“What’s going to happen to our elders?” That was
my first thought when I learned that some grants that helped fund Minnesota’s
43 Living-at-Home/Block Nurse Programs (LAH/BNP) were not renewed
during the most recent round of Department of Human Services Community
Service/Services Development (CS/SD) grants.
Throughout Minnesota LAH/BNP staff and volunteers provide assistance
to elders to help them remain healthy and safe in their own homes.
According to a 2008 survey conducted by the United States Department
of Health and Human Services Administration on Aging, most seniors
prefer to remain in their homes, which represent independence and security.
Most services are offered on a sliding scale basis and no one is turned
away because of inability to pay for services.
Keeping elders out of nursing homes makes financial sense as well.
According to the 2006-2007 Cost and Services report by Elderberry Institute,
every dollar invested in LAH/BNPs saves taxpayers $3.50. Elderberry
Institute is the umbrella organization for LAH/BNPs.
In the same report, 40 Minnesota metro and rural LAH/BNPs were shown
to have kept 1,138 people out of nursing homes for 8,238 months and
saved more than $35 million, which would have been the cost of nursing
home care if they had been admitted. During the 2008 legislative session
Governor Tim Pawlenty and legislators expressed concern over the increasing
percentage of the state budget expended for nursing home care costs.
Annual program budgets for the metro area LAH/BNPs average $110,000.
Each program uses a combination of funding sources that includes grants
from the state (CS/SD and other Department of Human Services funding),
foundation grants, donations and fees for some services provided.
The St. Paul Payne-Phalen
Living-at-Home/Block Nurse program is larger than most programs.
In fiscal year 2006-2007, when our program kept 89 East Side elders
at home and saved more than $4 million dollars, our budget was
$257,000. Two CS/SD grants that provided a majority of the funding
in recent years were not renewed for the coming year. The impact
of the loss will mean changes to Payne-Phalen’s program
including staffing and service cuts.
Many local, state and
national elected representatives do appreciate the value of having
LAH/BNPs available to seniors in their districts. Two newer LAH/BNPs
on the East Side, North East Neighborhoods in District 2, and Dayton’s
Bluff Seniors in District 4, were among 12 new Block Nurse Programs
throughout Minnesota to receive $20,000 in base funding as part
of a bill passed during the recent legislative session. Payne-Phalen
and other established programs also receive this base funding.
The Payne-Phalen Program
is seeking new grants, donors and other sources to fill the gap
so we can continue our work. But since we didn’t
have a lot of notice about the grants that weren’t renewed, we’re
concerned about how we’ll be able to provide for the elders who
rely on us. I’m particularly worried about some of the East Side
elders I’ve come to know—people like Teri, Norm, Helen
and Cal.
Teri, 56, was introduced to the BNP by friends. The program typically
serves persons 65 and older, but the age limit may be lowered when
individuals have disabilities. Four years ago Teri had surgery for
a brain tumor. The effects of the tumor left her paralyzed on the left
side. After spending six months at Courage Center getting rehabilitation,
Teri and her husband moved from their home in Forest Lake to an accessible
apartment in a senior building near Lake Phalen. Teri attends monthly
social gatherings and has helped as a volunteer in the Block Nurse
office.
Norm is an 85-year-old widower. His two adult children live in other
states. Since the first of this year Payne-Phalen staff and volunteers
have visited Norm 29 times. He has received help with medical forms,
nursing assessments, wound care and rides to medical appointments.
We also found someone to assist him with cooking, housekeeping and
lawn services. When he has questions about a health issue, is concerned
about his ability to drive due the weather, or needs help with a situation
at home, he calls us.
Helen is an 82-year-old
widow who has no children. She has macular degeneration and is
legally blind but has been able to stay in her home with the help
of rides to the doctor and bank from staff and a volunteer who
takes her shopping every other week. At a monthly blood pressure
clinic the block nurse noticed that Helen’s
blood pressure was dangerously low which put her at risk of a heart
attack or a fall. Our nurse called her clinic to obtain a change
in her medications which stabilized her pulse and prevented medical
complications. Helen also enjoys visits from nursing students and
attends the Payne-Phalen program’s monthly
social gatherings.
Cal is 80 and has outlived
three wives. He is a Korean War veteran and has health issues including
diabetes, hypertension, and vision problems that require regular
visits to the VA Medical Center. A block nurse staff person picks
him up and accompanies him to visits and helps him navigate the
halls of the clinic. After each visit he says, “I
don’t know what I’d do without you.” Our staff
also helps educate Cal about his diabetes. He has his blood pressure
checked at a free monthly blood pressure clinic that the block nurse
program conducts in his building.
Lack of funding to sustain LAH/BNPs should be of grave concern for
any elder, their caregivers, relatives, neighbors, and anyone in the
community who hopes to be an elder one day. The repercussions of cuts
to our program could be noticeable soon, and in some cases they might
be serious, not to mention costly in the long term. Pawlenty and the
legislature have expressed increased share that nursing homes have
taken up in recent state budgets.
Employers could see
a rise in absenteeism as adult children need time off work to care
for elderly relatives, since block nurse staff and volunteers won’t
be available to provide visits and rides to doctor appointments.
If we have to discontinue blood pressure clinics and are unavailable
to notice elders whose symptoms indicate health conditions so we
can refer them to their primary clinics to get treatment, there
may be an increase in the number who suffer falls, strokes, or
heart attacks.
What’s going to happen to our elders? I’m
afraid of finding out what the answer will be. ![end of story]()
Mary Gallagher is manager
of elder/volunteer services for the Payne-Phalen Living-at-Home/Block
Nurse Program in St. Paul. FII: 651-774-7078 www.blocknurse.org/payne
Editor’s note: As the population of Minnesota and the United
States continues to age, the demand for services like the Living
at Home/Block Nurse Program will only increase. The programs provide
a vital service in keeping elderly and disabled person safe in their
homes and involved with their communities. Most St. Paul neighborhoods
have Living at Home/Block Nurse Programs. There are also programs
in parts of Minneapolis and in the rest of the state. For a list
of programs or to learn about issues affecting these programs, visit
www.elderberry.org
