A senior citizen lives alone, and her grown children live out of state. In the middle of the night, she wakes with sharp chest pains and calls 9-1-1. When she arrives at the hospital, she’s faced with the admitting process; she is concerned for her health but worries about contacting her family. The doctor and nurses provide clear explanations of procedures, her condition and choices. But she’s distracted by pain and anxiety and soon realizes she hasn’t understood what they said. She feels alone and confused. The doctor has moved on to another patient.”ž”ž
This woman’s experience might be different if she were living in Yellow Springs, Ohio. A member of the local emergency squad, Miami Township Fire-Rescue, would ask her if she would like a volunteer from the senior center to meet her at the hospital to help her through her time in the emergency department (ED).”žIf she answers “yes,” the squad members would call the Yellow Springs Senior Center Emergency Room Reassurance team’s cell phone, and a volunteer would go to the hospital to stay with the patient through her time in the ED.
It Takes a Village
There’s an old adage that states, “It takes a village to raise a child,” but the responsibility to one’s neighbor has no age limit in Yellow Springs. For example, trained volunteers from the Yellow Springs Senior Center Emergency Room Reassurance program are on call 24 hours a day to provide support to seniors at the hospital.
In larger, more mobile communities, seniors may not know their neighbors, and might not have nearby friends and relatives to rely on. Yet even though Yellow Springs is a neighbor friendly community, many of its elderly residents don’t have anyone who can assist in the first hours of a health emergency. That’s where the reassurance program, which complements the senior center’s mission of helping seniors retain independence and quality of life, comes in.
The program was conceived by Senior Center Director Rodney Bean. While waiting for his aunt to be bandaged in the ED, he noticed the Miami Township Squad bring in an elderly man he knew from Yellow Springs. “It was obvious he was alone and anxious,” Bean said. “He needed support, so I stayed with him; then I thought perhaps we could work out a system to serve others.” Bean worked out a rough plan with the chief of Miami Township Fire-Rescue; the center bought a cell phone, and five volunteers were recruited. These first volunteers and the squad refined the plan, and they worked out many details of the program. Senior Center employee Corinne Pelzl serves as program coordinator. Today, 10 volunteers meet quarterly to organize monthly schedules, review progress and discuss issues.
Beverly Shoemaker, a registered nurse and clinical team coordinator for the Greene Memorial Hospital (GMH) ED, admits that her first thought upon hearing about the program was why they hadn’t thought of it, a testament to the simple elegance and power of a good idea. “They put a lot of thought into it,” she says.
Miami Township Fire-Rescue Fire Chief Colin Altman and Assistant Chief Denny Powell enthusiastically welcomed this new volunteer service. With the cooperation of GMH and Miami Township Fire-Rescue, the reassurance program is a compassionate, simple answer to questions that arise when a health emergency strikes.”ž
“The intent is to provide moral support,” says Powell. But practical support is also a benefit of the program. The hospital staff and squad gain peace of mind knowing that the patient has a ride home if they aren’t admitted to the hospital. The program was originally designed with live-alone seniors in mind, but the application has been expanded to any senior. Even seniors with friends who live nearby can benefit when they don_t want to call upon friends in the middle of the night.
Comfort and Compassion
Despite the warm colors and friendly faces that greet patients at GMH’s John C. Hoctel Emergency/Trauma Center, ED Director Marsha Maurer notes, “It’s a scary environment. It’s not something they [patients] planned for their day.”
Reassurance volunteers bring bags with novels and puzzles, loose change, blank event reports and the laminated name”žtag that identifies them. They perform such duties for the patient as making phone calls, and making the patient comfortable with beverages, tissues and calming or distracting conversation. They can also facilitate the filling of prescriptions.
Training focuses on clearly defining the volunteer’s role in patient support. A manual provides potential situations and suggestions for handling them, as well as a list of “dos” and “don’ts” that clearly outlines the volunteer’s role in the ED. The main focus of the rules is to follow the patient’s lead and provide what each individual requests rather than using a one-size-fits-all approach to companionship. Other points are remaining available to the patient and ED staff without intruding or getting in the way of treatment, and maintaining confidentiality, including the fact that the patient has been taken to the ED.
Pelzl points out that reassurance volunteers aren’t patient advocates and express no medical opinions or interpretations. Instead, they facilitate direct communication between the medical staff and patient. They also help the medical staff by providing comfort to the patient in the stressful and busy ED environment. Their presence may also be beneficial”žlater on when family members arrive at the ED and need reassurance and practical assistance. Even the most helpful and sympathetic medical team may appreciate additional support for families so they can remain focused on patient care.
There has been no trouble attracting volunteers for the reassurance program. “It’s such an appealing idea that it is not hard to get people to”žsign on,” Pelzl says. “The reassurance volunteers have just been saints.”
Volunteer Byron Dann says his first experience included a stop for food as he drove the patient home.
The volunteers’ job isn’t over once the patient arrives home. Volunteers complete a form that describes the incident, its outcome, time spent on the visit and any suggestions that may improve the program. This attention to detail and thoughtful analysis of possible needs has been integral to the program’s success and professionalism.
Filling a Need
The GMH staff gives the senior center volunteers high marks for their service and follow-through, saying that each has been an excellent representative of the program. Maurer said, “As nurses and patient advocates, we appreciate the fact that we can walk away from the bedside and feel confident about the patient’s well-being and safety.””žVolunteer Byron Dann says his personal experience in hospitals with ailing family members has been useful training for the program.
Martie Jensen identifies with ED patients, saying, “I can imagine that it would be pretty scary.” Husband-and-wife team Naida Sutch and Mac Gillespie were recruited by Pelzl after their support of a neighbor during a medical crisis. They say they were pleased to join the group because it fills an important need.”ž
The participating organizations are unaware of a similar program anywhere else. They hope other communities will use it as a model, adapting it to their needs. Members of the Yellow Springs Senior Center staff can be reached at 937/767-5751 orysscoffice@woh.rr.com.
Nikki Rogers,PhD, is a researcher for Wright State University Department of Community Health in Dayton, Ohio. She can be contacted at”žnikki.rogers@wright.edu.“ž
