A new model of elderly care

By Angela Toda
ICHS Dr. Ric Troyer (right), PACE medical director, with a patient and staff member at ICHS Legacy House. (Photo provided by ICHS) Guijuan Chen, a senior, worries about living in her International District (ID) apartment alone. Problems with her balance and a few spills have left her feeling unsafe. Chen emigrated from China 25 years ago. She loves living in the ID and doesn’t want to move to a nursing home, or to leave her friends and neighborhood.

“I feel more comfortable,” said Chen. “I can’t regularly meet my friends if I live in a nursing home. I can’t communicate. No one will speak Chinese.”

Recently, Chen found an answer. She signed up for the International Community Health Center (ICHS)’s PACE program, which launches on July 1 at the ICHS Legacy House.

PACE, which stands for Program of All-inclusive Care for the Elderly, is a new model of care that keeps seniors out of hospitals and nursing homes. Instead of a patchwork of providers and services, all of Chen’s health care will be managed by one 11-person team that will be in constant communication. She will obtain all or most services at home or at the ICHS PACE center, based on a plan that is unique to her needs. All transportation is included.

“PACE is team-based,” said Dr. Ric Troyer, ICHS PACE medical director. “The team talks together about patients and their concerns. A team-crafted care plan that is individualized is a much more robust way to take care of a person to help them meet their goals. The beauty of PACE is that it is inclusive of medical, social, and long-term care services.”

Troyer will provide primary care at the ICHS PACE center at Legacy House, along with Dr. Alan Chun, a veteran ICHS physician. As Chun transitions his practice to the PACE program over the next six months, he anticipates many of his senior patients will follow. His remaining patients will be in good hands, he says, with an up-and-coming team of committed family practice doctors, many of whom speak Cantonese and Toisanese.

They make a formidable duo. Troyer brings a background in geriatrics and Chun brings many trusted years providing care to the Asian Pacific Islander (API) community through ICHS.

“I have patients that are in their 80s and their 90s who are still living independently,” he said. “As they get older and their capabilities diminish, it’s risky for them to remain there. They say, ‘There’s no way I’m going to assisted living, there’s no way I’m going to a nursing home.’ But in reality, it gets more challenging as they age.”

It’s not just that people don’t like nursing homes. Troyer points out that people tend to be happier and healthier living at home.

“Home has a lot of importance to a lot of people,” he said.

“Cognitive impairment can create confusion when you take people out of their routine. For some, social connections are important. They’ve worked out systems to be safe with neighbors. If you move to a new location, you break those social connections.”

A PACE program for the API community

ICHS CEO Teresita Batayola sees the ICHS PACE program as the next step in the nonprofit health center’s commitment to caring for API elders. ICHS took over operation of Legacy House, a 75-room assisted living facility, from the Seattle Chinatown International District Preservation and Development Authority (SCIDpda) earlier this year. The move paved the way for the ICHS Healthy Aging and Wellness program, which manages PACE along with the assisted living center, an adult day care program and daily meal program at the Bush Asia Center, which offers healthy lunches and snacks that reflect Asian tastes.

Staff and providers speak a number of Asian languages and dialects. Group activities include mahjong and taichi.

“ICHS is stepping up to serve the needs of a multicultural and aging population,” said Batayola. “We recognize the best way to care for people is to consider their full spectrum of needs, and especially for services to be delivered in a culturally and linguistically competent way.”

Eligibility and enrollment

PACE is geared specifically for people who are nursing-home eligible, having difficulty staying independent and need assistance with their daily function or activities. It is open to seniors age 55 and older with disabilities, or those age 65 or older, who reside in the PACE service area and are able to live safely in the community with PACE services. There are no costs or out-of-pocket expenses for Medicare and Medicaid-eligible participants. The first step is meeting with an enrollment specialist.

“You’ll complete paperwork and we’ll talk about the program and if it fits your needs. After that, we’ll arrange for a home visit to determine if modifications at home need to be made,” said Troyer. “The entire interdisciplinary team meets as a group to determine if you can safely live in the community, including the number of caregiving hours, when you will come into the center, and if you need durable medical equipment.”

The PACE program offers clear advantages, said Troyer.

“I don’t know of a better model for caring for and supporting elderly people who want to live in their own home. With PACE, caregivers don’t have to feel alone navigating choices. They have support.”

Chen, a retired practicing physician for more than 40 years, is also an enthusiastic supporter. She feels the intensive care she’ll receive from the program will help her better manage chronic conditions, including hypertension and sciatica. She can remain active in her dancing group and tend her patch at the Danny Woo Community Garden.

“PACE provides medical assistance and help 24 hours a day, seven days a week,” she said. “I have confidence in my care team and Dr. Troyer, and their ability to manage my health all at one center.”

ICHS PACE at Legacy House is currently accepting applications. For more information, call 206-292-5184.

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