J U LY 2 0 0 6
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Bailey-Boushay House is a nursing
residence and day health center
owned and operated by
Virginia Mason Medical Center.
homefront
Pills, Pills
and More Pills
Getting better at taking life-saving medication
H
IV/AIDS drugs can save lives. But taking the medication correctly is not easy to do. That’s
why medication management — fi nding ways to help people start and stay on life-saving
drugs — is job one in Bailey-Boushay’s Adult Day Health program.
To work, AIDS drugs require at least 95 percent adherence (taking pills on a prescribed
schedule), day in and day out, forever. Skipped pills give the virus time to mutate and develop resistance. When
that happens, the drugs stop working.
Many people are doing well using BBH medication management services. In 2008, the average medication
adherence score (based on all day health clients as a
group) rose to 97 percent.
“The steady improvement in adherence rates is great
HIV/AIDS drugs can save lives.
news,” says social worker Billy Burton. “Now the big
But taking the medication correctly
challenge is to do even better” for people struggling at the
is not easy to do.
far ends of the spectrum.
This year Bailey-Boushay is exploring (continued inside)
in this issue
JOIN
the BBH Volunteer
Team!
Volunteering at BaileyBoushay House offers a
chance to help people who
are facing physical and
mental challenges live
with dignity.
See inside for details.
Above: Many BBH clients take up to 20 to 30 pills every day.
continued from page 1
two new ways to help clients develop the
motivation, skills and confidence to
take medication successfully for the rest
of their lives.
Burdens and benefits of medication
“Our clients take an average of 11 routine
medications — up to 20 or 30 pills
every day,” says BBH Executive Director
Brian Knowles.
Clients take powerful drugs to keep
the AIDS virus at bay and more pills to
counter the debilitating side effects (such
as nausea, diarrhea and vomiting) of those
toxic drugs. They take pills to treat other
AIDS-related health conditions, and more
pills for health problems completely unrelated to AIDS. Many also take medication
for depression, anxiety and other mental
illness. Finally, add medicine for commonplace health changes related to age, life
style and genetics.
nurse and social worker. It’s a private, 5- to 15-minute talk
about anything related to taking medicine. No appointment
required.
Adherence To Go is for clients who — because of mental
illness, chemical dependency and homelessness — have had
the least success taking medication consistently. AIDS drugs
could help them, but they can’t focus on taking pills while
wrestling with other life problems.
One client was “on and off the meds for years,” he says.
“I was in denial and was too embarrassed to let anyone know
I had the disease.” The only time he took his medication
regularly was while incarcerated: “At the Department of
Corrections, they bring you the pills on time every day, and
you never miss.”
Educating and
helping clients take more responsibility
for their own health is the
long-term objective.
Expanding choices and building trust
In Adherence To Go conversations staff ask: “What’s chaotic
in your life that prevents you from taking your medication?”
Staff gather information and make a detailed plan to help
each client overcome barriers to taking pills. Help might
come in the form of reminders, cueing devices, home visits,
help with organizational skills or counseling. The goal is to
fi nd what works for that individual.
Educating and helping clients take more responsibility
for their own health is the long-term objective. For example,
understanding that their lab results are tied to medical
adherence is a big focus. (Viral load goes down and T-cell
count goes up when HIV medication is working and people
are getting healthier.)
“Education helps people make better choices,” Billy
Burton says.
Above: Denial kept him
from taking AIDS
medications for years.
Right: Bailey-Boushay
provides a bridge that
helps clients move into
higher independence.
Forming a bridge to independence
“I still gag when I take my 19 pills a day,” says Ron Padgett,
an adult day health client since 2004.
“Almost daily,” he says, “I would think about quitting —
still do. It’s a conflict: you have to take the AIDS meds but they
make you sicker.”
Client Leon Nobles adds: “You have to have them, but it’s
hard to take them. Hard just to remember to take them. A lot
of the time I just get mad and don’t want to do it.”
“It’s easy for people to be overwhelmed,” Brian Knowles
says. “But taking all their medications successfully is vital to
the quality and quantity of our clients’ lives.”
Adherence To Go gets going
Since January, any client who wants extra help (and a takehome snack for the evening) can drop in for a chat with a
The second initiative helps a smaller group of clients at the
other end of the adherence spectrum. They are healthy
enough to take the next logical step: graduation from BaileyBoushay House.
Their future promises a new set of challenges and
stressors — in work, school, relationships and self-care. What
will help them continue taking 20 to 30 pills a day for life?
Twice a month BBH hosts a dinner meeting for clients
making the transition to more independence.
The event is social (eating together), educational (guest
health care speakers) and an opportunity to give and receive
peer support. Clients can share the struggles they face after
being disabled for so long. Two BBH staffers also attend.
Ron Padgett’s new life has already begun. He works
part-time as a housecleaner (“it’s exhausting”) and is an
active community volunteer. Making this progress, he says,
“makes me feel a lot better about myself.”
He’s already recognized that “talking in public (as a
volunteer) is not hard for me. What’s very hard is to remember
to take pills.”
In addition to the twice-monthly dinner, clients in transition can request one-on-one support from staff. And the day
health program remains open to them for support if they feel
the need for it.
“Bailey-Boushay wants to provide a bridge that helps
clients move into higher independence with confidence and
encouragement,” Brian Knowles says. “We’re a success when
people don’t need us anymore.”
Driving to Make a Difference
What a longtime volunteer gets from giving back
M
ore than 100 volunteers serve meals, give
rides, help with activities, and offer nonjudgmental companionship to Bailey-Boushay
clients and residents seven days a week.
Volunteer jobs at BBH aren’t glamorous but they’re crucial
and deeply gratifying.
Dick Patton made it through his first six months as a
volunteer driver — and has stuck around for another
15-plus years.
“I do almost anything I can to not miss my shift — it’s that
important to me,” Dick says.
The beginning of a beautiful relationship
Dick had no idea what he was getting into. Or what he would
get out of his new role.
“I knew nothing about AIDS — back then no one else did,
either,” Dick says. “I’d just begun a career in real estate, had
a car and a flexible schedule, and had a desire to help out.”
He hadn’t volunteered anywhere before. “Looking back,”
he adds, “it was high time I did.”
Join the BBH Volunteer Team!
“The world is lucky to have Bailey-Boushay
House. Driving is the least I can do, to give
back to something bigger than me.”
DICK PATTON
Making connections five minutes at a time
“I’m a taxi driver,” Dick says. “I pick Adult Day Health clients
up here, take them out there. It is a necessary thing for the
clients’ to have a reliable ride for medical appointments and
critical errands.”
On the way, drivers and riders talk about the weather,
their lives, where they’re from, what’s happened that day.
“I’ve spent all these years in five-minute relationships,”
Dick says. The clients continue to amaze me. I’m in awe of
their strength and courage. You can’t be here without realizing how humbling and grounding this experience is.”
Volunteering at Bailey-Boushay House offers a chance to help people who are
facing physical and mental challenges live with dignity.
We’re always looking for:
• Drivers (on weekdays or weekends)
• Meal servers (for lunch any day)
Currently, we also have volunteer openings for:
• Reception desk (hours are very flexible). You’ll welcome patients and
visitors, answer busy phones and assist staff.
• Hair styling (once a month for three to four hours). If you are licensed to
cut hair, you can boost patients’ self-image and sense of well-being.
To learn more: Please contact our Volunteer Coordinator at (206) 322-5300.
Committing to something bigger than oneself
The people he meets at BBH keep Dick coming back year
after year.
“They impress me,” he says. “They’re good people,
sincere and with no pretense, absolutely honest. And with
all they face — taking 25 to 30 pills every day, living on $200
a month, going through such lows in medical life.”
“My life is good,” Dick says. “I’m healthy, my wife and
kids are healthy, we’re ok fi nancially. Yet this place and the
people here are good for me.”
Clients and staff treat volunteers as valued members
of the BBH community. “We couldn’t operate without them,”
volunteer coordinator David Pavlick says, “and their
commitment is truly wonderful.”
Case in point: last winter’s snowstorms. “Dick was here,
driving for us every day,” Pavlick says, “fi lling in for other
volunteers who couldn’t get in.”
“The world is lucky to have Bailey-Boushay House,” Dick
says. “Driving is the least I can do, to give back to something
bigger than me.”
Above: Volunteer driver Dick Patton (center) chats with clients.
Left: Brian Anderson (far left) and Steve Foss (far right) volunteer their time as
drivers/companions to help clients get to medical appointments and pick up
groceries.
homefront
NON-PROFIT ORG.
U.S. POSTAGE
PAID
PERMIT NO. 4636
SEATTLE, WA
Operated by Virginia Mason Medical Center
2720 East Madison Street
Seattle, WA 98112
ADDRESS SERVICE REQUESTED
INSIDE:
Pills, Pills and More Pills
Health
is the thing that makes you feel that
now is the best time of the year.
F R A N K L I N PI E RCE A DA M S
applause
Editor ............................................................................ Jeanne Lamont
Contributors............................................... Ellie David, Jeanne Lamont
Graphic Design ................................................................Dean Driskell
Marie Booker for her lovely piano playing of jazz standards.
The Threshold Choir for sharing their sweet and uplifting non-denominational hymns.
Recent gifts from:
Bennett Bigelow & Leedom, PS
Davis Wright Tremaine LLP
Kasin Family Foundation
MC Lile Company, Inc.
Photography ................................... Paul Joseph Brown, David Pavlick
Homefront is published by the Virginia Mason Foundation. For
placement of stories or information of community interest, please
contact: Bailey-Boushay House, 2720 East Madison Street, Seattle,
WA 98112, (206) 322-5300, www.bailey-boushay.org.
Bailey-Boushay House does not discriminate against qualified persons in admissions,
services or employment on the basis of age, disability, national origin, sex, sexual
orientation or any other basis prohibited by local, state, or federal law. These laws
include, but are not necessarily limited to, Section 504 of the Rehabilitation Act of 1973,
the Civil Rights Act, the Americans With Disabilities Act, the Washington State Laws
Against Discrimination, and the City of Seattle’s Anti-Discrimination Ordinances.
Printed on recycled paper. Copyright 2009 VMMC FORM 95574 (05-09).