SOURCE helps Georgia citizen remain a “big wheel”
His eyes hidden behind a very cool pair of Ray-Bans, Evan Dawson from a town in central Georgia, laughs easily. He takes advantage of a warm winter day to sit under the pecan trees in his yard, visiting with his niece and her husband. He offers to demonstrate his "Cadillac," a motorized wheelchair that allows him to get around in his house and down a ramp to his yard and, on Sundays, to his much-beloved church.
However, not long ago, Dawson's risk of falling and his increasing problems with transfers and ambulation threatened his independence. His niece and nephew had concerns because Dawson is 99 years old and lives alone. They talked to his physician, Dr. W. Kim Kitchens, who agreed that one option they had was to place Dawson in a nursing home. But he suggested, "Why don't we try the SOURCE program first?"
Kitchens offered an explanation to the family: "There are often complications with older or disabled patients. Many folks have a difficult time understanding their medical care because it can be so complex. SOURCE runs interference between physicians and members, explains the care to members and their support network and hires community service providers to do whatever needs to be done to keep members in their own homes. This encourages members to remain independent. A lot of trust develops between everyone in the process. Let's see if this can work for your uncle."
That suggestion began Dawson's great relationship with SOURCE, an enhanced primary care case management program operated through the Department of Community Health. First, Dawson's relatives made sure that Dr. Kitchens was on a list of program-approved physicians.
Dawson was then assigned a case manager who works with his physician, his informal support network of family and the paid Medicaid community service providers who would come to his house and help him with tasks he had trouble doing. She assigned care workers to his case.
Currently, Dawson's providers assist him with bathing and breakfast and help him with supper and preparations for bed.
The amount of care he receives is flexible. At his request, an aide will come in for two extra hours to cook enough of his favorite vegetables to tide him over for the night. A hot meal delivered at mid-day also helps.
Daily help is important, but Dawson achieved a turning point when a durable medical equipment provider insisted that he be allowed to test drive a motorized chair. The case manager accompanied the provider to Dawson's home to see if it would make a difference. It did. Dawson caught on immediately, and it changed his life. He can now drive to church each week, and he is much better able to get around his house. Best of all, he reconnected with his community.
His case manager visits him at least quarterly, but talks to him more often to find out how he's doing. The providers and his case manager confer monthly about his progress and continuing needs. Says Dawson, "My support workers have become as close to me as family."
The program’s ability to go into the home to see what is happening is invaluable to Dawson’s doctor. Says Kitchens, "Because SOURCE case managers and providers go to the member’s home, if something seems odd, they will tell me. Their vigilance helps me intervene more quickly and keep problems from escalating into emergency room visits or hospitalizations. This is what an integrated health delivery system should be. In Mr. Dawson’s case, SOURCE has worked well to help him continue to live quite comfortably at home with minimal paid care."
With a little help, Evan Dawson has been able to stay out of costly nursing home care. Whenever he rolls into church on Sunday morning in his motorized chair, heats up a meal of his favorite vegetables in his kitchen, or visits with family on his own front lawn, he basks in his independence.