HAMPSTEAD - In a house turned doctor's office, the group sat on chairs and couches formulating its plan.
"This is important stuff," Buck Harmon told the dozen attendees spending their Tuesday evening discussing senior care.
It was the fourth meeting of the Cooperative for Senior Advocacy, a group that spawned earlier this year from Harmon's distress over the lack of quality care for Carroll County's elderly. He roped in a doctor and a lawyer, the owner of an assisted living facility and a candidate for commissioner, nurses and average citizens to attempt to address what he sees as a gap in services for seniors.
On Tuesday, they made decisions about their group's future: They'd become an official 501(c)(3) nonprofit.
They'd craft a senior care plan.
They'd make a brochure and create a presentation about their group and its mission.
All this to fix the bottom line: "Seniors right now don't have good health-care opportunities in Carroll County," Harmon said as the 90-minute meeting drew to a close.
That needs to change - and soon, according to chairman Harmon.
More than 13 percent of Carroll's population is 65 years and older, according to the 2008 to 2012 American Community Survey. With the baby boomer generation aging, this number is only going to increase.
And they'll live longer, too, according to Dr. Peter Uggowitzer, a family physician based in Hampstead.
"It's basically something that we in the health-care profession as physicians have actually created," said Uggowitzer, the Cooperative for Senior Advocacy's co-chairman.
"This is the outcome of our treatments of heart disease, our treatments of cancer, our efforts to promote smoking cessation," Uggowitzer said.
How it all began
More than two years ago, Harmon's late father started to have issues with dementia. His memory loss worsened along with his health. And finally, it was time for him to stop living alone in his Eldersburg home.
He moved to an assisted living facility. After that experience, a stint in the hospital and a rehabilitation facility, Harmon grew frustrated. His father's pressure sores from his adult diapers, his upper gums' swelling and other incidents were due to the lack of proper care, Harmon said.
He felt his father's health had worsened, and Harmon attributes this to the staff's negligence. He felt he was teaching the caregivers how to provide basic care.
"It was so frustrating because the system is broken," Harmon said. "And I didn't realize it. And you don't realize it until you're up to your neck in dealing with it."
He decided the public needed to be warned of the hurdles associated with caring for a sick, elderly parent.
"I'm just laying awake at night trying to figure this stuff out," he said. "And I said, 'You know, I could write a book with all this stuff.'"
And so he did. Titled "Empowered Caregivers for Seniors with Dementia: Understanding the System," Harmon's book is sold on Amazon for $2.99. In the introduction, Harmon writes about his father's battle with dementia, the signs and symptoms. He discusses having a care plan for a senior, communicating with a person with dementia, how to plan for nursing home expenses and more.
He's put the book in the Carroll County Board of Commissioners' hands. He gave it to Carroll Hospital Center's president, expressing his concerns to hospital President Leslie Simmons that more needed to be done to give seniors the care they deserve.
Harmon's fears began to make waves in the health community. Carroll Hospital Center developed a task force to study the county's geriatric care - a result of Harmon's and others' concerns, Simmons said.
A group of assisted living and nursing home representatives, the Department of Citizen Services director, Simmons, Harmon and others convened for the first time in February. During the task force meetings, officials have taken inventory of Carroll's resources for seniors, identified opportunities for change and more.
"There's always room for improvement, we're always open to hear that," Simmons said in an interview, "and I think this community will sort of help in doing that."
What's the best approach?
Harmon had an initial burning question: Why did the hospital not have a geriatric unit, a wing dedicated to providing multidisciplinary care to senior citizens?
About a dozen years ago, the hospital introduced a 10-bed geriatric unit, Simmons said in an interview. But hospital staff soon realized 10 beds weren't enough.
"It was one of those things that we just quickly realized you can't just have one unit," she said. "You need to have this approach for a whole hospital."
The unit disbanded, and the hospital took a different approach. It required its nurses undergo NICHE certification, which stands for Nurses Improving Care for Healthsystem Elders. In training, they learn about senior safety, preventing falls, mental health and more.
It's an eight-hour training course that must be completed each year to maintain the certification, Simmons said.
Some members of the Cooperative for Senior Advocacy say that's not enough.
"They need more," Uggowitzer said. "They need specially trained nursing that have their own interest in terms of taking care of the elderly."
The geriatric population is on the hospital's radar screen, Simmons said.
"What happens is those rules and regulations in Medicare are changing, and they're so confusing, and the seniors in our community think the hospital changed those rules," she said. "I think the hospital is taking some backlash from regulations that we actually don't have any control over. So it's been tough - it's been a tough environment for our seniors."
The hospital has made some headway for seniors within the last year, according to Simmons. It added a case manager inside the emergency department to help identify resources and special assistance to patients. It introduced telehealth monitoring, which essentially allows hospital home care to monitor blood pressure, weight and oxygenation levels from the comfort of the patient's home.
Additionally, it's looking to hire a geriatric nurse practitioner available to any patient in the hospital.
"They'd be the inpatient advocate for the seniors' needs while they're admitted," Simmons said.
A grassroots effort
After the hospital's first geriatric care meeting, Harmon said he felt he didn't have any task force-related homework. So, he created his own.
Through phone calls, he held an informal meeting at Uggowitzer's office in a Hampstead home converted into a doctor's practice. More than a dozen Carroll residents showed up to discuss the state of elder care available in the county, determining the group should formalize.
At the second meeting, they created a name and a mission statement: The Cooperative for Senior Advocacy Group; "Partnering with seniors, their families and caregivers to advocate for the highest quality of care in all aspects of aging."
And at the fourth meeting, it discussed creating a presentation describing the group's mission. It decided to create a senior care plan, and a geriatric emergency department is chief among the ideas to be documented.
Harmon read out loud an NPR article detailing the Seniors Emergency Center at Silver Spring's Holy Cross Hospital. Opened November 2008, the ER consists of a specially trained staff, a geriatric social worker and golden brown rooms contrasting with white to make it easier for a senior to see where one exam room ends and another begins, according to the NPR article.
It's an idea worth pursuing, Harmon said. He's been in contact with Holy Cross Hospital and plans to arrange a visit to tour the department.
Flex funds from the Bureau of Aging and Disabilities budget could possibly be put toward such an effort, said Madeline Morey, director of the Department of Citizen Services - which oversees the bureau. First, the Carroll County Board of Commissioners and the state would need to approve the money for this use.
"Just like other human beings, they would have to provide services for those specific needs, but I was really intrigued about what the cooperative was saying about how some localities have really been able to make this work," Morey said in a May interview. "I'm still trying to determine what might be best for our community. Like I said, I was very intrigued."
That's the Cooperative for Senior Advocacy Group's plan: To find out what will work in the community to improve senior care locally. And time is of the essence, Harmon said.
"Everywhere you go, you can find someone who's had a family member or friend that has had an absolute difficult experience with that type of situation," Harmon said in an interview. "It's just the norm, and that should not be."
