TIME MAGAZINE: COVID-19 Exposed the Faults in America’s Elder Care System. This Is Our Best Shot to Fix Them

June 15, 2021 (Time Magazine) – When COVID-19 hit the United States, nursing homes in Washington State took the first hit, producing deadly outcomes for older adults. Conditions within long-term care facilities enabled a harrowing spread of any pandemic, let alone a novel coronavirus. Compounding on this, leaders within institutional care were slow to respond when it arrived.

The plight of residents in long-term care facilities across the United States is detailed in a report by Abigail Abrams from Time Magazine. It begins with individuals living at Life Care Center in Kirkland, Washington, in late February 2020 where COVID-19 killed dozens in just a few weeks.

The shocking death rate created a sense of panic and by early March the families of those living within Life Care Center held a press conference appealing to the public on behalf of their loved ones.

“Our families are dying. We don’t know what to do. Our calls for help aren’t working,” said Kevin Connolly, whose father-in-law lived in the facility. “We have limited resources to battle this disease, and I think somebody somewhere decided that this population of people wasn’t worth wasting resources on.”

Nursing homes vs infection

Many nursing home residents live in shared rooms and rely on staff who tend to numerous patients and who often work at various other facilities. The industry’s low pay and long hours make for high turnover. These characteristics can create a lack of consistency in controlling the spread of infection.

The nursing home industry is losing occupancy rates, workers, and money. The long-term care industry could lose an estimated $94 billion between 2020-2021 due to the costs involved in both fighting the pandemic and losing occupancy, according to The American Health Care Association and National Center for Assisted Living (AHCA/NCAL).

America is aging rapidly. According to the Census Bureau, around 10,000 Americans turn 65 every day. Most people want to age at home rather than in an institution. Still, people who qualify for Medicaid and Medicare have little to no choice in where they receive long-term care after reaching old age. Governments in many states mandate that they enter long-term care facilities even when home-based care services are available.

In many cases, when a person does not qualify for government-funded care or chooses to avoid mandated care in a nursing home, a family member must often forfeit a job to take on the responsibility of caregiving. And if no one in the older adult’s circle of support can provide that care, paid home based care is challenging to find due to worker shortages. Many workers are leaving the historically low-wage industry, according to the Bureau of Labor Statistics.

Policy helps pave the way to home and community-based care.

Policy momentum is growing toward home and community-based care for the elderly across the nation. One home-based care program available to Medicaid/Medicare recipients has a 45-year proven track record of success and operates in more than 31 states. PACE (Programs of All-Inclusive Care for the Elderly) saves the government money while offering a high-touch, team-based approach to eldercare for people 55 years or older who qualify for nursing home level care.   It receives a payment per participant to provide medical care and dental care, day center programs, meals, home health aides, and many other services to keep seniors safe and living in their own homes and communities. PACE aims to keep this elderly population out of hospitals and nursing homes while incentivizing a flexible, creative, team-based approach to care. On average, states pay PACE programs 13% less than the cost of other Medicaid services.

“The nature of payment provides significant flexibility, as well as really strong incentives for PACE organizations to really proactively monitor and get out in front and address existing and emerging health needs,” says Shawn Bloom, president, and CEO of the National PACE Association.

Data collected during the pandemic show that seniors enrolled in PACE contracted COVD-19 at just one-third the rate of those in nursing homes, according to the National PACE Association.

The push for greater government funding for programs like PACE is growing. President Biden’s proposal to spend $400 billion on home care over the next 4 years could pave the way toward boosting access to more Americans. And proposed legislation in California, Assembly BILL (AB) 540, would allow eligible seniors to be automatically informed about PACE right along with other Medicaid and Medicare options.

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Why We Support California Assembly Bill (AB) 523: Because Lifting Regulatory Bottlenecks Saved Lives During Covid-19 Crisis

Why Assembly Bill 540 Must Pass: Because seniors have a right to know about the PACE option for home and community based care

WelbeHealth Expands Executive Team with Key New Hire

Sepideh Chegini, MD, Joins WelbeHealth as Chief Medical Officer

MENLO PARK, Calif. (Feb. 17, 2021)  WelbeHealth, an all-inclusive medical care provider that serves frail elderly, helping them live independently in their own home, is proud to welcome Sepideh Chegini, MD, as Chief Medical Officer.

Dr. Chegini will oversee clinical care delivery, ensuring that participants receive the highest standard of medical care while upholding WelbeHealth values and enhancing the experience of its teams. Under her leadership, WelbeHealth programs will further expand into underserved communities.

“We are grateful to have Sepi join WelbeHealth to help us ensure the highest quality care for our frail and vulnerable seniors,” said Si France, MD, Founder and CEO of WelbeHealth. “Sepi has an extensive track record of leading and innovating within value-based care to drive exceptional clinical quality, an inspired culture, and satisfaction in patient-centered care.”

Dr. Chegini is a physician leader fully dedicated to serving the most complex and vulnerable patient populations. With vast experience in value-based care delivery, she is passionate about supporting seniors with complex personal and medical obstacles through integrated, high-quality, and innovative care models.

Previously, she served as the Senior Medical Officer at CareMore Health, leading the institutional Special Needs Plans nationally, delivering person-centric, holistic care to the most vulnerable patients in the comfort of their homes while driving improvements in clinical outcomes and program growth. Under her leadership, the program expanded into ten new markets, reaching its all-time best outcomes by building and supporting high-performing teams and leading with compassion, curiosity, and dedication.

Dr. Chegini also designed and launched CareMore Health’s first palliative care program across Los Angeles and Orange counties to support patients approaching end of life and those with the most complex care needs through an interdisciplinary team-based approach.

“I see it as a true privilege to be in this position and to serve our most precious and vulnerable seniors, establish meaningful human connections with them, enrich their overall health care experience, and support them on their journey so they can reach their full potential,” said Dr. Chegini. “I will work hard to evolve and grow our programs and support our team members so that we can impact more lives and help improve our participants’ quality of life.”

Dr. Chegini obtained her medical degree at the University of Rochester, where she developed her passion for the biopsychosocial medicine model and palliative care. She trained in internal medicine at the George Washington University.

WELBEHEALTH PACE IN MODESTO ROLLS OUT MOBILE CLINIC TO SERVE MODESTO-AREA SENIORS

Wildfire Safety Tips for Seniors

The California wildfires have resulted in some of the worst air quality in the nation.  Seniors can be extremely affected, especially participants in our PACE programs so we’ve created some tips for all seniors:
  1. Remain indoors when at all possible.  Keep windows closed to decrease exposure to smoke.
  2. If you MUST go out wear a mask and limit time outside.
  3. Any worsening cough, congestion or wheezing, please call your PACE center right away.
  4. If you need refills on your respiratory medications including inhalers please call and we are happy to refill if appropriate.

To find out more about PACE services we provide, please click here.

Free photo 1024746 © Frank Farrell – Dreamstime.com

Vision Exam Month

August is National Vision Exam Month.  Healthy vision is important for people of all ages and is key for seniors to be able to live more independent lives in their homes and communities.  Here are some tips from the CDC on how to keep your eyes healthy.

Try 6 Tips for Healthy Eyes—and a Healthy You

  1. Add more movement to your day. Physical activity can lower your risk for health conditions that can affect your vision, like type 2 diabetes and high blood pressure. As a bonus, it can help you feel your best. Pick activities you enjoy and remember, anything that gets your heart beating faster counts!
  2. Get your family talking… about eye health history. Some eye diseases—like glaucoma and age-related macular degeneration—can run in families. Although it may not be the most exciting topic of conversation, talking about your family health history can help everyone stay healthy. Ask your relatives if they know about any eye problems in your family. Be sure to share what you learn with your eye doctor to see if you need to take steps to lower your risk.
  3. Step up your healthy eating game. Eating healthy foods helps prevent health conditions—like type 2 diabetes or high blood pressure—that can put you at risk for eye problems. Eat dark, leafy greens like spinach, kale, and collard greens that are high in antioxidants called lutein and zeaxanthin, which help prevent macular degeneration and cataracts. Also pick up some fish high in omega-3 fatty acids like halibut, salmon, and tuna.
  4. Stay on top of long-term health conditions—like diabetes and high blood pressure. Diabetes and high blood pressure can increase your risk for some eye diseases, like glaucoma. If you have diabetes or high blood pressure, ask your doctor about steps you can take to manage your condition and lower your risk of vision loss.
  5. If you smoke, make a quit plan. Quitting smoking is good for almost every part of your body, including your eyes! That’s right—kicking the habit will help lower your risk for eye diseases like macular degeneration and cataracts. Quitting smoking is hard, but it’s possible—and a quit plan can help. Call 1-800-QUIT-NOW (1-800-784-8669) for free support.
  6. Give your eyes a rest. Looking at a computer for a long time can tire out your eyes. Follow the 20-20-20 rule—rest your eyes by taking a break every 20 minutes to look at something about 20 feet away for 20 seconds.

Regular vision exams are part of the comprehensive services provided by PACE.  For more about PACE services, click here.

Free photo 5904867 © Nedim Jukić – Dreamstime.com

Welbe’s Long Beach PACE Center Launches

The Long Beach Press Telegram covered the launch of our newest PACE center in Long Beach – LA Coast PACE:

LONG BEACH

By Gary Metzker

The golden years aren’t so golden for many these days, as the coronavirus pandemic shows no signs of abating.

At least 38,000 U.S. residents of nursing homes and other long-term care facilities for older adults have died from the coronavirus, according to the Centers for Disease Control. More than 142,000 people at those facilities have contracted the virus, and at least 90,000 more cases are suspected.

In California, there have been more than 2,400 deaths in long-term care facilities, and according to the Long Beach Health and Human Services Department, 118 deaths have been associated with long-term care facilities in the city.

Many families are not aware that there are other alternatives besides skilled nursing or assisted living facilities, especially during this health crisis.

WelbeHealth is an operator of Medicaid’s Program of All-Inclusive Care for the Elderly (PACE) across California. Its newest facility is in Long Beach at 1220 E. Fourth St., but because of the coronavirus pandemic, no one is visiting the location. Instead, the company has transitioned to a remote, at-home care model to serve seniors while keeping them physically shielded from the spread of the virus.

According to Sophia Guel-Valenzuela, regional vice president and executive director of the Long Beach facility, having seniors in a PACE program is a safer alternative because it can provide necessities, meal deliveries throughout the day, assistance in the home and meaningful social engagement.

“There has never been a stronger imperative to keep seniors living more independently in their homes and communities,” she said. “Our goal is to keep seniors socially engaged through games and special events. It’s important to keep people safe.”

Guel-Valenzuela said each client gets a 4G LTE tablet to use that enables them to talk to a doctor or a social worker as well as interacting with other people.

“The highlight of my week is to see the engagement going on,” she said. “Engagement coordinators host trivia games, bingo, card games. It’s like a big Zoom meeting.”

Guel-Valenzuela believes the combination of staying at home with interactivity is the template of the future for senior care.

“It’s safer to stay at home now,” she said. “I’ve been doing this for 18 years and this model of coordinated care is something I believe in.”

PACE provides comprehensive medical and social services enabling older adults to live in the community instead of a nursing home or other care facility. Its services are available at no cost to most participants as part of their Medicare and MediCal benefits.

“In our HomePACE model of remote care, we help seniors stay healthy and thriving while avoiding nursing facilities, which have tragically become hotbeds for the spread of coronavirus,” said Dr. Si France, founder and CEO of WelbeHealth in a statement. “We’re excited to expand our all-inclusive model of care into greater Long Beach to serve more vulnerable seniors when they need it most.”

WelbeHealth’s Long Beach location is accepting applications. Families can call 1-800-734-8041.

To learn more about PACE and services we provide, click here.

Tips to Stay Safe During Heatwaves

We are getting well into the summer months which means, hotter temperatures.  We’ve already seen a couple of heat waves come through California summer is officially only a few weeks old!  In addition to the heat, power outages can occur during these high-temperature periods.

Please take measures to stay cool and remain hydrated. Getting too hot can make you sick. You can become ill from the heat if your body can’t compensate for it and properly cool you off. As we age our bodies cannot handle the heat like they did when we were young.  Extreme heat can affect us in the following ways: The main things affecting your body’s ability to cool itself during extremely hot weather are:

  • High humidity. When the humidity is high, sweat won’t evaporate as quickly. This keeps your body from releasing heat as fast as it may need to. High humidity can cause you to sweat excessively which can lead to dehydration.  When your sweat does not evaporate quickly it can lead to feeling overly tired.
  • Personal factors. Age, obesity, fever, dehydration, heart disease, mental illness, poor circulation, sunburn, and prescription drug and alcohol use all can play a role in whether a person can cool off enough in very hot weather. Other factors that can play a role in adverse effects of heat would include fever, medical conditions, poor circulation, certain prescription drug and use of alcohol.
  • Muscle cramping may be an early sign of heat-related illness.

You are potentially at the highest risk for heat-related illness during these heatwaves. When it becomes hot outside, ask yourself these questions:

  • Are you drinking enough water?
  • Do you have access to air conditioning?
  • Do you need help keeping cool?

You can take the following protective actions to prevent illness or death:

  • Stay in air-conditioned buildings as much as you can. Air-conditioning is the number one way to protect yourself against heat-related illness or complications.
  • Drink more water than usual and don’t wait until you’re thirsty to drink.
  • Check on a friend or neighbor and have someone do the same for you.
  • Try not to use the stove or oven to cook—it will make you and your house hotter.
  • Try cool showers or baths to help you cool down.

Try to avoid going out in the hot sun, but If you need to go outside during hot weather:

  • Limit your outdoor activity, especially when the sun is hottest.
  • Wear and reapply sunscreen as indicated on the package.
  • Pace your activity, start activities slow and pick up the pace gradually.
  • Drink more water than usual and don’t wait until you’re thirsty.
  • Wear loose, lightweight, light-colored clothing.
  • Be careful in the sun to avoid sunburn. If you can see through your clothing you can get sunburned through them.

For additional tips from the CDC on keeping cool, click here.

To learn more about the services provided by our PACE program, click here.