For numerous at-risk elders, the following scenario is a frustratingly common one occurring daily in homes across the United States: A patient dealing with an injury, illness, or the irreversible ravages of old age falls through the cracks of a health care system that too frequently fails to address the needs of seniors who live alone or have a beleaguered elderly spouse struggling to provide their daily care.
Those who can afford the luxury of hiring private nurses, home health aides, and therapists to tend to their daily needs are indeed fortunate. But what about the countless numbers of “invisible” and economically disadvantaged seniors who are essentially homebound due to their declining health and suffer the indignities of abuse and neglect?
To address these concerns, as well as educate future generations of physicians, Nova Southeastern University College of Osteopathic Medicine’s (NSU-COM) Florida Coastal Geriatric Resources, Education, and Training Center (GREAT GEC) joined forces with the Aging and Disability Resource Center (ADRC) of Broward County to form an innovative educational alliance that is altering people’s perceptions of this imperative issue.
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(l-r) As a component of their required geriatric rotation, NSU-COM students David Tran, Chris Bailey, Michael Marro, and Russell Zhuravsky participated in a home visit conducted by the ADRC’s Gail Gannotta. |
The partnership, which began several years ago following a productive meeting between Naushira Pandya, M.D., associate professor and chair of the college’s Department of Geriatrics, and ADRC leadership, has proven to be an effective and enlightening way for physicians-in-training to witness firsthand the plight of seniors who are “aging in place.” During the initial meeting, which included Edith Lederberg, M.S., ADRC executive director, and Gail Gannotta, L.P.N., program director of the ADRC’s Senior Intervention and Education Program, the idea was hatched to have a select group of NSU-COM students, as well as residents and fellows, shadow Gannotta during her in-home visits with isolated and at-risk seniors.
“Once Edith and Gail explained what the Senior Intervention and Education Program does, which is outreach to isolated Broward elders through in-home visits to aid their efforts to care for themselves and remain independent in the community, I knew it would provide a great learning opportunity for our students,” Dr. Pandya explained. “We make occasional home visits in our program, but normally patients have to come to the NSU Geriatric Clinic for care. However, what Gail does is way beyond that, such as intervening after hospital discharge and helping seniors get back on their feet, free of charge. I thought that would be a great venue for our medical students who are doing their geriatric clinical rotations with us here at NSU.
Lederberg, who has served as the ADRC’s executive director for several decades, says there are many beneficial aspects related to this innovative alliance between an academic institution and a social service agency. “The program is replicable, able to sustain lives, and humane,” she stated. “We believe that involving the corporate world, nonprofit social service arena, and educational facilities can provide solutions to problems that are affordable, sustainable, and commendable at a time when the health economy is crying out for answers that may be found quickly if the search is pointed in the right direction.”
During a recent in-home visit, four NSU-COM students had the opportunity to accompany Gannotta as she conducted a follow-up visit with an essentially homebound and morbidly obese client who suffered from a variety of chronic health issues, including emphysema and diabetes. Unable to leave her condo freely because it lacks an elevator, the client was enmeshed in an agonizing web of health care bureaucracy that provided seemingly insurmountable obstacles instead of solutions. Fortunately, with Gannotta acting as a one-woman advocate for her client, the students were afforded a visceral view of what is occurring daily away from the confines of a clinic, hospital, or private physician’s office.
“Every time I get to expose my clients’ problems, especially to medical students from a prestigious school where I get to show them what’s going on in our community, right down the street from where they’re attending school, it makes me feel as if I have shed some light on a very, very dark place,” Gannotta added. “To me, the most important aspect is that we are helping our vulnerable and isolated senior population in Broward County to live with dignity, which can be accomplished by preventing abuse, neglect, and exploitation as well as premature nursing home placement.”
