Housing
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The Cathedral Square Difference
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Whitney Hill Homestead Whitney Hill Homestead is designed in the style of an extended farmhouse with long porches and courtyards. It provides a warm and gracious setting for those 55 and older who wish to combine independent living with reduced maintenance. With its pastoral setting, Whitney Hill offers a relaxed environm... More Information.
Why
Why do we need the change that SASH will provide?The SASH program assumes that seniors do not want to move from one residential setting to another as their needs change. When 25% of the population is elderly, licensed long term care facilities will provide critical specialty care and rehab for those who cannot remain in a community setting. Vermont’s SASH system is based on the premise that high concentrations of seniors – whether in a senior housing community or a residential neighborhood – will create the opportunity to deliver health and wellness services in a far more coordinated and integrated manner with better health outcomes at a lower cost.
Major Finding
Inadequate care coordination has been identified nationally as a major issue for older adults in assuring quality of care, particularly for frail elders and person with multiple health problems being served by multiple providers in multiple settings. The National Quality Forum (NQF) defines care coordination as “functions that help ensure that patient needs and preferences for health services and information sharing across people, functions and sites are met over time”. SASH aims to provide just this type of care coordination.
Severity of Need
The severity of needs among seniors living in the community is surprising. The vast majority are not eligible for the services needed when they need them or where they want them. The current regulatory, reimbursement, and legal systems discourage aging in community. A survey of several senior communities conducted by UVM Medical students in the fall of 2008 showed the following:
Assessment Category | Percentage of Residents Responding | Assessment Criteria |
Activities of Daily Living, General Health Concerns | 46% | Used the Emergency Room in the past year |
39% | Take 6 or more prescription medications | |
35% | Have fallen in the past year | |
29% | Not able to use transportation | |
23% | Not able to do their own shopping | |
Mobility | 40% | Use a cane or walker when ambulating |
9% | Use a wheelchair | |
Mental Health Status | 32% | Feel downhearted or blue |
24% | Feel anxious or nervous | |
17% | Reported being depressed | |
Nutrition | 64% | Moderate nutritional risk |
12% | High nutritional risk | |
Health Problems Reported | 60% | High blood pressure |
57% | Arthritis | |
38% | Hearing problems | |
37% | Chronic pain | |
31% | Cataract surgery or glaucoma | |
31% | Heart problems | |
17% | Diabetes |
Perhaps the most disturbing finding was that only 47% of the residents passed all four components of the cognitive screen.
