SASH is a great model
Southern Vermont is the New Zealand of Vermont -- "I’ve heard it is very pretty, but it is so far away, I doubt I will get there any time soon." -- is how folks in Burlington and Montpelier feel about us. This is now a bit better since Peter Shumlin, a Putney resident, trekked to the north to lead the state. We are out of sight, out of mind down here. This can be both good and bad.
For seniors and young, disabled folk it may be getting a bit better. A non-profit called Cathedral Square of Burlington has been rolling out across the state over the past two years a pilot program called SASH -- Support and Services at Home. At present, it is connected to Brattleboro’s Senior Housing and the greater community via the Brattleboro Housing Authority at Samuel Elliot Apartments, Hayes Court and Melrose Terrace developments, as well as Windham & Windsor Housing Trust’s Windsor Village Senior Housing in Windsor. Subsidized housing sites statewide have a concentrated population of seniors and young disabled people living in their senior housing facilities and are logical places to start and test this program relatively easily. The aim is to reach out into the wider community and offer the same services. This is slowly happening already. It will, of course, be harder to do when it requires driving around from private apartment to private home, much as the VNA does.
Fundamentally, SASH is about three things: 1. Help connecting services, with an informed team at the ready to back you up in a crisis. 2. Help transitioning in or out of hospitals (and ending up with good and appropriate discharge plans to transition you safely back home). 3. Wellness workshops and assessments including free exercise classes, check ins and coaching for wellness. Right on site, daily, at the senior housing facility is the person you can go to get this help. No scouring the Yellow Pages for resources, the names of which most of us do not even know. Last week, an old friend of mine, who, at 79, living in a fancy retirement community, had to go to a Boston hospital for cancer surgery. She had no one to go with her, to help her when she got discharged and has to rehabilitate in her apartment. Part of that, sadly, is her own fault because she is so secretive and will not let the staff know her diagnosis (a very poor one). If they had a SASH Coordinator in the expensive, private place she lives, perhaps that person would have been more proactive in offering services.
Vermont is getting older, a huge percentage of our population is graying. The SASH Program makes fiscal sense to the state because it should cost a whole lot less than having people end up in nursing homes funded, ultimately, by Medicaid, a state program. Once all of those baby boomers bounce into their retirement years, everyone knows that medical costs are going to go up, up, up. Housing will be an issue, too. Relatively few folks can afford the up-front and monthly costs of retirement community living. Housing offered by the Brattleboro Housing Authority and Windham & Windsor Housing Trust like Butterfield Commons in West Dover, the Huckle Hill Senior Housing in Vernon or Hayes Court in Brattleboro are great options. There your friends and neighbors are of an age, probably not too different in their financial state, and a new community of support can develop.
Alternatively, you can try to set up things so you can "age in place" in your own home as the phrase goes. Two years ago I sold my lovely house overlooking Lake Raponda, and bought a tiny house in town -- Wilmington -- all on one level, with a flat driveway (unlike the vertiginous one at that lake that gave visitors nosebleeds), and miracle of miracles, on a paved road! I had just turned 75. This house has a space downstairs with a bedroom and bath for the caretaker that perhaps one day I will need in order to be able to continue living at home. I really want to stay home, if I can, in my own home, with my friends nearby, and my dogs sleeping at the foot of my bed. I doubt that I am the kind of person who would thrive in a group living situation. So, I planned ahead.
All the friends I have in my age group are certainly thinking along the same lines. Some are moving into retirement communities, some into senior housing facilities. These places usually have a sliding rent scale tailored to your income in retirement. Most are tidying up their lives with up-to-date wills and healthcare proxies/advance directives, lists of their medications and doctors handy. This is just common sense when you see your contemporaries getting frail or ill. With the tsunami of elderly our country is facing, the state and the local housing gurus are trying to find ways to keep us all safe and relatively happy (aches and pains and all). Here in Wilmington we have a Town Nurse, in the job for something like 35 years now, and she is a one-woman SASH Program. I hope by the time she retires the SASH Outreach program will be in place and maybe even in Dover at the W&WHT senior housing facility, Butterfield Commons. If Southern Vermont is the New Zealand of Vermont, the Deerfield Valley must be its Tasmania. It might be some time before the SASH Program wends its way up the mountain to the 26 units at Butterfield. The SASH Program is a great model. Brattleboro Housing Authority and Windham & Windsor Housing Trust are to be commended for their efforts to provide proactive, home-based support within their communities. Soon, the two-year pilot program will be evaluated and there is every reason to believe the health outcomes will be impressive.
Claudette Hollenbeck, MSW, LICSW, is a retired social worker residing in Wilmington, and is on the boards of both Windham & Windsor Housing Trust and the West River Habitat for Humanity.
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