Healthy Aging:
Technology Brings Home Health Care to Isolated Seniors
Tucked into the snow-dusted foothills of the Eastern Sierra counties of Inyo and Mono are small clusters of homes and isolated dwellings, often reachable only by a dirt road. Nearly 14,000 square miles of rural outposts and five Indian reservations are connected by a single highway, U.S. Route 395.
Pioneer Home Health Care, Inc. was founded by administrator Patricia West in 1990 to provide skilled intermittent medical and rehabilitative care to frail, disabled and elderly patients in their homes. Based in Bishop, the region's largest town (pop. 3,680), Pioneer is the only service of its kind in an area the size of Maryland and the District of Columbia combined.
More than half the agency's clients are over 80 years old. "Our goal is to keep elderly folks out of the hospital and to keep them as well-informed and empowered as possible to manage their own disease processes," said West.
But the logistical challenges are considerable. To provide home health care to just one ailing resident can involve long hours of driving on roads subject to extreme weather conditions. For a small staff that is stretched thin (six nurses, three part-time; one physical therapist; one social worker; and two home health aides), the only way to increase efficiency is through technology.
In June 2007, TCWF awarded Pioneer a three-year $150,000 grant to continue to provide home health care to the frontier region. The funding enabled Pioneer to recruit a full-time physical therapist — a major effort in a region with no higher educational institutions for health professionals — and to purchase additional telehealth units.
Placed in the homes of medically fragile patients for a 30-to-60-day period, these easy-to-use desktop devices serve multiple purposes. They remind the patient to take prescribed medication, ask questions that help the patient monitor symptoms and know when to call a nurse, provide educational material about diet and medication, and relay personal health data (such as blood sugar level and blood pressure) to the agency for follow-up by a clinician.
"The unit becomes an extension of our eyes and ears, letting us use our human resources more effectively," West said. "Not a single one of our patients ended up with a re-hospitalization while they were on telehealth."
The grant also enabled Pioneer to replace the old, bulky laptops used by staff to document patient health data with high-speed, lightweight tablet-sized models.
"The old laptops had a flip-up top that became a barrier between the clinician and the patient," West said. "The patient would say, 'What are you writing about me?' But now they can participate. There's so much data that can be shared with the patient."
Environmental Health: Pursuing Public Health Threats by Putting Science First
For residents of the Bayview neighborhood of San Francisco, adjacent to Hunters Point Shipyard — who suffer disproportionately from asthma and other respiratory diseases — a storefront on Third Street serves as a bulletin board, education center and technical resource for environmental health issues.
Known as The Community Window on Hunters Point Shipyard, the storefront is a project of Arc Ecology, a nonprofit public interest organization founded in 1983 to address the effects of military activities and policies on the environment, public health and the economy.
Arc Ecology received a three-year, $225,000 grant from TCWF in September 2005 to continue to provide environmental health education and technical assistance to communities affected by environmental hazards on military bases.
The Community Window gives passersby a quick update on the removal, treatment and containment of PCBs, pesticides, petroleum hydrocarbons, solvents and radioactive contaminants that were released into the environment when the shipyard was an active U.S. Navy base. (The shipyard was closed in 1991; after each area is cleaned up, it will be developed for residential, industrial or other uses.)
Inside the storefront, residents can browse an extensive library of public documents about the cleanup and attend environmental health workshops. Detailed, user-friendly information is also available on the organization's website.
A planned series of community health assessment fairs will help residents evaluate the level of care they are receiving for existing conditions. In addition, Arc Ecology provides monthly environmental reports to the Hunters Point Shipyard Citizen's Advisory Committee, and staff scientists frequently speak to community groups.
"We put science first," said Saul Bloom, Arc Ecology founder and executive director. "We make risk calculations; we compare data. Our feeling is that there is far too much junk information out there, and it often does as much harm as good."
A 75-acre portion of the former shipyard is now being developed by the home builder Lennar Corporation. After an environmental review, Arc Ecology determined that airborne dust particles on the site — the area has strong prevailing winds — could potentially worsen the allergies and respiratory illnesses of Bayview residents.
As a result, the organization pressured Lennar to install new air quality monitoring stations, hire "dust monitors" empowered to shut down the project when wind speeds exceed a certain level, improve placement of the misters that dampen the soil, and drape the surrounding fence with dust-catching mesh.
On the other hand, a February 2007 evaluation by Arc Ecology determined that asbestos contamination on the site did not pose a long-term health hazard. "We are often telling the community that what they're concerned about is actually not what they need to be concerned about," Bloom said.
Tucked into the snow-dusted foothills of the Eastern Sierra counties of Inyo and Mono are small clusters of homes and isolated dwellings, often reachable only by a dirt road. Nearly 14,000 square miles of rural outposts and five Indian reservations are connected by a single highway, U.S. Route 395.
Pioneer Home Health Care, Inc. was founded by administrator Patricia West in 1990 to provide skilled intermittent medical and rehabilitative care to frail, disabled and elderly patients in their homes. Based in Bishop, the region's largest town (pop. 3,680), Pioneer is the only service of its kind in an area the size of Maryland and the District of Columbia combined.
More than half the agency's clients are over 80 years old. "Our goal is to keep elderly folks out of the hospital and to keep them as well-informed and empowered as possible to manage their own disease processes," said West.
But the logistical challenges are considerable. To provide home health care to just one ailing resident can involve long hours of driving on roads subject to extreme weather conditions. For a small staff that is stretched thin (six nurses, three part-time; one physical therapist; one social worker; and two home health aides), the only way to increase efficiency is through technology.
In June 2007, TCWF awarded Pioneer a three-year $150,000 grant to continue to provide home health care to the frontier region. The funding enabled Pioneer to recruit a full-time physical therapist — a major effort in a region with no higher educational institutions for health professionals — and to purchase additional telehealth units.
Placed in the homes of medically fragile patients for a 30-to-60-day period, these easy-to-use desktop devices serve multiple purposes. They remind the patient to take prescribed medication, ask questions that help the patient monitor symptoms and know when to call a nurse, provide educational material about diet and medication, and relay personal health data (such as blood sugar level and blood pressure) to the agency for follow-up by a clinician.
"The unit becomes an extension of our eyes and ears, letting us use our human resources more effectively," West said. "Not a single one of our patients ended up with a re-hospitalization while they were on telehealth."
The grant also enabled Pioneer to replace the old, bulky laptops used by staff to document patient health data with high-speed, lightweight tablet-sized models.
"The old laptops had a flip-up top that became a barrier between the clinician and the patient," West said. "The patient would say, 'What are you writing about me?' But now they can participate. There's so much data that can be shared with the patient."
Environmental Health: Pursuing Public Health Threats by Putting Science First
For residents of the Bayview neighborhood of San Francisco, adjacent to Hunters Point Shipyard — who suffer disproportionately from asthma and other respiratory diseases — a storefront on Third Street serves as a bulletin board, education center and technical resource for environmental health issues.
Known as The Community Window on Hunters Point Shipyard, the storefront is a project of Arc Ecology, a nonprofit public interest organization founded in 1983 to address the effects of military activities and policies on the environment, public health and the economy.
Arc Ecology received a three-year, $225,000 grant from TCWF in September 2005 to continue to provide environmental health education and technical assistance to communities affected by environmental hazards on military bases.
The Community Window gives passersby a quick update on the removal, treatment and containment of PCBs, pesticides, petroleum hydrocarbons, solvents and radioactive contaminants that were released into the environment when the shipyard was an active U.S. Navy base. (The shipyard was closed in 1991; after each area is cleaned up, it will be developed for residential, industrial or other uses.)
Inside the storefront, residents can browse an extensive library of public documents about the cleanup and attend environmental health workshops. Detailed, user-friendly information is also available on the organization's website.
A planned series of community health assessment fairs will help residents evaluate the level of care they are receiving for existing conditions. In addition, Arc Ecology provides monthly environmental reports to the Hunters Point Shipyard Citizen's Advisory Committee, and staff scientists frequently speak to community groups.
"We put science first," said Saul Bloom, Arc Ecology founder and executive director. "We make risk calculations; we compare data. Our feeling is that there is far too much junk information out there, and it often does as much harm as good."
A 75-acre portion of the former shipyard is now being developed by the home builder Lennar Corporation. After an environmental review, Arc Ecology determined that airborne dust particles on the site — the area has strong prevailing winds — could potentially worsen the allergies and respiratory illnesses of Bayview residents.
As a result, the organization pressured Lennar to install new air quality monitoring stations, hire "dust monitors" empowered to shut down the project when wind speeds exceed a certain level, improve placement of the misters that dampen the soil, and drape the surrounding fence with dust-catching mesh.
On the other hand, a February 2007 evaluation by Arc Ecology determined that asbestos contamination on the site did not pose a long-term health hazard. "We are often telling the community that what they're concerned about is actually not what they need to be concerned about," Bloom said.
client
The California Wellness Foundation
projects
“Grantee in Focus” articles for Portfolio newsletter
audience
Current and prospective grantees, policymakers, general public
goal
To provide snapshots of current grantee programs
The California Wellness Foundation
projects
“Grantee in Focus” articles for Portfolio newsletter
audience
Current and prospective grantees, policymakers, general public
goal
To provide snapshots of current grantee programs