TriHealth Senior Link

Josh Abell, Summer 2011

Senior Link provides comprehensive care for the program’s participants, who are served either through home visits or trips to one of Cincinnati’s three health centers (Park Eden, Court Street, Norwood). Senior Link’s fleet of buses is used to transport participants to the health centers and deliver medication to participants’ homes. Medications are provided by the health center’s onsite pharmacy. This unique style of healthcare is known as the Program for the All-Inclusive Care for the Elderly (PACE).

The variety of services provided are a result of the collaboration of the participant’s health care team, which includes a primary care member (doctor or nurse practitioner), nurse, health aide, dietician and social worker. Specialist care is also provided from a variety of caregivers including: physical therapists, occupational therapists, audiologists, dentists, podiatrists, psychiatrists, optometrists, and more.

For those participants who are unable to leave their home, all care is provided through home care visits. These include visits from their primary care team for medical needs or visits from health aides, who provide help with food, cleaning, laundry, and hygiene maintenance.

As an Urban Health Project intern, I had the opportunity to work at the Senior Link site in Norwood. While lessening the work load of the staff, I have been able to learn about this unique style of healthcare and the barriers faced by the poor elderly population of Cincinnati.

I assisted the various departments at the health center in Norwood. During the early morning hours, I helped the health aides by escorting the participants from the busses to their preferred seats in the day health center. For the duration of the remaining service hours, I assisted the clinical staff. My tasks included escorting patients to the clinic, recording their weight and vital signs, and shadowing the doctors and nurse practitioners. I also had the opportunity of shadowing on home visits to observe the various barriers that hinder patients from leaving their homes.

Outside of my structured daily tasks, I had the great opportunity of interacting with the participants. In addition to fulfilling healthcare needs, Senior Link provides the participants with the opportunity for socialization. Many participants report that their favorite aspect of the program is the camaraderie they gain from making new friends at the health centers.

Senior Link will be implementing the MOLST program. This program will establish a set of protocols for recording and executing medical orders of life sustaining treatment. This program is already a standard in many states, but will be used as a supplementary tool at Senior Link.

Today there remains confusion about the various types of advanced directives. Some healthcare professionals are uncertain as to when the directives are applicable and some patients harbor the misconception that advanced directives will result in care being withheld. The MOLST program will provide training for the primary care team to carry out end of life discussions and recording wishes regarding life sustaining treatments. The end result of the program will be a set of standing medical orders that will be applicable regardless of the patient’s decision making capacity.

To assist in the implementation of the MOLST program, I conducted a pre-MOLST survey to assess the Senior Link staff’s attitudes and understandings of advanced directives. The intern of the summer of 2012 will conduct the post-MOLST survey. The data will be analyzed to assess the impact and success of the MOLST training program.