How On Lok became a model for senior care nationwide

By Randall Yip, Executive Editor

(This story is made possible with the support of AARP)

It’s a busy Wednesday morning at the On Lok PACE Center in San Francisco.

Mostly Asian seniors strengthen their muscles and stretch out their limbs on the exercise equipment while another group listens as a facilitator excitedly talks about upcoming holiday festivities.

Nurses administer medication as elderly participants wait for lunch to be served. Downstairs the kitchen staff prepares that meal to meet the dietary needs of individuals. Around the corners doctors are checking blood pressures and discussing health needs with their patients. A dental chair sits empty, perhaps awaiting the next patient.

This all-in-one center is known as the Program of All-Inclusive Care for the Elderly (PACE). It’s one of seven facilities in the San Francisco Bay Area with two others scheduled to open early next year. The program about to begin its 55th year has been a model for other senior programs in more than 30 states, according to On Lok.

“Our goal is to keep the senior to live at that own homes which is very new, I would say, at that time. It’s a new concept to bring to the community that they can do it, they can still be independent,” On Lok’s Stephanie Szeto said to AsAmNews about the program that began in 1971 in San Francisco’s Chinatown.

“We provide them with community, we provide them with the medical need, transportation, meal delivery service, and social work service. Every participant that we serve has social worker that care for them and take care of things like medical needs and check in with the cognitive progression and all that.”

Danilo Manansala and his wife Rosalina Manansala have been going to PACE more than two years. They came from another senior program but joined On Lok when they moved.

“We like it very much because everything is easy,” said Rosalina Manansala, 69. during a sit-down interview with AsAmNews. We have exercise, we have the dancing, the singing, oh my gosh, we like that. We have many friends. The caregivers are so very attentive.”

She particularly likes singing. At our urging, she sang a rendition of Happy Birthday.

Her husband Danilo says Filipinos love music. However, his favorite activity is to practice tai chi. He says without On Lok, he believes he would be a burden to his children.

To be eligible for the On Lok Pace Program, an applicant must be 55 years or older and have a need such as mobility issues or perhaps declining memory. A small percentage of the clients are on private pay, but most get support through Medi-Cal or Medicare.

There are approximately 2,100 participants in the Bay Area. All must be approved to participate in the program by the state.

“It is the best to all elders, especially in San Francisco community,” Danilo Manansala said.

It’s not uncommon for seniors in the program to have chronic medical conditions ranging from cognitive impairment, heart failure to complex social care issues. Some of them have family in the area who still remain actively involved with their care. For others, the closest relatives may be in Asia.

“PACE program is designed to help take care of the medical issues but also support those other day-to-day needs,” said Dr. Janelle Ho, a doctor serving patients in the program. “We take care of folks from the time they get enrolled in the program all the way to the end of life,” Ho told AsAmNews.

Both physical and occupational therapy is offered to keep the client in the home, but there may come a time when a social worker must recommend a skilled nursing facility, assisted living or even hospice care.

When necessary, the medical team will refer a client to a counselor or psychotherapy.

“They are also very much in touch with the participant’s mood and home situation, families moving away, family is having conflicts. They’re always first line and knowing that, and they alert the other team members about it. And, yeah, they’re very much involved even towards the end of life. They’re the ones who will trigger referrals to our chaplain, make sure that funeral arrangements are in place. They have these conversations. They join the primary care physician in talking about advanced care planning,” said Ho.

Danilo Manansala put it simply.

“They care about the elders.”