Cheryl Condos doesn’t mind living on her own. She’s done it for nearly 30 years.
Before moving to Saratoga Springs over a decade ago, she was on a monthslong trip to England when the British government misplaced her paperwork; she ended up staying for four years. She lived near the famous White Cliffs of Dover, in Folkestone, on the country’s southeast coast and spent her time exploring the region, traveling throughout the country and talking British history with locals at the pubs.
“It was marvelous, absolutely marvelous,” she said of her time on the British coast.
She was one of the first residents to move into the Westview Senior Apartments in Saratoga around 15 years ago and enjoyed the early years forming a community of like-minded residents.
But life gets harder as one ages, and Condos has struggled with numerous medical conditions, including limited vision, weak muscles, tremors, and she has occasionally hurt herself in falls at her home. During a recent bout of pneumonia-like symptoms, she had a fluid buildup in her ears, limiting her hearing and interfering with her balance.
“For me to lose another sense with my limited vision was too much,” she said. “My hearing is as sharp as an eagle’s eye can see, and I really depend on it.”
Condos said she maintains a comprehensive awareness of the placement of items in her apartment, navigating her home with tunnel vision. The delivery of a recent package, though, altered the landscape of her living room just enough that she tripped and fell hard to the ground.
“That throws me off,” she said. “I really have to know where everything is.”
She suffered large bruises as a result of the fall, and while she didn’t break any bones, she suspected she may have strained a muscle.
“The problem is when I fall I can’t get up, it takes me hours to get up because I have no strength in my legs,” she said.
Recovery takes time too.
“It took me a week of just resting,” she said.
One of Condos’ first calls after the accident was to Phil Di Sorbo, who is leading a new program at the Saratoga Senior Center, where Condos has visited for years. The center’s new senior life transitions program aims to offer extra support to seniors “facing changes in their lives due to a serious illness or worsening health conditions.”
HIGH-TOUCH, NOT HIGH-TECH
Di Sorbo and Lois Celeste, executive director of the senior center, noted that the isolation and fear of the pandemic has acutely impacted seniors. Di Sorbo said that researchers think the pandemic actually accelerated dementia symptoms in some people.
“Now that we are coming out of that phase, the needs are all over the place,” Celeste said.
The new program’s group of volunteers step in to assess a senior’s specific life situation and the barriers that could get in the way of their medical care. They supplement that care with a supportive team approach to ensure the senior understands their medical decisions, is adjusting to new treatments and has a long term aging plan in place.
“We will meet with you and your caregivers to get an understanding of your current needs, gaps in your future plans, and what matters most for your quality of life,” according to the short summary of the program the center sent out in a newsletter earlier in the spring.
Di Sorbo, a longtime expert in the field of end-of-life care and support, former head of The Community Hospice Inc. and palliative care director at Ellis Medicine, built a team of volunteers with a range of experience and expertise.
The team includes a retired nurse with experience in respite and the ability to translate Spanish; a local psychologist who specializes in dementia care; a clinical nurse specialist attracted to the program through a personal experience; and a woman with a church background and contacts developed through years of state government advocacy.
Bill Vacca, a retired cardiologist with 40 years of experience practicing in Schenectady, including as chief of medicine at St. Clare’s Hospital, volunteered after a decades-long relationship with Di Sorbo. He said the program is a critical addition to the work of practicing physicians, offering seniors the kinds of help needed to give their medical care the best chance of working.
“Much of what’s being done at the senior center in Saratoga is a necessary complement to palliative care,” he said.
He highlighted the day-to-day challenges that can interfere with a person’s medical care: loneliness and isolation, difficulty getting medicines, lack of transportation, poor nutrition and inability to improve it, risk of injury and so much more. Doctors and other medical professionals may not have the ability to ensure those issues are addressed but they have an undeniable impact on the medical care, he said.
“These are all critical social determinants of care which dramatically affect the success rate of standard medical care, but for too long they have been neglected,” he said.
That’s where Di Sorbo’s program attempts to step in, assessing each person’s specific situation and needs and developing a plan to deal with any short term barriers – like transportation and nutrition – while also working with the senior to process critical long term decisions – like wills, powers of attorney and the kind of end-of-life treatment they wish to receive.
“It’s high-touch not high-tech,” Vacca said.
The program is a natural extension of the palliative care that Vacca and Di Sorbo devoted much of their careers to. While often thought of as the comfort care provided in the final days of life, palliative care can extend for years to patients with chronic conditions that will shape the final years of their life. Palliative care works with patients with serious illness to manage both the symptoms and the stress of living with that illness.
Vacca said the “miracles we have in medicine” are incredible tools for health workers, but they can’t solve every medical problem on their own. Low-tech supports like a volunteer visiting a senior to offer a conversation and some housecleaning are also critical.
“The thing that’s often overlooked is how to supplement [medical treatments] with the human touch,” Vacca said. “As a young doctor, oftentimes we get so caught up in the technical part of care, the tests and treatments, surgeries, they become consuming…but only with experience can you see how their effectiveness can be amplified by addressing the social determinants of care.”
Vacca, who doesn’t provide medical care in his volunteer role, can serve as a medical adviser of sorts, helping seniors in the program understand and process what their doctors are telling them and help them work through any important decisions about their care.
“I help them interpret what’s going on in their healthcare,” he said.
Di Sorbo summed up the kind of support they offer seniors in the program in three words: “Whatever they need,” he said.
Condos, who during a career working on criminal justice issues in New York City helped establish one of the first rape crisis centers, immediately saw something of interest in the short announcement of the program, knowing that she had decisions to make but not knowing where to start.
“As soon as you put out the bulletin, the next day I jumped at it,” she said. “I was looking for any kind of program that would tie up loose ends that I needed…My god, this is the thing I have been looking for for years.”
She said she hopes to stay in her apartment as long as possible but knows that there may be a time she needs to move somewhere with more assistance. She said she knows what kind of care she wants in the long run but needed help with formalizing those decisions.
“I needed information on how to do this, that and the other,” she said. “There are so many things involved in terms of health, legal issues, hospitals. It was very important to be able to understand that and make a decision about what I did want and didn’t want.”
Di Sorbo opens a new file for each of the program’s clients, first assessing day-to-day challenges that must be addressed immediately and then thinking through the big picture.
“She had urgent needs, because she was falling and isolated,” he said of Condos. “And in the long-range: How do you get the support you need? Whether it’s clutter in the apartment or getting advanced directive to ensure she got what she wanted, in our program we unravel the layers based on the person and their needs and empower them to get what they want.
Condos described a feeling of immense relief after meeting with Di Sorbo and sorting through important medical and life decisions.
“It was like there were these loose strings hanging, and I understood, but didn’t know how to pull it together,” she said. “I feel completely at peace just understanding these basic things, and they are basic things. It’s complete relief, absolute relief. It’s a peace that I can’t describe.”
“You do take charge of your life,” Di Sorbo told Condos. “You are an empowered person.”
After her recent fall, Di Sorbo made sure she made the necessary medical appointments and ordered a device that will connect Condos to emergency medical services if she falls again and needs help.
“Serious illness can be so overwhelming, and it really doesn’t need to be,” Di Sorbo said.
The senior center is seeking volunteers and seniors interested in the program. Di Sorbo can be contacted at 518-584-1621 ext. 206.