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Living-at-Home helps older adults like Olga Mitro live independently in their own homes, surrounded by their memories and their belongings.

No Place Like Home

Living-at-Home Helps Seniors, Saves Health Care Dollars

lga Mitro's sunny apartment in Greenfield Terrace is full of family photos and gifts from her three sons -- shamrock placemats from Ireland and sculpture from Africa -- and it smells like buttery, fresh-baked cinnamon cookies. "I enjoy baking for people," says the 87-year-old, who did catering before she retired. Mrs. Mitro also enjoys helping people. When she moved to Greenfield Terrace three years ago, she began volunteering for Living-at-Home, the University of Pittsburgh Medical Center's unique care management program that helps older adults live independently in their own homes, surrounded by their memories and their belongings. "Living-at-Home provides free, ongoing in-home care in several Pittsburgh neighborhoods for people who are 70 and older," explains Missy Sovak, MSW, LCSW, ACSW, who is manager, Geriatric Outreach. "Living-at-Home social workers, nurses, and community workers visit clients, help identify their medical needs, and recommend the UPMC or community services that can deliver needed care. These services range from home-delivered meals to help with

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grocery shopping, housekeeping, bathing, and yard work." Olga Mitro volunteered by driving Living-at-Home clients to the doctor or grocery store, and by visiting and baking for Greenfield Terrace residents, such as Nancy Kramer. "Living-at-Home is wonderful," says Ms. Kramer, who took care of her parents all her life. "Whatever it takes to help people, they'll do it." When arthritis and a broken leg made it hard for Mrs. Mitro to get in and out of chairs, she became a Living-at-Home client as well as a volunteer. "We were able to help her work with her insurance and get a seatlift chair," Missy Sovak says, "so she could continue to live on her own." Mrs. Mitro's husband is confined to a nursing home. Living-at-Home's staff of 13 serves 600 clients, ages 71 to 101. There are two kinds of clients: well people who just want someone to call and check on them, and full-service clients who need help more frequently. A Living-atHome nurse may see full-service clients every two weeks, while a community worker assesses their condition every three months. Community workers visit other clients twice a year. Volunteers visit and help often.

"Living-at-Home social workers, nurses, and community workers visit clients, help identify their medical needs, and recommend the UPMC or community services that can deliver needed care."

M i s s y S o va k , m s w, l c s w, a c s w

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no place like home

THE VOICE OF UPMC SHADYSIDE

Living-at-Home's Renée Shaw, LPN, and her husband, community worker Mark Shaw, visit Jean Zelkowitz in Riverview Towers.

" What would I do without Living-at-Home?"

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iving-at-Home's Renée Shaw, LPN, visits Jean Zelkowitz in Riverview Towers every two weeks. She fills Mrs. Zelkowitz's pill containers, takes her blood pressure and pulse, checks her ankles for swelling, and helps coordinate her care with her primary care doctor, Donna Knupp, MD. "I am blessed with Living-atHome," says Mrs. Zelkowitz, 89. "I could never organize all my pills! And I don't want to make a mistake with the medications. How did people live to be 90 without all these pills?" While Mrs. Shaw sorts prescriptions, Living-at-Home community

worker Mark Shaw-- her husband of 27 years -- visits with Mrs. Zelkowitz. With 40 clients at Riverview Towers, this calm, gentle, friendly man is known as "the mayor." He asks Mrs. Zelkowitz about her talented grandchildren and her appetite, encourages her to keep her feet elevated when she watches television, and reminds her that she has Lifeline -- she can call for emergency help at any time. "Living-at-Home nurses and community workers do much more than put pills in boxes," points out Missy Sovak. "We may be the only people some of our clients see. If Renée knows how much a client would love a hamburger, she'll pick one up. Clients adopt us into their

families. And we speak frequently with family members, such as with Mrs. Mitro's sons, who do not live in Pittsburgh. They tell me how reassuring it is for them to know we're watching out for their mother." After saying goodbye to Mrs. Zelkowitz, Mark Shaw heads to the Squirrel Hill apartment of Irene Zober, 83. "I can stay independent thanks to Living-at-Home," remarks Miss Zober, a retired legal secretary and "Volunteer Extraordinaire" for Hadassah, the women's service and educational organization. "I just walked to the bank and back this morning, and I can walk to the drug store and to get my hair done," she says happily.

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no place like home

THE VOICE OF UPMC SHADYSIDE

"A nurse fixes my medications every two weeks. She hugs and kisses me when she arrives and when she leaves. Living-at-Home helped me arrange to get a meal delivered every day and to get someone to clean my apartment once a month." Miss Zober hands Mr. Shaw an insurance form and asks him to help her make sense of it. "What would I do without Living-at-Home?" she wonders. "They are so helpful."

"Every senior citizen needs a health advocate"

he Living-at-Home Program was one of the earliest projects of its type to employ medical and social workers to make it possible for a frail, elderly person to continue to live at home in the presence of serious disability. The Ladies Hospital Aid Society (LHAS) at Montefiore Hospital in conjunction with the Robert Wood Johnson Foundation brought the Living-at-Home Program to Pittsburgh in 1986. LHAS still assists the program, but the major supporter now is UPMC. Although there once were 20 Living-at-Home programs across the country, today there are only two, and Pittsburgh's is the only one to focus on case management. With Pittsburgh's high number of elderly residents and today's scattered families, the service is very much needed -- and cost-effective.

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"By helping clients live independently in their own homes, we decrease the need for acute, expensive care," Missy Sovak observes. "Our data show that Living-atHome last year decreased hospital admissions by 53 percent, decreased emergency room visits by 52 percent, and increased regular visits to primary care doctors by 10 percent. These regular checkups are important in helping patients manage their health." Primary care physician Donna Knupp, MD, praises the program as "very valuable in helping to prevent a disease process from worsening, and it is cost-efficient. Older people with chronic illnesses do better when they can be at home, where they are comfortable," she says. Dr. Knupp believes Living-atHome's caring staff effectively reinforce the health concepts she wants to get across to her patients. "Every senior citizen needs a health

"What would I do without Living-atHome? They are so helpful."

Irene Zober

advocate, someone to be a bridge between what the doctor says and what the patient understands. Education about health and medication is best done at home, rather than in a doctor's office or busy pharmacy. "And the Living-at-Home staff go above and beyond so many times," Dr. Knupp adds. "When I can't call them back until the evening, their pager is still on." Back at Riverview Towers, Jean Zelkowitz becomes philosophical as Mark and Renée Shaw wrap up their visit with her. "I've been very, very lucky in my life," she says. "I really don't want to live forever. But I do appreciate all Living-at-Home does to make my life more comfortable. And when I look around at my photographs and see my grandchildren, I feel happy knowing that another generation of great kids is coming along." For more about Living-at-Home, please call 412/473-6677.

Irene Zober walks near her home in Squirrel Hill.

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