After 25 years Roberta Merkle has left as President/CEO of Cornerstone Adult Services, a vanguard in geriatric day care that has grown to operate the Alzheimer’s center on Warwick Neck in addition to centers in Apponaug, Coventry and Bristol.

Yet Merkle is staying. She will be the architect of the relationship between Cornerstone and Saint Elizabeth Community working as Saint Elizabeth’s executive vice president of strategic initiatives. It’s a role that has her excited.

She’s not the only one.

Dr. Paul McKenney, Cornerstone president and assistant chief medical officer at Kent Hospital, says everything is perfectly aligned. He said it is the right timing, the right partnership with Saint Elizabeth and the right person. He cites Merkle’s abilities to plan, her knowledge of the health care providers network and advocacy. Merkle also holds a law degree and her legal skills are seen as integral to the newly created job. Cornerstone and Saint Elizabeth signed an affiliation agreement last April.

“Her emphasis has always been on what’s best for the client,” McKenney said.

What he sees is a continuum of care where the elderly can transition between Cornerstone and Saint Elizabeth and they and their families know the support systems are there for them. It could be as progressive as a client going from day care to assisted living and then nursing care. Yet there is the flexibility for patients to move within the system, for example leaving nursing care to return home and go on day care.

“It’s accommodating people according to their needs,” he said.

“No one has been more involved over the last two decades with issues confronting the care and well-being of Rhode Island’s elders. She knows how to build relationships from grassroots to the State House,” said Steve Horowitz, president/CEO of the Saint Elizabeth Community, in a statement.

“Things are changing so rapidly, getting Roberta’s perspective is so helpful,” Horowitz said yesterday.

With an aging population, Horowitz foresees an increasing demand for workers trained in caring for the elderly.

“The problem is going to be getting enough people to care for the people,” he said.

In addition to addressing such issues, the two organizations are also looking for operational efficiencies.

Merkle describes her role as streamlining and strengthening both organizations, “an architect of new opportunities and making them happen.”

The late Rev. P. Bishop Covel, pastor of Warwick Central Baptist Church hired Merkle as director of the Central Geriatric Day Care Center. Founded by the church and operating from the church basement, the center was one of the firsts of its kind in the country to offer day care services for the elderly.

“It’s the Energizer Bunny; it still keeps on going,” Merkle says of the facility that continues to this day to operate from the church.

At the time, Merkle had not yet discovered her passion for working with the elderly. Until that point she had worked with abused women. She gave Covel a two-year commitment. Under Merkle’s guidance, the geriatric center then serving about 40 clients with a staff of nine grew into Cornerstone operating four facilities serving 260 clients with a staff of 50.

She doesn’t envision the need lessening.

She expects the demand for day care to grow as people choose to live at home. She sees her job as facilitating a discussion between the boards and staffs of Saint Elizabeth and Cornerstone of “how best can we use the resources we have.” With those strengths and opportunities defined, she aims to identify how best to use the facilities of the two organizations and seek grants to make it happen.

Saint Elizabeth operates assisted living and nursing and rehabilitation facilities in East Greenwich, Bristol and two in Providence. It is bigger than Cornerstone, serving more than 250 with nursing care, 69 residents in assisted apartments and independent living for about 70 people with mobility impairments.

Merkle’s new job is really an extension of what she has been doing at Cornerstone.

“It is the vision of the board to take the organization and grow and develop is what has kept me here,” she said.

Merkle’s grandmother also had a lot to do with it.

Her grandmother suffered from dementia, although at the time Alzheimer’s was not recognized. Every morning her grandmother would get her street coat and wander if not restrained. Merkle now understands what was happening. Her grandmother was a devout Catholic and the ritual of attending morning mass was so ingrained that, although she could not articulate what she was doing, she was going through the motions.

Using that experience, Merkle separated clients exhibiting memory loss from others at the day care center. They were introduced to a slower program that later became the forerunner to the Alzheimer’s center Cornerstone operated from a former church on Warwick Neck. That property became the site for the current center. It is also where Saint Elizabeth will build a 34-unit affordable housing unit for the frail independent elderly. Ground for the $5.2 million project, funded by a HUD grant, is to be broken in April.

Merkle continues to operate from her current office in Warwick to ease the transition at Cornerstone where Dottie Santagata, director of Day Services for the past nine years, will take over as administrator.