You are the CEO of Your Health Care
By Jennifer Davis
Hebrew Senior Life staff
Gone are the days when patient care was simply a matter of following doctors’ orders. Today, many seniors and their families play an important role in health-care decisions. Dr. Robert Schreiber, physician-in-chief at Hebrew SeniorLife (HSL), welcomes this development with open arms. He champions programs that encourage healthy lifestyles and provide patients with tools for chronic disease self-management.
“By learning what they can do themselves to improve or cope with a medical condition, individuals can take control of their destinies when it comes to their health,” says Dr. Schreiber. “By setting goals, overcoming obstacles, and succeeding in meeting objectives, an individual in a way becomes the CEO of his or her care.”
A chronic disease is defined as a health condition that lasts a year or longer, limits what an individual can do and may require ongoing treatment. The incidence of chronic disease greatly increases in old age and can have a significant impact on quality of life. Seventy-five percent of adults older than 65 have at least one, and the average 75-year-old has three chronic diseases. Diabetes, arthritis, heart disease and respiratory ailments are all examples of chronic diseases.
Dr. Schreiber believes that seniors who suffer from chronic diseases can improve their conditions with the support of well-designed evidence-based programs. To be considered “evidence-based,” a program must have been proven effective through scientific research. Dr. Schreiber has introduced just such a program at HSL known as the Chronic Disease Self-Management Program (CDSM).
Developed and tested at California’s Stanford University, CDSM depends heavily on peer leadership. According to Dr. Schreiber, studies have shown that older adults often turn to friends and neighbors for health advice and tend to listen to them more readily than to their physicians. Participants in this program attend a workshop once a week for six weeks led by two individuals who are trained in the program but are not health professionals and may suffer from chronic diseases themselves.
The program promotes the participating seniors’ central roles in managing their own health. It teaches them how to set goals around issues such as nutrition, exercise and stress management and develop action plans to reach those goals. It also provides opportunities to practice new skills; encourages peer support; and talks about health promotion, not illness and disability. CDSM has met with great success at Simon C. Fireman Community and Center Communities of Brookline – both HSL independent supportive senior housing sites.
Assistant Administrator Mary McCarthy and resident Shirley Goldman, a retired nurse, lead the program at Fireman Community. According to Ms. Goldman, a key to success is learning how to set realistic goals.
For example, an individual with cardiovascular disease may wish to increase aerobic endurance. He or she may start by setting a goal to climb a set of stairs once a day instead of using the elevator. The ultimate goal may be to dispense with the elevator entirely.
“This program causes a shift in thinking about health beyond the traditional doctor/patient relationship,” says Mary McCarthy. “The experience nurtures a sense of autonomy among participating seniors. Support groups are often new to this generation and the participants take pride in reporting their success.”
Director of Programming Joanne LaPlante and resident and retired nurse Dorothy Voytek, report a similar experience at Center Communities of Brookline. They served as workshop leaders at their site.
“The most exciting benefit of CDSM was the establishment of peer support within the community,” says Joanne LaPlante. “One group continued to meet on their own well after the six-week program was finished. One participant shared that she now feels much more a part of the community and a special connection to those who were in the workshop with her.”
From a physician’s perspective, Dr. Schreiber could not be more pleased with CDSM’s success at Hebrew SeniorLife. “This program has been able to accomplish positive changes and outcomes in my patients that I could only hope would happen with the care I provide,” he says.
The Chronic Disease Self-Management Program is just the beginning of a growing trend toward promoting wellness programs to seniors within the HSL system of care. Simon C. Fireman Community will soon offer a program called “Healthy Eating for Successful Living,” which will focus on nutrition.
If all goes as planned, eventually every senior cared for in the HSL system will receive an annual wellness assessment and, if necessary, be referred to an appropriate program. If the Chronic Disease Self Management Program is an accurate barometer, this trend heralds a positive step forward in senior health care.
Above content provided by Hebrew SeniorLife in partnership with Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.
Posted December 2008
