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As We Age, It Gets Complicated!

Community Health’s Focus on Seniors

“There are 82-year-old farmers up in Shorewell who are still farming,” said Dr. Barbara Steinbrecher, a primary care provider at Community Health. “There is normal aging.”

Dr. Steinbrecher joined Community Health in 2020 after years of caring for seniors with issues like frailty, balance and falling, memory loss, dementia and chronic diseases like diabetes. She said looking at the whole individual and their activities of daily living are the key to their ability to live a safe, healthy independent life and age naturally.

“A lot of it is how you take care of yourself,” Dr. Steinbrecher said. ”Where do you see yourself in 10 years? We live in a society that changed in the 80s where people lived at home and multi generations lived together.” It’s not as common now. Living independently has added challenges for the elderly that can be addressed early on to allow them to maintain a lifestyle that preserves their independence.

With a median age of 43, the 2020 census ranks Vermont as the second oldest state in the US, tied with New Hampshire and West Virginia. Maine continues to hold the number one spot with a median age of 45. In Rutland County, the median age of residents is 45.9 years. That’s according to the 2018 Rutland County Community Health Needs Assessment, supporting the concern for an aging population in the area served by Community Health.

Data combined with clinical experience Community Health providers observe in the patients they treat every day affirms the concern for the gap in resources available for seniors in the Rutland area. To address these primary care issues of the elderly, Community Health is seeking federal funding for creation of a geriatric center in Rutland to bring the much-needed services and expertise closer to home.

The federal Department of Health and Human Services created the Healthy People 2030 initiative to focus on reducing health problems and improving quality of life for elderly Americans. In Rutland County, the elderly demographics are a priority identified in the 2021 executive summary of the health needs assessment which will be updated with new data in September. Community Health is a partner with Rutland Regional Medical Center and other health and human service organizations in the area in gathering data and information for the report.

Preparing for recognizable aging issues and diminished abilities is important, Dr. Steinbrecher said. And learning about predisposed family illnesses like diabetes and heart disease will provide individuals and families with information about what to look for, what to expect and how to provide care and support, issues that would be the focus at a geriatric center. “We are looking to see if you are able to bathe, dress, groom, walk safely, shop, take care of bills and make food,” Dr. Steinbrecher said.

Often, cognitive issues are missed when diagnosing the elderly, a vital aspect of what care is needed. And fragmented health care among multiple providers can often cause confusion and a lack of coordination with treatment and medication. Community Health care managers are part of a team that coordinate with primary care providers. “They know what to look for and they follow up with phone calls,” she said. Care managers are invaluable in tracking changes, treatments and medications particularly for the elderly with chronic illnesses.

There is no cure for dementia, but there is a lot that can be done to prepare for what will happen in the future. “People who have dementia can’t tell you what is going on, if they are in pain and their actions are often misunderstood,” she said.

Raising awareness to Alzheimer’s disease is one of the community movements Community Health currently supports. According to the 2018 assessment data, Rutland County has a rate of 36.8 Alzheimer’s disease deaths per 100,000, and the Alzheimer’s Association predicts that the number of Vermonters living with Alzheimer’s (13,000 in 2020) will increase over 30% by 2025.

A team from Community Health will take part in the September 25th Walk to End Alzheimer’s in Rutland. The walk is held each year nationwide to raise awareness and funding for Alzheimer’s care, support and research. This year the organization offers walk-from-home options as well as the community walks to consider Covid-19 precautions.

Community Health’s Behavioral Health team also has implemented special care for the elderly, focusing on signs of depression and struggles with articulating their desires to continue to live active, independent lives for as long as possible. The Behavioral Health team collaborates with primary care providers at every Community Health location as well as the nursing home service line which provides health services at three skilled nursing facilities in Rutland. A full-time social worker was added to the nursing home service line team this year, to work directly with seniors at the nursing homes.

“What complicates aging is that people are living longer, and we have more interventions for chronic diseases,” Dr. Steinbrecher said. “Inevitably we age and there is a normal biological process. Let’s start preparing now.”

Barbara Steinbrecher, DO, practices family medicine at Community Health Castleton. She interned at Central Maine Medical Center, studied family practice and geriatric medicine at Maine Dartmouth Family Medicine Residency in Augusta, Maine and completed her medical school training at the University of New England College of Osteopathic Medicine. Following a fellowship in geriatric medicine, Dr. Steinbrecher has maintained special  interest and knowledge in the aging process and illnesses in the elderly. A trained field biologist and ecologist, she enjoys hiking, gardening and loves being outside in the woods and in nature. 

Community Health is Vermont’s largest Federally Qualified Health Center (FQHC), a network of primary care, pediatric, behavioral health, dental and pharmacy services with offices in Rutland, Brandon, Castleton, West Pawlet and Shoreham. Community Dental offices are located in Rutland and Shoreham, Community Health Pediatrics is in Rutland and Behavioral Health services are available at all of our locations. Community Health Express Care Centers, open 7 days a week, are located at the Rutland and Castleton Community Health Centers.

For more information about Community Health’s career opportunities, check our Career Center or contact Jan Buxton or Anna White at 802-855-2086.

This article appeared on in August 2021.

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