for this reason, I just met two weeks ago, despite being her neighbor for almost two years. Another neighbor also stays home all day, although he is not always alone. When I mention the PACE program to his family as an option for healthcare, they respond with “oh, he’d never agree to go there.” I choose not to push the issue, even though he could receive services at home through PACE.

More and more terms are cropping up to describe this group: “shut-ins,” “home-bound,” and the idea that “they’re not joiners.” I talk with colleagues in the home care arena who report utter shock in their discoveries of how many older adults live alone in unsafe home environments. I see a fierce resistance to nursing homes and adult day programs among seniors.

Photo courtesy of Daria Bishop.

I also see a strong resistance among some new PACE participants regarding attendance at our Health Centers, which include an adult day program; however, after getting to know fellow participants and staff, they change their minds and sometimes even ask if they can come to the Center more often.

Depression comes up in social work and psychology research as a highly common, under-reported, under-diagnosed, and therefore under-treated condition affecting seniors. Social isolation and depression often go hand in hand, and increased socialization effectively decreases depressive symptoms. Seniors with depression are more susceptible to contracting infections and other illnesses that can land them in the hospital and put them at risk for losing function.

Many seniors fulfill their needs with in-home care. However, there are not enough caregivers to go around with the current caregiver shortage. The PACE Health Centers (one in Rutland and one in Colchester) offer a solution to this by having health care providers all in one place. Participants can receive assistance from an LNA in the shower, see their primary care physician, physical and occupational therapists, nutritionist, and social worker, and share a home-cooked meal with fellow participants. With care providers concentrated in one place, more seniors can be served. While those that are unable to make it to the Center can get services in their homes, Center-based services are stressed primarily for two reasons. First, for the above-mentioned benefits of socializing. And second, because PACE can be assured that there will be adequate staff at the Center, whereas the likelihood of a home care provider calling out sick and not finding a replacement is too great and puts this vulnerable population at too great a risk for hospitalization.

So, to those that “poo-poo” adult day programming, I urge you to give it a try. You may be surprised to find increased independence, meaningful friendships, and new-found knowledge of other services that could benefit you and help you maintain your independence as you age.

Naomi Galimidi is the Director of Intake and Marketing for PACE Vermont Inc.