It Takes A Village – Caring for Older Adults who Suffer from Asthma

This blog was authored by Rachael Meyer, a former JSI Environmental Health Intern. 

When I was growing up, my mom took me to visit my great-grandfather every Thursday for years. We picked up my great aunt from her home and took her to my great grandfather’s house to play cribbage, eat lunch, listen to a football game, and chat.

I didn’t understand it at the time but my mother was a caregiver to them. When we picked up my great aunt, we would go into her house and my mom would bustle around making sure nothing was underfoot, pill bottles were lined up, braille stickers were properly in place, and that the cut on her arm was healing. It was the same story with my great-grandfather. She convinced him to go to the doctor when he needed to, read the instructions on his medicine labels, and cleaned out his musty basement.

And then, there was me. While my mom was doing all this, I would be climbing up the tallest tree in the yard, taking my great-grandfather for a ride on his motorized wheelchair, and running off to the river. But my mom didn’t miss a beat—she was always ready to swoop in with my asthma inhaler when needed.

The importance of what my mom did for my great-grandfather and aunt was lost on me while I was running wild during those visits, but since my time and work on the Reducing Older Adults Asthma Disparities (ROAAD) study, it has hit home. The study shows that in-home care for older adults is incredibly impactful in helping asthma sufferers gain control of their conditions. I can’t imagine trying to address a person’s asthma without knowing the environment in which they live—the same way I can’t imagine my mom taking care of my aging relatives without being there for them every Thursday.

The ROAAD study highlights the importance of having health workers visit older adults in their homes. The community health workers who visited the study participants took health care and education directly to the patients. They were also able to connect them to more resources and assess in-home asthma triggers. By the end of the program, the rate of patients’ hospitalizations had decreased, they were able to afford medications and practiced better medication use.

The results of the study are timely. Currently, older adults have the highest mortality rate and the second-highest hospitalization rate for asthma. They also face challenges in asthma self-management. Many of them experience additional obstacles that include the inability to afford medicine and multiple health problems.

In some cases, these obstacles are further compounded by cultural and language barriers and the stresses associated with racial discrimination and poor housing conditions. In fact, Hispanic and Black, non-Hispanic people are 3.2 and 2.6 times more likely, respectively, to be hospitalized than White people in MA.  

My great aunt and great-grandfather were privileged to find themselves at the center of a community that supported them and a large family who loved and took care of them. Not every older adult has that network of people around to them. The ROAAD study has paved the way for future study into how in-home visits can impact the health of patients with other conditions.

Learn more about the Reducing Older Adults Asthma Disparities study.

Note: The ROAAD Study was initiated and led by the Massachusetts Department of Public Health in partnership with researchers from the University of Massachusetts Lowell and evaluation support from JSI for feasibility assessment. Lowell Community Health Center was the site of the study engaging their clinical, CHW, and administrative teams in service of their enrolled patients.