Older Adults Receive Care on Many Levels at South Shore Clinic
Nestled on a concrete island near a busy six-point intersection is a cozy haven that Joan Bigane, APN, FNP-BC, calls “a diamond in the rough.” The sparkling cherry wood floors and the pristine patient rooms give a clear hint of the quality of care older adult patients can expect at the Medical Center’s South Shore Senior Health Center.
“Hi, how are you doing?” Bigane silently mouths to a patient who has just taken a seat in the waiting room, careful not to speak too loudly. The patient, a tall African-American woman who looks years younger than anyone who could be called “senior,” walks slowly toward Bigane as if something hurts. Bigane reaches out to give her a hug.
“We give a lot of hugs here,” Bigane said. The nurses at South Shore believe compassionate care is important, since the 2,461 patients who come for care might have much more than clinical conditions needing attention. Many of the patients, mostly from the surrounding South Shore and nearby Chatham neighborhoods, are typically treated for multiple chronic diseases, such as hypertension, cognitive impairment, arthritis and type 2 diabetes.
Nurses and social workers are responsible for coordinating patients’ care outside of South Shore, which could mean a referral for support groups, home health agencies, community services or additional care at the Medical Center.
Because of patients’ complex medical conditions, physical and social activities are keys to older adults’ quality of life, especially those who live by themselves or only with a spouse. The nursing team often connects many patients with exercise classes at their local community centers to help them maintain their range of motion, and shows the couples at-home exercise techniques. “I taught one married couple how to massage each other with peppermint oil to ease joint pain from arthritis,” said Bigane, who has more than eight years of nursing experience at South Shore. “They were just blushing like two kids.”
Then, there are the conditions that medications cannot treat. When a patient cannot find transportation to the center, the nursing team coordinates a pickup or a home visit. For patients who cannot pay for medications, the nurses work with South Shore’ two geriatric social workers, Pat MacClarence, MSW, LCSW, and Jeff Solotoroff, MSW, LCSW, to find programs that offer the medicines for a more affordable price.
Palliative care coordination also is a large part of how nurses care for patients. The nurses agreed that this starts with having a maturity about the cycle of life and an acceptance that some patients are at the end of that cycle.
“We know that we may not always be able to cure all of our patients, so we are always aiming for quality of life,” said Lucy Mueller, RN, geriatric clinical nurse specialist. “Sometimes our idea of what’s good for them is not their or their family’s idea of what’s good for them. We might be afraid that in staying at home, someone will fall or be too isolated, but if the patient does not want to go to a nursing home or assisted living, we support that. If their wish is to die at home, we respect that.” To help family members cope with caregiver stress or death, nurses facilitate bereavement counseling and support groups.
The camaraderie between the nursing staff and the patients is obvious in nearly every encounter. Bertha Snapp, 87, has been coming to the Senior Health Center for two years. She sat waiting for the lab technician, Tasha Marks, MA, to draw blood when Jerry Pryor, LPN, poked his head in the door. “Hey!” they yelled excitedly to each other, like longtime buddies. Pryor extended both hands to greet her, and they exchanged a few jokes before he left to chat with another patient. “It’s nice here, except this,” Snapp joked, pointing at the needle pricking her arm. “Yes, I really like this place, especially the staff.”