DATE: Saturday, August 16, 1997             TAG: 9708160236

SECTION: LOCAL                   PAGE: B1   EDITION: FINAL 

SOURCE: BY PAT DOOLEY, STAFF WRITER 

DATELINE: VIRGINIA BEACH                    LENGTH:  151 lines

ELDERLY KEEP PACE WITH SENTARA'S 1-YEAR-OLD ADULT CARE ALTERNATIVE PROGRAM BLENDS CARE AND MEDICAL SERVICES TO HELP OLDER PEOPLE STAY AT HOME LONGER.

For most of her 81 years, Evelyn Copeland of Chesapeake took care of her family. A husband. Eight children. A handful of foster children. Twenty grandchildren. Sixteen great-grandchildren.

So when she suffered a heart attack about four years ago and, later, a stroke, Copeland's family wanted to make sure they looked after her.

Copeland spent a few months recuperating in a nursing home. Her only lingering problem was maintaining her balance: She needed someone with her when she walked.

A permanent stay in a nursing home might have been an option for Copeland, a widow since 1952. But her family wanted her home.

One of Copeland's daughters, Helen Cain, made room in her Chesapeake home. And 24-year-old granddaughter Melody Subotnik, a certified nurse assistant, quit her job to care for Copeland during the day, while Cain and other family members worked.

Then they heard about an innovative program for the elderly that combines the social aspects of adult day care with the medical services of a primary-care physician.

It would allow Copeland to get out of the house during the day, and her granddaughter to go back to work. What's more, Copeland's care would be paid for by Medicaid, the state health insurance for the poor, and coordinated by a multidisciplinary team that includes physicians, social workers, physical therapists and dietitians.

Called the Program of All-Inclusive Care for the Elderly, or PACE, Sentara Health Systems started it locally a year ago. It's part of a national effort to keep the elderly healthy and out of nursing homes.

On Friday, the Sentara Senior Community Care Center on Newtown Road - a former urgent-care facility where the PACE program is based - celebrated its first anniversary.

Some of the center's 41 local participants were on hand, as well as local dignitaries and representatives from the state department for the aged and Medicaid. Gov. George F. Allen sent a letterthanking the staff of about 30 medical professionals for its ``dedication in helping the elderly live independent lives.''

That's a major goal, said Steve Gold, a Sentara vice president.

PACE is an option for people 55 and older who are eligible for nursing homes but want to live at home.

The sickest, most frail elderly maintain their dignity and independence while receiving quality care, Gold said.

And PACE saves dollars.

About 70 percent of the state's nursing-home residents are eligible for Medicaid, which spends about $2,200 a month for each recipient.

By comparison, Medicaid pays Sentara about $1,825 a month for each PACE participant it covers, Gold said.

Sentara coordinates the participants' care, including transportation to and from the center, meals, medications, basic health checks, visits to specialty doctors, exercise, physical therapy and counseling, if needed.

In its first year, the program lost about $500,000, but Gold said the ``start-up loss'' was anticipated. The program will become more successful as more people hear about it and enroll, he said.

The local PACE program began with six participants; about four or five have been added each month. Six of the elderly died; six others stopped attending for various reasons.

Sentara believes the program is working, Gold said, by offering access to multiple caregivers via one resource, saving the state about 5 percent in Medicaid costs and providing participants with continued quality of life.

Mary Bond, 99, attends the program about three days a week.

A widow and mother of four, she lived on her own in a Norfolk apartment for about 13 years, until her eyesight began to deteriorate, said granddaughter Sandra Judd, who regularly delivered groceries to the apartment and helped her grandmother pay her bills.

``I started noticing little things,'' Judd said. Her grandmother, a longtime restaurant cook, was eating few meals but snacking on sweets. Sometimes, she fell.

About two years ago, Judd invited her grandmother home to live with her.

``I told her she'd always have somebody to talk to, and she didn't have to cook,'' Judd said. They could watch movies and old television programs, which she knew her grandmother enjoyed.

But when Bond fell and broke a hip six months ago, Judd worried she might have to go back on a promise to never put her grandmother in a nursing home.

A social worker told Judd about PACE. Now, Bond goes to the center from early morning until late afternoon on the days when Judd works. Sentara sends over a home-health aide to look after Bond until Judd gets home around 7:30.

``The program has really worked out for me,'' Judd said. ``It allows me to work and have her at home.''

Bond has made friends and likes the exercise, crafts and games available to her. Otherwise, she'd be home ``looking at the walls,'' she said.

Judd said her grandmother is upbeat about her days at the center.

So is fellow participant Evelyn Copeland.

``This is a nice place. I really like it,'' said Copeland, gently rolling back and forth in her wheelchair, her left foot pushing off the floor.

She sings hymns in the mornings after breakfast, plays catch with a beach ball and makes crafts. Recently she painted a bird cage and tulips constructed from wood.

Because she lives in Deep Creek, Copeland has the longest trek - 30 or 40 miles, she said - in one of the center's four vans. It takes about two hours each way, but she enjoys the scenery.

As the program grows, people like Copeland will be able to participate in PACE closer to home, Gold said.

There are about 30 programs nationwide and more in development, he said. Sentara's is the only one in Virginia. It plans to open three more centers, one in Norfolk or Portsmouth in spring.

Still, the program isn't for everyone, he said. Participants must be nursing-home eligible, based on a state health-department scale of tasks performed independently. And the family must agree to follow through on care at home.

For some people, a nursing home is still the best option, Gold said.

But families who take part in PACE often experience relief, said Ivy Burnham, the center's senior project director.

``My families don't feel that guilt,'' she said.

They count on the staff to pull together a wide range of services.

``We treat the whole person,'' Burnham said. ``It's a wonderful option of long-term care.'' ILLUSTRATION: A CHOICE FOR DIGNITY AND INDEPENDENCE

MARK MITCHELL/The Virginian-Pilot

[Color Photo]

MARK MITCHELL/The Virginian-Pilot

Lucille Caple celebrated her 75th birthday at Sentara Senior

Community Care Center with a birthday cake and congratulations all

around. The center combines the social atmosphere of adult day care

with the medical resources of a primary-care physician.

PACE: Program of All-Inclusive Care for the Elderly

Sentara Health Systems opened its Senior Community Care Center on

Newtown Road in Virginia Beach last year. The service is for people

55 and older who are eligible for nursing homes but would like to

keep living at home.

The program coordinates transportation to and from the center,

meals, medications, basic health checks, visits to specialty

doctors, exercise, physical therapy and counseling.

The program is covered by Medicaid, which spends about $2,200 a

month on each nursing home resident. PACE residents covered by

Medicaid need $1,825 a month, saving the state money.

WHO'S ELIGIBLE?

People 55 and older who are nursing-home eligible and living in

Virginia Beach, Norfolk, Chesapeake or Portsmouth.

As of July 1, participants are no longer required to be eligible

for Medicaid, the state health insurance for the poor. The center

accepts Medicaid, private pay and insurance.

By the summer of 1998, it is expected the program also will be

paid a flat fee by Medicare, the federal health insurance for the

elderly.

For more information, call the center at 456-2700.

PACE participants are offered a variety of activities, including

exercise, crafts and games. Transportation is provided to and from

the Virginia Beach facility, as well as to doctor's appointments.

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