1996-Present Across the nation, nurses are making a difference to senior citizens by helping them stay in their homes.
"It's so rewarding," says Debrah Jackson, RN, BSN, recently retired from Harris Methodist Health System in Fort Worth, Texas. "To see a senior who has been down and is now back up again is the most rewarding thing you can see in your life."
Jackson and 51 other nurses volunteer for the Living at Home/Block Nurse Program (LH/BNP) in Fort Worth.
The program, which began in Texas in 1996, uses nurses and other volunteer staff to coordinate services to the senior citizen population in everything from medical care and home repair to help with grocery and utility bills. The program has 302 clients, says Gwen Diggs, director of the program.
"We're helping seniors to stay independently in their homes," she says. "None of them want to go to a nursing home."
The nurses who volunteer for the senior program range from students at nursing schools to nurses retired from local hospitals, Diggs says. And they could always use more.
Most nurses volunteer on two-hour shifts as case management workers who give home assessments to determine what the seniors need, says Jackson, who is a board member of the community-based program. Nurses can work as often as they like, whether once a month or weekly, she says.
Once the assessment is made, volunteers and services are matched with a client. Among the volunteers are a doctor who makes house calls, housekeepers, and home repair workers. Other workers for programs such as Meals on Wheels also are brought in when help is needed with food, energy bills, and other costs to the elderly.
The program has kept hundreds of seniors out of nursing homes, Diggs says. "They give up when they go to a nursing home," she says. "If they can stay home, they have a will to live."
Barbara Coleman, 77, has been using the NSEAM program for more than a year. Nurses visited frequently to check her vital signs after recovering from cancer and a broken foot, she says.
"I am proud of them," Coleman says of the NSEAM volunteers. "When you start getting up in age, you don't have too many people interested in what you're going through."
Coleman says she would be in a nursing home without the program but prefers to be home.
The program has served as an important coordinator among different agencies and nonprofit outreach programs, says Kelly LaMendola, RN, BSN, an outreach nurse for the Fort Worth Health Department.
"I use NSEAM as a referral source if we run into an isolated family or a person who needs just a little bit of extra help," LaMendola says.
NSEAM received a United Way grant for a pilot called the Senior Isolation Project, which brings all of the local services together for a monthly meeting to discuss individual cases, LaMendola says.
"There are so many services to help people, but unless we know the referral process and the way they work together, we can't use them," she says.
For example, a driver for Meals on Wheels may observe that a client needs help with paying bills and getting medicines coordinated for the week. During the Senior Isolation Project meeting, this family can be brought up by the Meals on Wheels coordinator, and the other agencies can learn about their needs and offer help.
The LH/BNP model was started more than 20 years ago, says Malcolm Mitchell, executive director of the Elderberry Institute, which is based in St. Paul, Minn. It is a citizen-driven model, based on developing a local support network.
Minnesota leads the nation with 40 LH/BNPs located in neighborhoods throughout the state, Mitchell says. There is also one program each in North Dakota, Ohio, and Texas.
"It started in the St. Anthony Park neighborhood in Minnesota in 1981," Mitchell says. "Five women, including some nurses, said there must be a better way to handle the needs of the elderly who would like to stay home rather than end up at a nursing home prematurely."
The LH/BNPs are very cost-effective relative to nursing home care, Mitchell says. Given the cost of acute medical care nursing home stays, a typical LH/BNP's annual budget can be recovered by helping just two elders avoid or delay using institutional care for a year.
"A University of Minnesota study shows that 85% of the people enrolled would have been in nursing homes without the program," Mitchell says.
The program also does not strive to re-invent the wheel by duplicating community services already established. LH/BNPs typically coordinate existing social services and only supplement when needed services are not available or are difficult to obtain.
"The typical model in the healthcare field is a large corporation, and they do it top down," Mitchell says. "This model encourages small communities to work from the bottom up."
To volunteer for the NSEAM Living at Home/Block Nurse Program, nurses can call Diggs at (817) 338-2958 or visit http://new.elderberry.org/programs.asp.