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Senior Programs

A True LIFE St. Mary Testimonial

Bill and Nancy Marucci, of Southampton, Pa., have been married for 51 years. Nearly three years ago, they knew something was wrong when Bill kept falling, started hallucinating, and calling out in the middle of the night that people were trying to kill him.

Bill eventually was diagnosed with Lewy Body Dementia (LBD), a progressive neurodegenerative disorder that most commonly occurs in persons age 60 and older. Cognitive (thinking) impairment, abnormal behavioral changes and fluctuations in alertness are typical symptoms. Many patients with LBD also have evidence of Alzheimer's and Parkinson's disease* with an increasing decline in mental abilities and mobility. Nancy patiently and lovingly cared for Bill, however it was tiring, frustrating, and sometimes scary to see the changes in his personality and mobility and not fully understand what was going on.

"Some days I wanted to scream," says Nancy. "It could take him five to 10 minutes to physically turn himself around. He just couldn't do it, and he couldn't help it. And yet, when we played games, he had a mind like a steel trap. He could easily remember things from 20 to 40 years ago."

Nancy became more and more discouraged as the time and skills required to tend to Bill's needs continued to increase, and she found it ever more challenging to keep providing that level of intense care. Nancy heard about LIFE St. Mary from a relative who worked for a similar program in Bethlehem, Pa.

LIFE (Living Independently For Elders) St. Mary is a Program of All-inclusive Care for the Elderly (PACE), a comprehensive service-delivery system established by the Balanced Budget Act of 1997 as part of Medicare and Medicaid benefits. It is a unique care model designed to assist frail and disabled older adults and allow them to live safely at home with help from a team of healthcare experts specializing in geriatric care.

"The LIFE program provides a much-needed level of coordinated care for seniors and is a cost-effective alternative to traditional institutional-based care, like nursing home admission," says Gail Kosyla, Senior VP and Chief Financial Officer. "Providing the support that seniors need to stay comfortably in their own homes benefits the quality of life for the frail and elderly in our community as well as their caregivers."

After attending a conference to learn about the PACE program, Terri Rivera, Vice President, Mission and Community Health at St. Mary Medical Center, believed it to be a valuable service that would benefit the aging population of Bucks County. "This is a unique model that would round out St. Mary's continuum of care for those who are vulnerable," she says. The start-up team for LIFE St. Mary includes Emily Amerman, Executive Director; Suzanne Correll, Director of Finance; Dr. Daniel Haimowitz, Medical Director; Mary Ann Sheehan, Center Director; Lori Trotter, Director of Quality Assurance/Performance Improvement; Erin Oldt, Manager, Outreach and Enrollment; and Rita McCafferty, Administrative Coordinator.

The LIFE St. Mary team applied for and received approval from the state for the rights to serve all ZIP codes in Bucks County. They then set about opening the first center in the Lower Bucks area. Knowing that many program participants would have mobility challenges, a large, easily accessible building was identified in the Neshaminy Interplex complex off Street Road in Trevose, Pa. The ground floor was configured to meet program needs, and a health center and administrative offices were added on the second floor. The LIFE St. Mary Center opened in March 2010.

With Nancy's support, Bill, who will be 75 years old in September, was qualified by Medicaid and applied to LIFE St. Mary as one of the program's first participants. A team of experts - a doctor, nurse, social worker, physical therapist (PT), occupational therapist (OT), recreational therapist, home care nurse, and dietitian - assessed his needs and established a recommended program of care. An OT and nurse visited the Marucci's home and made modifications to help with his mobility - they installed hand grabbars in the bathroom, and brought him adaptive equipment, a hospital bed, and pulley system. The LIFE program works with participants in their homes as well as at the center. The program's goal is to keep participants as active as possible and safely in their homes for as long as possible.

Initially, Bill attended what he calls "school" three days each week. Over time, his plan was revised to meet his changing needs, and today he receives care at the LIFE St. Mary center Monday through Friday. On Tuesdays and Fridays, Nancy sends clean clothes with him to wear after he receives a shower at the center. On other days, a caregiver goes to the Marucci home at 6:45 a.m. to help Bill with personal needs before the LIFE bus comes to transport him to the center.

LIFE St. Mary has five vans and mini buses that provide participants with transportation to the center and off-site appointments as needed. Each van has a specially trained driver and escort who assist in getting people on and off the van, and interact with participants to ensure their comfort and safety. When Bill gets to the LIFE Center he enjoys a light breakfast and a full, nutritious lunch later in the day. He also works with several therapists. Nancy says his mobility has improved since he became a LIFE participant. "At first he couldn't walk by himself," says Nancy. "Now he does much better, although, one day he'll seem fine; the next he'll stumble. It's all part of the disease process." Activities at the center, such as word games, provide Bill with the brain stimulation he needs and although Bill struggles with short-term memory, he enjoys talking with friends at the center, especially about things that happened 20 years ago.

Bill sees nearly all his doctors at the LIFE center, where the LIFE primary care doctor is on site daily. Other professionals who treat participants in the site's health center include an optometrist, dentist, psychiatrist, audiologist, and podiatrist. LIFE St. Mary offers as many services as possible - medical, dental, social services, rehabilitative services, and more, all under one roof and one comprehensive care plan. Erin Oldt, Manager of LIFE's Outreach and Enrollment, has been involved with LIFE programs since 2000. "It's the best model I know of for healthcare for older adults," she says. "We really do things based on need and around what will help each individual the most. Our program has a lot of flexibility."

Should a participant need the care of a specialist off-site, the LIFE St. Mary team coordinates all appointments and provides transportation. Recently Bill needed cataract surgery, and LIFE arranged the appointment, as well as transportation for Bill and Nancy to the surgeon's office and back.

Nancy says everyone at LIFE St. Mary is as nice as they can be - the van driver, receptionist, therapists, aids, administrators - everyone. They counsel her. They supply all Bill's medications. And if she needs to talk with a care expert right away, someone is on-call 24/7. She says the support and care they give both Bill and her always makes her feel better.

Emily Amerman, Executive Director, was carefully selected to head up the LIFE St. Mary program. She previously worked with St. Agnes LIFE, the first PACE program in the area. She believes the coordinated care and close relationship that the LIFE program offers is a wonderful asset for participants and families alike. LIFE makes it easier for families to navigate complicated healthcare and long-term care systems.

Amerman appreciates the support St. Mary provides in sponsoring the program. "St. Mary is known for reaching out and caring for the community, especially for the poor and underserved. LIFE St. Mary expands our continuum of care to a low-income and frail senior population," she says. "I especially enjoy working with St. Mary."

Although LIFE programs offer a community-based alternative to costly nursing-home care, there is great pressure to control costs, especially in light of state budget constraints. The LIFE program is estimated to be 20-percent less expensive than nursing home care," says Amerman, "and for that reason, federal and state policy makers support it. We are grateful for the foresight of our legislators."

"This is the best healthcare and long-term care for older adults I've ever seen," says Nancy. "Bill is able to live at home with me, get high quality care and coordinated services. They help me understand what is going on with Bill and offer solutions that make life a lot easier. Since I can never leave Bill alone, I get everything I can done while he's at the center. LIFE St. Mary is the best thing that has ever happened to us. If Bill wasn't there now, he would be in a nursing home. This program has been a God send."

LIFE St. Mary opened March 1, 2010, with seven participants. Today nearly 100 people are enrolled. To be eligible, a person must be 55 or older; live in the LIFE St. Mary service area, need services that require a nursing-home level of care, be able to live safely in the community with LIFE-services support, and qualify financially. Many participants qualify through Medicare or Medicaid.

The LIFE St. Mary Center is located at 2500 Interplex Drive in Trevose, Pa. The center is open 8 a.m. until 4:30 p.m. Monday through Friday. Older adults who live in the following Bucks County ZIP codes can apply to participate: 18940, 18954, 18966, 18974, 18977, 19007, 19020, 19021, 19030, 19047, 19053, 19054, 19055, 19056, 19057, and 19067.

For more information about LIFE St. Mary, visit www.LIFEStMary.org or call 267.991.7600. To learn more about National PACE Association, visit www.npaonline.org.