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Avenue's Senior Health Center closes its doors
Closure of the clinic is a 'tremendous loss' to the valley's most vulnerable population
By Sarah Gaffney
Most people visit downtown Willow Glen for its trendy shops and restaurants. But for about 400 elderly patients in Santa Clara County, Lincoln Avenue is where they go for medical treatment. That is, until this Friday, when the Avenue's Regional Medical Senior Health Center sees its last patient.
The 5-year-old subsidized clinic, which until last year was owned by Alexian Brothers hospital and now operates under the auspices of Columbia/HCA Corp., is the latest victim of federal cuts in Medicare spending. Medicare subsidies that help fund the clinic's operation will be discontinued at the beginning of next year, under a provision of the federal Balanced Budget Act.
For geriatric health care advocates, the center's closure is a monumental loss to the community.
"The clinic was really a unique program in the community," says William Fisher, executive director of the Los Altos-based Alzheimer's Association of the Bay Area. "It's not going to be replaced easily. For the 800 patients and their families who were there [over the five years] ... it's going to be a challenge for them."
What distinguished the clinic from other health-care facilities was its multidisciplinary and personalized approach to geriatric health care. The clinic's staff was composed of a geriatrician, a geriatric nurse practitioner and medical social workers. Patients were treated for routine medical needs, as well as acute geriatric ills such as Alzheimer's disease and dementia.
"I can just tell you from the point of view of ourselves, as advocates for people with Alzheimer's disease, it's a tremendous loss," says Fisher, who reports that just over 19,000 people in Santa Clara County suffer from the disease. "With the exception of [Valley Medical Center], I don't know of any other Santa Clara County resources that have the same depth of program that this clinic had."
Columbia notified patients at the end of last month about the clinic's closure. According to Leslie Kelsey, spokeswoman for the Regional Medical Center, formerly known as Alexian Brothers Hospital, every attempt is being made to find other health care providers and transition patients.
"The clinic staff has been concentrating its efforts, ever since the letter went out, on working with patients and their families to coordinate their transition to their next physician and providing them with referrals to physicians," Kelsey says. "Those referrals are being made based on the best fit for the patient."
Kelsey reports that many of the patients are being referred to Valley Medical Center's geriatric program, as well as non-Columbia physicians and specialists. But, advocates claim, these often frail patients and their distraught families need more than just a physician. They need to find personalized care in a comfortable setting such as the Senior Health Center.
"This clinic really helped people feel comfortable," says Mary MacMaster, former executive director of Willow Glen Villa, an assisted living facility on Gaton Drive.
When the center first opened, MacMaster worked closely with its staff in creating programs for patients who resided at Willow Glen Villa.
"They did support groups, they came and talked to family members about dementia. They were so wonderful. They went above and beyond at all times," she says.
And, adds MacMaster, the staff spent an extraordinary amount of time meeting with families and determining the unique care needs of each patient. "The initial interview would take anywhere from two to three hours," recalls MacMaster. "Nobody was rushed through. [Patients] weren't just numbers. They had names."
But, according to Fisher of the Alzheimer's Association, the clinic's micro approach to care doesn't fit in a medical system where patients are seen in precise increments of time, and where the bottom line often takes precedence over the patient's needs.
"These people cost the system more," says Fisher. "Increasingly in managed care, we try to deliver primary care in units of time ... these are people who take more time because they are elderly, they're a little bit slower and they are confused, cognitively and mentally ... to put it crudely, they're not a profitable segment of the health care consumer group. They're a real challenge."
And, says Fisher, clinics such as the Senior Health Center can quietly disappear because their patients are so severely incapacitated that they're incapable of galvanizing support for their cause.
"If this were an HIV clinic or a breast cancer program and it was closing, the survivors of those illnesses, the people whose bodies were touched with the disease, would be clamoring for something to be done about it," says Fisher. "But in the case of people with Alzheimer's disease, they're so confused early on, they're not advocates on their own behalf anymore--they're basically out of the discussion."
On Oct. 29, the door to a small medical office on Lincoln Avenue will close forever. Most people walking the trendy avenue may never have taken notice of the plain-façade building. But for 400 people in Santa Clara County, it offered care, support and services that are hard to replicate in this era of managed care.
"It's one of the best, certainly in San Jose if not all of Santa Clara County," says MacMaster. "It's a real crime that this is closing ... the seniors so desperately need it. Unfortunately, I guess it's seen its day."
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Willow Glen, California Since 1992
