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No place like home

Nursing professor’s innovative program brings care to those aging in place

By Brelyn Powell

 

Helen Jones, 72, visits her primary care physician at Laburnum Medical Center in Richmond, Virginia, once a month to monitor several chronic health conditions. Between those visits, she can make a quick trip to the first floor of her apartment building to receive supplemental care in a weekly free wellness and care coordination clinic provided by the Virginia Commonwealth University School of Nursing’s Richmond Health and Wellness Program.

The onsite clinic aims to improve the health of older and disabled adults at Dominion Place, an independent-living facility near VCU’s Monroe Park Campus.

Jones recalls a time when a reaction to her blood pressure medication, one of many prescriptions that she takes daily, caused her face to swell. The Richmond Health and Wellness Program team was at Dominion Place that day and helped coordinate her care with her primary care physician to get the prompt medical intervention that she needed.

“Situations like that are scary, but [the VCU team] makes me feel safe,” Jones says. “I come downstairs when I need their advice or help, and they’ll come to my room to check on me if they don’t see me down there.”

The Richmond Health and Wellness Program was founded in 2012 by Pamela Parsons, Ph.D., GNP-BC (M.S.’84/N; Cert.’92/GNP; Ph.D.’04/N), associate professor and director for practice and community engagement in the VCU School of Nursing, with the help of Patricia Slattum, Pharm.D., Ph.D. (B.S.’85/P; Cert.’91/AHP; Ph.D.’92/P; Pharm.D.’92/P), vice chair for graduate studies in the VCU School of Pharmacy.

Pilot data, funded through a VCU Council on Community Engagement Grant during the program’s first year, showed a high number of chronic diseases and high rates of non-urgent emergency room use for aging adults in congregate-living situations, with factors related to the social determinants of health influencing the health care and quality of life for many of the residents. Guided by the findings of the pilot funding, in 2013, the RHWP was awarded a three-year, $1.5 million grant from the Health Resources and Services Administration, the primary federal agency for improving health and achieving health equity, to expand and refine the program.

Parsons serves as the director of the RHWP, and under her leadership, the program has had a measurable, positive influence on the health outcomes of the residents it serves. One successful impact of the program has been a reduction in emergency room use for those that may have been able to have their care needs addressed in other settings, such as primary care.

RECOGNIZING EXCELLENCE

Parsons was named the Judith B. Collins and Joseph M. Teefey Distinguished Professor in 2015 in recognition of her devotion to the complex care of older adults.

The professorship serves to advance the work of outstanding nursing faculty and to recognize a practitioner who demonstrates excellence in teaching, service and research.

“Pam meets that criteria in every way,” says former VCU faculty member Judith Collins, RN, MS, WHNP-BC, FAAN (Cert.’75/N), in whose name the professorship was created to celebrate her retirement after more than 30 years of service to VCU and the Richmond community.

The fund also honors Joseph Teefey, Collins’ husband, and his commitment to health care throughout his career as director of Virginia Department of Medical Assistance Services and then vice president of VCU Health System until his retirement in 2000.

Friends, family, colleagues and students of Collins contributed nearly $300,000 to establish the professorship in 2003. The fund has since grown to surpass the $500,000 milestone required to become a distinguished professorship and, at almost $800,000 now, is nearing the $1 million needed to establish a chair in the School of Nursing. When the fund reaches that milestone, it will continue to benefit Parsons and her community work.

“Support from the professorship has undoubtedly enhanced my ability to reach out into the community and develop my projects in innovative ways,” Parsons says.

In addition to rewarding excellence, professorships are critical to recruiting leading scholars to VCU’s team of educators.

“Funding for professorships helps our school to attract and retain dynamic faculty,” says Jean Giddens, Ph.D., RN, FAAN, dean and the Doris B. Yingling Endowed Chair in the VCU School of Nursing. “Those faculty support and enhance the great work underway at our school.”

BRIDGING THE GAP

The unique model of the Richmond Health and Wellness Program involves interprofessional teams of nursing, medicine, pharmacy, social work and psychology students, overseen by licensed clinical faculty, taking their services out of a clinical setting and into congregate-living facilities where residents are aging in place. Individuals are evaluated where they live, providing a better understanding of how their health status may be impacted by factors related to their daily living and social determinants of health.

“We have the opportunity to have more in-depth and intimate conversations with the residents,” says nursing student Lindsay Culver. “We often don’t get to see how patients are in their home life, and this experience allows us to bridge that gap.”

Culver, who will graduate in May 2017, values the opportunity provided by the program to collaborate with students from other health care disciplines and believes that having interprofessional experiences during her education will make her a more confident professional in her future nursing career.

In addition to Dominion Place, the RHWP holds clinics in four other senior apartment buildings and is continuously growing and evolving as the team builds partnerships within the community.

Parsons and her team recently announced a new initiative made possible by a $25,000 grant from UnitedHealthcare, the largest health insurance provider in the country. The grant will allow the RHWP to address food insecurity among seniors by providing free, weekly meals, cooking demonstrations and nutritional education programs at three of the senior living communities in its network. FeedMore, Central Virginia’s primary hunger-relief organization, supported the program by donating the food that will be served.

Such efforts empower the residents to improve their diets with healthy eating choices while helping the VCU team identify seniors who might benefit from services provided by other community partners like FeedMore’s Meals on Wheels, a meal delivery service for homebound seniors and disabled adults throughout Central Virginia.

“Projects like this allow us to engage in the community in a way that matches the mission of VCU and the School of Nursing,” Parsons says. “It has been and continues to be a rewarding adventure.”

 

To learn more about the Richmond Health and Wellness Program and the School of Nursing, contact Kate Haydon, senior director of development, at (804) 827-0020 or khaydon@vcu.edu.