Seniors are a vulnerable population. Increasing frailness and decreasing mental capacities make seniors easy targets for exploitation. Reduced income sources can impact health and wellbeing. Isolation can prevent proper medical care and trigger depression. There are services to help, however. Elder Gatekeeper programs are but one.
Elder Gatekeeper programs are designed to check on seniors and those with disabilities regularly. Gatekeeper volunteers are trained to identify at-risk individuals and, in many cases, refer them to community programs for assistance.
Identifying those that require intervention isn’t easy, especially in these times of social distancing. However, volunteer organizations make it their aim to assist the most vulnerable in our communities. One of these is the Gatekeeper Program.
The Spokane Mental Health Elder Services Program in Washington State is the program that most subsequent Gatekeeper Programs are based on.
Who Makes Up Gatekeepers?
Gatekeepers are typically individuals who come in contact with seniors through work. These can include meter readers, bank tellers, postal workers, pharmacists, newspaper deliverers, librarians, and store clerks. These volunteers work together with social workers and other agencies to assist seniors.
How Does This Program Work?
Gatekeepers’ training includes identifying signs that someone needs assistance, such as confusion, a sudden drop in health, or a home falling into disrepair. Once a problem has been detected, the Gatekeeper will call a Helpline or the Area Agency on Aging to arrange for assessment or service.
After the Helpline of AAA receives the referral, agents send a written report to a social service worker, who will make a home visit. The Helpline will continue monitoring the situation until it has been remedied.
What Are Gatekeepers Trained to Look for?
In addition to the situations mentioned above, Gatekeepers are trained to look for:
- Changes in grooming habits
- Changes in the condition of the home
- Old newspapers lying around
- The calendar on the wrong month/year
- Little or no food in the house
- Strong odors
- Many pets
- Empty alcohol containers
- Empty pill bottles
- Confusion
- Disorientation
- Inappropriate responses
- Repetitiveness
- Forgetfulness
- Depression
- Dejection
- Sleeping or eating complaints
- Anxiety
- Anger and hostility
- The recent death of a relative, friend, or pet
- Suspected abuse
- Loss of hearing or sight
- Loss of mobility
- Confusion about money
- Unable to go outside or to the store alone
- Lack of social relationships
- Fearful behavior
What Services Are Offered?
An elder in need might benefit from medical care, help with household chores, transportation to and from doctor’s appointments or the grocery store, food preparation, meal delivery, or home repairs. Other necessary services might include counseling, legal advice or intervention, subsidized fuel delivery, or in extreme cases, nursing home admission. Generally, however, the idea is to provide seniors’ services to remain in their homes and independent for as long as possible.
Who Benefits from Elder Gatekeeper Programs?
Although the senior receiving assistance is the primary beneficiary, others also benefit from Elder Gatekeeper Programs. Gatekeeper volunteers find a sense of meaning and contribute to the community through their efforts. Social workers are alerted to situations they may not otherwise be aware of. Families of seniors, especially those that live far from their elderly loved ones, also benefit from knowing that someone is looking out for them.
What Have Been the Results?
In Oregon, there were 400 referrals to Adult Protective Services for possible neglect or elder abuse. In that state, over 8,000 individuals have been trained as volunteer Gatekeepers.
One study followed referrals through the Spokane, Washington program to Spokane Mental Health Clinical Case Management Program. Over 40 percent of those referrals came through community-based Gatekeepers. Seniors referred to the program were often economically disadvantaged, socially isolated, and without a regular physician. A one-year follow up found that most Gatekeeper referrals had a regular physician and had fewer cognitive problems that impacted their lives at the time of the follow-up.
The Senior Reach program in Spokane, based on a Gatekeeper model, has effectively reduced isolation, improved cognitive function, and increased optimism about the future among those referred to the program. Additionally, seniors demonstrated increased positive interactions with others, decreased emotional disturbance, and were less likely to be depressed.
Another study found that the Gatekeeper program reduced emergency and hospital admissions, saving approximately 14 million dollars in healthcare costs by preventing premature nursing home placement.
The Colorado Senior Reach and the Mid-Kansas Senior Outreach (MKSO) are two programs modeled after the Spokane Gatekeeper program. Seniors referred through these two programs were less socially isolated, less depressed, and had decreased suicide ideation after the intervention.
The Samaritans of Merrimack Valley, MA, have established a Suicide Prevention Training for Gatekeepers of Older Adults that work at nursing homes, assisted living facilities, and senior communities. Gatekeepers are trained in risk and protective factors for suicide and how to complete a suicide risk assessment. It’s hard to measure the impact these volunteers have had on at-risk seniors. However, based on other programs, it undoubtedly has saved lives.
The Gatekeeper model has been deemed so successful that other countries have adapted it to meet their needs. For instance, after the 2011 earthquake and Fukushima nuclear power plant meltdown, Japan set up a Gatekeeper program to address residents’ mental health and reduce the risk of suicide.
How to Become Involved
Not all Gatekeeper programs use the term Gatekeeper, which may make it more difficult to find an agency that trains volunteers in your area. If that is the case, contact your local Area Agency on Aging and ask for more information on volunteering as a Gatekeeper. Several agencies offer training for businesses as a way of giving back to the community.
Keep in mind that if you see an elder in need, do not hesitate to contact your local Area Agency on Aging for more information on how to help, even if you have not yet been trained as a Gatekeeper.
Elder Gatekeep Programs Wrap Up
Community outreach programs like Elder Gatekeeper Programs provide a valuable service for vulnerable seniors by helping them get the support they need. Trained volunteers can reach isolated seniors and make referrals to agencies that can assist them. As a result, seniors can remain independent longer, cutting the costs of nursing home placement considerably.
