Visiting nurses group provides a lifeline for the Valley’s elderly

By RICHARD L. BOCCIA

In Youngstown, 17.4 percent of the population is over 65, compared with 13.3 percent over 65 in Ohio.

YOUNGSTOWN — From arthritis to depression to the loss of driving privileges, seniors sometimes face a perfect storm of threats to health and well-being.

Those problems only get harder when older people struggle alone, but that doesn’t have to be the case, says Tammy Shells. She’s the psychiatric nurse and case manager at the Visiting Nurse Association of the Greater Youngstown Area.

From an office on Indianola Avenue, the association sends nurses to provide in-home care and education to seniors, funded by Medicare, Medicaid and sometimes Workers’ Compensation, the Department of Veterans Affairs or private insurance. Besides monitoring vital statistics and making sure that patients take their medication properly, Shells teaches patients coping skills such as relaxation and meditation.

Her message to seniors after 18 years working as a psych nurse?

“There is help available. There are people very interested in their welfare willing to connect them with the right resources to help them,” Shells said, although that support sometimes goes unused. “The [number of] people in need of treatment is greater than the [number of] people receiving treatment.”

Shells manages half a dozen patients, although her caseload is normally about 15 patients.

Suzanne Tucci, director of the association who worked as a nurse for 17 years, said part of the problem is that seniors may be out of sight and out of mind.

“A lot of the elderly are here alone ... their children have moved on to other places for employment. Their daughter or son may be in California or New York,” Tucci said, and children living out of state can’t monitor their parents as effectively as those who stay nearby.

“We have such a high elderly population in this area,” said Tucci.

In Youngstown, 17.4 percent of the population is over 65, compared with 13.3 percent over 65 in Ohio and 12.4 percent nationally, according to the 2000 census.

Doctors and hospitals recommend in-home care after seeing some seniors. Referrals also come from family and neighbors, though the nurses operate under doctors’ orders only.

The first visit to a patient’s home lets the nurse assess their medical and mental health, and the state of their household — whether they can maintain the home and keep enough food stocked.

For some of Shells’ patients over the years, losing driving privileges complicated getting to the store, and arthritis made lifting groceries difficult. All of these difficulties may work against a patient’s taking medication properly, or may lead to depression.

“Some primary care doctors might assume that depression or dementia is a normal part of aging when it’s not,” Shells said.

Depression may stem from the losses that are a part of aging. Seniors face the death of spouses, friends and acquaintances, and unresolved grief can deteriorate into depression. Combine that with facing retirement and the possibility of chronic illness, and “it takes its toll,” Tucci said.

In their work, Tucci and Shells fight misconceptions about mental illnesses such as depression.

“It’s an illness like diabetes or cancer,” Tucci said.

In an emergency room, some elderly patients would rather hear that they’ve endured a heart attack than a panic attack, Shells said. “Sometimes people can put their hands around a physical diagnosis better than a mental health diagnosis,” she said.

Getting patients to admit they need help can be a challenge, Shells said.