Often nurses are faced with the daunting task of helping older adults adjust to life when they experience chronic disease and the inevitable changes associated with aging.
Stay Healthy, a program at the Madison Senior Center, in Madison, New Jersey, helps the elderly to stay healthy, active, and involved. It is nurse-managed and focuses on health promotion and disease prevention service free of charge to the elderly in the surrounding community.
Program in action
On the last Wednesday of every month, the craft studio at the center is converted to the Stay Healthy program. Staff members and clients meet with me by appointment for physical assessment and to discuss personal concerns, clarify misunderstandings, and ask questions. Important topics like medications, lab reports, sleep hygiene, and nutrition, are all discussed.
At the end of the meeting, any necessary referrals are made, and each and every person is encouraged to stay mobile and socially involved. Where appropriate, I discuss the option of assisted living and arrange facility visits.
These sessions do not replace primary care; rather, they supplement, clarify, and complement it. I become an advocate for the client and the client is a knowledgeable participant in his or her own care.
Clients are also seen on a walk-in basis one additional day, usually the day scheduled for trip sign-ups. At that time, I am available to discuss the program, distribute informational handouts, and assess vital signs.
Jacqueline Bennett, a retired RN, greets clients when they arrive for scheduled appointments, takes their blood pressure, and makes future appointments. The senior center van is available to provide transportation from the persons home to the center, when necessary.
Getting it started
Having previously directed a college-managed nursing center, I saw great potential for a similar service at the Madison Senior Center.
More than 13% of the people in the surrounding area are age 65 and older; most have multiple chronic illnesses and diminished functional ability that could be improved by risk reduction and behavioral changes.
At the same time that I was considering this possibility, the number of elders who were participating in the center activities and programs was increasing. I found myself being called aside on a regular basis with health-related questions.
Because I was retiring and wanted to continue my gerontologic practice on a limited basis, this seemed like a perfect fit. It was a way for me to serve the community that I love.
To get the program off the ground, I described the Stay Healthy program in writing, outlined goals, and built partnerships with relevant local officials and people in the community the senior center coordinator, the mayor, the director of nursing at the Department of Health, the health educator, and the borough manager.
Everyone has been supportive and enthusiastic in the process. Initially, insurance coverage was reviewed by our borough administrator; the borough already provided insurance for all personnel, volunteers, and programs at the senior center.
Funding, which has been approximately $700 for equipment and $600 for printing costs so far, is provided by the center, with additional support from the N.J. Alliance for Drug and Alcohol Prevention. Edna Ierley-Byrne, the center coordinator, works closely with me in terms of allocating funds, buying equipment, and working on publicity.
Department of Health nurses and the borough health educator collaborate with the Stay Healthy program, provide consultation when necessary (for example, material for diabetes, use of medical equipment), and participate in joint health-related programs, including a series on safe use of medication. Clients are encouraged to join other health-related programs, such as Healthy Bones, a community-based walking program, line dancing, and additional senior center activities.
Approximately 100 clients have been seen since the start of the Stay Healthy program in June 2004, in 500 visits.
Although no formal survey has been conducted, clients have commented positively about the program, the medical referrals, and about the opportunity to discuss health-related issues and personal concerns with a nurse. Several clients have mentioned that it was the nurse who identified skin lesions that turned out to be malignant.
A real side benefit is that clients are participating more consistently in senior center activities and several have become volunteers in one of its many programs. Most important of all is that clients are now taking a more proactive approach to staying healthy.
Editors note: Read a related article online about the Prescription for Better Health and Wellness Award given to the Stay Healthy Program.