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Highland Valley aims to honor elders’ wishes

“For the most part, every elder we meet is wanting to stay out of a nursing home and stay home, or in the setting they choose,” said Valerie Flory, director the agency’s home care program.

Some tell social workers they would rather die than enter a nursing home, even if that means taking their own life.

“It’s more common than you would think,” Flory said. “It’s our role to help see if we can work with that person to alleviate some of those feelings.”

She said agency caseworkers work on setting up services that will honor the elder’s wishes.

“The ultimate goal is to keep people in the setting they want to be in,” said Nancy Maynard, acting director of Highland Valley.

The agency often is called by family members who need help getting a loved one through a crisis related to aging that might bring continued independent living into question. When elders are resistant to accepting help, though, this can be tricky.

Flory said that, in assessment visits, Highland Valley staff try to reassure clients that the key to continued independence can be as simple as accepting a little bit of help.

“Instead of taking away their independence, we are trying to preserve their independence,” she said.

The services offered by Highland Valley run the gamut. They can be as simple as meals delivered to the home, or more complex: help with homemaking needs such as cooking, cleaning, shopping, household chores and home maintenance, or personal care services including bathing, dressing, menu planning, money management and other daily living needs. Services are based on income eligibility and clinical need, Maynard said.

If an elder exceeds the income eligibility, the agency provides referrals to private programs that offer an array of services to help elders maintain their independence.

“Sometimes the littlest help can make all the difference in making it all work — or making it all work for a little bit longer,” Maynard said.

Highland Valley also offers day care services that provide social interaction for elders who are physically healthy and in good cognitive condition, and more intensive day care services for those in more compromised health.

The agency also offers referrals to a host of programs, such as companion services run by area councils on aging that could provide some support to elders, provides a 24-hour elder abuse hotline and runs a protective services program.

Roughly 100 people work for Highland Valley, about 50 at its headquarters in the Cutlery Building on Riverside Drive in Northampton and another 50 in its meals program, which provides 600 to 700 meals daily to people in their homes and at 12 congregate meal sites around the region.

Among the agency’s caseload of 750 clients, there are 10 people who are over 100 years old and still living at home or with a family member.

Flory said that when staff work with elders who say they’d rather die than leave their homes, they try to address with them specific measures that will help them stay put, telling them, “our goal is to keep you out of the nursing facility, so lets see how that can happen.”

On the other hand, Maynard and Flory said, there are times when entering a nursing home is actually a good option because it offers stability in terms of food and medication, a safe place to live and regular contact with people.

When people choose to move to a nursing facility, they said, it should never be considered a failure.

“Some people thrive,” Maynard said. “Sometimes that is absolutely the best solution for somebody.”

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