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“We had two daughters who brought their parents with Alzheimer’s, and who were declining so much the daughters were just fraught. We found an adult family group home for the parents, and developed so much trust and rapport with the daughters that one felt confident taking a month’s vacation because she trusted us to deal with any problems that came up.”

The PACE programs are attractive to payers because they reduce overlap of services, provide preventive care, and most are able to shorten acute and long-term care stays. For many patients, the National PACE Association reports that they are able to provide care less expensively under one umbrella than participants or government sources would pay otherwise.

Centralization of records gives all providers access to thorough, up-to-date reports, insight into family and personal dynamics, and a better grasp of what’s necessary for a holistic approach. Centralized pharmacy services decrease the chances of negative interactions and other polypharmacy problems.

Mutual satisfaction

Nationally, PACE programs report little turnover of their nursing staff. Nurses attribute this to better teamwork in the PACE environment and higher job satisfaction. The collaborative approach means that the physician, nurses, therapists, and direct care providers meet each morning to review their participants, discuss any changes, and brainstorm solutions to any potential problems. There’s no hierarchy except when it comes to signing orders, and the physicians are there in the meeting and ready to do so.

“Working in PACE is such an opportunity to learn because nurses see something new every day,” Kefgen says. “And it gives nurses an opportunity for growth and daily satisfaction.”

“Everyone has their say, and PACE allows different disciplines to problem-solve together and respect each other, whether a physician or a geriatric assistant,” Thornton says. “Nurses are in the middle of care and treatment, playing a complex role in coordinating care and communicating with participants, families, and the team.”

“You really get job satisfaction when you make a difference in people’s lives every day,” Filak-Taylor says. “You lose that in a hospital, and even in long-term care, but that’s why I became a nurse.”

For families and participants, PACE programs can alleviate daily fears and responsibilities for their health and welfare.

“I didn’t know doctors or English or transportation,” says Jie Bing Huang, 79, through translator Sabrina Cheng, MSW. “My children are working so there was nobody home and nobody to talk to. My health was declining, so I asked to come into On Lok in 2000. It gave me hope because they really listen to me, I can rely on them, and I know that someone who knows my health condition will check on me regularly and take care of me and comfort me.”

Although, on average, participants are enrolled for five years before they die, dozens have been participants for 10, 20, or more years, including some now in their 90s or 100s. “We learn to provide what’s important to them, and are able to do what they need most at the end of life,” Thornton says. “Ninety percent of participants are very, very rewarding.”

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