Five Questions With: Kelly Lee

"While the research that we conducted was very helpful in demonstrating the value of adult day, we consider it a small step towards fully understanding how it helps people with particular diseases."

Kelly Lee is vice president of operations of PACE/Adult Day Center of Westerly. She holds a master of science in health service administration with a concentration in gerontology from Salve Regina University. She serves as a Trustee for the NewportFed Charitable Foundation and is a member of Leading Age RI. She played a leadership role in a recent yearlong research project by LeadingAgeRI, which found that hospitalizations among seniors using adult day services declined by more than 13 percent.

PBN: Does adult day service care diminish hospitalization rates particularly successfully for certain conditions and diseases versus others?
LEE:
While the research that we conducted was very helpful in demonstrating the value of adult day, we consider it a small step towards fully understanding how it helps people with particular diseases. We hope that the study (and the results) will help us secure a funder to do more in depth research with a larger statistical sample so that we can accurately extract findings by disease and demographics to identify who can benefit most from adult day services.

PBN: In what ways do adult day services increase the complete care of elderly individuals, e.g. improved communication among caregivers, the left hand knowing what the right hand is doing?
LEE:
Adult day centers provide “one-stop shopping” for caregivers who want to keep their loved ones in the community. We’re a non-residential facility that supports the health, nutritional, social support, and daily living needs of adults in professionally staffed, group settings. Many times people come to us for socialization and prevention services, however, in the long-term they appreciate the skilled assessments, treatment, and transitional care following hospital discharge that we provide. Our team of professionals works hand-in-hand with the participant daily and it provides information to their loved ones and to their medical providers, ensuring coordinated and appropriate care.

PBN: Did your research cover the effect of adult day services on behavioral health issues?
LEE:
The research looked at the entire range of physical and behavioral issues that affect the health of our participants. As you well know, many mental health issues contribute to hospitalizations. While this study did not provide statistically valid results by disease, we believe that the ongoing behavioral health assessments and counseling that adult day provides contributed to the reduced hospitalizations that resulted. However, we can’t know that conclusively from this limited study. It’s a wonderful beginning and we hope to learn more from a larger study if we are able to secure a funder.

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PBN: With CMS tracking hospital readmission rates for nursing home residents beginning next year, how much pressure are nursing homes under to get their readmission numbers down?
LEE:
Adult day provides an alternative to nursing home-eligible seniors. We’re not competing with nursing homes, rather providing a different service as senior care is never a one-size-fits-all proposition. While governmental accountability affects us all, we won’t be held to those same CMS standards. However, we do expect to share these findings with our nursing home counterparts and it wouldn’t surprise us adult day professionals if our some of our best practices are introduced within nursing homes to help keep hospitalizations down. The membership of LeadingAge RI covers the full continuum of elder care and we learn from (and share information with) each other.

PBN: To what extent is isolation a health problem for elders, in and of itself, and is
breaking down isolation a major reason for the success of adult day services?
LEE:
There are a host of benefits to adult day. This study appears to support the hypothesis that society benefits from the coordinated care that adult day offers because of decreased hospitalization costs. The participants receive multi-pronged benefits. We are all complex human beings and social isolation can definitely affect mental and physical health. Participants are kept physically and socially active which benefits them. For those with memory impairments, we can also say that they are kept in a supportive, safe environment during waking hours. From a family’s perspective, we know that most families have dual-income wage earners so mom or dad are often left alone during the day out of financial necessity. Adult day provides coordinated care during those working hours. Family members can be productive at work, knowing that their loved ones are safe. Sons and daughters also don’t need to spend time away from work driving their parents to doctors’ appointments and they can rest easy, knowing that their mother or father’s care is being coordinated by licensed professionals that specialize in geriatrics.

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