Retirees Pioneer a Health Program Just for Them

They never intended to be health-care trailblazers.

But when the small team of seniors set forth from Annapolis, Md., in search of a community-based home health program formed by and for seniors, they came back empty-handed. Although they looked hard in Florida, Arizona and other predictable places, in the late 1980s there simply weren’t any blueprints to follow or projects to emulate.

So they began designing their own program, well aware that its success could make a crucial difference as they aged. The idea was to find a way to provide services in their community that would help people remain in their homes if they became frail or ill. No one wanted to move to a nursing facility. Still, with the mean age in their retirement community already 72 1/2 years and climbing, “it was clear something was needed,” Margery Ettlinger recalls.

Ten years later, the Heritage Harbour Health Group has grown into an unusual nonprofit organization and something of a national model. Although the list of services offered is fairly ordinary, the program is novel because it is funded, packaged and governed entirely by its 1,600 members--all residents of the Heritage Harbour seniors community several miles west of Annapolis.

These days, the $85 in annual dues buys each member blood pressure screenings, flu shots, monthly health seminars, and bereavement and dementia support groups. Nurses are available for medical consultations in both the office and the home--and there are plenty of stories of late-night house calls because of falls, cuts and other mini-emergencies.

Members can get help submitting Medicare claims for physician, hospital and specialty services, and guidance on such difficult issues as living wills and advance directives. They also can receive referrals for medical and dental problems, along with discounts on prescriptions, hearing aids and long-term-care insurance.

Extra charges apply only for home health aides and, starting this year, services to intensely manage an individual’s overall care.

And now the health group is broadening further. The start of its second decade will focus on building a 10-bed center to offer respite care for members struggling with chronically ill spouses--a facility right down the block that the Maryland Legislature supported with a $150,000 construction bond. A stay there would entail separate charges.

“They’ve done good work in their community and they have an excellent reputation,” says Maryland state Sen. Robert R. Neall, one of two lawmakers who pushed the bond bill forward. “It’s a very needed public service.”

The progress has been touted nationally, and two similar projects in North Carolina and Michigan owe at least part of their existence to the early counsel they got from Heritage Harbour.

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Yet it’s the success at home that means the most to people like Dorothy Dunn, 86, a widow who suffers from severe arthritis. She fears she could not have remained in her house of 12 years without the five-days-a-week aide the health group screened and sent her, and the emotional reassurance the staff provides.

“They’ve been of such great help,” Dunn says.

Executive director Maeve Ostrowski, who has been aboard since Day One, never tires of such testimonials: “It’s the fact that we’re here, and they can get us 24 hours a day.”

Every Monday, 76-year-old Orlando Bonar stops at the health group to have his blood pressure monitored--his continuing vigilance since a mild stroke in 1998. The office, just a few blocks from his home, is a bright but spare 1,250 square feet on the ground floor of a small shopping center on Heritage Harbour’s main thoroughfare.

“When I go over there and they tell me my blood pressure’s fine, I have the feeling that I’m safe,” he says.

Unfortunately, the former police officer has needed to use the health group for far more. When he and his wife signed up four years ago, she already was experiencing problems from Parkinson’s disease and dementia. He knew he’d need help close at hand, although he had no way of knowing how soon he’d become a full-time caregiver and require nursing as well as respite assistance. On both fronts, he says, the health group’s support was “tremendous,” and by the time his wife died in November, he felt as if Ostrowski and the rest of the staff were family.

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Last year the health group logged more than 8,000 “service contacts,” compared with 1,691 in 1994. The 1999 numbers included 2,789 blood pressure screenings, 682 house calls and 226 cases in which the staff managed ongoing home care.

More than 2,500 residents 55 and older live in the houses, townhouses and high-rise condominiums of Heritage Harbour. Many seniors initially had to be sold hard on what a co-op health group could do for them.

Ettlinger, 82, remembers how she and her husband pitched the concept in living-room Q&A; sessions. With others doing the same, the campaign eventually netted 100 founding members who provided the nascent group with $58,000 in 10-year, no-interest loans.

Now, when the health group holds its monthly open house, nearly all newcomers walk away as new members. “The results help to sell people,” says Kathleen O’Neill, 76, president of the group’s nine-person board of directors.

The group has received two huge gifts from a local benefactor and resident--$150,000 to establish a permanent endowment, followed months later by $250,000 to buy the property for the respite facility that Ostrowski and board members believed was so sorely needed. County officials lent support.

The group hopes to open the facility by 2002. Ostrowski believes it’s a logical extension of the health group’s mission. “One person once said to me, ‘I feel like we have a giant security blanket wrapped around the whole community.’ ”