Health care providers grapple with aging


More than 80 Island health care providers gathered at the Dreamland ballroom in Oak Bluffs on Friday, November 8, as part of a “Taskforce on Healthy Island Aging.” The aim was to consider issues and action that will shortly be important to serving the growing population of people aged 65-plus on Martha’s Vineyard.

The attendees reviewed a recently-completed study by a team of students from the University of Massachusetts Medical School/Graduate School of Nursing’s Rural Scholars Group that called for immediate action to serve residents over age 65 who are expected to include one third of the Island population by 2030, according to preliminary numbers reported by Peter Temple, executive director of the Marthas’ Vineyard Donors Collaborative (MVDC).

The taskforce is a subset of the Dukes County Health Council (DCHC), which arranged funding for the medical student research project. Its mission is to create a supportive community for aging on the Island.

Healthy aging is defined by the group as “the development and maintenance of optimal mental, social and physical well-being and function in older adults by promoting community-wide health and wellness through a cooperative integrated network of community members including elders, health practitioners, health and social service organizations.”

Paddy Moore of West Tisbury, DCHC executive director, said after the meeting that she hoped the gathering would be a watershed for action.

“We were pleased that 85 people registered for the meeting,” she said. “We’ve been given shocking information on the growth of the senior population. We knew they were coming, but now we’re aware of it. Aging population is a national phenomenon, but the impact will be more profound here because we’re a retirement destination.”

Ms. Moore said the Island’s political leadership needs to take notice and plan. “We are trying to engage leadership in this projected growth that will impact all facets of life here. We are not exaggerating. This will stress every aspect of infrastructure here, and not just for seniors. The greatest impact will be felt in ten years, but we have to deal now with housing and transportation.

“This is the beginning of what will be a long conversation. We’ve met with all the Island selectmen, and we will meet with other affected government entities, including finance committees and zoning boards.”

After reviewing the Rural Scholars’ study and recommendations on Friday morning, the group divided into six workgroups to begin identifying ways and means to deal with a senior population that will likely quadruple between 2010 and 2050.

The workgroups included: creating a one-stop referral service under an umbrella organization linked to all health care organizations; devising a transportation system for elders to use; creating affordable housing both for seniors and for the expected increase in year-round caregivers needed on-Island.

Several providers cited the work of Vineyard Healthcare Access as a well functioning model that accesses services for clients beyond its health care service charter.

Mr. Temple and Ann Bookman, a consultant on aging and now director of the Center for Women in Politics and Public Policy at the University of Massachusetts-Boston, helped to facilitate the meeting..

The morning session was designed as an interactive exercise that produced a frank exchange of opinions and suggestions, including discussion of what were termed “elephants in the room.”

Nell Coogan, director of development and community relations at Martha’s Vineyard Community Services, set the tone early when she asked for transparent dialogue from her colleagues.

“There is an elephant in this room, and the elephant is the competition and some histories between organizations that we need to overcome in order to get somewhere,” she said. Her comment appeared to strike a chord in the packed ballroom.

Speakers from various agencies were frankly critical about a lack of cooperation and communication between agencies, and several had harsh words for the Martha’s Vineyard Hospital’s role in delivering needed services, particularly in the fields of mental health and substance abuse.

Cooperation and integration between Island service organizations and a larger role for Martha’s Vineyard Hospital in health care issues and solutions were recommendations urged by the Rural Scholars team.

“This is really important. We have to get our act together fast, with the growth of seniors that is coming,” Sandy Corr-Dolby of Horizons Geriatric Care Management in Vineyard Haven said of the need for interagency cooperation.

Ann Smith, executive director of Featherstone Center for the Arts, provided some texture in her comments. “There are people and organizations in this room today who have never spoken with each other, who fear that other organizations will steal their donors. This meeting has worked because you have to get the elephants out of the room in order to make Martha’s Vineyard a better place to live,” she said to applause.

David Vigneault, “Regionalization is a word that’s a third rail on the Island, but we’ll get better leverage through integration of Island groups.”

Several attendees echoed a sentiment from Island mental health clinician Sheila Shapiro on a need for additional and more dedicated involvement by the Martha’s Vineyard Hospital, to address issues of health care on the Island related to substance abuse and urgent care for psychotic patients .

“My experience is that there is a discrepancy between the hospital’s mission statement and what happens. Partners Healthcare’s mission casts a broader net, and it might be helpful if those two entities talked to each other,” Ms. Shapiro said.

“There are no beds available for psychotic patients who need time to stabilize from an episode. They are sent off-Island,” said Joy Ganapol, a clinician at Martha’s Vineyard Community Services.

Several speakers, including Ms. Moore, said that the hospital is providing new programs but has not communicated them to the community. James Klingensmith, assistant director of elder services for Dukes County, an adjunct of Elder Services of Cape Cod and the Islands, suggested that one new hospital program could have far-reaching results.

“The hospital has a new pain management program, though it is not well known, that allows Partners specialists in Boston to consult, live on a TV screen, with patients on the Vineyard,” he said. “It works. I’ve used it.”

Noting the lack of gerontologists on the Island, he suggested, “maybe Partners could use (the pain management program) as a model for gerontology care here.”

By mid-afternoon, volunteers for the six workgroups had gathered around tables to begin working on solutions and suggestions proposed during the morning session.