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Silver Linings: In Lebanon, finding the 'LIGHT' to help frail seniors stay at home

By GRETCHEN M. GROSKY
New Hampshire Union Leader

February 26. 2017 9:42PM


LEBANON — It’s described as a “one-of-a-kind program in New Hampshire” to help Lebanon’s frailest seniors stay at home.

The Local Interdisciplinary Geriatric Homecare Team (LIGHT) brings together a community nurse, a long-term care counselor and an outreach worker to help as many as 20 seniors at any one time with everything from medication management to getting help with food and utility bills to long-term care planning.

The goal is to keep these seniors living at home for as long as possible – and it costs the clients nothing.

“It’s been a lifesaver for frail elders in Lebanon who are struggling to live on their own,” said Roberta Berner, executive director of the Grafton County Senior Citizens Council. “It’s a one-of-a-kind program in New Hampshire.”

The program is run by Berner’s agency, with much support from the Upper Valley Community Nursing Project, Berner said. It is another example of how communities are working to support the state’s rapidly aging population.

New Hampshire ranks among the top three states in the country for oldest population, with some experts deeming this demographic trend a “silver tsunami.”

Jane Conklin, LIGHT’s long-term care counselor from ServiceLink Resource Center of Grafton County, said the team meets weekly to talk about their clients.

Some of the clients are referred by Dartmouth-Hitchcock Medical Center and others by the Alice Peck Day Memorial Hospital in Lebanon. Others contact LIGHT directly, Conklin said.

The team makes house calls and helps clients with their overall wellness. Their “wellness” includes many aspects, from their physical health to their living situation to emotional support, Berner said.

Conklin said they also help find seniors new living arrangements if they cannot stay at home. She said some of their clients only need temporary support with things like medication management, while others have needed assistance for a year or longer.

“They’re on-site with the senior,” Berner said. “They are their trusted helpers.”

Berner said the team also has cleared “a real hurdle” by being able to talk to medical providers directly about their clients’ care.

“Clients were willing to give permission to speak to one another and they’ve been able to share information that’s been critical to the clients’ care,” Berner said.

Funding for LIGHT has come in pieces since it began as a pilot program three years ago, Berner said.

One day of Conklin’s ServiceLink work is dedicated to LIGHT and is paid for by donations. Community Nurse Terry Fuller’s time is also paid for by donations as well as grants.

Upper Valley Senior Center outreach worker Kappy Scoppettone’s two days with LIGHT was being paid by Dartmouth-Hitchcock, but that funding ended Dec. 31. Berner said the city, along with Granite United Way and other donors, picked up Dartmouth-Hitchcock’s share.

“They didn’t want the outreach worker to go away,” Berner said. “She is an invaluable team member for them.”

Berner compared the LIGHT program to the Support and Services at Home (SASH) program in Vermont, which currently is receiving Medicare funding as a model program for other states.

The difference between LIGHT and SASH is that LIGHT provides services at home, while SASH stations an around-the-clock nurse and outreach worker at federally funded elderly housing complexes.

According to the Centers for Medicare Services, SASH has been proven to reduce Medicare and Medicaid spending. Medicare spends between $700 and $1,000 per year per senior on the program, but SASH estimates it saves about $1,536 year per patient, according to a 2014 study of the program. It also found the seniors experienced fewer trips to the emergency room.

Medicare has funding available to federally funded elderly complexes in all states as a result of the success of SASH.

“We looked at the SASH program as a model and we liked what we saw up in Burlington,” Berner said. “In a rural area, we thought it might be better not to have it at senior housing but to have it in the community.”

Berner said looking to Medicare funding for the LIGHT model may be something that is pursued in the future. She also believes the program is unique in New Hampshire and says Lebanon may be on the only community in the state that pays for an outreach worker.

“Funding has been so stagnant and reduced over the last decade that a lot of programs don’t have the funding to make this happen,” she said.

For more information on the LIGHT program, contact Jane Conklin at 448-1558.

Silver Linings is a continuing Union Leader/Sunday news report focusing on the issues of New Hampshire’s aging population and seeking out solutions. Union Leader reporter Gretchen Grosky would like to hear from readers about issues related to aging. She can be reached at ggrosky@unionleader.com or 206-7739. See more at www.unionleader.com/aging.


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