'No problems here'

The LIFE center on 41st and Woodland is a life saver for some of West Phila.'s elderly. At the Living Independently For Elders center on 4101 Woodland Avenue, 55-year-old Al Ballard is the life of the party, moving from one conversation to another with his fellow members in eager anticipation of the next smile and the next chuckle. Wearing a broad grin and a Charlotte Hornets cap, Ballard claims he's never been happier than when he's at the LIFE center. "You don't have no problems here," he said. "This is the best thing." One of 74 LIFE members, the retired machinist comes in three times a week to catch up with friends, relax and enjoy himself, all the while under the watchful care of the center's comprehensive staff. With the over-65 population expected to grow dramatically from 12 percent to 20 percent by 2050, according to Nursing Gerentology Professor Neville Strumph, medical professionals have seen the field of gerontology expand accordingly. The Nursing School already operates a Center for Gerontological Science and the Medical School runs an Institute for Aging. At the LIFE center, doctors, physical therapists, dieticians, social workers, recreation therapists and chaplains all work under the same roof, providing "one-stop" care for the elderly -- who often have trouble getting from one hospital to another. The center offers a variety of medical services in the clinic -- from dental work to podiatric care -- and also provides members with activities such as discussion groups and horticulture. "All I gotta do is go back there and they'll fix it up," Ballard said, referring to the center's clinic. Born in South Carolina, Ballard moved to Philly in his twenties and worked in a factory until an accident with a baling machine mangled his left hand. Ballard said it was a struggle to support his family with his disability payments and an even greater struggle to find money with which to visit a doctor. But having been at the center for eight months, Ballard is a walking advertisement for the center, singing its praises left and right in gratitude for his current level of care. "Anyone can sit at home and eat and watch TV, but they don't do anything for themselves," he said. "A lot of people really don't need to be in here because they don't appreciate it." Opened in September 1998, the LIFE center was the result of Nursing Professors and LIFE center Faculty Co-Directors Karen Buhler-Wilkerson and Mary Naylor's investigation into alternative healthcare options for the elderly. Naylor and Buhler-Wilkerson proposed the project to the Nursing School in 1994, wanting to create a center that offered care for the elderly while allowing them to remain in their communities. "Clinically they are at a level already where they would typically need nursing home care, but they don't want to go into a home." Executive Director of the LIFE center Christine Allen said. "They want to stay in their community." Every morning and afternoon, van drivers from the center bus the LIFE members to and from their houses throughout many of the poorer neighborhoods of Philadelphia. Medicare is a prerequisite for membership at the LIFE center. Members are predominantly African American and most live with their families, coming several times a week to the center for physical therapy and medical checkups. Like Ballard, however, the majority of members find that the main attraction lies not in the medical treatment, but with the friendly atmosphere generated by the people in the spacious, well-lighted center. "I thought my daughter was trying to get rid of me," 83-year-old Elise Love said, "but I decided to come and see, and I like it." The average day for members begins with a morning snack, which might include a cup of pudding -- an especially important activity since many of the patients are diabetic and have to carefully regulate their intake of sugar. After eating, the center's members either break up to receive therapy or congregate to hold discussions on subjects ranging from religion to U.S. presidents in the large conference space that is especially full on Fridays when the chaplain holds a Bible study. The entire center is designed to accommodate wheelchairs and the bright colors used in the decor help members differentiate between walls and doors. Working on a first name basis, the staff bathe and clean members who are unable to do so for themselves, building an intimate rapport that helps identify potential health problems that might be missed at a routine checkup. "In some ways it's kind of like a family," said Nursing senior Jessica Pitts, who does her clinicals at the center. "Even the members know me by name." A section of the center, called the "Circle of Care," is specially intended to handle the 12 to 16 members with serious dementia -- half of which are Alzheimer's cases. The section has a higher staff-to-member ratio and allows members with dementia to roam freely within the confines of a carefully monitored area. "It's a whole package with a whole team involved in taking care of these people," LIFE center Geropsychiatric Nurse and head of the Circle of Care Beth Gage Greco said. "I think the family members get a lot of support." Since the LIFE center's founding, similar centers have followed suit in Pennsylvania, with a fourth expected to open soon. "What we have are fragmentary systems that lack continuity," Buhler-Wilkerson said of the majority of current medical options for the elderly. "This messy system can turn into this fantastic care center with continuity."

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