Dr. Raymond J. Hauser, who recently retired after spending his entire 38-year medical career at The Lutheran Home at Topton, admits that he “wasn't very enthusiastic” about entering the field of geriatric medicine when he first started out as a physician.
"A third-year resident finishing his training introduced me to his 15 nursing home patients and that was the extent of my formal geriatrics education," Hauser says, chuckling at the memory. “I’d get a call reporting that ‘The patient isn't quite himself,’ and it was difficult obtaining more information from the patient or nursing staff. I really struggled caring for those patients that year.”
In fact, geriatrics was still a relatively new field without specialty status when Hauser, now 67, came to Topton in 1977.
“I started as a staff physician right out of my residency and all of a sudden I had more than 200 nursing home residents to care for,” he says. “Fortunately, Pastor Paul Buehrle, executive director of The Lutheran Home at the time, said, ‘Whatever you need to practice the best geriatric medicine you can, we’ll get it for you.’”
Armed with textbooks and journals, combined with information gleaned from attending conferences and his on-the-job experience, Hauser not only became certified in geriatrics with the first group of geriatricians in the United States in 1988, but also was invited to be a member of the test construction committee to write the Certificate of Added Qualifications in Geriatric Medicine exam from 1992 to 1996—a career highlight that he still describes as “incredible.”
Another highlight, he adds, was training second-year Reading Hospital Family Practice residents in geriatrics for 17 years, which in 1987 earned him and his partners the “teacher-of-the-year” award.
When a bicycle mishap left him with several broken bones, he was back to work in four days, making his rounds in a wheelchair!
Hauser, who became Topton’s medical director in 1979, marvels at the transformation he’s seen in nursing home care. He notes that the community’s first computer—given to him in the early 1980s by the appreciative daughter of a patient—had only 640K of memory and dual floppy disc drives.
“This was before the Internet, of course, but we were able with use of a modem to do literature searches from the National Library of Medicine database. We actually managed to do quite a lot with that computer—when the accounting department at the Home wasn’t borrowing it!”
As for changing roles in patient care, he says that in “the old days,” most people went to nursing care centers to spend the rest of their lives there.
Back then, he continues, the general attitude across the industry was: “‘What can you do for these patients who are basically here to die?’ Well, it turns out there’s a lot you can do. If you take the time to identify and treat their chronic health problems, you can do plenty to improve their overall functional status and quality of life.”
Moreover, he adds, expanding types of care such as memory-support, personal care and a focus on both in- and outpatient rehabilitation, with the goal of returning people to their homes, have transformed the industry.
Hauser, who also served as a staff physician at Luther Crest, a Diakon Continuing Care Retirement Community in Allentown, Pennsylvania, from 1983 to 2002 and as medical director there from 2000 to 2002, is quick to point out that he’s leaving with “mixed feelings,” particularly when it comes to the friendships he’s made with both residents and staff.
“The patients have been great,” he says. “They’re sad to see me go, but they've been very supportive about my decision and have told me to enjoy my retirement.” He stresses, though, that he’ll also miss the “hard work and devotion” of Topton’s nurses and nursing assistants.
The physician says that he and his wife, Pat, plan to spend more time with their grandchildren in Connecticut and will probably do some traveling.
He’ll also keep riding his bicycle about a hundred miles each week, despite a nasty crash in 2014 that resulted in broken ribs, pelvis and sternum—but that kept him out of commission only briefly.
He smiles at the memory, noting, “I was really banged up, but I was back to work in four days, making my rounds in a wheelchair!”
In fact, “I've missed very little work over the years and it’s been wonderful. I've really enjoyed it here. It’s been home for me.”