“I’ve been here 50 years. I was the first house in Evergreen Meadows. Why would I want to go someplace else?” Jim is 92 years old, and deeply in love with his mountain home. Living in the mountains can be challenging for anyone, and it can get a little trickier as one ages. But it is getting easier for Evergreen’s elderly community thanks to Evergreen Community Assistance Referral and Education—ECARES—run through the EMS Division at Evergreen Fire/Rescue.
“I started wondering, am I going to be able to stay in my home?” says Penny, after a close friend of hers took a spill in her driveway. “The rescue squad came to help her, and that’s how we learned about ECARES. They really were a godsend, and they’ve given me the tools to stay in my home longer. Honestly, they walk on water as far as I’m concerned.”
“We fill gaps people didn’t even know were there.”
In 2016, after a mill levy passed, Evergreen Fire/Rescue Chief Weege pursued a budget increase in an effort to serve Evergreen’s aging community, keeping them safe and healthy in their homes for as long as they could. Three years later, ECARES was licensed and integrated with Colorado’s Community Integrated Health Care Services (CIHCS) with one full-time community paramedic and two community paramedics on ambulance. Community paramedicine is a healthcare model allowing paramedics to assist with primary healthcare and preventive services to underserved populations in the community, improving access to care and avoiding duplicating services.
Spearheading the program was EMS Chief Dave Montesi, and Annie Dorchak, who has more than 34 years experience as a paramedic. “There are gaps that need to be filled,” Annie says. “When the state developed this program, it was to fill gaps in health care and community needs. We fill gaps people didn’t even know were there.”
The ECARES team is comprised of medical professionals, but they are regularly on-the-ground with high-risk clients and patients, and so the work reaches beyond triage or traditional medical care. ECARES paramedics make routine home visits for wellness maintenance and vital sign surveillance, monitor medication inventory and compliance, do lab draws and non-emergent treatments such as fluids for dehydration, and general risk management around the home.
“We’re stepping outside the realm of traditional paramedicine, and we’re able to do these paramedic house calls,” explains Dr. Jeff Henson, a board certified chiropractic physician and EMT who regularly sees community members like Jim.
“Oh, you can’t escape them,” Jim says. “Last time Dr. Jeff was here, he said, ‘Jim, you don’t look so well.’ And I thanked him for the compliment. Then he took my blood pressure—it was almost non-existent. He said, ‘You gonna call, or should I call Conifer Medical Clinic?’ Boom, I was in there right away. And they found out I was taking the wrong pill at the wrong time of day and another pill I shouldn’t be taking.”
The overall goal of ECARES is to allow for the Evergreen community to safely age-in-place, with the reassurance of someone looking out for them. Both Jim and Penny admit that it’s easy to become “lax” about medications, doctors’ appointments and other healthcare necessities when it is challenging to leave home. And home is where they want to be—where they want to stay. “They bridge that gap between doctors and hospitals and you, and they explain things that the doctors don’t have time to say. They take the time to explain medication, supplements,” says Penny. But there is an education piece that is equally important and empowering. “They also help you be a little bit more assertive. It used to be if the doctor said XYZ, I didn’t question it. They taught me to be more assertive about getting information from the doctors.”
The education piece includes risk management services for fall prevention, fire mitigation and other glaring safety concerns. For Jim, that included installing a radon detector in his home. For Penny’s friend, it was clearing a safe path in the driveway to prevent future falls. It is removing literal road blocks, but also figurative ones that crop up in the medical system that may leave patients confused or uncared for. Penny adds, “They come and answer my questions. They make sure I have the resources I need. If I have trouble understanding something or getting information from the doctors, they know how to get around that. If I had a problem and didn’t know where to turn, I could call them up and they would tell me what to do.”
“Sometimes we help clients see that this is what needs to happen; we help negotiate for what they need,” Dr. Henson says. As familiar, professional voices, the ECARES team serves as a go-between so that people get proper care. Annie says, “We’ve assessed people and found a reason they need to go the hospital right now,” which can be a tougher conversation for a client who wants to remain home. When they can, ECARES navigates the circumstances, allowing for individuals to safely reside in their homes. “Having strong relationships with local doctors and healthcare facilities allows us the opportunity to help facilitate a more optimal and productive aging in place scenario,” Dr. Henson says.
The impact on the community is palpable, and ECARES has accomplished so much more. This year, their small-but-mighty team of five are slated to hit 500 home visits, some weekly or bi-weekly, sometimes one-off meetings. They work closely with Centura and Conifer Medical clinics, as well as Mount Evans Home Health & Hospice, the Jefferson County Housing Authority and Evergreen Christian Outreach to serve community members in need.
ECARES also offers congruent services like “Annie’s Shed,” which provides medical equipment for individuals unable to obtain items like walkers, wheelchairs, and other high-use products necessary for quality-of-life and mobility. “People were donating these items to us, and at the same time others were asking if we had any,” Annie recalls. “So now, we have a shed. We loan or give durable medical equipment to people who need it.”
There is a lot of growth scheduled for the coming year as well, including more collaboration with local providers and educators to get tools and resources into the hands of elderly community members hoping to age-in-place.
“This service is free—we’re offering this service to you,” Annie says. They want community members to continue to feel safe and healthy in the mountain area, living good lives in the place they’ve always called home.
Jim’s advice sums it up best: “They made me a lot sharper about what I’m doing, made me more alert. And that’s an important part of their work. Without them, I wouldn’t have had the opportunity to learn all this. They’re great people and it’s a program that I think every adult should use.”
