Program gives patients LIFE


Senior citizens whose health problems would have put them in a nursing home in the past now have a health-care option that preserves their freedom, thanks to a new program run by Penn's Nursing School.

The program, Living Independently for Elders (LIFE), opened Oct. 9 with a ribbon-cutting and open house at the LIFE care center at 4100 Woodland Ave.

"By giving people really good health-care support, primary services and preventive care in one place, we can prevent people from being placed in nursing homes," explained Karen Buhler-Wilkerson, Ph.D., R.N., FAAN, professor of community health in the School of Nursing and co-director of the LIFE program with Associate Professor of Nursing Mary Naylor, Ph.D., R.N., FAAN.

Funded by the Commonwealth of Pennsylvania as part of a federal initiative to provide comprehensive, cost-effective care for the elderly, the LIFE center brings together primary and specialty care, social services and support in a single outpatient day care facility.

LIFE clients will be picked up at their homes two to three times a week to receive treatment and support services at the center. Doctors, advanced practice nurses, social workers and other specialists will provide not only medical treatment and social services, but recreational and social activities as well.

The facility also has a greenhouse, recreation center, laundry facilities, beauty salon and kitchen, which will serve meals to clients. "It's like a home away from home, with all of the parts required to make life enjoyable," Buhler-Wilkerson said.

A separate center designed for patients with Alzheimer's disease has its own dining hall, quiet rooms and parlor arranged in a circle, so that patients who are temporarily agitated may walk around it.

Most importantly, the LIFE program offers support and services for the patients' families as well. "So many times, we deliver health care that just shifts the burden onto the family," Buhler-Wilkerson said. "This is the right way to do it."

Like the other clinical practices of the Penn Nursing Network, the LIFE program is integrated into the Nursing School's research and educational program. Undergraduate, master's and doctoral students in the Schools of Nursing, Medicine, Dental Medicine and Social Work will have opportunities to study at the LIFE center.

"LIFE is inseparable from the research agendas of the schools and our efforts to study and invent new models of interdisciplinary care," she said.

LIFE is modeled on a 25-year-old program in San Francisco's Chinatown called On Lok ("peaceful abode"). The On Lok program was replicated in other cities, and the success of these programs led Congress to authorize the Program of All-Inclusive Care for the Elderly (PACE). The Pennsylvania program is known as the Long Term Capitated Care Assistance Program (LTCCAP) to avoid confusion with the PACE prescription program.

Because the Penn Nursing Network receives a flat fee for each patient, Buhler-Wilkerson said, "the patient's needs determine what type of care they get" - including hospitalization or nursing-home care if necessary, a departure from the old model in which the type of funding received dictated the type of care patients got.

Nationally, the program has proven successful at both lowering the cost of long-term care and improving its quality.

The LIFE program is the first of its kind anywhere to be located within an academic setting and the Nursing School is the first in the country to be chosen to run such a program.

LIFE, which will serve Medicare, Medical Assistance and paying clients in West and Southwest Philadelphia, Center City West, Fairmount and North Fairmount, is one of two LTCCAP programs being launched this fall in Philadelphia. The other, which will serve South Philadelphia, is run by St. Agnes Medical Center.

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Originally published on October 15, 1998