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NADSA Managing Director Delivers Keynote Address at Launch of First Center in Grenada

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Teresa Johnson shared information about NADSA in two live television programs and one live radio program

An inquiry call from a potential business owner about opening an adult day center in Grenada sparked two years of activity, part of which included a geographic study to verify they were talking about the country of Grenada—not Grenada, MS! On Saturday, March 23, 2013, Teresa Johnson delivered the keynote address at the launch of the first adult day center in the country of Grenada. The landmark event provided our first international opportunity to showcase the National Adult Day Services Association (NADSA) and support one of our members in their quest to introduce a new healthcare delivery system that can change the island.

The current formal health and support systems in Grenada include hospitals and nursing homes. Located on St. George’s Island, one of three larger islands comprising the country of Grenada, PESEIS offers an opportunity to improve the lives of people through a new healthcare system promising safe, modern, innovative care to the islanders. (PESEIS is an acronym for the human dimensions model that the nursing services will follow, which will look after the Physical, Environmental, Sociocultural, Emotional, Intellectual and Spiritual dimensions.) The new community-based program can serve as an emerging provider of transitional care and short-term rehabilitation following hospital discharge. Utilization of an adult day center can reduce hospitalizations and thereby reduce health care costs for Grenada’s health care. Native Grenadian Ann Raeburn-Lewis, RN, owner and founder of the proposed center, has the professional and business experience to establish the successful new approach to healthcare.

Teresa and her son Shannon were invited to the mansion of Governor General Sir Carlyle Glean while visiting Grenada

Teresa and her son Shannon were invited to the mansion of Governor General Sir Carlyle Glean while visiting Grenada

According to the Pan-American Health Organization (PAHO), the older population of Grenada is primarily affected by diabetes, hypertension, and coronary or cardiovascular diseases and their complications (Pan American Health Organization, 2001). Although Alzheimer’s and dementia do not currently top the list of chronic diseases among the population of Grenada, the prevalence of diabetes is reason for alarm and reason for preparation to care for people with dementia. According to a study conducted in Japan, diabetes appears to dramatically increase a person’s risk of developing Alzheimer’s disease or other types of dementia (Study: Diabetes Doubles Alzheimers Risk, 2011). The researchers also found that people over 60 with diabetes were twice as likely to develop Alzheimer’s within 15 years. The implications of chronic disease extend beyond the patient to include costs of caregiving such as physical, emotional, and financial tolls that impact individuals, families, and society (e.g., lost productivity, premature nursing home placement).

PESEIS Adult Day Care & Walk-In Clinic will bring a breath of fresh air to health care for the elderly in Grenada. For the most part, retired adults are cared for either at home, or are placed in a state-run nursing home where some are seldom visited by relatives. Since no adult day care services currently exist on Grenada Island, this gives PESEIS the opportunity to become a leader in the field while enhancing the delivery of healthcare on the island. PAHO estimates that 10 percent of the population lives with some type of disability, making responding to their needs a key concern of the health sector (Grenada Growth and Poverty Reduction Strategy, 2012-2015, 2011). PESEIS can help bridge this gap in services on the island, also.

William and Ann Raeburn-Lewis, business owners for the new PESEIS adult day center, were gracious Grenadian hosts

William and Ann Raeburn-Lewis, business owners for the new PESEIS adult day center, were gracious Grenadian hosts

PESEIS will set an example for what healthcare should look like in Grenada as it achieves its mission to provide high quality professional nursing, health, medical, rehabilitation, and recreational services to senior citizens. We expect PESEIS employees to network with other adult day center workers from the United States and other countries as they embark on this new journey. Their training employees on preventive measures can impact the chronic health conditions of the people being served, but also on meeting the needs of people with diseases that may be forthcoming to the population, such as Alzheimer’s.

The need for adult day care as a public facility was identified as a concern for the elderly in a Participatory Poverty Assessment conducted in 2007-2008 on Grenada, Carriacou and Petit Martinique (National Assessment Team of Grenada, 2008). Moreover, introduction of an adult day center appears to fit well with the Ministry of Health’s Strategic Health Plan, which most recently targeted developments in health care and health systems during the period 2007-2011. The older adult population is expected to increase by more than 10 percent in the next decade (Pan American Health Organization, 2007). After careful research conducted by Ann Raeburn-Lewis, it is her projection that by the Year 2020, the elderly population in Grenada over the age 65 will reach approximately 30,000. Having that portion of the population over the age of 65 will put a serious strain on the financial ability of the Government of Grenada to provide adequate health services to them. As the “over 65” group increases in the coming years, the management of chronic diseases will more than likely pose a major challenge because the demand for hospital services and services in the community will increase.

Since there is no formal system for follow-up and referral for patients discharged from General Hospital, PESEIS can work out a system where the General Hospital as well as other medical facilities can contact them so they can follow up to see if the patient needs an adult day care service. The introduction of adult day services in Grenada promises safe, modern, innovative care to the islanders.

The rendering below is for the future building of PESEIS Adult Day Care and Walk-In Clinic. Meanwhile, the program will open in two locations housed in existing buildings in separate parts of the island to launch the business.

PESEIS Adult Day Care

PESEIS Adult Day Care

For more information about PESEIS, visit

—Teresa D. Johnson, MBA

Posted in Advocacy, Research