Scotland House to offer care for older adults
Scotland House to offer care for older adults
By NORA DOYLE-BURR
Jul. 23, 2018
QUECHEE, Vt. (AP) — A program that will offer care, entertainment and support to older adults is set to open in the newly renovated former Scotland by the Yard off Route 4 in August, services that are likely to be in growing demand as residents of the Twin States age.
Staff at the Scotland House in Quechee will offer a range of services including assistance with nutrition, medication management, help using the bathroom, showering, foot care, dementia care, as well as activities such as tai chi, discussion groups, horticulture and pet therapy. In doing so, the program will give the older adults' families and friends a break from caregiving.
"The Scotland House is more than day care," said the program's director Gretchen Cole, during a presentation about the program at the Thompson Senior Center in Woodstock earlier this month.
The goal of the program is to help seniors age 60 and older to continue to live in their own homes and communities, and as much as possible on their own terms, even as they age and as their cognitive and physical abilities decline, Cole said.
Scotland House will "focus on the person and not on the limitations" they may have, she said.
Demand for programs like the Scotland House is expected to grow in the coming years as the region's population continues to age.
In Vermont, nearly 30 percent of residents are expected to be 65 and older by 2030, according to estimates by the Vermont Agency of Commerce and Community Development in 2013, the most recent data available. Similarly, New Hampshire residents 65 and older will make up almost 30 percent of the state's population by 2040, according to population estimates from the state's Office of Energy and Planning (now the Office of Strategic Initiatives).
"Adult day programs meet a critical need by enabling older adults who otherwise would not be safe if left alone to have care and supervision during the day while their families work or take care of other needs," Senior Solutions Executive Director Carol Stamatakis wrote in a letter in support of the program that was provided to the Vermont Department of Disabilities, Aging and Independent Living as part of the program's application for licensure.
In a phone interview, Stamatakis said community members have told her about the need for more adult day programs in the Upper Valley. Similar programs exist in Bethel, Newbury, Vt., and Springfield, Vt., but it can be difficult for families to make a long trip.
When caregivers don't have access to the respite provided by adult day programs, which allows them to keep working or do other things they need to do, the person being cared for can end up in a nursing home, Stamatakis said.
"The whole area was underserved," said Jill Lord, the director of community health at Mt. Ascutney Hospital and Health Center. "...This is really filling that gap."
Lord, who sits on the board of the Scotland House, said that there is likely a greater demand than the 21 people per day that the program will be able to accommodate. But, to start with, "we want to do it well," she said.
The program, which costs $17 per hour and will be open Monday through Friday, 7:30 a.m. to 5 p.m., is less costly than nursing home care and it allows the adult to remain living at home. The program is not for everyone — those who need lifts in order to get around and those who cannot feed themselves will not be able to attend. Those who do participate will be required to attend the program for at least four hours, two days each week. Transportation provided by the Thompson and Bugbee senior centers will be available for an additional cost that has yet to be determined, Cole said.
The Scotland House will accept private payment, Vermont Medicaid, some forms of long-term care insurance, as well as caregiver and dementia grants. They also hope to work with the Veterans Administration to provide contracted services for veterans. At this point, however, the program cannot accept New Hampshire Medicaid, meaning New Hampshire seniors who depend on Medicaid for such services will not be able to participate.
Board president Jerry Fredrickson, who attended Cole's talk said he'd like to be able to accept New Hampshire Medicaid and VA benefits.
"I'd like to solve those problems, rather than say we can't," he said.
Sorting out a way to serve low-income New Hampshire residents could be a steep challenge, however.
"I was told since we are located in Vermont, New Hampshire will not allow us to be certified to bill New Hampshire Medicaid," JoAnne Bohen, director of Springfield (Vt.) Area Adult Day Services, said in an email.
But Wendy Aultman, chief of the New Hampshire Bureau of Elderly and Adult Services, said in an email that if adult day programs go through the necessary steps, they should be able to bill New Hampshire Medicaid, even if they're in Vermont.
"If a provider is interested, please have them contact me and I can connect them to the right person to work with them to become enrolled," Aultman wrote. "I find assisting providers with this process is helpful, so that it is not so overwhelming."
So far, dozens of people are on the list of hopeful participants, said Deanna Jones, the director of the Thompson Senior Center who is on the board of Scotland House.
Scotland House is primarily intended to serve residents of Woodstock, Pomfret, Bridgewater, Barnard, Hartford, Hartland, Reading, Plymouth, Vt., and Norwich, Cole said. But residents of other towns are invited to apply and their applications will be considered if there is availability.
In his letter of support for the Quechee program, Mt. Ascutney Hospital and Health Center CEO Joseph Perras said he anticipates Mt. Ascutney and the related Ottauquechee Health Center in Woodstock will refer three to four people per month to the Scotland House.
In addition, Perras said the program would help reduce emergency room visits and hospital admissions by helping to assist seniors in managing their medications and helping to monitor their physical and mental health needs. In addition, the meals provided in the program can help address nutritional challenges some seniors face when they can no longer shop or cook for themselves.
Participants will receive lunch provided by the Thompson Senior Center, as well as a snack. A kitchen on site will be available for cooking projects during the day, but is not sufficient to cook meals, Cole said.
The activities and social interaction offered by the program is expected to help counteract some of the effects of aging such as declining cognitive and mental health.
"We believe the adult day care program can stimulate their minds and raise their spirits thus improving the quality of life and ability to remain in their home," Perras wrote.
Perras also said the program may help relieve some of the stress on family and friends caused by the shortage of workers available to provide care to seniors in their own homes.
In addition to Cole, the Scotland House has a business office manager and a caregiver, who is a retired registered nurse. The program is currently interviewing people for a variety of positions, including registered nurse, licensed practical nurse, caregiver, social worker, per diem staff and volunteers.
In addition to people, the Scotland House is also seeking funding. It so far has raised about $610,000 in donations, but would like to raise another $75,000 by the end of the year. Its application for 501c3 nonprofit tax status is pending.
There are no similar programs currently available on the New Hampshire side of the Upper Valley. Lake Sunapee VNA & Hospice operates respite programs in Lebanon on Fridays and in New London on Mondays and Thursdays. The programs, which run from 10 a.m. to 3 p.m. are geared for people with memory loss or dementia and aim to give their caregivers a break. The Lake Sunapee program is described as a social model and doesn't provide the medical supports that adult day programs do.
"That would be great if the one in Quechee is a medical model," said Jeana Newbern, marketing & community outreach manager for Lake Sunapee Region VNA. "I think there's a need."
There used to be several adult day programs on the New Hampshire side of the Upper Valley, but all have closed in recent years. Grafton County Senior Citizens Council operated adult day programs in Lebanon, Plymouth, N.H., and Haverhill until nearly 10 years ago, said Roberta Berner, the council's director. Valley Regional Hospital, through its Connecticut Valley Home Care, operated an adult day program in Newport, but that closed two years ago after Lake Sunapee VNA took over the hospital's home care division, Newbern said.
Funding issues were only part of the problem, Berner said.
"It was really the requirements," Berner said. "We felt like we were turning ourselves into a pretzel."
The adult day programs were required to meet the same requirements as nursing homes, including having a medical director, dispensing medications and providing nursing staff.
"It was really outside of our expertise," she said.
Eventually, Berner said former clients became clients of home health care agencies.
"Of course it's a lot less social," she said.
For meals and activities, Berner said she and her staff encourage caregivers to bring older adults to the senior centers.
On a Wednesday afternoon earlier this month, the site of the soon-to-open Scotland House was quiet.
The 2,000-square-foot building housed Scotland by the Yard, a Gaelic apparel and gift store, until a couple of years ago. The business' owner Don Ransom retired after 63 years in business. He was unable to find a buyer for the store.
Woodstock Area Adult Day Services, the formal name for Scotland House, purchased the land and buildings for $350,000 in August of last year, according to town records. The five-acre property is assessed at $400,800.
In addition to the old store, which will house the adult day program, the property also includes a 1960s-era cape and a standalone garage that the organization is currently renting out and using for storage, Lord said.
The remodeling project for the former store has included adding two bathrooms, including one with a handicapped-accessible shower, to the one that was already there. They've also opened up the space, creating a large living room that will hold recliners participants can use to rest.
There is a dining area with additional windows installed to allow more light into the room. The dining area opens out onto a small patio. Though there are no animals grazing in the field below the building, the trees and grass surrounding it are green and lush.
"You see just the beauty of nature," said Lord. "It's going to be enriching and nurturing."
The kitchen will include a refrigerator and stove, which the residents and staff will be able to use for snacks and breakfast.
A second floor loft will hold the business office. Other staff offices will sit off the dining area on the first floor.
Cole said she expects there will be two open houses around the time of the opening next month. The first will be for participants and their families, and the second will be for the general public.
"We felt participants and families would like to have something that is more intimate," she said.
Information from: Lebanon Valley News, http://www.vnews.com