Amy Cotton loved nursing long before she entered the profession. Cotton’s grandmother, Clarice Gooch Hoyt, a nurse in Down East Maine who made house calls on horseback, was a constant source of inspiration. Cotton calls her “a pioneer.”

“I have a tape of her talking about her life as a nurse and all the things she did,” said Cotton, nurse practitioner and program director for Rosscare’s Center for Healthy Aging. “My Gram was astonished by the things I do as a nurse.”

Sadly, Clarice Hoyt passed away in 1993.

“She lived with my mother and I was fortunate to be able to witness the impact that caregiving had on my Mom,” said Cotton.

This personal experience proved useful when Cotton compiled information for the “Employed Caregiver’s Survival Guide,” available from Rosscare.

“The combined stress of working outside the home and caring for an elderly relative can take a toll on the caregiver’s own health,” said Cotton. “Caregivers often feel like they have to do it all, when in reality the responsibilities can be shared with family, friends and community resources.”

A key resource is Rosscare’s Center for Healthy Aging, an affiliate of Eastern Maine Healthcare. The center helps frail elderly individuals, who need medical monitoring and health care but are unable to routinely travel to a doctor’s office, to remain independent and in their own homes.

Cotton and her co-worker Sally Smith, gerontological nurse practitioner, make home visits to seniors and provide them with care that otherwise might be unavailable.

Some of the services of the center include:

. Memory evaluation.

. Health care in collaboration with the senior’s primary care physician.

. Geriatric assessment for seniors with multiple chronic health conditions.

. Community resource and referral information.

. Chronic disease education.

“Aside from providing access to routine care, we assess the home environment,” said Cotton, who also teaches college courses on health care for seniors.

“We check and make sure the home is safe and walkways are free of clutter,” she said. “One fall can land an older person in the hospital and often a person doesn’t return home after that. We also check that there is enough food in the house. We get a mental snapshot of a person’s life, all the while working with family members.”

Home care can keep little problems from becoming large ones. Cotton and Smith think of their services as “proactive health care.”

“Heart disease and lung disease need medical management. This is not possible if the person is unable to travel,” said Cotton. “Even a cut or sore can become infected and cause a major health concern if not treated early.”

Cotton became interested in starting the center when she realized people were continually being readmitted to the hospital because of their lack of timely access to routine health care.

“This is a supportive service to augment and enhance access to health care, which elders deserve,” said Cotton. “It is a privilege for Sally and me to collaborate and support so many community physicians and try to fill this gap.”

The amount of time Cotton spends with her patients varies according to their needs. For some hospice patients, visits are once a week, while other patients require her services only in the winter, when traveling can be treacherous.

In order to receive services from the Center for Healthy Aging, patients need a doctor’s referral.

“It has been very exciting to create a needed service in my community. Currently, 13 doctors refer patients to me. Being a Maine girl, raised in Hampden, I am very pleased to provide advanced-practice nursing in my community,” said Cotton. “I love what I do. I have the world’s best job. I get to visit with seniors, use my nursing skills, provide education, and connect with the families of my patients.”

For more information, contact Rosscare’s Center for Healthy Aging at 973-7095, or visit online at www.emh.org.

Carol Higgins is director of communications at Eastern Agency on Aging in Bangor. For information on EAA programs and services, call Marilyn or Chuck at 941-2865 or log on www.eaaa.org.