When you have an loved one growing older, it can be a challenging process to figure out what’s best for their living situation, and who will help take care of them.
LIFE (Living Independently For Elders) at Lourdes is the newest healthcare choice for elders living in Southern New Jersey.
Lourdes offers Program of All-Inclusive Care for the Elderly (PACE), a unique program that can assist elders to live safely at home while being helped by a team of healthcare experts.
Listen in as the Medical Director of Life Saint Francis, Dr. Pam Fenstemacher shares the services that are provided as well as who is eligible, the goal of the program, and why PACE is a great option for your loved one.
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LIFE Program Benefits To Seniors
Featured Speaker:
After going to medical school at New York University, Dr. Fenstemacher trained in Family Medicine, and then Geriatric Medicine at the University of Pennsylvania. Dr. Fenstemacher taught Family Medicine residents and cared for the elderly, while also working as a medical director in many settings. In 2012, she became Board Certified in Hospice and Palliative Care Medicine as well.
Dr. Fenstemacher continues to teach and write about Geriatrics and Medical Direction, the second edition of her book, Post-acute and Long-term Care Medicine: A pocket guide was published in January 2016.
Because she was interested in exploring Medical Direction in the PACE model, in 2011 Dr. Fenstemacher became involved in working with LIFE programs in Pennsylvania, which have included Genesis's for-profit LIFE at Home, and the non-profit programs of Mercy LIFE and LIFE at The University of Pennsylvania School of Nursing. She is happy to be the medical director of LIFE Saint Francis.
Pam Fenstemacher, MD
Pamela Fenstemacher, MD, CMD, FAAFP, began working in the PACE environment in 2011 when she became a medical director of her first LIFE program.After going to medical school at New York University, Dr. Fenstemacher trained in Family Medicine, and then Geriatric Medicine at the University of Pennsylvania. Dr. Fenstemacher taught Family Medicine residents and cared for the elderly, while also working as a medical director in many settings. In 2012, she became Board Certified in Hospice and Palliative Care Medicine as well.
Dr. Fenstemacher continues to teach and write about Geriatrics and Medical Direction, the second edition of her book, Post-acute and Long-term Care Medicine: A pocket guide was published in January 2016.
Because she was interested in exploring Medical Direction in the PACE model, in 2011 Dr. Fenstemacher became involved in working with LIFE programs in Pennsylvania, which have included Genesis's for-profit LIFE at Home, and the non-profit programs of Mercy LIFE and LIFE at The University of Pennsylvania School of Nursing. She is happy to be the medical director of LIFE Saint Francis.
Transcription:
LIFE Program Benefits To Seniors
Melanie Cole (Host): When you have a loved one growing older, it can be a challenging process to figure out what’s best for their living situation and who would help take care of them. Life Centers are the newest healthcare choice for elders living in Southern New Jersey. My guest today is Dr. Pam Fenstemacher. She’s the medical director at Life Saint Francis. Welcome to the show, Dr. Fenstemacher. Tell us what Life Centers, Living Independently for Elders, even is?
Dr. Pam Fenstemacher (Guest): Well, thank you for inviting me onto your program. Life Saint Francis is a program that strives to keep seniors living safe and independently in their homes for as long as possible. We take care of folks that are 55 years of age or over, that live in our demographic area and meet the criteria for being a nursing home level of care eligible. One criteria is that they must be able to live safe in the community with the services of PACE or the Life Program.
How does the PACE model work, you ask? Well, we’re an interdisciplinary team model where we try – the interdisciplinary team, which involves social workers, primary care providers, nurses, home healthcare nurses, clinic nurses – we as a team strive to develop individualized care plans that meet the needs of the PACE participant in the community.
Melanie: So, Doctor, tell us more about the model.
Dr. Fenstemacher: Well, at the core of the PACE model is the interdisciplinary team and the care plan that they develop. For example, if you have an elderly parent who is living in your home and they need to have someone to take care of them during the day because they have some memory loss or some cognitive impairment, one of the things for them we could do is if they aren’t able to care for themselves and get themselves ready in the morning, we may send someone out to their home, a home health aide, to try to help get them ready in the morning and then bring them into the center. We are center based, so we have an adult day center where they can be during the day while their loved ones are at work. During the say, not only at the adult day center, but we also have a medical clinic, so if they have any medical problems or ongoing medical care that’s needed, they can be seen. They also get meals and have activities during the day. One of the unique things about PACE is we also have transportation. We have a transportation department that actually will bring them to the center, and after their day of activities they will be transported back home and if in need, and if their family isn’t home yet, we often will send home health aide out to their home to help get them ready and take care of them at the end of the day until their family arrives home.
We are a program of all-inclusive care of the elderly. We not only provide medical care, nursing care, we have a therapist on staff that can do therapy during the day if that is needed – not just recreational therapy, but we also have physical therapy, occupational therapy, speech therapy, if needed. We have a podiatrist on site. We have a dentist that comes on site. We have multiple other consultants that also come on site to try to give comprehensive social and medical care of our folks.
Melanie: What a wonderful program and, Dr. Fenstemacher, how does PACE differ from other long-term care alternatives?
Dr. Fenstemacher: One of the things we pride ourselves in is that we have these individualized care plans where we try to coordinate the medical care of all of the participants in our program. What makes us a little different? We’re not only a program, but we also get funds from Medicare and Medicaid, and we use those funds to take care of our folks. We can do things that other insurance programs can’t. We don’t have to follow all of the Medicare and Medicaid rules. We can do things like send someone directly from the center – if we think they’re having issues – to the nursing home for a short stay instead of having to hospitalize them. Say they’re feeling a little weak, or they need a little therapy, we can either do it on site or if they need IV antibiotics, we can send them directly to the nursing home and avoid a hospitalization entirely. Many folks find that that is really a great benefit mainly to caregivers.
We also give respite. Our participants are entitled to a certain amount of respite as needed where they can -- if their loved ones want to go away on vacation and their mom is elderly and confused or frail and can’t take care of themselves, we can send them to the nursing home for a couple of weeks of respite while their family goes away on vacation, for example.
Being that we’re all-inclusive, we also give medications. Our staff of primary care providers is the primary medical care of these folks, and we also have primary nursing care. We not only prescribe medications, but we also make sure that they get the medications for them. All of the providers here – pretty much we all have geriatric experience and myself, and the nurse practitioners are geriatricians as well. As geriatricians, we have this special focus of the elderly.
Melanie: And how do you work with the families in this Life Program? How can they get involved?
Dr. Fenstemacher: Families are – we see them as our partners. We partner with the family to try to work with them to make sure that their loved ones get the care they need. It’s not about us, it’s not about the caregivers, it’s about partnering together with the caregivers to see where we can meet their needs – if they have to go to work, they’re working and they need someone there then we bring their folks into the adult day center so that they can have care during the day, for example. We try to work creatively with the families to meet the needs of our participants.
Melanie: What about the cost to the elderly population for this and how do you work that and explain that to families?
Dr. Fenstemacher: Fortunately, the vast majority of our participants have Medicaid and Medicare, and that’s where our funding comes from is from Medicare and Medicaid. We do have a few people that have Medicare only, and they – our Medicare only people – we also, for a small fee, they can also participate in our program and pay that Medicaid fee. The vast majority of our folks, probably close to 80% are what we call dually eligibles – they have Medicare and Medicaid.
Melanie: So, wrap it up for us, Dr. Fenstemacher, on why you would like people to choose the Life Program, or PACE. Give us a wrap-up. Tell us your best advice.
Dr. Fenstemacher: I would say – 93% of PACE participants nationally remain at home, avoiding a nursing home or assisted living placement. 83% of PACE participants see a reduction in hospital stays and 33% of PACE participants experience an increase in life-expectancy and quality of life. For our program, what we can give that other people cannot give them is that we can give them a longer life and a higher quality of life with our wrap around services, and that’s where I think we really excel, in not just giving hands-on care, but also, I think our hearts are there also caring for our participants.
Melanie: And then one last question, Doctor, what about socialization? Speak about that for a minute, and how that’s involved and the social aspect of this is so important for this population and explain a little bit about how that works?
Dr. Fenstemacher: You did touch on something very important. Many of our participants have problems getting around – they have functional deficits is what we say in the PACE world, meaning they can’t actually – if it wasn’t for us they’d be home-bound. What we do is we have transportation that can assist not only our participants getting to doctors’ appointments and seeing their primary care providers, but also get them to the adult day center where they can have activities that are geared towards their ability level. Being we’re a medical day center, we specialize in folks that have more deficits and more disabilities than the average day center is capable of caring for. We specialize in developing socialization and also activities that are appropriate to their level of ability.
Melanie: Thank you, so much, for being with us today, it’s such important information. You’re listening to Lourdes Health Talk, and for more information, you can go to LourdesNet.org, that’s LourdesNet.org. This is Melanie Cole. Thanks, so much, for listening.
LIFE Program Benefits To Seniors
Melanie Cole (Host): When you have a loved one growing older, it can be a challenging process to figure out what’s best for their living situation and who would help take care of them. Life Centers are the newest healthcare choice for elders living in Southern New Jersey. My guest today is Dr. Pam Fenstemacher. She’s the medical director at Life Saint Francis. Welcome to the show, Dr. Fenstemacher. Tell us what Life Centers, Living Independently for Elders, even is?
Dr. Pam Fenstemacher (Guest): Well, thank you for inviting me onto your program. Life Saint Francis is a program that strives to keep seniors living safe and independently in their homes for as long as possible. We take care of folks that are 55 years of age or over, that live in our demographic area and meet the criteria for being a nursing home level of care eligible. One criteria is that they must be able to live safe in the community with the services of PACE or the Life Program.
How does the PACE model work, you ask? Well, we’re an interdisciplinary team model where we try – the interdisciplinary team, which involves social workers, primary care providers, nurses, home healthcare nurses, clinic nurses – we as a team strive to develop individualized care plans that meet the needs of the PACE participant in the community.
Melanie: So, Doctor, tell us more about the model.
Dr. Fenstemacher: Well, at the core of the PACE model is the interdisciplinary team and the care plan that they develop. For example, if you have an elderly parent who is living in your home and they need to have someone to take care of them during the day because they have some memory loss or some cognitive impairment, one of the things for them we could do is if they aren’t able to care for themselves and get themselves ready in the morning, we may send someone out to their home, a home health aide, to try to help get them ready in the morning and then bring them into the center. We are center based, so we have an adult day center where they can be during the day while their loved ones are at work. During the say, not only at the adult day center, but we also have a medical clinic, so if they have any medical problems or ongoing medical care that’s needed, they can be seen. They also get meals and have activities during the day. One of the unique things about PACE is we also have transportation. We have a transportation department that actually will bring them to the center, and after their day of activities they will be transported back home and if in need, and if their family isn’t home yet, we often will send home health aide out to their home to help get them ready and take care of them at the end of the day until their family arrives home.
We are a program of all-inclusive care of the elderly. We not only provide medical care, nursing care, we have a therapist on staff that can do therapy during the day if that is needed – not just recreational therapy, but we also have physical therapy, occupational therapy, speech therapy, if needed. We have a podiatrist on site. We have a dentist that comes on site. We have multiple other consultants that also come on site to try to give comprehensive social and medical care of our folks.
Melanie: What a wonderful program and, Dr. Fenstemacher, how does PACE differ from other long-term care alternatives?
Dr. Fenstemacher: One of the things we pride ourselves in is that we have these individualized care plans where we try to coordinate the medical care of all of the participants in our program. What makes us a little different? We’re not only a program, but we also get funds from Medicare and Medicaid, and we use those funds to take care of our folks. We can do things that other insurance programs can’t. We don’t have to follow all of the Medicare and Medicaid rules. We can do things like send someone directly from the center – if we think they’re having issues – to the nursing home for a short stay instead of having to hospitalize them. Say they’re feeling a little weak, or they need a little therapy, we can either do it on site or if they need IV antibiotics, we can send them directly to the nursing home and avoid a hospitalization entirely. Many folks find that that is really a great benefit mainly to caregivers.
We also give respite. Our participants are entitled to a certain amount of respite as needed where they can -- if their loved ones want to go away on vacation and their mom is elderly and confused or frail and can’t take care of themselves, we can send them to the nursing home for a couple of weeks of respite while their family goes away on vacation, for example.
Being that we’re all-inclusive, we also give medications. Our staff of primary care providers is the primary medical care of these folks, and we also have primary nursing care. We not only prescribe medications, but we also make sure that they get the medications for them. All of the providers here – pretty much we all have geriatric experience and myself, and the nurse practitioners are geriatricians as well. As geriatricians, we have this special focus of the elderly.
Melanie: And how do you work with the families in this Life Program? How can they get involved?
Dr. Fenstemacher: Families are – we see them as our partners. We partner with the family to try to work with them to make sure that their loved ones get the care they need. It’s not about us, it’s not about the caregivers, it’s about partnering together with the caregivers to see where we can meet their needs – if they have to go to work, they’re working and they need someone there then we bring their folks into the adult day center so that they can have care during the day, for example. We try to work creatively with the families to meet the needs of our participants.
Melanie: What about the cost to the elderly population for this and how do you work that and explain that to families?
Dr. Fenstemacher: Fortunately, the vast majority of our participants have Medicaid and Medicare, and that’s where our funding comes from is from Medicare and Medicaid. We do have a few people that have Medicare only, and they – our Medicare only people – we also, for a small fee, they can also participate in our program and pay that Medicaid fee. The vast majority of our folks, probably close to 80% are what we call dually eligibles – they have Medicare and Medicaid.
Melanie: So, wrap it up for us, Dr. Fenstemacher, on why you would like people to choose the Life Program, or PACE. Give us a wrap-up. Tell us your best advice.
Dr. Fenstemacher: I would say – 93% of PACE participants nationally remain at home, avoiding a nursing home or assisted living placement. 83% of PACE participants see a reduction in hospital stays and 33% of PACE participants experience an increase in life-expectancy and quality of life. For our program, what we can give that other people cannot give them is that we can give them a longer life and a higher quality of life with our wrap around services, and that’s where I think we really excel, in not just giving hands-on care, but also, I think our hearts are there also caring for our participants.
Melanie: And then one last question, Doctor, what about socialization? Speak about that for a minute, and how that’s involved and the social aspect of this is so important for this population and explain a little bit about how that works?
Dr. Fenstemacher: You did touch on something very important. Many of our participants have problems getting around – they have functional deficits is what we say in the PACE world, meaning they can’t actually – if it wasn’t for us they’d be home-bound. What we do is we have transportation that can assist not only our participants getting to doctors’ appointments and seeing their primary care providers, but also get them to the adult day center where they can have activities that are geared towards their ability level. Being we’re a medical day center, we specialize in folks that have more deficits and more disabilities than the average day center is capable of caring for. We specialize in developing socialization and also activities that are appropriate to their level of ability.
Melanie: Thank you, so much, for being with us today, it’s such important information. You’re listening to Lourdes Health Talk, and for more information, you can go to LourdesNet.org, that’s LourdesNet.org. This is Melanie Cole. Thanks, so much, for listening.