Geriatric Nurse Proposal Moves Tentatively Forward
West U. City Council gave the go-ahead at Monday night’s meeting to continue to explore the idea of a geriatric consultant for the city’s aging population.
The concept, brought to council’s attention at a previous meeting, involves having a certified nurse who can check on the welfare of at-risk seniors in the city. The idea has been discussed since last year, after a group from the Senior Board and the Good Neighbor Team went to an elderly resident’s home to do some housecleaning. The resident was found on the living room floor, in need of medical attention.
The proposal estimates the program to cost the city $13,000 annually. The nurse is estimated to work five hours weekly at $50 an hour. Maureen Beck made the presentation to council, and offered her services as a geriatric nurse practitioner to fill the position.
“I have a broad range of experience,” said Beck. .”My goal with this program is to assist Toby (Senior Services Manager Toby Brooks) in the evaluation of high risk residents. Identifying them through either visits of the Good Neighbor Team or police or fire notifying her there is a problem. The goal isn’t to keep everyone in the home forever – some people can stay as long as possible is we give them support.”
Beck says she can work with residents’ families and physicians by evaluating the condition of the resident’s home, taking blood pressure, assess their medications, check the resident’s ability to move around their home and finding out how the resident gets their food. She would then propose a care plan, which would be suggestions to the resident or their family.
“I am not going to do anything different than a geriatric care manager or company, or Sheltering Arms would do when they go out and asses a home,” said Beck.
“I think the issue is, is this something the city wants to get involved in?” said Mayor Bob Kelly.
“The key is, if they are not competent that whoever would be responsible for them, that you are not trying to substitute yourself for other decision makers,” said City Attorney Alan Petrov.
“My concern is where all this is ultimately headed,” said Kelly. “If you get to the point where you think this person cannot live by themselves anymore, what are you going to do?”
“One of the things you can do is find a neighbor, if they are willing to step in or ask that guardianship be sought,” said Beck. “Someone has to go to the Medical Center and say we have someone in trouble who is a danger to themselves.”
Brooks says she has identified 20 residents she believes would benefit from the program. She indicated that there was one resident who has called 911 54 times since January.
“That’s costing the city a lot of money,” said Brooks, who compared the proposed program to Harris County’s Adult Protective Services. She indicated that she would have an easier time communicating with APS if she had the service of someone with Beck’s credentials.
“I think the key from the legal perspective is making sure people clearly understand the limitations of a program like that,” said Petrov. “We are not trying to substitute ourselves for any kind of medical care. I think it can be done. I think you need to make sure you have appropriate disclaimers and information about what it is your limitations are and what their expectations would be.”
Parks and Recreation Director Tim O’Conner told council that the city’s medical director was not interested in the program, which caused concern to Councilman Bob Fry.
“It disturbed me a little when you said you would not be working with a physician,” said Fry. “You threw up a big red flag when you said the medical director doesn’t want anything to do with it.”
Beck indicated that she has not spoken to the medical director, and thought there may be a misunderstanding on what the program entails.
Councilman Michael Talianchich said he thought the program would be a great service to the community for “not a lot” of money, and suggested a trial run for six months.
City Manager Michael Ross told council that a pilot program could be initiated through senior services, and staff could report back to council in December, before the January budget goes into effect. Ross also said a meeting could be arranged between Senior Services staff, Beck and the medical director.
Staff will report again to council before the 2009 budget is adopted in October to address issues raised about the program at Monday’s meeting.