Lyle and Lori walk into a Dexter Road home on a recent August morning like old friends catching up on a conversation from the last time they met.
Sinatra is crooning in the background and homeowner Margaret Kralovich begins explaining how her smoke detectors went off unexpectedly at night, presumably because of the high humidity.
Lyle agrees humidity can have that effect and they continue to talk about the alarms, how Kralovich handled the nighttime disturbance, and the upgrades that have been made to ensure safety in her home.
It’s a friendly visit, but Lyle and Lori are not just casual acquaintances of the older Marion resident. They are Lyle McKay, paramedic and emergency medical services director for the town of Marion, and Lori Desmarais, RN, Marion public health director and nurse, and, most importantly to Kralovich, the main faces of Marion Cares, a Community EMS program that launched in 2022 and is changing the way care is offered in town.
Marion Cares involves multiple town departments who meet regularly, including the Council on Aging, Fire Department, Police Department, Health Department and more. McKay and Desmarais are its primary ambassadors conducting hundreds of home visits, mainly to older adults in town, to evaluate patients and check vitals, do home assessments including modifications to avoid slips and falls, and identify and resolve safety issues like outdated smoke detectors or the need for lock boxes. The town also recently added discharge care to its list of programs, offering home visits for people when they are discharged from hospital or nursing home settings.
The Community EMS program is a new way of looking at emergency services, says Marion Fire Chief Brian Jackvony, one that focuses on prevention and avoiding the need for emergency responses.
“We see the increase of older adults in the community like similar communities that surround us and we’re trying to take the first step towards being proactive rather than just reactive,” Jackvony said. “That was really the reason to get behind initiating the Community EMS program.”
“It really focuses on interrupting the need to call 911 and preventing hospital visits,” he continued. “I think the end goal, the big goal, is to keep people in their homes as long as possible.”
The program has been a big success with McKay and Desmarais making more than 120 home visits in the first half of this year alone. It is one of only 16 in the state at the moment, including similar efforts in New Bedford and Fall River, according to data from the Marion program.
Ask those who need the care offered and their responses are enthusiastic. Kralovich called Marion Cares and its team wonderful and Fern Flynn, a Marion resident who also receives well-being visits said she appreciates having the option of a home visit.
“I’ve had blood pressure issues in the past,” Flynn said. “And this helps me keep ahead of it.”
Surprisingly to EMS and Fire Department staff, the preventative focus has also boosted firefighter morale.
“It leaves you feeling embedded in the community,” said Jackvony. “You feel like you’re part of it. You feel like they trust you to not only respond in an emergency, but to help them prevent an emergency and when you build that level of trust, it pays all sorts of dividends for the department.”
“We always look to build community equity, and when I say equity, I mean faith, trust, and confidence in the fire department,” he continued. “And I think that’s felt throughout the agency.”
Much of the success of the program built upon existing relationships between town and regional networks and agencies, said McKay.
“I’ve been here four years and one of the unique features that was already established was relationships with other departments and agencies within the town. So it’s really made moving into a Community EMS Program much more seamless,” he said. “Monthly meetings already took place between the Board of Health, Fire Department, Police Department, and Council on Aging. We’ve had representatives from Coastline and Bristol Elder Services as well. So we were able to have those outreach resources within our network.”
Desmarais agrees. She started in her position at the height of the pandemic, quickly getting a feel for how the town operates. “I found that in this community everyone kind of works together,” she said. “I was brand new…but coming here and doing vaccinations, COVID vaccines, I definitely got a lot of support from fire, police, everybody from town hall and also the Council on Aging. And if I didn’t have all the support, I wouldn’t have been able to pull off a lot of the things that we were able to do here.”
The team points to many moments where an interaction led to medical intervention that left untreated might have caused more significant problems in the future. A blood pressure clinic, for example, exposed a hypertensive event where a quick response avoided a potential stroke. A routine visit revealed fluid buildup in a patient’s lungs that was then addressed before it could develop into a bigger respiratory problem.
“He was one of our patients that we were seeing on a normal basis and that’s another benefit, that we kind of get to know the baseline of people,” said Desmarais. “And when we see something off or we feel like they’re not acting appropriately or even just sound different with the way they’re breathing, we can initiate some type of plan to see if something’s going on.”
Care offered through the program can also go beyond medical treatment.
One local woman called Desmarais during a summer heat wave to say her home was very warm and she felt off. Desmarais, who checked the message despite being off work and in New Hampshire, relayed the concern quickly to her assistant who alerted the Fire Department.
The woman was transported to the hospital for care, but the team didn’t stop there. The Council on Aging agreed to purchase an air conditioner for the home. The Fire Department checked with the woman’s landlord and, using the COA’s credit card, went out and bought the air conditioner.
The woman came home to a note on her door about contacting the police about a new air conditioner.
“Then the fire department went over and installed the air conditioner for her,” said Jackvony, adding, “It does make us proud to be able to do the small things that make a difference on a regular basis within the community.”
Interested in finding out more about the program? Regular clinics and awareness events are posted in the Council on Aging newsletter. Residents can also call the Fire Department at 508-748-3596 and ask for information or a home visit.
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