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Photograph by Jacqueline Ramseyer
Unstoppable: Georgine Rose, here with her beloved Miss Priss, was diagnosed with AIDS in 1995, but it hasn't slowed her down. The 76-year-old great-grandmother goes to kickboxing and step aerobic classes on a regular basis.
Healing Hand
Health Connections AIDS Services makes living with the disease just a little bit easier
By Susan Wiedmann
As with many of her fellow senior citizens, Campbell resident Georgiene "Georgy" Bennett must take prescription medication daily. She also has to watch her diet and make certain that she does not overexert herself. But Bennett doesn't dwell on her medical condition, nor does she try to hide it from the world.
"I'm a 76-year-old great-grandmother living with HIV, and I'm too blessed to be stressed," she said. "And stressed spelled backwards is desserts."
By using such humor and her lifelong positive attitude, Bennett refuses to let her HIV status--she is on the borderline between being HIV-positive and having AIDS--affect her spirited personality. In the mid-'90s, while she was being treated for spinal meningitis, she was diagnosed with HIV and didn't even know what it was.
So, she took an eight-week AIDS seminar at Kaiser and has since become an active participant at AIDS events, including the Walk for AIDS. When certain friends started treating her differently because of her condition, Bennett said she found an easy solution.
"I don't have people in my life-I call it my garden-who are not dependable. I weed them out," she said.
Bennett has had invaluable help since her diagnosis. The Campbell-based Health Connections AIDS Services provides Bennett and more than 600, mostly poverty-level, clients with much-needed assistance in daily living. This has become especially important since the advent of AIDS cocktails about five years ago.
Health Connections has a small group of social workers which helps AIDS patients find answers to the myriad questions that come up for patients, and arranges for services. It also has nurses on staff that make visits to the homes of people who have AIDS, or are HIV-positive.
The organization is funded by federal and county sources, along with donations.
"The program has moved from being a very medical model before 1996, when everyone was dying and the nurses needed to be there to manage IVs," said the new Health Connections Director, Frank Keillor. "Since 1996, they have focused on what can be done for people who might live a long time."
New Health Connection clients are often in a state of shock over their diagnosis. Some are individuals who, under ordinary circumstances, are overwhelmed by the complexities of daily life. Doctors or local agencies refer them to the program for help with disability and other benefits, housing problems, food and nutrition, emotional support, transportation and emergency money. Eight Health Connections social workers assess client needs, and arrange for specific services by using community resources.
"Sometimes, it's just taking them across the street and sitting down for a meal and asking them what they need," social worker Linda Colling said.
But, at other times it's much harder. A lot of walk-in clients are homeless, and the social workers have to find them temporary housing while addressing their other problems.
Eight registered nurses work in teams with the social workers and, after consulting with doctors, they schedule regular home visits.
"You get a different picture of them at home, a more involved picture," said R.N. Jeannine Jordan. "A lot of clients had problems before they got HIV disease."
Nurses do not administer the medications, but they make certain that the clients are taking the prescribed regimen of protease inhibitors, also known as AIDS "cocktails." Part of the visit includes a weight and lung check. If a nurse determines there is any malnutrition, and there often is, Meals on Wheels will deliver special microwaveable frozen meals to the client's home.
Only a doctor can determine whether an HIV-positive status has turned into full-blown AIDS, but a T-cell--white blood cell--count of 200 is generally considered the borderline.
In a healthy individual, a T-cell count is in the thousands, and if that person becomes ill, the number of T-cells rises to fight off the infection. When a person infected with HIV becomes ill, the T-cells cannot replicate themselves. As the immune system becomes further compromised, more serious infections occur--another indication of AIDS.
In 1999, Darnell, 42, had lost his mother to a long illness, so he attributed feeling unwell to the stress caused by her death. (As with most of the clients interviewed for this article, Darnell did not want his last name used.) He began losing a lot of weight, and tests revealed he was HIV-positive. By early 2000, Darnell was in a hospital, with an AIDS diagnosis and a bleak future. His T-cell count was 10 and his weight was down to 112 pounds.
Today, Darnel's T-cell count is up to 180 and he now weighs 171 pounds. He's thinking about getting a part-time job.
For Darnell, the medications are working beautifully, and Health Connections has provided him with other necessary assistance.
"I couldn't have done it without the help that is out there," he said. "Health Connections basically saved my life."
Before becoming its director, Keillor was the Health Connections clinical services manager, and has been involved in caring for AIDS patients since 1985. He remembers that prior to the introduction of protease inhibitors in the mid-'90s, patients had an average life span of about 11 months from the onset of symptoms.
"People would do whatever they could to survive through the Christmas holidays because no one wants to die at Christmas time, either because they want to live it or they don't want their families to have a memory of their death around that time," Keillor said. "So, in the late '80s in San Francisco, in the week or two after New Year's, there was just an incredible death rate. It was a time when I was actually in the field as a nurse, and I lost 20 or 25 clients in a week."
But Danny, 56, another Health Connections client, is still alive after receiving an HIV diagnosis in 1984. He has had AIDS for about the past 10 years.
"I'm a walking miracle," Danny said about surviving for so long with the disease.
Because the social workers can only handle a set number of AIDS patients at a time, Health Connections also has a waiting list of people, hoping to get help from the organization.
The program pays for all necessary services not covered by insurance, even if the clients are undocumented. Until it became part of the Health Trust of Santa Clara Valley in 1999, Health Connections was the Visiting Nurse Association AIDS Project. Today it receives most of its funding through donations, and from federal and county funds under the Title I Ryan White CARE Act.
In its quarterly surveillance report of October 2000, the Santa Clara County Public Health Department stated that there were 1,274 individuals with AIDS in Santa Clara County. But that figure does not include HIV-positive cases, which, under state law, do not have to be reported.
Keillor said about 2,000 people in the county are HIV-positive. The majority of people served by Health Connections have AIDS.
The demographics of the disease in the county are constantly changing, according to the health department, but there has been an increase in the number of Latinos and Asians with AIDS.
Ernie, 57, has AIDS, and he knows all about family rejection. "They don't want me because I am gay," he said.
Ernie was always blind in one eye and never learned to read or write, but now finds enjoyment in listening to books on cassettes.
"Without Health Connections, I would be lost, invisible," he said.
Regarding a reported rise in AIDS cases recently, Danny and Darnell, who are both gay, said they think many young people don't think much about the future, so they abuse alcohol or drugs, and thereby lose their inhibitions and risk unsafe sex.
Social worker Frank Salerno is critical of recent advertisements for AIDS medicines, because he thinks they promote complacency about the disease.
"The ads show healthy, muscular people climbing mountains, but they don't have pictures of my patient [in the hospital] with a tube or another patient taking 39 pills every day to stay alive," Salerno said.
Keillor pointed out that AIDS is not just a gay disease. He said that in the non-Western world about 95 percent of the cases are transmitted heterosexually, and that, in this country, the incidence of AIDS among heterosexuals is spreading.
According to Keillor, about 20 percent of Health Connections' clients today are women. One of Colling's clients was prostituting even though she had the disease, and another client is a heroin addict, who has been in and out of prison, while trying to beat her addiction.
A new client is pregnant, with diabetes and serious mental health problems. She is now in a special clinic awaiting the birth of her baby. Doctors say the baby may be born with AIDS, in which case Health Connections will become involved in helping the family unit.
"We have to really hold our judgments back," Keillor said, about working effectively with some clients.
The social workers have noticed an increasing number of HIV cases among heterosexual women, especially at the lower socio-economic levels and in certain minority groups. Social workers interviewed for this article said that in those communities, some women are not empowered to insist that their partners use condoms.
Bennett is one of the luckier women. Her T-cell count is now up to 454, from a low of 180. She said she thinks that her medication is helping her stay well, but that the Health Connections staff and her powerful mental attitude have also made a big difference.
For Colling and the other social workers and nurses, it is not important how someone got the disease.
"Before I took this job I never even thought of AIDS or HIV that much, but these are human beings who are sick," Colling said. "I guess I think of the illness a lot like cancer or any other disease. At least half of my clients acquired the disease through some sort of surgery in the late '70s or early '80s. "
Regarding a cure for AIDS, Keillor is not optimistic, but he said there will probably be an immunization against it one day, though not soon enough.
"There are a lot of people out there who have had the virus for 15 years without any problems, without any cocktails," Keillor said. "I think they perceive themselves, and we perceive them, as just walking time bombs, They are not safe insofar as they can spread the disease, and sooner or later, whatever kicks the virus off will eventually happen to them."
For more information about Health Connections, call 408.961.9850 or visit www.healthconnections.org.
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Campbell, California
