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CAREGIVER SOLUTIONS 2013 PUBLISHER Donna K. Anderson EDITORIAL Vice -President & Managing Editor Christianne Rupp Editor Megan Joyce CONTRIBUTING WRITERS Barbara Trainin Blank Richard Cheu Claire Yezbak Fadden Marielle Hazen Stephanie Kalina-Metzger Dr. Linda Rhodes ART DEPARTMENT Production Coordinator Renee McWilliams Production Artist Janys Cuffe SALES Account Executives Karla Back Angie McComsey Jacoby Valerie Kissinger Doug Kline Ranee Shaub Miller Sue Rugh Sales & Event Coordinator Eileen Culp ADMINISTRATION Business Manager Elizabeth Duvall

Dear Readers, Throughout this past year, a number of my friends have become more involved in the care of a parent. It’s carried out with love and compassion and the desire to ensure their loved one’s comfort and safety. They’ve had to deal with money matters, safety concerns, and health issues. And I have seen the consequences of them trying to keep up with their careers, their family affairs, their new caregiving responsibilities, and, lastly, themselves. As the saying goes, “You don’t know what you don’t know.” This edition of Caregiver Solutions, includes information that can help caregivers make more informed decisions and become aware of programs and services that are available in their community. Many caregivers find that they have had to sacrifice advancement opportunities in their careers. We have included an article that talks about options you may want to consider the next time a career opportunity arises so you can realistically consider it. You have frequently asked questions. Caregiver Solutions has answers to those questions, with information about waivers and programs that may benefit your loved one, information about the Caregiver Support Program, an article that broaches the topic of how to pay for nursing-home care, and other relevant topics. An important feature in Caregiver Solutions is the Directory of Providers and Services. Whether you’re considering a move or some type of care or assistance for your loved one, please check it out. The organizations included are eager to discuss how their services can help in your caregiving responsibilities. Your situation is unique to you, but you don’t have to be alone in your journey. Look to your local Office of Aging; they have a wide range of people and programs to assist you. Join a support group; hear from other people whose experiences are similar to yours. Read what you can, whether it’s in print or online (use only reliable sources, though). And most importantly, don’t forget to take care of yourself and your needs.

Christianne Rupp, Editor

Contents 2013 4

Working Families: Setting Realistic Expectations

Understanding Hospice Care: What it Is and What it Isn’t

Frequently Asked Questions by Caregivers

Improving the Mental Health of Chronically Ill Patients

Easing the Discomfort in Alzheimer’s Patients

Resources

Directory of Housing & Care Providers

Directory of Ancillary Services

Support and Information

Project Coordinator Loren Gochnauer Copyright © 2013 On-Line Publishers, Inc. All rights reserved. All listings and advertisements have been accepted for publication on the assumption that the information contained in them is true and accurate and that all merchandise or services offered in the advertisements are available to the customer according to the conditions warranted therein. The appearance of advertisements or products or services does not constitute an endorsement of the particular product or service. On-Line Publishers, Inc. disclaims any and all responsibilities and liability which may be asserted or claimed resulting from or arising out of reliance upon the information and procedures presented in this guide.

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Paying for Nursing Home Care

The Pennsylvania Caregiver Support Program

Reducing the Risk of Falls in the Elderly

Simple Solutions

Federal and State Waivers and Programs

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Working Families: Setting Realistic Expectations By DR. LINDA RHODES

One major cultural shift we haven’t talked about is the impact that women in the workforce have on how families provide care. This matters because the majority of caregivers are women, many of whom are thrown into a juggling act that they simply can’t withstand. Raising kids, sustaining a marriage, and maintaining a career is enough for anyone’s plate, but add caring for one or two aging parents (which, on average, consumes about 20 hours a week), and you can expect the juggling act to end with a crash. Men, too, are increasingly becoming caregivers, but the majority are in their mid-70s and are caring for an ailing spouse. Most baby boomers providing care to parents are working, and their employers report that their work productivity is lessened by nearly 20 percent; they also suffer from higher levels of stress, depression, and health problems than their colleagues who don’t have parents needing care. If you are a working caregiver, you might have had or are considering a number of alternatives to help you balance your family life with your job. Some of these might be the following: • Letting go of advancement or promotion opportunities • Reducing hours to part time • Asking for or finding a less demanding job • Passing up extra shifts that would earn more money • Turning down new training opportunities that require traveling out of town 4

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• Expending all your personal leave, sick days, and vacation days to provide care • Taking unpaid leave (Family Medical Leave Act) • Resigning from your job Because of the 2008 economic downturn, many workers are reluctant to take time off work to provide caregiving because they are afraid of losing their jobs, or they can’t afford to lose the wages. On the flipside, some families are taking an extra job just to pay for the out-of-pocket costs associated with providing care. In any event, before you take drastic steps, especially quitting a job, be aware that women who leave a job during their working years to provide full-time caregiving are 2.5 times more likely to live in poverty once they reach retirement age than women who remained in the workforce. These women can expect to lose an estimated $659,000 in wages, Social Security, and pension contributions, as well as lost coverage for healthcare insurance over her lifetime (source: AARP Policy Institute). My guess is that your parents certainly don’t want this for your future, so consider taking these steps to achieve balance between your job and caregiving: 1. Talk to your supervisor about your situation. If you employer has an employee assistance program, explore your options. Because of the huge numbers of workers faced with caregiving, companies are offering more assistance to their employees. www.BusinessWomanPA.com

2. Explore whether you can complete any of your work at home instead of at the office (telecommuting). 3. Ask how you can use the Family Medical Leave Act and how it can best complement the days you have accumulated for vacation and personal leave. 4. Research opportunities at work, such as splitting your responsibilities with another coworker (job sharing) in a similar situation or devising a more flexible schedule (flex time). 5. Ask your human resources department whether it offers any information and referral services to help you track down benefits and resources to care for your aging parent. Human resources also might provide the services of a geriatric care manager to help you create a caregiving plan. 6. Look into the option of using an adult day center that offers therapeutic and social activities for your parent while you are at work.

7. If you have siblings, create a Caregiving Resource Assessment worksheet showing how this impacts your job (for example, days you’ve been off work, lost vacation days, and so on). Discuss how they can help. For example, you all might contribute to covering a nonmedical senior care aid to assist or pay for adult day center services. It’s best to explore all your options at work before you walk away from your own economic security, so necessary for your older years. Don’t wait for your work performance to start slipping before you approach your supervisor.

Excerpted from Dr. Linda Rhodes’ new book, The Essential Guide to Caring for Aging Parents. Please see a review of her book on page 28. Dr. Linda Rhodes, a former secretary of aging for the state of Pennsylvania, is a Patriot-News columnist, gerontologist, and author of Finding Your Way and The Essential Guide to Caring for Aging Parents (Penguin Group 2012). Go to www.lindarhodescaregiving.com to learn more about her book and receive free resources and videos.

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Improving the Mental Health of Chronically Ill Patients By RICHARD CHEU A diagnosis of chronic illness unleashes many negative emotions in the patient: fear, anxiety, despair, anger, and grief. If these negative emotions are not addressed and dealt with when they first appear, the patient may become focused on the past and grieve for what has been lost: a better job, a child’s graduation, a special vacation, or retirement. It is important to control, reduce, and eliminate this emotional baggage before it immobilizes the patient and prevents 6

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them from moving forward to a meaningful and fulfilling life. The caregiver is at the core of a patient’s care. She/he often knows more about the personality, habits, and lifestyle of the patient than anyone else. The caregiver can encourage the patient to take responsibility for her/his mental, physical, and spiritual health. When confronted with a serious problem, most people instinctively know the best solution to the problem. They are faced with three possible actions: “do it,” “don’t do it,” or “I’ll think about it.”

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Many patients will prefer the last option and choose to procrastinate until it becomes too late to achieve the best possible results. If the patient, however, is given an opportunity to express and discuss the problem and alternative solutions, she/he often will choose to do what is right no matter how distasteful it may seem. The caregiver can be the means by which the patient confronts and conquers the negative emotions that are preventing her/him from moving forward with treatment and achieving a greater quality www.BusinessWomanPA.com

of life. The caregiver does this by becoming an active listener. The usual conversation between two people, especially at cocktail parties, consists of two people talking “at each other,” each trying to tell her/his story without really understanding or, perhaps, not caring about the other person’s story. Active listening is a method of listening in which the listener focuses on what the speaker is saying, tries to develop an understanding of the meaning of what has been said, and responds to the speaker through encouraging body language, such as a nod of the head or smile. This encourages the speaker to continue talking openly about important or troubling issues. The listener does not tell her/his own story, does not make any judgments about what the speaker says, and concentrates on helping the speaker to express her/his most important feelings and thoughts. In other words, the listener engages the mind and disengages the tongue. Five Tips for Helping Caregivers to Become Active Listeners • Avoid an environment with distractions such as a window onto a busy street, noise, or frequent interruptions. Sit close to the speaker and look directly at her/him. This body language tells the

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speaker that you are interested in what she/he is saying. If the speaker is in bed, don’t sit on the bed. Sit in a chair beside the bed, sit upright, and lean toward the patient; these are signs of attentiveness to what the speaker is saying. • Take mental notes. As the speaker speaks, try to summarize what is being said. Pause the conversation periodically to review with the patient what has been said. Keep mental notes of where the discussion began, is now, and how it ends. At each pause, say something that asks the speaker if you understand what has been said thus far. “I think you are saying …” or “Do you mean that …?” • Begin the conversation by asking about some aspect of the patient’s life before chronic illness. “What was it like when …?” “What did you do before you retired?” Allow the patient to direct the conversation to topics and concerns of greatest interest. • Use silence to the patient’s advantage. Most people are afraid of a lull in a conversation; five seconds seems like five hours. Be patient and wait for the speaker to resume speaking. Look for signs that the speaker is thinking hard about what to say or how to say

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something very important. Use body language to show that you continue to be interested and are not in any hurry, such as a nod or smile. The speaker will let you know when the conversation is over. Like a 911 call, “Be the last one to hang up.” • Know yourself. Are you an extrovert or introvert? Either personality type can become an effective active listener if the listener is aware of the barriers to good listening associated with her/his personality type. Extroverts have no problem talking. In fact, they often talk too much and don’t pay enough attention to what the other person is saying. Introverts, on the other hand, don’t like to speak until they are certain that what they will say is correct. Silence is not a problem for an introvert. The biggest challenge for an introvert can be starting a conversation or keeping it going when the speaker is also an introvert.

Richard Cheu, author of Living Well with Chronic Illness a Practical and Spiritual Guide, is a Catholic hospital chaplain, a caregiver for his chronically ill wife, and was a neurophysiologist and an EMT. Please see a review of Richard Cheu’s book on page 28.

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Paying for Nursing Home Care By MARIELLE HAZEN

Admitting a loved one into a nursing home is stressful and emotionally draining. Compounding the stress and heartbreak is the daunting task faced by the spouse and family members: navigating the complicated maze of Medicare, Medicaid, and private insurance rules associated with paying for nursing home care. The costs of long term-care can be financially devastating. Getting competent planning advice from an experienced attorney as early in the process as possible is very important to protect your rights and ensure that you access all available public and private benefits. It is a common misconception that any planning to protect resources for the spouse or other family members must be done five years before admission into the nursing home. This is simply inaccurate. In most cases, even after admission into the nursing home, it is not too late to do planning to protect resources for the spouse or family members of the nursinghome resident. Many people mistakenly believe that Medicare will cover the cost of nursinghome care. Medicare coverage for nursing-home care is actually very limited. Medicare is a federal health insurance program for individuals 65 years of age or older, certain younger 8

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individuals with disabilities, and individuals with end-stage renal disease. Medicare is not a means-tested program. Generally, you are eligible for Medicare if you or your spouse worked for at least 10 years in Medicare-covered employment. Medicare Part A benefits cover nursing-home costs when both the following limited conditions are met: 1. There must have been a three-day hospital stay within 30 days of being admitted into the nursing home. 2. You must require skilled care, which means you need skilled nursing or rehabilitation staff to treat, manage, observe, and evaluate your care. If you meet the criteria for Medicare coverage of your nursing-home stay, the benefits will be limited to 100 days of coverage. Under Original Medicare, as long as you continue to meet the qualifications, the full cost of care will be covered for the first 20 days, and then for days 21-100 there will be a copayment. For 2013, the daily co-pay amount is $148 per day. Many supplemental insurance plans cover this copayment. After 100 days, Medicare coverage ends. Note that for people with Medicare

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Advantage Plans, the costs may be different. It is a common misconception that upon admission into the nursing home, all assets have to be turned over to the nursing home. This is not the case. Rather, after exhausting any Medicare and private insurance benefits, you are required to pay privately from your income and resources until you qualify for Medicaid. Unlike Medicare, Medicaid is a state and federal program that will pay nursing-home costs for people with limited income and assets. In Pennsylvania, the Medicaid program is administered by the Department of Public Welfare. In order to qualify, you must meet all of the following requirements: • U.S. citizen/resident alien • Resident of Pennsylvania • 65 years of age or disabled or blind • Require nursing-facility care • Meet financial-eligibility requirements outlined below For single individuals, financially qualifying for Medicaid means assets have been depleted to between $2,000 and Continued on page 10 www.BusinessWomanPA.com

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Paying for Nursing Home Care Continued from page 8

$8,000. Most assets are countable for Medicaid purposes, including, but not limited to: property, bank accounts, investment accounts, retirement accounts, deferred annuities, and the cash value of life-insurance policies. Up to $536,000 in equity in the primary residence of a single nursing-home resident can be excluded if the nursinghome resident intends to return home. This is not a way of protecting the residence, however, because when the nursing-home resident dies, depending on how the property is titled, it may have to be sold and the proceeds used to repay Medicaid benefits through the Estate Recovery Program. Estate Recovery is described in more detail below. For married couples, the financialqualification rules are more complicated.

The spouse of a nursing-home resident (the “community spouse”) is entitled to keep certain excluded resources, including the residence, one automobile, tangible personal property, and his or her qualified retirement accounts. Most other resources are considered available resources. In addition to the excluded resources, the community spouse is entitled to keep one-half of the available resources, provided one-half doesn’t exceed a maximum number, which is currently $115,920. For example, if the total available resources is $50,000, the share for the community spouse will be $25,000. If the total available resources is $500,000, the share for the community spouse will be $115,920 because that is the maximum. This maximum number is subject to

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change every year. After the death of a Medicaid recipient, the Department of Public Welfare will seek to recover benefits paid out from the estate of the Medicaid recipient. This program is called Estate Recovery, and it applies to individuals who were 55 years or older at the time assistance was received. In certain hardship situations, DPW will waive the recovery claim. Pennsylvania’s Estate Recovery Program currently applies only to assets owned solely by the Medicaid recipient at the time of his or her death. As mentioned above, a home owned by a Medicaid recipient at the time of his or her death would be subject to Medicaid Estate Recovery. However, if the home is owned jointly by the Medicaid recipient and a community spouse as tenants by the entireties, and if the Medicaid recipient dies first, under current law the home would not be subject to Estate Recovery, even after the death of the community spouse. In this same situation, if the community spouse dies first, the home would become an available asset of the Medicaid recipient and would be exposed to nursing-home costs and Estate Recovery. The importance of comprehensive planning with an experienced attorney to protect resources for your family and minimize exposure to Estate Recovery cannot be overemphasized. There are many exceptions and exclusions in the Medicaid rules that allow resources to be protected for a community spouse and other family members. Getting advice from an experienced attorney as early in the process as possible is very important to protect your rights and the financial security of your family.

Marielle Hazen is a Certified Elder Law Attorney and owner of Hazen Elder Law, an estate planning, elder law, and special-needs planning law firm. More information can be found at www.HazenElderLaw.com.

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The Pennsylvania Caregiver Support Program There are approximately 52 million Americans serving as caregivers of older adults. Adult family caregivers caring for someone 50+ years of age number 43.5 million, and 14.9 million care for someone who has Alzheimer’s disease or other dementia. Americans are living longer, and as the population ages, the number of caregivers will also continue to rise in the coming years. Caregivers are an essential element in our healthcare system, accounting for about $450 billion worth of unpaid labor in the U.S. in 2009. Caregiving already has become the new norm for many, as we find ourselves helping loved ones who are disabled, frail, or suffering from Alzheimer’s disease, Parkinson’s disease, and kidney and liver diseases,

Benefits & Services for Caregivers

which have been on the rise. Daughters are more likely to provide basic care (i.e., help with dressing, feeding, and bathing), while sons are more likely to provide financial assistance. A number of studies have shown that women caregivers are more likely than men to suffer from high stress due to caregiving. The major focus of the Pennsylvania Caregiver Support Program is to reinforce the care being given to people over the age of 60 or adults with chronic dementia. To determine what your particular needs are, both the caregiver and receiver, the package of benefits begins with an assessment. You could also take advantage of other benefits available such as counseling, education, and financial information.

Assessment Criteria (Federal and State)

• Assessment of caregiver and care recipient needs • Counseling on coping skills • Respite care

State No**

Federal No

Caregiver must be related to the care receiver.

Household income of care receiver is used to determine eligibility.

Yes

Care receiver must require assistance with two or more ADLs.

No (1)

Yes (2)

Maximum amount of monthly reimbursement for caregiver expenses (depending on reimbursement rate chart) is:

$200

$300

Maximum amount of reimbursement for home modification/assistive devices (depending on reimbursement rate/cost-sharing chart and availability of funding) is:

$2,000

Information to caregivers includes advice on how to access: individual counseling, locations of local support groups, and caregiver training to assist caregivers in making decisions to solve problems related to their caregiving role.

Yes

Caregiver must provide daily hands-on caregiving to care receiver.

Yes

Caregiver must reside in the same household as care receiver.

• Training in caregiving skills • Home chore caregiving skills • Financial assistance to purchase supplies or services • One-time grant for home adaptations • Benefits and counseling on services available through local, state, and federal programs • Referrals to family support or disease-specific organizations such as Children of Aging Parents or the Alzheimer’s Disease & Related Disorders Association • Assistance in completing benefits and insurance forms

Eligibility If you are age 18 or older and the primary caregiver* of a functionally dependent person who is age 60 or older, you may be eligible for assistance. If you are age 18 or older and the primary caregiver* of a relative who is age 18 to 59 with dementia, you may be eligible for assistance. If you are age 55 or older and the primary caregiver* of a relative who is age 18 or younger and lives with you, you may be eligible for assistance. *A primary caregiver is the “one identified adult family member or other individual who has assumed the primary responsibility for the provision of care needed to maintain the physical or mental health of a care receiver and who does not receive financial compensation for the care provided.” For specific program information, please contact your local Area Agency on Aging.

**Unless care receiver is 19-59 years of age with dementia or other disability. www.BusinessWomanPA.com

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Understanding Hospice Care: What it Is and What it Isn’t By CLAIRE YEZBAK FADDEN I was at the medical center near my home when the administrator of my mother’s board and care introduced the word “hospice” to me. In her gentle way, she was getting me acquainted with the term. I had heard the word before. It was used for situations that wouldn’t have a positive outcome. Just hearing her say hospice made me afraid. She and I were in the doctor’s office with my mom.

For some 10 years, my mother had suffered from Alzheimer’s disease. She was in the late stages of the disease. That’s when Mom’s doctor told us “everything that could be done medically was being done. The truth is,” the doctor said, gesturing toward my 89-year-old mother, “we are moving in the direction of comfort care.” Since that meeting, I have learned a lot about hospice care. The most important lesson is that having hospice intervention for my mom didn’t mean that I had given up on her. It meant employing a level of care designed to improve her quality of life, even at its end. It meant that I sought optimal physical and emotional comfort for her in a way that minimized her pain. In fact, due in part to the efforts of the hospice care workers during the next 16 months, my mother’s quality of life improved. I believe their care extended her life. What is Hospice Hospice dates back to medieval times when travelers, the sick, wounded, or

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dying would seek a place for rest and comfort. Today, hospice offers a comprehensive program of care to patients and families facing a life-limiting illness. Hospice is primarily a concept of care, not a specific place of care. Hospice emphasizes palliative rather than curative treatment, quality rather than quantity of life. Its goal is to relieve and soothe the symptoms of a disease or disorder without affecting a cure. Who’s Involved Hospice care involves teamwork between the caregivers and the family. Working with the patient and the patient’s family, a care plan is outlined. Emotional, spiritual, and practical support are given based on the patient’s wishes and family’s needs. The hospice physician, nurses, aides, social workers, clergy, volunteers, and other professionals work together to ease the difficulties and uncertainties of the dying process. How to Decide At any time during a life-limiting

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illness, it’s appropriate to discuss all of a patient’s care options, including hospice. By law, the decision belongs to the patient. If your loved one is unable to make medical decisions, a relative or friend must have a durable power of attorney for healthcare issues to be able to authorize any medical-related services. The requirements to be hospiceappropriate include: • The patient must be diagnosed with a terminal illness by a physician. • Because of the illness, the patient is considered to have a life expectancy of six months or fewer, if the disease runs it normal course. • The patient must sign a statement acknowledging that they choose hospice

treatment over curative treatment for their terminal illness. Understandably, most people are uncomfortable with the idea of stopping aggressive efforts to “beat” the disease. Hospice staff members are highly sensitive to these concerns and always available to discuss them with the patient and family. A patient who needs hospice care exceeding six months can remain in the program. Is Hospice Care Covered by Insurance? Hospice coverage is widely available. It is provided by the Medicare Hospice Benefit (under Medicare Part A, or hospital insurance) and by most private insurance providers.

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To be sure of coverage, check with your employer or health-insurance provider. It covers medical services, medications, durable medical equipment, supplies, and treatments related to managing your lifelimiting illness and approved as part of your individual care plan as stated above. It’s comforting to know that hospice affirms life and regards dying as a normal process. Its goal is to neither hasten nor postpone death. For more information on local hospice services, and to determine if your loved one is “hospice appropriate,” contact your healthcare provider and your insurance carrier.

Claire Yezbak Fadden, a freelance writer, is comforted by the team of hospice workers who provided comfort care for her mother.

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Easing the Discomfort in Alzheimer’s Patients

Esther Cohick, an Asper Unit team member, enjoys a moment with her mother, Anna. A resident of Messiah Lifeways’ Asper Unit, Anna enjoys her music.

By BARBARA TRAININ BLANK At present, Alzheimer’s is unpreventable and incurable. But that doesn’t mean the situation is hopeless. New approaches to individuals suffering from the disease and other forms of dementia can make their lives more fulfilling and help caregivers reach out to them more effectively. Sounds of Music It’s long been known that music therapy offers benefits to individuals with challenges by addressing their physical, emotional, cognitive, and social needs

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through music. It has also been observed that people with dementia seem to respond to music, often remembering lyrics despite memory limitations. At Messiah Lifeways (formerly Messiah Village), a community for seniors over 55, the Asper Unit for individuals in advanced stages of dementia has implemented a music program with a twist. The unit has provided iPods to each of its 53 residents so they can listen to the music they like and might soothe them best. The staff turns on the iPods, but they can be clipped onto the shirts of residents, who have access to the handset. The iPods were purchased in the fall

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through a special fundraising drive, according Krystal Robinson-Bert, a neighborhood enrichment specialist at Messiah Liveways. The response has been enthusiastic. “No one doesn’t enjoy the earphones,” Robinson-Bert said. With the help of family members and staff, residents can personalize playlists, which gives them a sense of autonomy and the chance to listen to music they’re familiar with and holds pleasant memories for them. They can make the music louder or softer at will. The staff at Asper has learned to be in touch with the “signals” of residents to www.BusinessWomanPA.com

New approaches to individuals suffering from Alzheimer’s and other forms of dementia can make their lives more fulfilling and help caregivers reach out to them more effectively.

recognize when music will be helpful, said Robinson-Bert. Esther Cohick, an Asper Unit team member, has seen an enormous change in residents since the program was launched—including her mother. Cohick has seen her mother’s “whole life” changed by having an iPod. “This has been a wonderful thing, very therapeutic,” Cohick said. “My mother has anxiety and trouble with transitions. If she has that perplexed look, or if she’s bored or restless and wants to listen to music, she can play the iPod. My mom likes patriotic songs and hymns, and

she’ll start to sing all the verses of the music.” The iPods don’t take the place of group music programs common to senior communities. But during downtimes in the schedule, they allow residents to “initiate” listening and change their playlists at will. Moreover, group settings may not provide the opportunity for team members to draw out the individual musical tastes and preferences of residents. As Cohick knows, family involvement in the program is “really key,” because

their loved ones know what the residents like to listen to. “I see that when I visit her and she’s listening to music that she’s happy,” she said. “I can even hear her singing before I come in. Sometimes she dances. Music breaks up the boredom and relieves anxiety, and it stirs memories.” The iPod program was initiated because of family members, in fact; some had seen media coverage of a similar program at Bethany Village. Improving Communication Dementia residents may become

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Chaplain James Day talks with a dementia resident during a validation therapy session at Country Meadows.

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depressed, agitated, and hostile when they realize their cognitive impairments and try to hide them. They may have once been active socially but now spend more time alone and decline social invitations. “They have feelings and needs they can’t express,” said Ashley Uhler, executive director of program strategy for Country Meadows Retirement Communities, which assists residents with memory deficits in a variety of settings through their Connections Memory Support Services program. “If we intervene earlier, we can help these residents function better longer and not withdraw from life as much.” Family members are also saddened and frustrated by what they see as the “irrationality” of the Alzheimer’s or dementia resident and the loss of the person he or she was before. They may blame themselves for not being able to do more. One way to enhance communication between residents and their family members or caregivers is through validation therapy. Developed specifically for patients with cognitive impairment, validation therapy is based on respectful communication—hearing and acknowledging the other person’s opinions, regardless of whether or not the listener agrees with them or finds them rational. “Validation therapy means accepting the person where he or she is, not necessarily that you’re expected to experience his or her sense of reality,” Uhler explained. “It’s frustrating and degrading for the resident to be told he or she is wrong. It always ends in www.BusinessWomanPA.com

With services designed to provide positive solutions to the challenges of aging and customized schedules based on your needs with no minimum number of hours required • Bathing & Dressing • Meal Preparation & Cleanup • Medication Reminders • Light Housekeeping/ Home Support confrontation, and at the end of the day, does it really matter? The caregiver has to pick battles.” For example, if a resident starts speaking about his or her mother as though she were still alive, validation therapy would suggest that the staff member shouldn’t play along but not try to correct the person, either. Instead, the staff member can say, “Tell me about your mother,” which could stimulate several minutes of positive feelings in the resident. Staff at Country Meadows receives training in this method to help keep arguments to a minimum and preserve residents’ dignity. Family members and caregivers can also request training. “It’s not counseling, and it’s not complicated,” said Uhler. “We want the therapy to be user friendly.” Validation therapy builds trust with dementia patients, she adds. Despite their memory issues, they’re often very perceptive. “You can’t provide care if they don’t trust you. Validation therapy teaches you how to respond and how not to.” The therapy also helps residents share feelings, even if it’s nonverbally. “It’s not about making them feel better necessarily, but about allowing them to feel they’re being listened to,” Uhler said. “It’s not sympathy, which can be dismissive.” Validation therapy is not the end-alland-be-all but only one of the “tools” in the caregiver’s toolbag, she added. But it is effective in helping family members learn to “enjoy the moment”—to realize there is beauty and humor even in these situations when a loved one has dementia. www.BusinessWomanPA.com

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Reducing the Risk of Falls in the Elderly

By STEPHANIE KALINA-METZGER Statistics from a York County coroner’s report show that 54 residents aged 65 and older died due to accidents in 2012, with 49 of those deaths attributable to falls. According to the Centers for Disease Control, one in three adults age 65 and older falls each year. Of those who fall, 20 to 30 percent suffer moderate to severe injuries that make it hard for them to get around or live independently. Older adults are hospitalized five times more often for fall-related injuries than for injuries from other causes. The statistics are sobering, but with a little knowledge, 18

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caregivers can take steps to increase the chances that their loved ones remain fall free throughout their lives. One of the first steps, according to Melissa Graham, information specialist for the York County Area Agency on Aging, is to make sure that the home is safe. “Caregivers can evaluate a person’s home and take steps to reduce tripping hazards and improve lighting. If stairs have only one railing, add a second one. We also suggest that caregivers install grab bars both inside and outside of their tubs and showers and next to the toilet,” she said, adding that home assessments are often available for those who are in rehab. “They can arrange to have their home evaluated prior to being discharged.” www.BusinessWomanPA.com

Mom Deserves Better than Living Alone Graham suggests taking the health of the individual into account as well. “All the evidence shows that falls are not a normal part of aging. Those who have fallen really need to talk with their doctor as to which direction they should go. They may need a professional skills assessment to determine if physical therapy is needed or if an underlying health problem is going unaddressed,” she said. Caregivers should meet with the patient and the doctor to discuss both prescription and over-the-counter medications. “Drug interactions can cause dizziness or drowsiness, placing individuals at risk for falling. It’s also important to make sure they have their eyes tested regularly,” Graham said. Exercise is another important activity that combats the effects of aging and aids in preventing falls. “You should encourage them to exercise regularly to increase leg strength and improve balance. The exercises don’t have to be aerobic. Many can be sitting down in a chair or standing behind a chair and can improve not only balance, but strength, flexibility, and endurance,” said Graham.

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A Matter of Balance Studies show that seniors benefit from socialization, so it may be helpful to suggest a class designed to improve their balance and decrease their potential for falls. The Agency on Aging sponsors a program called A Matter of Balance. Developed through Boston University and MainHealth’s Partnership for Healthy Aging, it’s designed to help reduce the fear of falling and increase activity levels of www.BusinessWomanPA.com

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older adults who have concerns about falling. It consists of eight two-hour classes. “During this time, they learn to view falls and the fear of falling as controllable. They also learn to set realistic goals for increasing activity, while improving strength and balance,” said Graham. The classes are conducted by two volunteer coaches who are trained by the Agency on Aging, and the program is evidenced based, meaning it was developed, tested, and proven to reduce falls.

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Caregivers can take steps to increase the chances that their loved ones remain fall free throughout their lives.

Healthy Steps for Older Adults For seniors who don’t want to commit to eight two-hour classes, they can enroll in a shorter program through the

Pennsylvania Department of Aging called Healthy Steps for Older Adults. “This program has recently gone through the evidenced-based process and is offered at some local senior centers. It’s the same type of concept as A Matter of Balance, but it’s done in two two-hour workshops,” said Graham, who added that there’s also a follow-up program called Healthy Steps in Motion, which incorporates exercise. Silver Sneakers Program The Silver Sneakers Program is designed especially for seniors and offers group exercises ranging from cardio, to yoga, to classes designed to improve muscular strength and range of movement. “A lot of insurance companies will pay for this program,” said Graham. Go to silversneakers.com to locate a class near you and remember to contact your insurance company to determine coverage. Falls Free York Coalition Takes Steps to Reduce Risks

Lancaster Harrisburg (717) 569-0451 (717) 695-4472 Toll-Free (877) 254-4763

The Falls Free York Coalition was started in 2010 and is part of a national falls-free coalition to reduce the number of falls and fall-related injuries among older adults. It is comprised of healthcare providers, community service providers, community leaders, and older adults to combat the problem of falls in the elderly. “The mission is to reduce the risk of falls through partnerships, education, and awareness. Our hope is that older adults will have fewer falls and fallrelated injuries, thereby maximizing their independence and quality of life,” said Graham. “So much is being done now to combat this very serious problem among our elderly, and we want to keep that momentum going,” she added.

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Federal and State Waivers and Programs Waivers offer an array of services and benefits such as choice of qualified providers, due process, and health and safety assurances. The name waiver comes from the fact that the federal government “waives” Medical Assistance/Medicaid rules for institutional care in order for Pennsylvania to use the same funds to provide supports and services for people closer to home in their own communities. In Pennsylvania, the Department of Public Welfare administers multiple Medical Assistance/Medicaid waivers. Each waiver has its own unique set of eligibility requirements and services. AIDS Waiver Office of Medical Assistance Programs 717.772.2525 For people diagnosed as having AIDS or Symptomatic HIV; not enrolled in a managed care organization, health insurance organization, or hospice program; no age limit; requires a level of care provided in hospital, skilled nursing facility, or intermediate care facility; and is not residing in an institution or inpatient setting.

COMMCARE Waiver Office of Social Programs 717.783.8182 For people diagnosed with a traumatic brain injury; are age 21 or older; need special rehabilitation level of care; not dependent on mechanical ventilator supports; and the disability results in at least three substantial functional limitations. Michael Dallas Waiver Program for Technology-Dependent Individuals Office of Medical Assistance Programs 717.772.2525 For people in need of nursing facility level of care as certified by a physician; no age limit; technology dependent due to physical disabilities. Home and Community-Based Waiver Program for Attendant Care Services (OSP/AC Waiver) Office of Social Programs 717.705.5060 For people ages 18 through 59; requires assistance with activities of daily living due to a medically determined physical

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impairment that can be expected to last for a continuous period of not less than 12 months; mentally alert and capable of selecting, supervising, and, if needed, firing an attendant; able to manage their own financial and legal affairs; and be found in need of a basic service. Independence Waiver Office of Social Programs 717.772.2094 For people with physical disabilities; disability results in at least three substantial functional limitations; disability is expected to continue indefinitely; age 18 or older; not dependent on mechanical ventilator supports; and requires nursing facility level of care. LIFE (Living Independence for the Elderly) Lancaster County 717.381.4320 Lebanon County 717.376.1133 York County 717.757.5433 LIFE is a managed care program for elderly recipients who have been determined to need “nursing facility level of care” but wish to remain in their home and community as long as possible. The program is known nationally as the Program of All-inclusive Care for the Elderly (PACE). All PACE providers in Pennsylvania have the name “LIFE” in their name. Please note: This federal program is not the PACE prescription drug program for Pennsylvanians. OBRA Waiver Office of Social Programs 717.772.2094 www.BusinessWomanPA.com

For people with developmental physical disabilities; disability results in at least three substantial functional limitations; disability manifested prior to age 22; disability is expected to continue indefinitely; requires intermediate care facility for people with other related conditions level of care. Nursing Home Transition (NHT) Program Cumberland County Area Agency on Aging 888.697.0371

York County Area Agency on Aging 800.632.9073 The OPTIONS Program provides an intensive assessment of consumers, generally 60 years or older, and is administered by staff from the Area Agency on Aging (AAA). Combined with additional information obtained from the consumer’s primary care physician, care alternatives are identified and discussed with the consumer. Services range from those outside the home, such as nursing facility or

personal care home, to a wide array of services in the consumer’s home, such as home health, respite, environmental modifications, etc. Pennsylvania Department of Aging Waiver Department of Aging 717.787.6207 For people 60 or older; must meet nursing facility level of care criteria; and wish to be treated in own home or other community setting.

Dauphin County Area Agency on Aging 800.328.0058 Lancaster County Office of Aging 800.801.3070 Lebanon County Area Agency on Aging 717.273.9262 York County Area Agency on Aging 800.632.9073 The NHT Program assists consumers who want to move from a nursing facility back to a home of their choice in the community. Families or caregivers are fully informed of all long-term living options, including the full range of homeand community-based services, and receive the guidance and support needed to make an informed choice about their long-term living services.

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Frequently Asked Questions by Caregivers

What is the waiver program offered through the Pennsylvania Department of Aging? There are several waivers available through the Pennsylvania Departments of Aging for people aged 60 and older who meet the eligibility requirements and income limits. Under the program, home- and community-based long-term care services can be provided as alternatives to nursing care. Services are funded through a special waiver of certain Medicaid restrictions, allowing payments typically used for nursing-home care to be used for home-

care services. The consumer is able to choose which local organization or company/agency will provide the services. All service providers are certified by the Pennsylvania Department of Public Welfare to ensure that they meet Medicaid standards. Some services/benefits that individuals can be approved for are: • Adult daily living services (adult daycare) • Attendant care (personal care) • Community transition services (moving assistance) • Companion services (escort)

Personal care is quality care.

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At Juniper Village we believe that quality is knowing an individual and being attentive to their needs and wishes! We offer services that provide flexibility and individuality in defining quality of life. • Simple lease agreement for all levels of care, with no high up-front costs • Respite care, relieving caregiver stress and providing social interaction and care for the resident • Long-term residency, with our vibrant connections activities program and consistent care

From the first call and tour, to setting up a personalized schedule of activities the week you move in, to communicating with your family monthly, as a resident of Juniper Village you will become part of a family that cares for you. We invite you to become part of the Juniper family where personal care means quality and affordability. Juniper Village ... SENIOR LIVING AT LEBANON

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? • Counseling • Environmental accessibility modifications (home and/or vehicle) • Financial management services • Home health services • Home medical equipment and supplies • Meal delivery (hot or prepared) • Non-medical transportation • Personal emergency response (PER) system • Respite care services (temporary caregiver relief) See page 22 to see an overview of waivers and programs offered.

A Will – It should say what your loved one wants to do with his or her property, including how and when the assets will be distributed. Advanced Health Care Directive – This offers the assurance that your loved one’s decisions regarding his or her future medical care will reflect their values and wishes. Durable Power of Attorney for Healthcare – This gives you, the caregiver, the right to make healthcare decisions. It takes effect when a loved one becomes mentally incapacitated and is unable to

make his/her own healthcare decisions. Your agent must act consistently with your desires as stated in the document. Durable Power of Attorney for Finances – This allows a caregiver to manage their loved one’s finances and takes effect when a loved one becomes incapacitated and no longer able to pay the bills, file tax returns, manage investments, and make other important financial decisions. HIPAA authorization – The Health Information Portability and Accountability Act (HIPAA) keeps health information and records private. Your

What is respite care? Respite care provides relief from your caregiving responsibilities on a short-term basis, which could be for a day or two or even up to a month. Care may range from personal to nursing care. Respite care may be offered through a local retirement community, through home care services, and through a statefunded program, such as adult daycare programs. Respite care offers you the ability to rest, relax, and regroup, confident that your loved one is the hands of trained and qualified professionals. What are my obligations as a caregiver? As the caregiver, you should make sure your loved one is in a safe and healthy environment, whether that is their home, your home, or a nursing home. He or she should be protected from any type of abuse—physical, mental, or financial. Some documents that you should have in place are listed below. What are some of the most important documents a caregiver should have in place? The most common legal documents that every caregiver should have are: www.BusinessWomanPA.com

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? loved one must authorize in writing that you may receive their health information. Otherwise, their doctors aren’t obligated to share any details about their health with you, the caregiver. You will need to have a copy from each doctor’s office. Sign it at the office and then keep a copy for yourself and the person you’re caring for. Of course, the doctor’s office will also have a copy. What services are available from Pennsylvania Area Agencies on Aging? Area Agencies on Aging, county- or multi-county-based agencies that partner with the Department of Aging, provide a wide range of services, such as assessment of need, care management, in-home services, transportation, protective services, adult daycare, legal services, healthcare counseling, and senior centers. Services may vary from county to county, so it is wise to call your local AAA for particular services or programs. Is there someplace I can get help with drug bills for someone in my care? Many senior citizens with low incomes

are eligible for assistance with payment for their prescribed medications through PACE/PACENET programs. Who is eligible for PACE? To be eligible for PACE, you must be 65 years of age or older and a Pennsylvania resident for at least 90 consecutive days prior to the date of application. For a single person, your total income must be $14,500 or less. For a married couple, your combined total income must be $17,700 or less. Prescriptions: co-pay for generic, $6; co-pay for single-source brand, $9. Who is eligible for PACENET? To be eligible for PACENET, the qualifications are the same as PACE. However, the total income for a single person can be between $14,500 and $23,500. A couple’s combined total income can be between $17,700 and $31,500. Prescriptions: co-pay for generic, $8; co-pay for single-source brand, $15. Monthly $40 deductible.

It’s the Quality of Your Life that We Care About! At Spring Creek, our team of skilled healthcare professionals is committed to meeting your loved one’s skilled nursing needs in a beautiful home-like environment. Our short-term and sub-acute rehabilitation programs deliver resident-centered care to maximize full potential. We offer a full array of exemplary services to include: Physical, speech, and occupational therapy Respiratory services, including ventilator and tracheostomy care Nutritional services Secure Alzheimer’s community Wound care clinic

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Call your local Area on Aging office for forms or more information. What is PACE Plus Medicare? Under PACE Plus Medicare, PACE/PACENET coverage is supplemented by federal Medicare Part D prescription coverage—offering older Pennsylvanians the best benefits of both programs. Older adults continue to receive the same prescription benefits while, in many cases, saving more money. What is the APPRISE Program and where can I get more information? The APPRISE Program is a free program operated by the Area Agencies on Aging to provide health-insurance counseling and assistance to Pennsylvanians age 60 and over. They can help you understand Medicare benefits by explaining Medicare, Medicare Supplemental Insurance, Medicaid, and long-term care insurance. They can explain the Medicare appeals process, help you select a Medigap insurance policy, explain the Medicare prescription Part D benefit, and explain financial assistance programs. Call 800.783.7067 or your local Area Agency on Aging for more information. The services are free of charge. I heard that communities must now be licensed as a personal care home or an assisted living residence. Is that true? Yes, that is correct. At the beginning of 2011, personal care and assisted living can no longer be interchangeable terms. Specific requirements must be met, and communities (including retirement communities and CCRCs that offer those services) must be licensed as one or the other, although they can meet requirements and be licensed for both. www.BusinessWomanPA.com

Errands Shopping Light Housekeeping Friendly Companionship Meal Preparation Flexible Hourly Care Respite Care for Families

Do home care agencies need licenses too? Yes, home care agencies (HCAs) and home care registries (HCRs) must now be licensed by the Department of Health to provide home care services, medical and nonmedical.

Are there caregiving tax breaks I can take advantage of? You may be able to claim your loved one as a dependent on your tax return. To qualify for dependency, you must pay for more than 50 percent of your qualifying relativeâ&#x20AC;&#x2122;s support costs for the year. With changes occurring in the healthcare laws, it is advisable to check with your tax preparer to find out what you qualify for, such as medical deductions and a dependant-care credit.

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Responding to the Needs of Americans 60 and Over

What is the Pennsylvania Caregiver Support Program? Previously called The Family Caregiver Support Program, the Pennsylvania Caregiver Support Programâ&#x20AC;&#x2122;s major focus is to reinforce the care being given to people over the age of 60 or adults with chronic dementia. The package of benefits begins with an assessment to determine what benefits best meet your needs and the needs of the person receiving care. Then you will choose an option from available supportive services. Other benefits could also include counseling, education, and financial information.

Are there any other online sources for additional information? Yes. Visit www.heretohelp.pa.gov. There is an abundance of information to be found at Here to Help on the PA Government Portal. www.BusinessWomanPA.com

ADVOCACY. ACTION. ANSWERS

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Chester County 610.344.6350

Dauphin County 717.780.6130

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Resources Balancing Work and Caregiving for Children, Adults, and Elders By Margaret B. Neal, Arthur C. Emlen, Nancy J. Chapman, Berit Ingersoll-Dayton www.sagepub.com Exploring how caregivers juggle their responsibilities of work and family, the authors suggest that dependant care needs to be addressed as a corporate, family, and community concern. They present the stress factors experienced by workers caught between the conflicting demands of these two roles. Policies, benefits, and services reviewed range from approaches that intervene in the caregiving process to those that change the world of work with such alternatives as flexible working hours, child-care facilities, and tax credits for dependants. The Boomer Burden: Dealing with Your Parents’ Lifetime Accumulation of Stuff By Julie Hall www.theboomerburden.com Professional estate liquidator Julie Hall walks baby boomers through the often painful challenge of dividing the wealth and property of their parents’ lifetime accumulation of stuff. From preparation while the parent is still living through compassionately helping them empty the family home, The Estate Lady® gives invaluable tips on negotiating the inevitable disputes, avoiding exploitation from scam artists, and eventually closing the chapter of their lives in a way that preserves relationships and maximizes value of assets. I Will Never Forget Elaine C. Pereira www.iuniverse.com In her touching memoir, I Will Never Forget, Pereira shares the sometimes heartbreaking and occasionally humorous story of her mother’s journey through dementia, as seen through the eyes of her little girl. I Will Never Forget shares a powerful, emotional story that can help people affected by dementia take comfort in knowing that they are not alone. 28

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“If I Should Die Before My Dog—” Joe and Cathy Connolly www.amazon.com What would happen if you could no longer care for your dog? If he/she outlived you? Would the new caretakers know about your dog’s needs? Joe and Cathy Connolly have witnessed several pets lose their human guardians and saw how difficult it was for those pets to adjust. If I Should Die Before My Dog is a beautifully written prompted journal that enables you to share everything you would want a new guardian to know about your beloved pet in the event you were no longer able to take care of him or her. Ice Cream in the Cupboard A True Story of Early Onset Alzheimer’s By Pat Moffett www.patmoffett.com In his moving memoir, Ice Cream in the Cupboard, Pat Moffett chronicles not only his wife Carmen’s struggle as she slips away, but also his own struggle as he navigates his new role as caregiver. Thanks to his experience with Carmen, Pat believes Ice Cream in the Cupboard can be an educational tool for those who already care for someone with Alzheimer’s disease. It will make you reevaluate and renew your appreciation for the people you love. The Essential Guide to Caring for Aging Parents By Dr. Linda Rhodes www.penguin.com Written by an expert on aging who cared for her own parents and in-laws, The Essential Guide to Caring for Aging Parents leads you through the elder care maze. Learn how to spot signs that a loved one requires special attention, get advice on ways to talk to your parents about their health, help arrange for their care, and address their needs and wishes. All aspects of elder care are also discussed, including living options, insurance, legal matters, and how to become your parent’s medical and financial advocate.

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The Emotional Survival Guide for Caregivers: Looking After Yourself and Your Family While Helping an Aging Parent By Barry J. Jacobs, PsyD www.emotionalsurvivalguide.com The Emotional Survival Guide for Caregivers helps family members navigate tough decisions and make the most of their time together as they care for an aging parent. The author urges readers to be honest about the level of commitment and emphasizes the need for clear communication within the family. While acknowledging their guilt, stress, and fatigue, he helps caregivers reaffirm emotional connections worn thin by the routine of daily care. This compassionate book will help families everywhere avoid burnout and preserve bonds during one of life’s most difficult passages. Living Well with Chronic Illness: A Practical and Spiritual Guide By Richard Cheu www.chroniclivingwell.com Author, neurophysiologist, and pastoral counselor Richard Cheu tackles the impact of this surprisingly widespread problem in his new book, Living Well with Chronic Illness: a Practical and Spiritual Guide (April 2013). Cheu is intimately familiar with the care of the chronically ill. For nine years, he has been caring for his wife who has a progressive neurological disease. Drawing on his knowledge and experiences in neurophysiology, counseling, and patient care, he has been able to help her maintain a positive attitude and good health through physical and social activities.

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DIRECTORY OF HOUSING & CARE PROVIDERS Avenues Eldercare Adult Day Center 717.832.3854 1200 Grubb Road pschultz@avenuesofpa.org Palmyra, PA 17078 www.avenuesofpa.org Avenues Eldercare is a community-based program that encourages older adults to live as independently as possible in their own homes.

Bayada Home Health Care 4807 Jonestown Road, Suite 254 Harrisburg, PA 17109

717.652.1130 cbenfer@bayada.com www.bayada.com

Bayada Home Health Care provides home health aide and R.N./L.P.N. nursing services for adults in their own homes to help maintain independence. Shifts consist of three to 24 hours.

Bethany Village at Home 5225 Wilson Lane Mechanicsburg, PA 17055

717.591.8332 kbruner@asbury.org www.bethanyvillageathome.org

We provide quality in-home care services for adults 55+ in Mechanicsburg, Pa., and surrounding areas. Services are customized to the needs of each client. Private pay/LTC insurance.

The Campus of the Jewish Home 717.657.0700 of Greater Harrisburg drizio@jhgh.org 4000 Linglestown Road www.jewishhomeharrisburg.org Harrisburg, PA 17112 See ad page 16

Central Penn Nursing Care, Inc. 1910 Fruitville Pike, Suite 1 Lancaster, PA 17601

717.569.0451 mstrayer3@me.com www.cpnc.com

Providing cost-effective homecare to clients in homes, hospitals, and retirement communities. All levels — homemaker-companions, personal care aides, CNAs, RNs, and LPNs. Free nursing assessment. See ad page 20

ComForcare Senior Services Harrisburg 2330 Vartan Way Harrisburg, PA 17110

717.545.6051 harrisburgpa@comforcare.com www.harrisburgpa.comforcare.com

Lancaster 150 Farmington Lane Lancaster, PA 17601

717.824.3643 chris.lancaster@comforcare.com www.lancaster.comforcare.com

York 140 East Market Street York, PA 17401

717.718.9393 yorkpa@comforcare.com www.yorkpa.comforcare.com

Providing compassionate, non-medical care in the home by fully licensed, insured, and trained caregivers. ComForcare has supported independence, dignity, and quality of life since 1996. See ad page 7

Comfort Keepers 7A North Clover Lane Harrisburg, PA 17112

717.920.9898 ckharrisburg@comcast.net www.comfortkeepers.com

Cross Keys Village – 717.624.5350 The Brethren Home Community info@crosskeysvillage.org 2990 Carlisle Pike www.crosskeysvillage.org New Oxford, PA 17350 You will not find a stronger continuum of care or a campus with more services. Come discover our blend of values and value. See ad page 9

Elm Spring Residence 118 Pleasant Acres Road York, PA 17402

Griswold Home Care 6 West Main Street Shiremanstown, PA 17011

717.840.7676 vafolk@yorkcountypa.gov

717.975.0540 www.griswoldhomecare.com

RN-owned and operated. Serving Cumberland County for 25 years by providing personal care, homemaking, friendly companionship, and transport 24/7. Home Care Plus Award recipient 2013. (Continued next page)

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DIRECTORY OF HOUSING & CARE PROVIDERS Homeland Center 1901 North Fifth Street Harrisburg, PA 17102

717.221.7902 homeland1@pa.net www.homelandcenter.org

Homeland Center, a continuing care retirement community, offers beautiful personal care suites, skilled nursing, hospice, rehabilitation, and dementia care, all delivered by highly competent and compassionate staff. See ad page 13

Homeland Hospice 2300 Vartan Way, Suite 115 Harrisburg, PA 17110

717.221.7890 homeland1@pa.net www.homelandhospice.org

Homeland Hospice, a service of Homeland Center, provides the highest level of care and support at the end stages of life while serving as a compassionate resource for families. See ad page 13

Hospice & Community Care 717.295.3900 (founded as Hospice of Lancaster County) www.hospicecommunity.org Lancaster 685 Good Drive, P.O. Box 4125 Lancaster, PA 17604 York 224 St. Charles Way, Suite 200 York, PA 17402 Compassionate serious illness and end-of-life care and bereavement support for patients and families. Medical, emotional, and spiritual care at home, in nursing homes, hospitals, and our Hospice Inpatient Centers. Lancaster and surrounding counties and York and Adams counties. See ad page 12

Juniper Village at Lebanon 717.272.8782 1125 Birch Road tanya.flemming@junipercommunities.com Lebanon, PA 17042 www.junipercommunities.com At Juniper Village, we believe that maintaining and promoting an active body, an engaged mind, and a fulfilled spirit are keys to healthy aging. See ad page 24

Juniper Village at Mount Joy 717.492.9692 607 Hearthstone Lane liz.markey@junipercommunities.com Mount Joy, PA 17552 www.junipercommunities.com Personal care is quality care. At Juniper Village, we believe that quality is knowing an individual and being attentive to their needs and wishes. See ad page 24

Life Time Adult Day Care 3 Crossgate Drive Mechanicsburg, PA 17050

717.975.9762 jhutcheson@cparc.org www.cparc.org

Compassionate daytime care for older adults and support to their caregivers. Over 30 years of experience. Now conveniently located in Mechanicsburg. See ad page 21

Lutheran Retirement Village at Utz Terrace 2100 Utz Terrace Hanover, PA 17331 See ad page 19

Lutheran Social Services South Central Pennsylvania 1050 Pennsylvania Avenue York, PA 17404

717.637.0633 lsterner@lutheranscp.org www.lutheranscp.org

717.854.3971 mwilliams@lutheranscp.org www.lutheranscp.org

For 60 years, Lutheran Social Services has been providing seniors throughout York, Adams, and Franklin counties with homes and services designed to meet their needs. See our ad and listings for locations and contact information. See ad page 19

Magnolias of Lancaster 1870 Rohrerstown Road Lancaster, PA 17601

717.560.1100 nsiler@integracare.com www.integracare.com

We provide care for residents with memory-impairing diseases. Our specialized program caters to residentsâ&#x20AC;&#x2122; specific needs. Enhanced care services available for those requiring higher levels of assistance. See ad page 2

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REHABILITATION FACILITY RESPITE ADULT DAY CENTER HOME CARE SERVICES HOSPICE CARE

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DIRECTORY OF HOUSING & CARE PROVIDERS Messiah Lifeways 100 Mount Allen Drive Mechanicsburg, PA 17055

717.790.8201 life@messiahlifeways.org www.messiahlifeways.org

Messiah Lifeways offers more options for caregivers and everyone 55+, including: coaching, enrichment, community support, and resident communities. See ad page 15

Riddle Village 1048 West Baltimore Pike Media, PA 19063

610.891.3700 www.riddlevillage.org

Comprehensive Lifecare program with ideal Main Line location adjacent to Riddle Memorial Hospital. Multiple dining venues, expansive fitness area with indoor pool, and underground parking garage.

Senior Helpers 3806 Market Street, Suite 3 Camp Hill, PA 17011

717.920.0707 bobbi@seniorhelpers.com www.seniorhelpers.com

Positive solutions for aging in place with dignity. Companionship, personal care, and our specialized dementia care allows us to provide non-medical, in-home care. See ad page 17

SeniorLIFE York 1500 Memory Lane Ext. York, PA 17402

717.757.5433 www.seniorlifeyork.com

SeniorLIFE is an all-inclusive care, non-residential program. Services include transportation, physician and nursing services, and much more. Call for complete service listing and eligibility requirements. See ad on the back page

Shrewsbury Lutheran Retirement Village 717.235.5737 800 Bollinger Drive jstanley@lutheranscp.org Shrewsbury, PA 17361 www.lutheranscp.org See ad page 19

Specialty Home Care 1251 East Chocolate Avenue P.O. Box 362 Hershey, PA 17033

717.533.4400 mike@specialtyhomecare.com www.specialtyhomecare.com

Hershey’s premier home care company! Homemaker, transportation, and personal care services. Free, in-home assessment, no obligation. Veteran benefit experts!

Spring Creek Rehabilitation & 717.565.7050 Healthcare Center tchristiana@sc-care.com 1205 South 28th Street www.springcreekcares.com Harrisburg, PA 17111 Spring Creek offers a full array of exemplary services, including physical, speech, occupational, and respiratory therapies. A secure dementia unit, wound care clinic, ventilator, and tracheostomy care. See ad page 26

StoneRidge Retirement Living 717.866.3200 440 East Lincoln Avenue stacia.keith@stoneridgeretirement.com Myerstown, PA 17067 www.stoneridgeretirement.com StoneRidge is a full-service CCRC in Myerstown, Pa. Since 1924, we’ve been providing quality senior care just a short drive from Reading, Lebanon, and Hershey. See ad page 25

Surrey Services for Seniors 28 Bridge Avenue Berwyn, PA 19312 See ad page 17

610.647.9840 info@surreyservices.org www.surreyservices.org

Synergy HomeCare of Mid Penn 717.243.5473 453 Lincoln Street, Suite 110 michellelisk@synergyhomecare.com Carlisle, PA 17013 www.synergyhomecare.com/midpenn Synergy HomeCare offers customized in-home care for seniors and those limited by Alzheimer’s disease or dementia, patients recovering from surgery — even new mothers. Our team specializes in providing a care plan that works for you. (Continued next page)

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DIRECTORY OF HOUSING & CARE PROVIDERS Tel Hai Retirement Community 1200 Tel Hai Circle Honeybrook, PA 19344

The Village at Kelly Drive 750 Kelly Drive York, PA 17404 See ad page 19

610.273.9333 nfischer@telhai.org www.telhai.org

717.854.5010 jgochoco@lutheranscp.org www.lutheranscp.org

The Village at Sprenkle Drive 1802 Folkemer Circle York, PA 17404 See ad page 19

717.764.9994 hbair@lutheranscp.org www.lutheranscp.org

Visiting Angels Living Assistance Services

Lancaster 202 Butler Avenue, Suite 302 Lancaster, PA 17601

717.652.8899 717.737.8899 www.visitingangels.com

VNA of Central PA/ Crossings Hospice of the VNA 3315 Derry Street Harrisburg, PA 17111

717.233.1035 800.995.8207 www.vnacentralpa.com

The Woods at Cedar Run 824 Lisburn Road Camp Hill, PA 17011

717.737.3373 lkyle@integracare.com www.integracare.com

We offer three lifestyle choices: Independent living encourages residents to thrive. Senior living adds the security of professional assistance. Memory care embraces state-of-the-art practices for memory loss. See ad page 2

717.630.0067 visitingangelshanv@comcast.net www.visitingangels.com

Hanover 104 Carlisle Street, Suite 1 Hanover, PA 17331

York 1840 East Market Street York, PA 17402

Visiting Angels 9A North Progress Avenue Harrisburg, PA 17109

717.393.3450 angelsat156@aol.com www.visitingangels.com 717.751.2488 visitingangelsyk@comcast.net www.visitingangels.com

COLOR KEY FOR DIRECTORY OF CAREGIVING PROVIDERS INDEPENDENT RESIDENCES PERSONAL CARE HOME ASSISTED LIVING RESIDENCE DEMENTIA UNITS NURSING CARE COMMUNITY

REHABILITATION FACILITY RESPITE ADULT DAY CENTER HOME CARE SERVICES HOSPICE CARE

See ad page 27

Have a lifestyle change on the horizon? Let this be your guide. 17th Edition Now Available! • Active adult and residential living • Independent and retirement living communities • Assisted living /personal care residences • Nursing and healthcare services • Home health, companions, and hospice care providers • Easy-to-read format

In print. Online: onlinepub.com Call for your free copy today! (717) 285-1350 32

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AREA AGENCIES ON AGING Chester County Area Agency on Aging Cumberland County Aging and Community Services Dauphin County Area Agency on Aging Lancaster County Office of Aging Lebanon County Area Agency on Aging York County Area Agency on Aging

610.344.6350 717.240.6110 717.780.6130 717.299.7979 717.273.9262 717.771.9610 www.p4a.org

Your local offices of aging act as advocates for Pennsylvania’s seniors—promoting their continued physical, social, and economic self-sufficiency.

GERIATRIC CARE SERVICES

INSURANCE AmeriHealth VIP Care – Lancaster County 866.533.5490 www.amerihealthvipcare.com Keystone VIP Choice – Chester County 800.450.1166 www.keystonevipchoice.com maya.stewart@amerihealthcaritas.com See ad page 35 Long Term Care Consultants 717.394.4287 Marcille Crossland, LUTCF, CLTC m.crossland@verizon.net 1560 Lititz Pike, Suite 4 www.integratedbusinessconsultantsinc.com Lancaster, PA 17601 See ad page 22

MOVING & RELATED SERVICES

Elder Healthcare Solutions, LLC 717.825.8828 211 Pauline Drive #315 contact@elderhealthcaresolutions.com York, PA 17402 www.ehs-pa.com

Transition Solutions for Seniors, LLC 717.615.6507 1075 Hunters Path rochelle@supernet.com Lancaster, PA 17601

Elder Healthcare Solutions assists with navigating healthcare, lifestyle, and living options. From geriatric care management to assessments, care coordination, and transitional support — know your options! See ad page 23

Move organizing and implementation: sorting, packing, disposal of unwanted items, unpacking, resettling, home staging, cleaning, and selling (through Prudential HSG), work with estates. See ad page 5

Senior Caregiving Solutions 717.228.8067 Serving Lebanon, senior.caregiving1@verizon.net Lancaster, Dauphin, and www.seniorcaregive.com eastern Cumberland counties Licensed, clinical social worker (15 years as geriatric care manager) advises and guides families. Conducts assessment, then makes recommendations, including options within community. Specialty – dementia.

Advanced Hearing Aid Center 610.781.9001 Six Locations Serving www.advancedhearingaidcenter.org Southeastern PA Free hearing exams! Sales, service, and repairs on all hearing aids. House calls at no charge. Servicing local independent, assisted living, and personal care facilities. Locally owned and operated. See ad page 9

Kilmore Eye Associates 890 Century Drive Mechanicsburg, PA 17055 See ad page 10 www.BusinessWomanPA.com

Angel Pet Cremation Services Serving South Central PA

717.921.2117 www.angelpets.org

“Helping pets and their people any way we can.” Low-cost spay/neuter. Loans of live traps, cages. Free ID tags. Pet cremation services, too.

TRANSPORTATION SERVICES

HEALTH

Cumberland/Perry Health Education Resource Center 306 Fairview Street Carlisle, PA 17015

PET SERVICES

717.497.7002 www.cpherc.org

717.697.1414 www.kilmoreeye.com

Access Bus and Van Sales 629 Wyndamere Road Etters, PA 17319 See ad page 35

717.932.6060 thughes@accessbusandvan.com www.accessbusandvan.com

Need A Lift Accessible Van Rentals 717.932.6060 629 Wyndamere Road reppinger@ineedalift.net Etters, PA 17319 www.wheelersvanrentals.com Wheelchair-accessible van rentals to meet your transportation needs by the day, week, or month. Get online – get a quote – make your reservation today. See ad page 35 Red Rose Transit Authority 45 Erick Road Lancaster, PA 17601

717.291.1243 info@redrosetransit.com www.redrosetransit.com

Offering transportation solutions for those 65 and older. Seniors ride free on our bus routes or at a discounted rate on our sharedride service. BUSINESSW

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Support and Information All About Vision www.allaboutvision.org

Eldercare Locator 800.677.1116 www.eldercare.gov

National Library Service for the Blind & Physically Handicapped 800.424.8567 www.loc.gov/nls

Alzheimer’s Disease Education and Referral Center 800.438.4380 www.alzheimers.org

Epilepsy Foundation of America 800.332.1000 www.epilepsyfoundation.org

American Cancer Society Response Line 800.227.2345 www.cancer.org

EyeCare America 877.887.6327 www.eyecareamerica.com

Needy Meds www.needymeds.org

American Diabetes Association 800.254.9255 www.diabetes.org

Family Caregiver Alliance 800.445.8106 www.caregiver.org

Office of Minority Health Resource Center 800.444.6472 www.omhrc.gov

American Speech Language-Hearing Association 800.638.8255 www.asha.org

Guide Dog Foundation for the Blind 800.548.4337 www.guidedog.org

PACE/PACENET 800.225.7223 www.aging.state.pa.us/aging

Medicare & Medicaid Services 800.633.4227 www.cms.hhs.gov

Pennsylvania Department of Public Welfare 800.692.7462 www.dpw.state.pa.us

Medicare Rights 800.333.4114 www.medicarerights.org

Rural Information Center Health Service 800.633.7701 www.nal.usda.gov/ric

BenefitsCheckUp www.benefitscheckup.org

Medicare Telephone Hotline 800.633.4227 www.medicare.gov

RxAssist 401.729.3284 www.rxassist.org

CareCentral www.carecentral.com

National Alliance for Caregiving www.caregiving.org

Shriners Hospital Referral Line 800.237.5055 www.shrinershq.org

Caregiver Action Network 800.896.3650 www.caregiveraction.org

National Council on Alcoholism & Drug Dependence, Inc. 800.622.2255 www.ncadd.org

American Urological Association 800.828.7866 www.auanet.org Arthritis Foundation Information 800.283.7800 www.arthritis.org

Caregiver Media Group 800.829.2734 www.caregiver.com Children of Aging Parents 800.227.7294 www.caps4caregivers.org Christopher & Dana Reeve Paralysis Foundation 800.225.0292 www.christopherreeve.org Crohn’s and Colitis Foundation of America, Inc. 800.932.2423 www.ccfa.org

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National Parkinson Foundation, Inc. 800.327.4545 www.parkinson.org

Simon Foundation for Continence 800.237.4666 www.simonfoundation.org

National Health Information Center 800.336.4797 www.health.gov/nhic National Institute on Aging Information Center 800.222.2225 www.nia.nih.gov National Institute of Mental Health Information Line 800.647.2642 www.nimh.nih.gov National Insurance Institute Helpline 212.346.5500 www.cancerandcareers.org/resources

oman CAREGIVER SOLUTIONS 2013

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Serving Cumberland, Dauphin, Lancaster, and York Counties Call on us for experience, knowledge, and superior customer service.

Sales of New and Pre-Owned Specialty Transportation Vehicles Buses: • Up to 45-passenger seating • Wheelchair Accessible • Varied Floor Plans Vans: • Full-sized or Mini Vans • Side or Rear-Entry • Wheelchair Accessible

• Accessible mini-vans • Rent by the day, week, or month • Get a quote or make a reservation online • Serving Central PA and surrounding counties • Pick-up and delivery can be arranged

FINANCING & LEASING AVAILABLE

(717) 932-6060 If you have Medicare and Medicaid …

AccessBusandVan.com

Come Home to

Offered by the same company that serves more than 110,000 members in AmeriHealth Caritas Pennsylvania, AmeriHealth VIP Care is a new health plan exclusively for people with Medicare and Medicaid coverage.

Call today to learn about the Medicare plan that treats you like the VIP you are. Call 1-877-679-1261 (TTY 1-855-241-3649) | 7 days a week, 8:00 a.m. to 8:00 p.m. www.amerihealthvipcare.com AmeriHealth VIP Care is a Medicare Advantage organization with a Medicare contract and a contract with the Pennsylvania Medicaid program. This plan is available to anyone who has both Medical Assistance from the State and Medicare. AmeriHealth VIP Care is available in Lancaster, Lehigh and Northampton counties. Y0093_PRA_628_Accepted_04032013

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Stress of being a caregiver can take as much as 10 years off of your life.

Stop the stress and learn how to ÀQG WKH EDODQFH On average, those caring for their aging parents spend about 20 hours a week with those caregiver duties. Combined with a full time job, children, and day to day life, the stress can be overwhelming. There is a solution. Senior LIFE has compiled tips and solutions for caregivers in a brochure entitled: “Find the Balance: What’s Best for Them, and For You.” Call today for your complimentary copy, and stop the stress.

Senior LIFE York 1500 Memory Lane Extension 717-757-5433 www.seniorlifeyork.com