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Mental Health Matters SPRING 2017 | VOL. 31 ISSUE 2

In this issue

  1. Supporting Seniors with PACE By Verna Sellers, MD, MPH, CMD, and Kathy Worley, MSN, RN, FNP-BC
  2. Staying healthy as we age By Peter Betz, MD

Supporting Seniors with PACE

By Verna Sellers, MD, MPH, CMD, and Kathy Worley, MSN, RN, FNP-BC

An integral part of the continuum of healthcare, PACE (Program of All-Inclusive Care for the Elderly) is a national program that empowers participants to maintain their independence and live in their homes despite the challenges of aging. These challenges can include chronic disease, social isolation, depression, cognitive impairment and the need for assistance with the activities of daily living.

PACE provides a skilled interdisciplinary team to oversee medical, physical, emotional and spiritual needs. The PACE team includes geriatricians, nurse practitioners, nurses, dietitians, physical, speech and occupational therapists and social workers. PACE drivers transport participants to and from the center, approved referral providers and medical appointments. The program provides seniors with daily activities, meals and exercise programs, all of which are designed to be mentally, socially and physically stimulating. PACE services also include 24-hour on-call nurse and physician services, prescription medicines, clinic visits, mental health care, durable medical equipment and nutritional services.

PACE providers stay by the participants’ sides through the changes in their health and the aging process. Staff members work with them to help improve their cognitive and learning abilities by providing close medical oversight that allows them to anticipate healthcare changes and needs. By following participants through the aging process, the PACE team adapts functional, comfort and end-of-life care plans as needed.

CARE WHERE YOU NEED IT

PACE services are available in participants’ homes, PACE centers, assisted living facilities and hospitals. In-center care can include socialization activities, clinic visits, therapy sessions, meals, snacks, scheduling of appointments and regular assessments.

PACE services at home include an RN home care coordinator who oversees the home environment for safety, a registered nurse coach who oversees transitions during an illness or stay in a healthcare facility, as well as home visits by social workers, rehabilitation therapists and patient care aides. PACE at home provides durable medical supplies necessary to help maximize functioning and independence. Staff members also train caregivers and family members who want to help their loved ones with the activities of daily living.

Considered a safety net for its participants, PACE has been shown nationally to decrease urgent care visits, hospital admissions and number of days in the hospital.

WHO IS ELIGIBLE?

To be eligible for PACE, participants must be 55 or older, reside in the PACE service area, be able to live safely in the community with support from PACE and meet state criteria for nursing-home level care.

PACE is a nonprofit program funded through a unique arrangement with Medicaid and Medicare. If a participant is eligible for Medicaid and Medicare — or Medicaid only — there may be no cost to join the program or to receive services provided by PACE. If a participant is eligible for Medicare only, there is a monthly cost. Participants who do not qualify for Medicare or Medicaid may still join PACE by paying out of pocket for services.

Kathy Worley with her mother, Betty.

Independent at home

Betty, 83, doesn’t spend her days alone at home anymore. Although she suffers from blindness and other physical conditions, she is transported several times a week to PACE (Program of All-Inclusive Care for the Elderly), where she receives medical care and enjoys connecting with other seniors from the community.
Because of her fragile health, Betty would qualify for admission to a skilled care facility. Yet since joining PACE, she has been building her strength with the help of PACE staff, so that she can remain safely in familiar surroundings.
Betty’s daughter and caregiver, Kathy Worley, works as a family nurse practitioner at the Centra PACE clinic in Gretna. She has learned first hand the peace of mind that PACE brings to caregivers and families. Knowing that PACE is there to help her mother has enabled her to reclaim the role of daughter, and their visits are now more enjoyable.

Verna Sellers, MD, MPH, CMD, is medical director of Centra PACE. Kathy Worley, MSN, RN, FNP-BC, is a nurse practitioner with Centra PACE-Gretna.

Centra PACE centers locations:

  • 407 Federal Street, Lynchburg
  • 1530 South Main Street, Farmville
  • 1220 West Gretna Road, Gretna

• • • • • • • • •

Staying healthy as we age

By Peter Betz, MD

Many of us like to think that 50 is the new 30, but the reality is that 50 is when we begin to enter the older stage of our lives. Genetics and lifestyle may cause some people to age faster than others, but most baby boomers (those born between 1946 and 1964) and Gen Xers (born from 1965 to 1980) pride themselves on their youthfulness despite their numerical age. However, no matter how good you feel, most experts agree that when you turn 65 and qualify for Medicare, you are considered geriatric. It is important, therefore, to work with your healthcare provider to ensure that your cholesterol, blood pressure and sugar are all under control and to follow your provider’s recommendations for screening and preventative measures.

Although physiological changes that accompany aging may keep you from feeling like a youngster, there are many things you can do to promote a healthy lifestyle and help stave off illness and physical or mental disabilities. The key is to make a list of the things you know are good for you and then to actually do them.

This is not always easy. Change is difficult because it requires you to alter your lifestyle. So how do you make a change in your routine that includes healthy activities? One thing you should not do: punish yourself and then make yourself feel guilty in the process.

Lifestyle - Top Tips

Be physically active

Everyone knows exercise is important to staying healthy. But if you try working out at the gym and discover that you don’t like it, don’t force yourself to go to the gym. Instead, find an activity that you enjoy. If you like to walk, take a walk around the block or go hiking; if you like to play tennis, find a partner and play a match; if you enjoy gardening, go plant some flowers. Swimming and running might be better for you than gardening or playing tennis, but if you don’t have a pool or you can’t run, do what you can. The key is not how you exercise, but that you do something that requires activity.

Stay intellectually active

Intellectual stimulation should be engaging and fun. Choose something that is new and different and requires focus and brain power. Learn a new skill and expand your horizons. Whatever the activity, it should be exciting to you. In other words, choose something that speaks to you. If you like puzzles, learn to play chess; if you like to garden, become a master gardener; if you like to be in the kitchen, take a cooking class. Not sure what to do? Do a little bit of everything, and something will pique your interest.

Manage your diet

If food and eating are important to you, pay attention to tasting your food. Be mindful and appreciate the distinctions of flavor and taste. The best food critics are not overweight because they love their food in a different way than most of us do. They savor every bite, every portion, every experience. They appreciate the nuances. Learn to recognize food that is good for you and tastes good. If something tastes really good to you, eat it. If you love a chocolate bar, enjoy every bite of it, but don’t eat 20 of them. If you take the time to savor your food, you will come to truly appreciate taste instead of quantity.

Sleep is important

Sleep is important, but artificially induced sleep may not be. Try to avoid sleep medicines — they can cause tremendous problems, including the risk of falling. Managing sleep is just as important as managing diet and exercise.

Peter Betz, MD is the medical director of geriatric psychiatry at Centra Medical Group Piedmont Psychiatric Center.

Geriatric psychiatric services

Centra’s Geriatric Psychiatric Program at Virginia Baptist Hospital provides personalized treatment to adults ages 65 and older who are in crisis and in need of immediate stabilization. Centra also offers outpatient geriatric psychiatric services at Piedmont Psychiatric Center in Lynchburg.
In addition, consultation and liaison services are offered to community agencies and facilities to assist with referrals for:
  • possible admission
  • Geriatric psychiatric assessments
  • Coordination of care plans
  • Ongoing psychotherapy/education interventions with patients and families
  • Collaboration with an organization’s staff related to behavioral challenges
  • Training of staff on geriatric topics, including dementia, problem solving, managing aggressive behaviors, stress in the senior years, etc.

For more information:

PACE - 434.200.6516

Centra’s geriatric psychiatric services - 434.200.4447

or visit

Produced by Centra Mental Health Services and Communications/ Marketing Department. To get on the mailing list for the electronic version of Mental Health Matters.

For referrals or admissions, call the Mental Health Intake & Resource Center, 434.200.4444 or 800.947.5442, 24 hours a day.

For more information about the Mental Health Services division, please call 434.200.4447.

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