Archive of news about Center for Aging and Health/Division of Geriatric Medicine faculty and staff
Quarter 1 of 2008

Prevention Classes, Screening Clinic, and Physical Therapy at Chapel Hill's Seymour Center

February 21, 2008
Sarah Madry, Center for Aging and Health
This article is online at www.med.unc.edu/aging/archivenewsQ1_2008.htm

Many elderly people fall from time to time, some break bones and some have only cuts, sprains, and sores as a result. But approximately twenty to thirty percent of injuries from falls result in hip fracture or head injury. Twenty-five percent of those hip fractures will be fatal within six months due to the onset of pneumonia or other consequences of the fall and disability afterwards.

The dean of the University of North Carolina at Chapel Hill’s (UNC-CH) School of Medicine, William Roper, has determined to decrease the falls and adverse outcomes of falls for North Carolina citizens by awarding one of the school’s recently created “Investments for the Future” grants to Jan Busby-Whitehead, MD, chief of the Division of Geriatric Medicine and director of UNC-CH’s Center for Aging and Health.

Busby-Whitehead, in partnership with the Orange County Department on Aging and the UNC-CH Division of Physical Therapy in the Department of Allied Health, has used money from the grant to create two programs at the department’s Wellness Clinic at the Seymour Center in Chapel Hill. Both of the new offerings focus on falls prevention, mood disorders, and memory impairment. The “Senior Wellness Clinic” which focuses on boosting “Mood, Memory, and Mobility” and the “Get Some Balance in Your Life” class are directed by UNC-CH geriatricians and clinical specialists in aging, who also work closely with Busby-Whitehead at UNC clinics and UNC Hospitals.

The balance class is taught by Tiffany Shubert, PhD, MPT, adjunct assistant professor at the UNC Institute on Aging. The class focuses on exercises and strategies to build hip, leg, knee, and foot strength which are necessary for maintaining balance ability as one ages. The class also incorporates static and dynamic balance exercises, endurance, and gait (walking rhythm). In addition to the exercise classroom, the Seymour Center has an exercise equipment suite, which offers brand new machines: two elliptical treadmills, two recumbent bikes, one recumbent stepper, and seven other strength building machines, all donated by UNC Health Care. There is an on-site personal trainer available to instruct individuals in equipment use. There is also an onsite physical therapy clinic for individuals who need more extensive treatment of balance or function before beginning an exercise program.

The “Mood, Memory, and Mobility Boosting Program” medical director is Racquel Daley-Placide, MD, a UNC-CH geriatric evaluation clinic physician and assistant professor in the School of Medicine’s Division of Geriatric Medicine. She emphasizes the multi-disciplinary nature of the clinic: “At our clinic, geriatric specialists from several disciplines screen elders for mood disorders, memory impairment, and mobility impairment with the goal of providing the patients and their primary doctors with information. A fall can deny a senior his or her independence, so we are stressing falls risk assessment and prevention of falling. During the screening visit, we will spend about an hour asking questions and performing evaluations that will tell us about the client’s everyday physical and mental function. Usually we will ask the client in for a follow-up visit to see how they are doing. We do not offer regular medical care, but the results of the screening we do can be very helpful to the patient and his or her doctor as they apply themselves to health, wellness, and independence issues.”

Partnering university and community has, in the last decade, been officially codified by the university; each year faculty members take a tour of the state by bus, the Carolina Center for Public Service is a strong advocate for employee and faculty community service, and the university system president, Erskine Bowles, is encouraging his chancellors to enter into university-community initiatives. It may be, however, that geriatricians are quicker to see the value of getting university services out from under the shadow of campus columns and into the town and county, because elderly people who need clinical services often can’t get to them easily. “A physician who specializes in older people, which is the definition of a geriatrician,” explains Busby-Whitehead, “is much more often faced with a barrier of patient transportation and access issues than other specialists. Rural elders and those with very low income often can’t come to us. Some elderly patients are so frail that a visit to the hospital or doctor’s clinic, even with a friend or family member there at their side to help them, can be a severe trial for their health and their mental state. I have felt strongly for a long time, as have the Orange County Department on Aging administrators with whom the Center for Aging and Health has worked closely for years, that seniors need care centers they can get to easily, that have a comfort score a little higher than the typical physician’s office.” One of the physical therapists currently helping Seymour Center patrons with their balance, Charon Andrews, PT, agrees. She says, “People are more comfortable coming to the Seymour Center for physical therapy and wellness screening services as opposed to going to the hospital complex, which can be intimidating and hard to access.”

The Seymour Center offers a much more relaxed atmosphere than the typical doctor’s office. As you enter the building from the easily accessible and large parking lot, the buzz of activity at the front desk within the spacious foyer lit by walls of huge windows signals that the Seymour Center is no quiet backwater but is exercising itself vigorously for its patrons. From the comfortable, art-filled living room radiate multiple corridors leading invitingly to classrooms, lecture halls, sitting rooms, and balconies overlooking more activity spaces and an outside patio protected from the wind by the three enclosing sides of the building.

If you wind your way past the activities that might be taking place, such as the ping-pong game, the computer training center, or the Tai Chi class, you will find the UNC clinicians led by Dr. Daley-Placide informally giving expert services in the well stocked exercise room and exam rooms. This combination of comfortable, multi-use surroundings and clinical services has been built into the planning of the new county senior centers. Myra Austin, the Wellness Coordinator at the Seymour Center, says, “Robert and Pearl Seymour, the Chapel Hill couple who summoned personal and community resources to idealize and fund the center, knew from the beginning that they wanted to have some services of UNC’s geriatric faculty in the senior center. This goal has been actualized because of the UNC medical school’s Investment for the Future grant.”

Keeping your balance, in the widest sense, can be difficult for anyone at any age, but when physical balance problems enter your health problem menu, they can topple your other carefully contrived schemes for independent living. If you want to keep your eye on the ball, your head up, and your feet on the floor, a visit with Dr. Daley-Placide and her team at the Seymour Center Wellness Clinic might help you put your best foot forward.

The Mood, Memory, and Mobility Boosting Program clinic is on Tuesday mornings from 8:30 AM to 12:30 PM. Each visit takes approximately one and a half hours from start (initial paperwork) to completion (discussion of team findings). The multi-disciplinary team will see four new patients on the first, second, and third Tuesdays of the month. The 4 th Tuesday of the month sessions will be held for previously screened patients who desire follow-up attention. It is possible that the clinic will charge for services in the future, but at present, no charge is made for the screening and advice offered by the specialists.

The “Get Some Balance in Your Life” class is from 11 AM to 12 noon on Tuesdays and Fridays at the Seymour Center. (Call 919-968-2070 to enroll.)

The exercise suite at the Seymour Center and its equipment are available to Orange County residents for a fee to those aged 55 and older. Applicants must complete a physical function screen done on-site by one of UNC’s Division of Physical Therapy faculty members. Those who don’t pass the screen may be referred to on-site physical therapy appointments to increase ability so that the person may eventually be able to use the center’s fitness equipment. For information call 919-968-2070.