Advance care planning, volunteer facilitators, housing, and transportation for the elderly were at the forefront of Healthy Aging Martha’s Vineyard (HAMV) annual meeting Wednesday morning.
For the past year, HAMV, an Island senior advocacy group, has been focused on advance care planning, an ongoing process between patients, families, and health care providers to ensure patients receive medical care consistent with their values, beliefs, and goals.
The annual meeting’s main event was a video call with Bill Novelli, chair of the Coalition on Transforming Advance Care (C-TAC), a nonprofit organization focused on planning for those with advanced illnesses.
Novelli gave a presentation sharing scenarios and stories of doctors and patients that come up during the planning process.
Novelli highlighted frequent communication about end-of-life treatment and death, especially important as an illness gets worse so patients are receiving the care they want. One conversation on a patient’s future treatment is not enough. A lack of advance care planning can lead to unnecessary suffering, unnecessary hospitalizations, and unwanted treatment — all resulting in a high cost to families and the country.
“The important thing is that you can’t have a conversation and then that’s set in stone. People change from 65 to 70, 75 to 80 and so on and so forth. All the more reason why these documents and their conversations with their adult children have to be current… somehow we have to take into account that people change. As they advance in change and advance in illness these changes occur more frequently,” Novelli said.
Holly Bellebuono, HAMV’s executive coordinator, said that talking about end of life care and death is intimidating and can be difficult for families to talk about. “It’s not, in our culture, a very natural conversation to have yet,” she said. She asked if Novelli has seen a cultural shift in the topic of death.
Novelli said he believes there is a cultural shift in talking about end of life care with new programs addressing the topic of death and dying and the aging generation of baby boomers being more involved in the conversation. “Things are changing and I think they’re changing for the better.”
In 2018, HAMV focused on advance care planning through community outreach and education and establishing relationships with advance care planning leaders throughout Massachusetts such as the Massachusetts Coalition for Serious Illness Care, The Conversation Project, and Honoring Choices.
HAMV has been working with the Martha’s Vineyard Commission (MVC) and Martha’s Vineyard Community Services to collect and analyze data, write grants, and provide back office support to ensure seniors have access to health care, housing, and transportation.
HAMV has partnered with the MVC and the Martha’s Vineyard Hospital to conduct a study of Greenhouse assisted-living nursing homes. HAMV is also supporting the hospital’s work with Navigator Homes in trying to find a site to build a new nursing home.
The options for elderly housing models go beyond the traditional nursing home model. In addition to building new living facilities such as Greenhouse homes, HAMV is also looking at modifying existing homes to make them safer for seniors through handrails, ramps, and other installations.
Bellebuono said the “intergenerational model” has seen success by having a senior living with a young person such as a college student or seasonal worker and that HAMV is looking into ways to adopt this model for the Island.
By looking at existing off-Island elderly housing models in places such as Vermont and Maine, HAMV plans to create its own model specifically suited to the Island.
Bellebuono said Lila Fischer, a public health nurse on the Island, has been conducting home assessments along with her health assessments to look at senior home safety standards and develop ways homes can provide better accessibility.
Transportation needs continue to be an important issue for seniors as well. Bellebuono said senior transportation needs to be responsive, flexible, accessible, and well suited to a rural environment.
At the conclusion of their meeting HAMV made a call to action, asking people to sign up for work-groups as volunteer facilitators to plan and implement housing, transportation, and other support programs for seniors on the Island.
People can find more information about the workgroups and how to join them on the HAMV website at hamv.org/workgroups.