Dr. Roshni Samuel is the new resident medical director of Gloucester's PACE facility.
She is also a daughter.
It was, she says, her love for her parents, the thought of their aging, and the realization that when they aged, she wanted a better and broader level of quality care available for them, that first motivated her early interest in geriatric medicine and gerontology.
That interest led the young, then-New York City based internist, to pursue specialized studies in geriatrics and gerontology, which in 1997 took her to Boston for a Harvard Geriatrics Fellowship Program.
It was there she met Dr. Elisabeth Brodwick, a director of Elder Service Plan of the North Shore/PACE and the person who would eventually recruit her to lead Gloucester's PACE medical operation, a position she officially stepped into in January.
PACE, an acronym for "Program of All-inclusive Care for the Elderly," is a national, federally funded nonprofit Medicare/Medicaid program with six facilities in Massachusetts.
Like all PACE facilities nationwide, the Gloucester site provides its 112 "clients" with a unique model of interdisciplinary coordinated "team" care designed to do many things, chief among them: keep them out of nursing homes and in their own homes, living independent, active lives.
"The PACE national model," says Dr. Samuel, quietly but emphatically, "is amazing, just amazing — and the Gloucester facility is just a Wow!"
On Tuesday, March 13, local residents can see just what makes Gloucester's PACE operation a "Wow!" when the facility, located at 29A Emerson Ave., hosts a free open house from 4 to 6:30 p.m.
All are welcome to meet, greet and mingle with Samuel and members of the PACE Gloucester "team" at a catered finger-food buffet, and take an impromptu tour of the facility. Informational literature will be available for anyone interested in PACE either for themselves, a family member, friend or neighbor.
Statistics show that almost a third of the city's 28,000 residents are seniors or about to turn senior, and PACE serves the needs of the frailest and most vulnerable of that sector; those age 55 and older, who are certified by the state as needing nursing home level care.
Nursing home level certification, is, in fact, a primary requirement to qualify for PACE care In Massachusetts, where nursing home costs average $8,000 to $12,000 per patient a month, The PACE option, which costs an average of half that, represents substantial savings for taxpayers, Samuel says.
While that's important, says Samuel, what's even more important is what PACE provides. According to a New York Times article (Jan. 8, 2009), "in a fragmented system ... many experts laud (PACE) as long-term health care done right."
"There are," Dr. Samuel says, "so many facets to caring for this patient population."
PACE clients, she observes, "come in all configurations, and their needs are assessed accordingly. Some need daily home visits to help with shopping, housekeeping, organizing medication; some need daily visits to the facility for rehabilitation, wound care or treatment of a myriad of medical, psychological and age related depressions, conditions and complications. PACE provides and coordinates them all.
Socializing is crucial to their mental and emotional well-being, and a full calendar of activities, including three meals a day in the facility's dining room, keeps the center buzzing with life Mondays through Fridays.
"Life," Dr. Samuel says, "is what it's all about." And that's not, she adds, just for the client, but for the caregiver, too.
"We care for the caregivers," she says. "We recognize their needs and challenges and value their participation, insights and observations."
One day last week, she recounts, "when I arrived for our morning team meeting, a caregiver called saying her 90-year-old mother may have had a mini-stroke.
"By 8 a.m., two of our nurse practitioners were headed for a home visit," she relates. "It was determined that the woman could stay at home for monitoring, but if the daughter later determines her mother needs hospital care, we'll make all arrangements, including personally escorted transportation."
Close and frequent interaction with clients allows team members to observe changes in behavior that might be symptomatic of changes in their condition. Increased trips to the bathroom, for instance, might indicate a urinary infection, and treatment can quickly follow.
Observation through personal interaction is an important part of the PACE model, which began 27 years ago in San Francisco's Chinatown.
The Chinese reverence for their elderly, says Samuel, made the American practice of consigning their aging parents to nursing homes abhorrent, so the first day-care PACE model was developed in a community center to serve Chinatown's local elders.
It was called "On Lok," which is Cantonese for "peaceful, happy abode."
That, according to Samuel, describes what she found when she interviewed for the job she now holds at Gloucester's PACE facility,
And for someone who, over the course of 20 years of practice, has now seen all manner of elder care facilities, that alone is worth a "Wow!"
Joann Mackenzie can be reached at 978-283-700, x3457, or at jomackenzie@gloucestertimes.com.
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