Dr. Jeffrey Brenner and Camden Coalition Staff

The power of love: A provider story

Margarita Santiago cheers on her patients and staff at STARS Adult Medical Day Care

Margarita Santiago worked in the hospice industry for seven years, providing care for patients and their families at the end of life. Three years ago, she was working for the Camden Coalition as an enrollment specialist, enrolling the very first patients into our ongoing Randomized Controlled Trial. Now she is the co-owner and Director of Operations of STARS Adult Medical Day Care, a new long-term care option for patients with complex health and social needs in Camden, and one of our community partners. There’s one thing, she says, that has united all three stages of her career: love.

“When I worked for the Coalition, over three years ago, in my interviews, they asked me how I engaged at the bedside,” Margarita says. “And I said, ‘Everyone that I approach is my sister, my brother, my mom, my grandparent.’ It’s easy to love someone that you consider family. But if you treat them like an outsider, that’s when the walls come up.”

Opening STARS was a years-long dream for Margarita. When working in hospice, she saw many adult day care facilities that provided basic services, but she saw that many patient needs— for cultural connectivity, for engagement, for community— weren’t being met.

“We invested all of our life savings in here,” she says, “because we believe in Camden and we believe in this population, and I feel that they’re left behind. It’s easy to talk about the underserved population, but what are we doing to fix the problem? What are we doing to give them quality of life and the proper care that they need?”

Margarita knows that cultural connection is a huge part of patient-centered care. The big back room of STARS is filled with the sounds of merengue and laughter; patients and staff dance together across the floor while another group plays dominoes in a corner. Margarita is everywhere, larger than life: cheering for the dancing patients, posing for pictures, gossiping with the domino players, checking in with staff and with her business partner, Anna, who was a probation officer for 27 years. She grabs the hands of a patient, an older gentleman in a wheelchair, and dances with him as gently and playfully as if he were her own grandfather.

Ninety percent of STARS staff is bilingual, and they have Spanish meals three times a week. “Their culture… it’s their identity, it’s who they are,” says Margarita. “I have a guy that won’t come here if I don’t serve him rice five days a week. They’re going to where they feel at home, and they feel at home here. They fit in. And they like the fact that our drivers are bilingual, that the two owners are bilingual, that we look like them. They enjoy having old-time conversations with us.”

The family-like community at STARS, along with a rigorous commitment to health literacy and care management, has led to dramatic results in patients’ health and wellbeing. Margarita talks about active seizure patients who haven’t had a seizure since they enrolled, hypertensive patients whose blood pressure is now under control, diabetic patients with “coma-level” blood sugar numbers that are now in a normal range. One patient with severe obsessive-compulsive disorder will now sign herself in in and play cards because she sees the other patients and staff as her family.

But the patient she talks about the most is Nicolas, a Camden Coalition patient who was one of the highest utilizers of emergency department services in the city. Nicolas had 55 emergency department visits in the six months before our team connected him to transitional housing through the Interfaith Homeless Outreach Council and to STARS’ daytime programming. In the seven months since he’s been off the streets and going to STARS every day, Nicolas has only been to the hospital twice. In April, he got a new apartment of his own through our Housing First program. Margarita credits his dramatic improvement to having a structured and welcoming place to be.
At STARS, “he can relax, he feels safe. He feels significant,” she says. “How beautiful is it to feel significant every day? And to feel valued every day? That’s what we bring to the table. I mean, it’s not rocket science to love someone. It’s simple.”

Posted: May 9, 2017