Heal for America -- A great idea -- shape it to help the aging and frail

Yay! Heal for America is an idea whose time may be just in time for the aging in place of boomers and seniors. No doubt you've been reading for years about 'Teach for America' -- a much sought program for those newly minted college grads, these 'best and the brightest' want to inject their enthusiasm and energy into teaching in public schools, often in areas of the country where talent is most scarce. It's a prestigious and competitive program and, in some cases, helps those who might be interested in a teaching career.

In yesterday's WSJ, Dr. William Healey suggested that a similar concept could be applied to medical care delivery in the home -- a brilliant idea which can be tailored to help the vast majority of elderly who want to avoid institutionalization and age in place. But as they age, they may become more frail and may not be regularly visited by family or friends. The parallel is clear: underserved youth populations and aging seniors with chronic disease. Let's clarify what needs to happen.

1. First, the HFA basics of care. Dr. Healey suggested that Heal for America (HFA) graduates could be aligned with visiting nurse organizations, trained to check on medication regimens, taught to detect signs of poor nutrition offer nurse/doctor-provided material and advice, perhaps even check vital signs, then call and clarify physician instructions. A side and perhaps even more compelling benefit could be a visit or regular phone call with a frail, lonely and isolated individual who needs the human contact. 

2. Add training for evaluating home safety. When these trained and eager young college grads are inside the home of an elderly individual, they could take a look around for warning signs. Is the home a dangerous place? Are rugs and thresholds contributing to fall risk? Are stairs a threat? Is the thermostat manageable?  Perhaps a local social services organization be contacted to see what retrofits are simple but could make a world of difference to safety.

3. Assess need for monitoring or assistance. The HFA health assistant could be trained to assess frailty -- does it appear that a senior struggles to get around the home, has difficulty acquiring groceries, cooking, getting up and dressed, managing a walker or wheelchair? The HFA program doesn't have to solve all of these problems, just help participants notice them and refer, perhaps arranging regular visits from a home care work or checking that a senior might qualify for a program like PACE.

4. Can the senior reach others and be reached? One of the frustrations of telehealth equipment (even as its adoption grows) is its limited focus on the patient exclusively as a patient -- the equipment is not PC-based and doesn't enable social interactions via PCs or smart phones). If home care and telehealth nurses are too busy to spend the time to evaluate connectivity of a home-bound individual, why not ask the tech-sophisticated HFA health assistant to do it -- maybe even directing a local tech provider to come to the home and set up a computer for e-mail and internet access.

5. Broaden the funding sources -- engage AARP. Dr. Healey suggested that disease specific organizations might provide some of the funding and that wealthy donors might pitch in to cover remaining costs.  But if we start to think about the aging of our population, the likelihood of living longer with chronic illness, and increased risk of hospitalizations and institutionalization from sub-par medication adherence, home care, and safety, Heal for America is squarely part of the AARP social mission -- helping its members 'improve the quality of life as they age.' Growing a robust HFA program to match the 7300 young people enrolled in Teach for America could use some AARP Foundation funds to lead the way, creating the program and funding (at least) the initial training.

Finally, a thought about inspiration and the role of colleges. Teach for America is very trendy and grads of the best schools apply. The program recruits at those schools, including Harvard: Says one Harvard and TFA grad: "I was the one responsible for getting the services kids need."

Colleges, especially those with pre-med and other care-related career seekers, should pave the way to Heal for America promotion and prestige. Especially in tough economic times when the staggering cost of graduate education may be deferred a few years, Harvard, Duke, Yale, and Johns Hopkins, all with top geriatrics programs in their medical schools, could kickstart a post-college eye-opening health care experience.

Is it as inspiring as teaching kids?  Only if the program's PR and schools make it so.  Please add your thoughts and voice to help make Heal for America the next big thing for college grads.