Partnerships to Enhance Aging Services

Pictured L. to R.: Bonnie Dingess, Clinical Manager for the Area Agency o Aging District 7, Inc. and Teresa Bran, Director of Social Work and Pastorial Care with Southern Ohio Medical Center.

Partnerships to Enhance Aging Services
Bonnie Dingess, Clinical Manager, Area Agency on Aging District 7, Inc. and Teresa Bryan, Director of Social Work and Pastorial Care, Southern Ohio Medical Center, Portsmouth, Ohio, were presenters at a national conference held in Atlanta, Georgia.
Their workshop, “The Bridges Program,” demonstrated a unique partnership between the Area Agency and Southern Ohio Medical Center that enhances aging services by assisting elders and their families during a health crisis.
The Southern Ohio Medical Center social work team and staff from the Area Agency developed a hand-in-hand approach inside the hospital system to help elders and their families reduce re-admittance after hospitalizations, limit confusion, and ensure effective community-based care planning.

Who benefits from “The Bridges Program”?

A patient over 60 years of age
• needs short-term rehabilitation after being in the hospital
• has a physician express concerns about the patient’s ability to manage his/her care at home
• currently has little help at home
• has care needs that are expected to increase and is interested in learning about community resources

This partnership enhances patient services by identifying patients over 60 years of age in need of help after discharge; offers the right amount of information at the right time for patients requiring short-term rehabilitation services; makes follow-up contact with patients after leaving the hospital; and provides information, education and assistance to patients and family members.

To participate, a patient of Southern Ohio Medical Center speaks to the hospital medical social worker about participating, or after discharge from Southern Ohio Medical Center, the individual calls the Area Agency on Aging District 7 at 1-800-582-7277.