PACE: A Different Model for Senior Care

Rev Lewis Preston participates in the PACE program.
Rev Lewis Preston participates in the PACE program.

JACKSON: Thanks for coming in Anne and tell me about the program you found in Cuyahoga County—PACE?

GLAUSSER: Yes PACE or Program of All-Inclusive Care for the Elderly. The overarching goal of the program is to keep folks out of institutions like nursing homes and in the community. This could be in their own home, or a family member’s home, or even in an assisted living center—depending on what kind of care a person needs and how much family support they have.

The idea behind PACE is to provide community-based comprehensive, coordinated care for older adults—something lacking in the current healthcare system.

Here’s how PACE Medical Director Dr. Peter DeGolia explains it:

DEGOLIA: So we work hard to make sure that our preventive services are provided, that problems are caught early, and begin to manage problems early. That’s critical, that’s a basic principle of senior care: identify a problem early, address it early, so it doesn’t get out of hand.

JACKSON: You spent some time with one PACE participant, right, to get a sense of the program?

GLAUSSER: Yes. Reverend Lewis Preston who lives with his daughter Linda Maple out in Bedford. Preston’s 95 and very sharp for his age, but he’s got some chronic health conditions like osteoarthritis and memory problems. He needs a nursing home level of care but that’s not where he wants to be.

PRESTON: I don’t want to go to no nursing home. I want to stay. One of my wives, she was in the nursing home. She stayed there 9 years and she couldn’t talk, couldn’t eat, she couldn’t walk, she was just lying there…

GLAUSSER: Now this is a lively guy—he collects and cracks black walnuts and has this amazing smile and real charm. And his daughter wants to be able to keep him at home with her but she works. So here’s where the PACE program comes in. It’s built for people like Maple who work fulltime. It provides transportation to and from an adult day center M-F so family members can go about their lives and not have to worry about their loved ones during the day. This is a key component of the PACE program—this adult day center where there are activities and lunch is served and people talk or read or watch TV or sit in the sun—it’s a really bustling place. And also at this center, under the same roof, are all the health and social services an older adult might need. There’s a physical therapy wing, a place for bathing and personal care, social workers, a doctor’s office…they’ll even do a person’s laundry. This comprehensive approach to care helps keep folks healthy, in the community, and takes some of the pressure off of family caregivers.

JACKSON: Let’s talk cost. How’s PACE compare to a nursing home?

GLAUSSER: It’s cheaper. An average nursing home runs about $7000 a month per participant. PACE costs about $4000 a month per person.
And I should mention that those people who qualify for both Medicare and Medicaid pay no extra fees for PACE.

JACKSON: So who is eligible for PACE?

GLAUSSER: Right now it serves some 400 older adults. But here’s the catch: it’s only available to those who live in Cuyahoga County. You also have to be over 55 yrs old and require a nursing home level of care.

Now, there are other PACE programs across the country—about a hundred of them—but MacGregor PACE is the only one in Ohio. DeGolia says the program is growing, catching on in more areas, especially rural areas, but to start a PACE program requires a lot of legwork including partnerships at the local, state, and federal level which can be hard sometimes to wrangle.

JACKSON: Thanks Anne.

GLAUSSER: Thank you.

JACKSON: You can catch Anne’s video about Rev Lewis Preston and the PACE program—as well as find out more about caregiving in general—on a Be Well health special this Monday NOV 17 on WVIZ/PBS. That’s at 7:30pm.

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