Service with a personal touch

Advocates help elderly navigate medical issues

Sylvia Topp (left) and Elizabeth Conlin are paired in the At Your Side program. Topp visits and helps Conlin at medical appointments. (David Kamerman/Globe Staff)

By Wendy Killeen

When Elizabeth Conlin attends doctor appointments, Sylvia Topp is right there with her.  "She understands a lot of the medical things," Conlin said. "What I don't catch, she does. I don't have to worry that I missed anything." 

Conlin, 79, is a great-grandmother from Salem dealing with complicated health issues, including cancer. Topp, 69, is a semi-retired psychologist from Beverly Farms.

They were brought together by At Your Side, a new medical advocacy program offered through North Shore Elder Services in Danvers. Its mission is to help the frail elderly, people with physical or mental challenges, and those with limited English proficiency navigate the healthcare system. It also aims to provide people a better understanding of their illnesses, medications, and treatments.

"The healthcare system is broken," said Dr. Jonathan Fine of Cambridge, founder and program director of At Your Side. "People are lost in the labyrinth. They can't get prompt attention, sometimes even for urgent problems. They go from one doctor to another. Many can't get a primary care doctor and fall back on the emergency room.

"More and more are referred to specialists who know little about them and have only a few minutes to spend with them. There are more diagnostic tests and more medications with strange names. People are bewildered, confused, and anxious. And the problems are compounded for the clients we are especially interested in."

At Your Side is a spin-off of Bedside Advocates, which Fine, 77, a retired primary care physician, cofounded in Boston in 2005.

Fine said when he began "making the rounds" to launch At Your Side in areas outside Boston, he found "a fellow visionary" in Paul Lanzikos, executive director of North Shore Elder Services.

Lanzikos said the agency had been considering a medical advocacy program of its own. Instead, it joined with two other local agencies serving high-risk clients, SeniorCare Inc. and the Independent Living Center of the North Shore and Cape Ann, and adopted Fine's initiative.

The launch of the program was supported by grants from The Roberta Thall Charitable Foundation and the North Shore Community Health Network. Services are free.

Fine said the goal is to recruit about 50 volunteers this year, with half being retired doctors, nurses, psychologists, and social workers, and the others "lay people" who have experience helping older family members or friends. There's an orientation and a six-hour core curriculum training. And there is follow-up instruction on issues such as depression and end-of-life care.

Volunteers are paired with a client, who may request to be part of the program or be referred by a caregiver. Ideally, the volunteers visit at home, but they also continue with them through hospitalizations or nursing home admissions.

Fine, who is a medical advocate for several people, said the average time commitment is four hours a week. But, he stressed, the time is based on the client's needs and schedule.

He said the pairs often develop a deep friendship and trust, and become part of an extended family. "You really get to know people, their anxieties and how you can help in their moments of crisis," said Fine, who is also founder of Physicians for Human Rights. "It's enormously rewarding."

He and Lanzikos see the program as a model that will spread throughout the state and country. "Aging is something we all do," said Lanzikos. And the elderly "are the fastest growing part of our population." He said North Shore Elder Services provides home care to about 5,000 people a year and the average age group is mid-80s.

"I used to be very lonesome at home," said Conlin. Then, she said, "They got Sylvia to come in on Mondays and she still does."

When Topp accompanies Conlin to doctor appointments, she takes notes and gives Conlin a duplicate. She also keeps Conlin's son and daughter updated.

Several months ago, Conlin fell at home. She was hospitalized, then transferred to Blueberry Hill Skilled Nursing and Rehabilitation in Beverly, where Topp continued to visit her.

"Most of the time we just talk," said Topp. "And when she is well enough, we'll go shopping. You just figure out what the person needs."

"She helps me put on my shoes and pull up my socks," said Conlin. "She helps me a lot. I don't want to part with her."

For more information about At Your Side, call 978-750-4540 or visit www.nselder.org.

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