Collaborative Effort Helps Seniors Avoid Nursing Homes, ERs

Jun 7, 2013

A few days a week, Joe Finkelpearl goes to the Jewish Community Center and makes phone calls.

He calls a few dozen fellow seniors from an office and chats them up, talking about sports and books, but also ensuring their meals are delivered and their furnaces are working in the winter.

An 81-year-old retired widower, he is a volunteer for Agewell Pittsburgh, a one-stop referral system that provides coordinated access to services for seniors who are living independently.

"It gives me something to do, and it gives me a good feeling to call them and say 'hello,'" Finkelpearl said. "To make friends, some of them have become telephone friends, ands some have become friends in the lunchroom. They come in and eat; it's good for me and good for them … I hope," he said.

AgeWell Pittsburgh is four social service agencies that are working to keep the elderly healthy and independent as long as possible, which improves their quality of life while keeping health care costs down. The agencies, Jewish Family and Children’s Services, Jewish Association on Aging, Jewish Community Center and the Jewish Federation of Greater Pittsburgh, serve around 5,600 people.

Jordan Golin, director of clinical services at Squirrel Hill Psychological Services, part of Jewish Family and Children’s Services, said their formula, which involves staff at these organizations coordinating services isn’t easy.

"This level of collaboration is really hard," he said. "It requires a lot of trust, just like a relationship, like a marriage. There will be things that we do and mistakes that are made, and we have to correct those mistakes."

The program was started eight years ago with some federal and state funding. Golin called it a “virtual organization.”

"It's virtual in the sense that we don’t have a board, we don’t have a building, we don’t have a payroll, we take three existing organizations and put a collaborative structure on top of them in order for us to function as if we were a single organization," he said.

Golin said their biggest feat is in allowing seniors to live in their homes as long as possible while ensuring they are involved in the community and keeping down overall health care costs. Nursing homes and hospital visits are more expensive than living at home and regular doctors' visits.

"Study after study has shown that older adults have preferred to remain in their homes as they age," Golin said. "They don’t want to live in a facility; they don’t want to live in an institution. Quality of life is greater when they are living in the community. They seem to remain healthier physically, emotionally, mentally when they are living in their residence of choice than if they are living in an institution."

Hospital and nursing home admission rates for Agewell clients were lower than the estimated rates for other Medicare recipients in Pittsburgh and nationwide for the 11-month period ending in March 31.

According to an assessment tool developed with the University of Pittsburgh, Agewell clients reported an estimated 28 emergency department visits per 100 clients per year, fewer than half the estimated 68 emergency room visits per Medicare recipients elsewhere in Pittsburgh and 55 per 100 Medicare clients nationwide. That saves money, since an emergency room visit can range up to $6,932.

While there are those types of successes in independent living, there’s also the risk of isolation and depression, which is where volunteers like Joe Finkelpearl come in.  

"I think a lot of them need companionship of some kind, some people to talk to just talk and I think it helps that they know that someone cares for them … a little bit," he said.

Finkelpearl said he lets those he calls know about programs and activities at the Jewish Community Center.

One of the seniors who comes in for activities is Elfi Rook, an 88-year-old Holocaust survivor.

"I feel at home here," she said. "I have no problem being here."

With Pittsburgh’s aging population, Agewell is expanding. The program has been working with the Squirrel Hill Health Center. The center has recently begun piloting Agewell’s risk assessment tool, which ranks seniors who are in danger of hospitalization or nursing home admission.

This story was co-reported with reporter Kris Mamula as part of a partnership with the Pittsburgh Business Times.