WATERVILLE — Community agencies and hospitals both work to keep seniors healthy, but they don’t do a very good job of working together, Roger Renfrew, an administrator at Skowhegan’s Redington-Fairview General Hospital told a crowd at Spectrum Generations’ Muskie Center Thursday morning.
Renfrew said that, as the number of older Americans increases and agencies such as Spectrum lose federal funding, hospitals might need to accept responsibility for the role those agencies play in public health.
Renfrew, who is also president of the Maine Geriatric Society, said the trend toward longer lives is not temporary, and that society needs to adjust.
“We talk about this silver tsunami, but a tsunami comes up onto land and then washes out to sea,” he said. “That’s not going to happen. This is a (permanent) change.”
And, while demand for senior services climbs, the resources the federal government is providing to them diminishes.
“We’re in a perilous time for an organization like Spectrum Generations,” Gerard Queally, president of Spectrum, said. He said that, with funding for nonprofits getting tighter, “any community organization can go down.”
Much of the funding for Spectrum and other agencies that address aging across the country are funded by the Older Americans Act, which was hit by sequestration cuts last year.
Spectrum’s Meals on Wheels program was forced to temporarily scale back services, providing fewer visits to fewer seniors.
Queally said the cuts are hitting just when the entire system should be rethought.
“What worked in 1973 when the Older Americans Act was passed should not work in 2013 and definitely won’t work in 2023,” Queally said.
Renfrew and Queally shared their views with a group of about 50 people, many with ties to area hospitals and agencies, at Spectrum’s 41st annual meeting.
Filling a medical need
Spectrum provides a wide range of services to the community, including several that contribute to senior health. Volunteers with the Meals on Wheels program bring nutritious meals to seniors twice a week. During their visit, they look for signs that a health crisis might be imminent.
When services like that are cut back, more medical emergencies are likely to happen, which increases hospital costs.
There is a fundamental change in healthcare, Renfrew said, in which hospitals are working to keep healthy people healthy, rather than just treating the critically ill.
“We’re not just waiting for someone to knock on the door of the emergency room, we’re out there,” he said. “This will require the help of community organizations.”
Renfrew said articles about the loss of nonprofit programs are beginning to crop up in medical journals as health care professionals begin to realize what it is they’re losing.
He said hospitals need to step up and help secure funding for those agencies.
“I do think we will have greater responsibility in defending our programs,” he said.
Not working together
Renfrew said there are longstanding traditions preventing hospitals and agencies from working more closely together.
He said they could collaborate, not only by networking, but by coordinating services and even, one day, by sharing funding.
But right now, Renfrew told the crowd of about 50, the medical landscape looks nothing like that.
“Organizations have overlapping interests and different interests, and those differences can pull us apart,” Renfrew said.
Each hospital and agency is used to carrying out its own mission, working in an isolated silo.
“We don’t really get a good overall view,” he said. “There’s a lack of communication between the silos.”
Renfrew himself made a change he described as a small step toward collaboration between Spectrum and his own practice at Redington-Fairview. When he recognizes that a patient has memory problems, he now refers that patient to Spectrum and gives the patient literature identifying services Spectrum provides to help seniors cope with that issue.
Such a small step may seem simple and obvious, he said, “but it doesn’t happen with any consistency across the spectrum of care.”
With working together in even this small way considered a rarity, hospitals and agencies are a long way away from delivering comprehensive health care and support to the populations they serve.
Renfrew said it is difficult to convince doctors and hospital administrators of the need for collaboration, and suggested that professional associations of physicians might be one good forum to get the message across. He said the conversation is just getting started.
But Queally said a clock is ticking, and he plans to push for change to happen quickly.
He said he is beginning a dialogue with hospitals and other healthcare providers, asking them to recognize the benefit of Spectrum and to agree to do more to support its services.
“I don’t know how that conversation plays out,” he said. “It’s a very difficult conversation to have.”
But unless they do, he said, they might be facing large expenses down the road, as under-funded agencies are forced to pull back.
He said Spectrum will also change dramatically in the near future.
“I don’t know what it will look like, but I’ll know we’ve failed if we look like we do today in 2018,” he said.