2023 Southern Oregon Retirement Connection Guide

Table of Contents (continued)

Table of Contents (continued)

Information & Guide Request

Letter from the Publisher

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Publisher: Amy Schmidt

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Regional Marketing: Erin Greeno

CareAvailability.com: Barret West

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Retirement Connection Guide

PO Box 820067, Portland, OR 97282

Phone: 541-227-6635

Fax: 503-334-2868

www RetirementConnection com

mktg@RetirementConnection com

Contents of this guide may not be reproduced in whole or part without consent of the publisher While every effort has been made to include accurate data, the publisher cannot be held liable for material content or errors Copyright 2023 by Retirement Connection The opinions and beliefs expressed in advertisements and by authors of all articles do not reflect the opinions, beliefs or official policies of Retirement Connection Guide

Content published herein is submitted by colleagues and advertisers with the sole purpose of providing education on aging and retirement issues, and to help people make informed decisions

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Care & Health Services

Adult Day Programs

Ambulatory Aids

Care Management

Emergency Response Systems

Health Insurance/Medicare

Home Health/In Home Care

Housing

Adult Foster Care Homes

Assisted Living/Residential Care

Independent Living

Preferred Location

Professional Services

Elder Law/Estate Planning

Financial Planning

Long-Term Care Insurance

Additional Information

Hospice

Medical Equipment/Supply

Prescription Assistance

Rehabilitation/Therapy

Respite Care

Other

Dear Readers,

Memory Care

Nursing Home

I thought the pandemic was tough, then 2022 happened. Our family started the year with positive news that my husband had won his battle against cancer. After several emergency room visits, significant weight loss, a change of physician and many, many tests later- we learned his cancer had grown and was now affecting other organs. We quickly shifted our priorities to plan for what we could, and celebrate as many milestones as possible. The first milestone was my daughter’s high school graduation and prep for college, then my son getting his driver's license, birthdays, and renewing our 20 year wedding vows.

Luckily, I am a planner and our family already had some measures in place, such as: purchasing a long term care insurance policy years ago and sharing our preferred healthcare and final wishes.

Moving/Real Estate Services

Reverse Mortgages

Other

When do you expect to need housing, service(s) or product(s)?

Now Within 6 months 6 to 12 months Later

What type of funding will you use to pay for services?

Private Pay

Medicare

Long Term Care Insurance

Comments?

Medicaid or Public Assistance

Health Insurance

Veteran Benefits

These past few months sometimes feel like I am living in limbo- not able to move forward, but still thankful for the present. While managing our own struggles, two of our dear friends passed away unexpectedly. I share this, not to be somber, but as a reminder. A reminder to be our own best healthcare advocate, to ask questions, and even switch providers if necessary. A reminder to plan for the things you can: your will, advanced directives, bank account access, digital legacy with passwords, and more. We never know how long each of us has, so do not take time or relationships for granted.

This Retirement Connection Guide has helped me more than I expected. I received advice and support from insurance representatives, elder law attorneys, hospice and home care providers. Our family personally used the companies included within the pages of our publication. It has been very fulfilling to see our work come to fruition. I have also been touched by the care, compassion and professionalism of those we met with.

My advice…please plan ahead when possible, be patient with yourself, and ask as many questions as you need. The providers we work with have been amazing in serving seniors and their families. Sometimes it's not possible to plan and a crisis may occur. CareAvailability.com and Retirement Connection Guide are both great tools to help you connect with the providers in the Southern Oregon area. Retirement Connection is provided free of charge because our sponsors/ advertisers have provided financial support to maintain and update the guide and the website. Please return the favor by contacting our sponsors when you encounter a need. If your physician’s office, church, or other organization would like additional copies, we are happy to provide these at no cost. Please call us, visit our website or email us at:

mktg@RetirementConnection.com to order as many as you need.

Amy Schmidt, Publisher

How to Use This Guide

Getting Started is Easy

Our guide is organized into 3 primary sections and identified by color tabs:

1. At Home Care & Health

This section offers two comparison spreadsheets/ grids One for Home Health Medical Care and another for In-Home Personal Assistance

First, familiarize yourself with the different levels of care offered by each license type We have included home care definitions to assist you in finding the care that best serves your needs This section also includes additional homecare resources and caregiver registry services

2. Community Resources & Services

This section is alphabetical and includes hundreds of services and organizations that work with older adults, those with disabilities and their families This section includes everything from Caregiver Resources, Social Security, Care Management, Senior Centers, Upcoming Events, etc

3. Housing

Begin by reviewing the Housing Definitions at the beginning of the section to determine which level of care best fits your needs Then turn to the easy to read comparison grids; which are separated into 5 primary care levels: Independent Living, Assisted Living/Residential Care, Adult Foster Homes, Memory Care & Skilled Nursing/Intermediate Care The communities are separated by county so you can quickly search a specific geographic area If you are unsure where to begin you may want to contact a Housing Placement & Referral Specialist found at the beginning of the housing section

Home Care Definitions:

Behavioral Health can include the prevention, intervention, treatment, and recovery support to people with addiction and mental health needs. Behavioral health may also include care for patients with memory loss and confusion, but typically includes more intensive treatment and intervention than simple redirection.

Homecare agencies provide non-medical services. Personal care may include: dressing, feeding and personal hygiene to facilitate self-care; homemaking such as housekeeping, shopping, meal preparation, and transportation; or respite care to provide support to the family. The Department of Health licenses home care agencies.

Home Health Care includes skilled nursing services, physical therapy, occupational therapy, speech language therapy and medical social services. A home health care agency may choose to be Medicare certified to be reimbursed for their services. Home health agencies may also teach you how to care for yourself.

In-Home Care/Personal Care is care related to activities of daily living. Care may be provided by Home Health or Homecare Agencies. These services are typically not covered by medical insurance or Medicare and do not require a physician’s order.

Intravenous Therapy is any medical treatments/medications that need to be introduced to the body via a patient’s veins. Numerous IV Therapies can be provided in-home under supervision of an MD. Some of these include: inter-infective/antibiotic therapies, hydration therapy, pain management, chemotherapy and central line care and maintenance.

Master of Social Work (MSW) is a master’s degree in the field of social work. MSWs help promote more integrated care with education and collaboration among care providers and support services.

Medicaid Certified A joint Federal and state program that helps with medical costs for some people with limited income and resources. Medicaid Certified facilities can offer services to individuals receiving Medicaid benefits in exchange for reimbursement from Medicaid. Some people qualify for both Medicare and Medicaid (these people are called “dual eligibles”).

Medical Social Services are assistance with social and emotional concerns related to an illness including counseling or help finding community resources.

Medicare Certified facilities can offer services to individuals receiving Medicare benefits in exchange for reimbursement from Medicare. A physician’s order is required to be reimbursed by Medicare. Medicare is a Federal health insurance program for those 65 and over or for those who meet other criteria.

Nurse Delegated Tasks a licensed registered nurse may delegate specific nursing care tasks to qualified nursing assistants in community-based and in-home care settings. One task taught and delegated to one caregiver for one client. Before delegating a task, the registered nurse delegator must determine that specific criteria are met and ensure that the patient is in a stable and predictable condition.

Psychiatric Services refers to the agency's ability to offer services related to psychiatric support with the prevention, diagnosis, and treatment of mental illness. Services may include counseling or administering of medications.

Respite Care is short-term or temporary. It is designed to give families a break from the stress of daily caregiving. Respite care can be for a few hours, overnight, or for days. The amount of care changes with the needs of the family and the ill or disabled person.

Skilled Nursing requires the oversight of a staff nurse and may include: rehabilitation, wound care, therapy services, or other medical care. These services are typically provided by a licensed Home Health Agency. This is different than Nurse Delegation services that may use a third party agency or consultant to delegate as needed for an individual specific need.

Therapy Services (OT, PT, RT, ST)

Occupational Therapy (OT) refers to services to assess and treat patients to help them develop, recover, or maintain daily living and work skills. Occupational therapists help clients not only to improve their basic motor functions and reasoning abilities, but also to compensate for permanent loss of function.

Physical Therapy (PT) refers to services for the treatment and rehabilitation process where a physical therapist will often stretch, strengthen, facilitate muscles, challenge balance, test coordination abilities, teach home exercise programs to enhance basic mobility skills; to help lessen disability and pain and improve overall function and quality of life.

Respiratory Therapy (RT) refers to services for care of patients with deficiencies and abnormalities associated with the cardiopulmonary system. It may include the therapeutic use of medical gases and their equipment, humidification, aerosols, ventilator support, bronchi pulmonary drainage and exercise and respiratory rehabilitation.

Speech Therapy (ST) refers to services to assess and treat speech and swallowing disorders. Speech therapy can treat speech, language, cognitive skills or swallowing.

Wound Ostomy Continence Nurse (WOCN) WOC nurses have advanced training in acute and chronic wound care as well as the physical, emotional, and social issues of patients with ostomies (those who have had some kind of bowel or bladder diversion), stomas, acute and chronic wounds, and incontinence (those with bladder and bowel control and associated skin care issues).

Sources: Department of Health & Human Services, Administration on Aging and National Institutes of Health.

Includes skilled nursing services, physical therapy, occupational therapy, speech language therapy and medical social services. A home health care agency may choose to be Medicare certified to be reimbursed for their services.

AccentCare Home Health 2 , 691 Murphy Rd #236, Medford, 97504

Three Rivers HomeCare 2 , 555 NE 'F' St #B, Grants Pass, 97526

1 CHI Mercy Hospice is affiliated with Mercy Hospital (Mercy Healthcare Inc operates Mercy Hospice)

2 The following providers are affiliated with the Asante Health System: AccentCare Home Health & Palliative Care of Rogue Valley; Asante Hospice; Asante Ashland Community Hospital Home Health/Hospice & Palliative Care; Southern Oregon Home Health; Three Rivers HomeCare

3 Sky Lakes Home Health is affiliated with Sky Lakes Hospital

4 Providence Home Health is affiliated with Providence Medford Medical Center

*The Home Health Agency you choose is responsible for all the supplies and services including physical therapy, occupational therapy, or speech therapy needed under your Home Health Plan of Care The exception to this requirement is limited to durable medical equipment such as wheelchairs, hospital beds, and oxygen tanks Other providers cannot bill Medicare for the items or services that are covered under your Home Health Plan of Care Please discuss your needs with your Home Health nurse prior to purchases to avoid additional expense for which you may be held responsible

*The Skilled Nursing Facility and Home Health provider list information was obtained from the cms gov website on March 2023 and compared to ADRC and Oregon Department of Health and Human Services

Acronyms for Long-Term Care:

AAA Area Agency on Aging

AARP American Association of Retired Persons

AD Alzheimer’s Disease

ADL Activity of Daily Living

AFH Adult Family/Foster Home

AL Assisted Living

ALF Assisted Living Facility

AOA Administration on Aging

APS Adult Protective Services

CCRC Continuing Care Retirement Community

CHF Congestive Heart Failure

COPD Chronic Obstructive Pulmonary Disease

CPR Cardiopulmonary Resuscitation

DHSSPD Department of Human Services, Seniors and Persons with Disabilities

DHS Department of Health Services

DNR Do Not Resuscitate

DSS Department of Social Services

ED Emergency Department

EMS Emergency Medical Services

ER Emergency Room

H&P History and Physical

HIPAA Health Insurance Portability and Accountability Act

I&R Information and Referral

ICF Intermediate Care Facility

ICU Intensive Care Unit

IHSS In-Home Supportive Services

IL Independent Living

ISP Individual Support Plan

JCAHO Joint Commission on Accreditation of Healthcare Organizations

LOC Level of Care

LTAC Long-Term Acute Care

LTC Long-Term Care

MAR Medication Administration Record

MMA Medicare Prescription Drug Improvement and Modernization Act

MMSE Mini-Mental State Examination

N4A National Association of Area Agencies on Aging

OT Occupational Therapy

PACE Program of All-Inclusive Care for the Elderly

PERS Personal Emergency Response System

POA Power of Attorney

POLST Physician Order for LifeSustaining Treatment

PRN Pro re nata (commonly used to mean “as needed” in Latin)

PT Physical Therapy

QA Quality Assurance

SHIP State Health Insurance Assistance Programs

SLS Support Living Services

SNF Skilled Nursing Facility

SPD Seniors and People with Disabilities

TCU Transitional Care Unit

TPN Total Parenteral Nutrition

URAC Utilization Review

Accreditation Commission

UTI Urinary Tract Infection

VA U.S. Department of Veterans Affairs

WHO World Health Organization

Information provided by: Retirement Connection

www.RetirementConnection.com

Tips for Engaging Patients with Alzheimer’s Disease

Whether you’re caring for a loved one with Alzheimer’s disease or you are a caregiver looking after a patient, it can be challenging to care for someone with memory loss. While Alzheimer’s Disease has varying stages, many patients start to find themselves losing train of thought, have difficulty finding the right words, and even start to speak less often. We’re sharing some tips to help you engage with people with Alzheimer's disease and minimize communication challenges.

Talk directly

It’s easy for people with Alzheimer’s to get overwhelmed and confused. To reduce this, talk slowly and clearly while making eye-contact with the patient. If possible, try to minimize distractions and background noisesuch as pausing music or the TV while speaking.

Patience

It can take a bit more time for people with Alzheimer’s to process what they are hearing and how they want to respond. Be patient in waiting for their response and offer reassurance. Don’t interrupt them but instead encourage them to take their time in responding.

Be Clear

Rather than asking open ended questions, ask questions with direct or yes and no answers. For example, rather than asking what do you want

to do today? Ask, would you rather go for a walk or start a puzzle? This helps the patient to be less overwhelmed and easily answer.

Be Visible

When possible, always approach a person with Alzheimer’s disease from the front, rather than from the side or behind. Try making eye contact, smiling, and matching the person's mood when appropriate.

While the challenges of communicating with someone suffering from memory loss are always evolving, we hope these tips help to ease frustrations and improve communication. Remember to be patient and don’t hesitate to get help if needed.

Article provided by: New Horizons In-Home Care 541-507-1234

www.NHCares.com

How to Avoid Caregiver Burnout

Caregiving can be a deeply rewarding experience, but it can also take a significant toll on the caregiver's physical and emotional well-being. Caregiver burnout is a condition that can occur when caregivers are exposed to chronic stress and strain without proper support or self-care.

Caregiver burnout can manifest in a variety of ways. Physical symptoms may include chronic fatigue, headaches, and muscle tension. Emotional symptoms may include depression, anxiety, and feelings of helplessness. Caregivers may also experience a decrease in their own quality of life, as they may have less time to pursue their own interests and hobbies.

One of the biggest contributors to caregiver burnout is the lack of support and respite care. Caregivers often feel a sense of responsibility to provide care 24/7, which can be physically and emotionally draining. It's important for caregivers to recognize that taking time for themselves is not a sign of weakness or neglect, but rather an essential part of maintaining their own well-being.

Many caregivers are thrown into their role without any formal training or support, which can make it difficult to navigate the complex medical and emotional needs of their loved ones. It's important for caregivers to seek out resources, such as support groups and educational materials, to help them feel more confident and competent in their caregiving role.

It's also essential for caregivers to practice self-care on a regular basis. This may include engaging in activities that bring them joy, such as exercise, meditation, or spending time with friends and family. It's important for caregivers to prioritize their own health and well-being, as this can ultimately lead to better care for their loved ones.

If you or someone you know is experiencing caregiver burnout, it's important to seek help. This may include reaching out to a healthcare provider, joining a support group, or seeking counseling. It's essential to recognize that caregiver burnout is a real and serious condition and that seeking help is a sign of strength, not weakness.

In conclusion, caregiver burnout is a common and serious condition that can have significant impacts on caregivers and their loved ones. It's essential for caregivers to prioritize their own well-being and seek out support and resources to help them navigate their caregiving role. With proper support and self-care, caregivers can continue to provide the important and valuable care that their loved ones need.

Article provided by: Home Instead

541-734-2700

www.HomeInstead.com/476

Advocacy

ADRC of Douglas County, (Ad pg #31)

1036 Douglas Ave #221, Roseburg, 97470 541-440-3677, 855-673-2372

American Association of Retired Persons (AARP), 601 'E' St NW, Washington DC, 20049 888-687-2277

Battered Persons' Advocacy, 1202 SE Douglas Ave, Roseburg, 97470 541-673-7867, 800-464-6543

Consumer Advocacy Unit of Oregon Consumer Office, 350 Winter St NE, Salem, 97301 888-877-4894

Cow Creek Band of Umpqua Indians, 2371 NE Stephens St #100, Roseburg, 97470

Disability Rights of Oregon, 511 SW 10th Ave #200, Portland, 97205

Fair Housing

541-672-9405, 800-929-8229

503-243-2081, 800-452-1694

Senior & Disability Services

is the local Area Agency on Aging that o ers many programs for older adults, adults with disabilities, and their caregivers in Josephine & Jackson counties including:

ADRC Aging & Disability Resource Connection

Any family member, friend, caregiver, or individual may contact the ADRC (website or phone) to learn abut resources & options available in Jackson & Josephine Counties to help seniors & adults with disabilities. Trained & certi ed sta assesses consumer needs over the phone or in-person to help them understand their service options & empower them to make informed decisions.

OPTIONS COUNSELING

Facilitating person-centered decision-making & resource planning

A supportive, proactive & interactive no-cost counseling service that helps seniors & families make informed decisions about meeting current & future long-term care needs. Counseling is provided by phone, email or in-persion.

Are you ready to have the most important conversation of your life & not know where to start? Senior & Disability Services can assist.

Local Associations

ALS Association (Lou Gehrig's Disease)

Douglas County, PO Box 22653, Eugene, 97402

Southern Oregon, 2305 Ashland St, Ste 'C' #458, Ashland, 97520

Alzheimer's Association – Oregon, (Ad pg #37)

American Diabetes Association – Oregon, 4380 SW Macadam St #270, Portland, 97239

800-272-3900

503-736-2770, 888-342-2383

American Heart Association – Oregon, 4380 SW Macadam St #480, Portland, 97239 503-820-5300, 800-242-8721

American Parkinson's Disease Association

800-223-2732

Arthritis Foundation – Oregon Branch Office, 4145 SW Watson Ave #350, Beaverton, 97005 800-283-7800

Cystic Fibrosis Foundation – Oregon Chapter, 2701 NW Vaughn St #203, Portland, 97210 503-226-3435

Douglas County Cancer Services, 2880 NW Stewart Pkwy #202, Roseburg, 97471

Epilepsy Foundation NW,

541-440-9409

541-990-1246

541-292-8775

Alzheimer's Association— Leads the Fight Against Alzheimer's

We are relentless. We are optimistic. We are inclusive. We are a group of people— staff and volunteers—determined to end Alzheimer’s and all dementia. Serving 38 counties in Oregon and Washington, the Alzheimer’s Association® Oregon & Southwest Washington Chapter fights for the more than 69,000 Oregonians and 120,000 Washingtonians living with Alzheimer’s disease. Our services include free and confidential support groups, community education classes, and extensive online resources. If you, or a loved one, are navigating Alzheimer’s, dementia, mildcognitive impairment or memory-loss, call our 24/7 Helpline at 1.800.272.3900.

Alzheimer's and Demential Caregiving Center (ALZ.ORG/CARE)

Caring for a person with Alzheimer’s or dementia often involves a team of people. Whether you provide daily caregiving, participate in decision making, or simply care about a person with the disease — we have resources to help.

Caregiver Support Group and Community Education Classes (ALZ.ORG/CRF)

Get easy access to resources, community programs and services. Our Chapter provides support, education, training, and other resources. Visit our Community Resource Finder for real-time support group and educational program listings.

Online Caregiver Forum

(ALZCONNECTED.ORG)

ALZConnected® is a free online community for everyone affected by Alzheimer’s or another dementia, including: people with the disease, caregivers, family members, friends, and individuals who have lost someone to Alzheimer’s. Connect with others who know, first-hand, how this experience affects your life.

Alzheimer's Navigator (ALZHEIMERSNAVIGATOR.ORG)

Alzheimer’s Navigator helps guide caregivers to answers by creating a personalized action plan and linking to information, support, and location resources.

TrialMatch

(ALZ.ORG/TRIALMATCH)

TrialMatch® connects individuals living with Alzheimer's, caregivers and healthy volunteers to clinical trials that may advance Alzheimer's research. TrialMatch allows users to search for studies without creating an account, choose whether to receive email notifications of new opportunities, and directly contact research teams.

Alzheimer's Disease Facts and Figures Report

(ALZ.ORG/FACTS)

The number of Americans living with Alzheimer’s is growing—and growing fast. More than 6 million Americans are living with Alzheimer’s. By 2050, this number is projected to rise to nearly 13 million.

Walk to End Alzheimer's

(ALZ.ORG/WALK)

Across the nation, the Alzheimer's Association Walk to End Alzheimer's® is full of flowers, each carried by someone committed to ending this disease. Because like flowers, our participants don't stop when something's in their way. They keep raising funds and awareness for a breakthrough in the fight against Alzheimer's and all other dementia.

Article Provided by: Alzheimer’s Association Oregon Chapter 800-272-3900

www.Alz.org/ORSWWA

Attorneys

Oregon

Diabetes Care Center and Nutrition Outreach, 2900 E Barnett #2, Medford, 97504 541-789-5906

Family Resource Center, 5 St John's Wy, Reedsport, 97467 541-271-9700

Klamath & Lake Counties Council on Aging, 404 Main St #6, Klamath Falls, 97601 541-205-5400

Leading Age Oregon, 7340 SW Hunziker St #104, Tigard, 97223 503-684-3788

Disability Programs

pg #32) ADRC Rogue Valley Council of Governments 541-618-7572

Alliance of People with Disabilities, 1120 E Terrace St #100, Seattle, 98122

Area Agency on Aging Douglas County Senior Services, (Ad pg #31) 1036 SE Douglas Ave, Rm 221, Roseburg, 47470

Disability Rights Oregon,

800-452-1694 Douglas Network Public Health,

Events

Please visit www RetirementConnection com and click on “Events” to find out about more happenings in your area For professional events, click "networking" Retirement

Roseburg Dream Center, 1900 SE Main St, Roseburg, 97470

Roseburg Rescue Mission, 752 SE Pine St, Roseburg, 97470

Army,

South Douglas Food Bank, 420 'E' St, Riddle, 97469

St Francis Community Kitchen, 323 Comstock Ave, Sutherlin, 97479

St Joseph Community Kitchen, 630 W Stanton St, Roseburg, 97470

541-673-5157

St Vincent DePaul, 116 N Main St, Myrtle Creek, 97457 Mon & Wed 9am-1pm

St Vincent DePaul Society, 112 E Central Ave, Sutherlin, 97479 541-459-3394

Sutherlin

Food

(continued)

Josephine County Continued

Perl Funeral Home & Siskiyou Memorial Park

541-772-5488

2100 Siskiyou Blvd. • Medford, Oregon 97504 www.PerlFuneralHome.com Cards

Complete Cremation, Funeral and Cemetery Services

Service to All Local Cemeteries

Respect and Honor to Our Veterans

Convenient Pre-Planning Options Available Call Any Time for Professional Assistance

Compassionate Care. Gracious Grounds. Respectful Remembrance. Cards

Rogue Valley Council of Governments, (Ad pg #32) 155 N 1st St, Central Point, 97502

Guardian & Conservator Center for Non-Profit Legal Services, 225 W Main St, Medford, 97501

Oregon Dept of Veterans' Affairs – Conservatorship, 700 Summer St NE, Salem, 97301 503-373-2085, 800-692-9666 UCAN

Health

* 1, 2, 4 Footnotes available on pg #15

For all of your HOSPICE needs. We provide compassionate personal and spiritual care, skilled nurses, and dedicated volunteers so you can focus on what’s important quality time with those you love.

677-2384

Starting one of the Most Important Conversations of Your Life

All too often families and individuals put off one of the most important conversations of their lives and then find themselves in a world of hurt, or worse, not having the capacity to communicate their desires at the end of life. Reasons for this vary, but the consequences end up being the same, others are left making the decision for you, often with long-term consequences for you and those around you.

With this in mind, we should think of starting this conversation as a gift that often brings a sense of connection with those around us. So, the question is how do I or we start such a conversation? The good news is you can start the conversation any way you wish. Perhaps by starting an engaged conversation with your loved ones about your wishes and hopes for how you would like to be treated in your last months. Perhaps using an event that those around you can relate to might be the starter. Whatever feels right is the way to start and far better than not starting the discussion at all.

Here’s how it started in my family. Years ago, after I had a significant bike accident, one of my adult children asked what treatment I would want if I were tragically hurt. This question began a discussion with my spouse and our closest family members. The result was a clear understanding of my desires and a document that empowers my family to make these decisions. It was freeing and enabling for all of us to speak openly about our thoughts on care and endof-life options.

Try starting with “I’d like to share my hopes and dreams for my last months of life.” You don’t need a goal, it’s an evolution of many conversations. As we age and go through

health issues, our sense of what we would like evolves. Your conversations over time or however long it takes should guide you to the following:

 What are my desires for aggressive care and weighing the balance of the burdens of such care?

 Who do you wish to be your advocate for these decisions when you are unable?

 Make sure your advocate will honor your wishes and share your desires even when they are saddened by these turn of events.

 Discuss your financial goals with whom would manage them when you are no longer able.

Often this conversation doesn’t begin because people might be fearful of the outcome of them. It doesn’t matter what you say; it is more important to open the dialog. Remember doing nothing or avoiding this discussion ultimately puts you at risk of having these important decisions made by others often without your input. In the worst scenario, you hand over these decisions to governmental entities by not finalizing your wishes with those you love. So please start the discussion with those closest to you. Article Provided by:

www.ClinicalTrials.gov is a registry of federally & privately supported clinical trials conducted in the United States & around the world The website contains information about a trial’s purpose, who may participate and phone numbers for more details Medical

What is AllCare PACE?

AllCare PACE (Program of All-inclusive Care for the Elderly) is a Medicare and Medicaid program that provides clinical and social care services in order to assist seniors so they can remain safe & independent in their own homes, or in the community.

AllCare PACE is a comprehensive, fully-integrated, provider-based, health plan for the most frail seniors in our community-those who’d qualify for nursing home level of care. The PACE model is centered around the belief that it is better for frail individuals and their families to be served in the communities they reside whenever possible. Although all PACE participants are eligible for nursing home level of care, 95% will continue to live at home.

AllCare PACE provides all Medicare-and Medicaid-covered care and services, and all other services the PACE team of health care professionals deem necessary to improve and maintain your health. This includes medications, as well as any other medically necessary care, such as doctor or healthcare provider visits, transportation, home care, social services, hospital visits, PT & OT, and coordinated social activities. All under the guidance of the PACE interdisciplinary team of professionals who provide comprehensive, coordinated medical services to help seniors age in place and improve the quality of life for themselves and their families.

To qualify for AllCare PACE, you must be 55 years or older, live within the service area (Josephine & Jackson County). Need nursing home level of care as certified by the state, and be able to live safely in the community with the help of AllCare PACE. If a participant is dualeligible (Medicare & Medicaid), there are no deductibles, co-pays, or other cost for their total care. If you don’t have Medicare or Medicaid you can pay privately for PACE services (fees vary, please contact AllCare PACE for more information)

Those seniors who especially benefit from AllCare PACE:

 Want to live at home, but need additional support

 Have difficulty getting to their doctor appointments

 Have absent, limited or stressed family support

 Are increasingly frail

 Need more coordinated medical care

 Need more social interaction

To see if you qualify for AllCare PACE, or for more information on how to enroll, Call or visit us online!

Article Provided by: AllCare PACE

541-474-8000

www.AllCareHealth.com/PACE

allcare pace

Depression and Suicide Screening Tools

Depression is a common mental health condition that affects people of all ages. However, older adults are at a higher risk of developing depression due to factors such as social isolation, physical illness, and life changes like retirement or loss of loved ones. Therefore, it is crucial to screen older adults for depression and suicidal ideation to provide early intervention and support.

Screening Tools for

Depression in Older Adults

There are several screening tools available to assess depression in older adults. Some of the commonly used tools include:

1. Geriatric Depression Scale (GDS): The GDS is a 30-item questionnaire that assesses depressive symptoms in older adults. It is a self-administered tool that includes questions about mood, energy, sleep, and appetite.

2. Patient Health Questionnaire-9 (PHQ-9): The PHQ-9 is a nine-item questionnaire that evaluates depressive symptoms in older adults. It includes questions about feelings of sadness, loss of interest in activities, changes in appetite and sleep, and suicidal ideation.

3. Center for Epidemiologic Studies Depression Scale (CES-D): The CES-D is a 20-item questionnaire that assesses depressive symptoms in older adults. It includes questions about mood, sleep, appetite, and social engagement.

These screening tools can help healthcare providers identify older adults who may be experiencing depression and provide appropriate interventions such as counseling or medication.

Screening Tools for Suicidal Ideation in Older Adults

Suicide is a significant concern for older

adults who experience depression. Therefore, it is essential to screen older adults for suicidal ideation. Some of the commonly used tools include:

1. Columbia-Suicide Severity Rating Scale (C-SSRS): The C-SSRS is a six-item questionnaire that assesses suicidal ideation in older adults. It includes questions about the frequency, intensity, and duration of suicidal thoughts, as well as any plans or attempts.

2. Geriatric Suicide Ideation Scale (GSIS): The GSIS is a 31-item questionnaire that assesses suicidal ideation in older adults. It includes questions about suicidal thoughts, behaviors, and risk factors.

3. Beck Scale for Suicide Ideation (BSS): The BSS is a 19-item questionnaire that assesses suicidal ideation in older adults. It includes questions about the intensity, frequency, and duration of suicidal thoughts.

In conclusion, depression and suicidal ideation are significant concerns for older adults, and screening tools can help healthcare providers identify those who may be at risk. These tools can be administered easily and quickly and can help healthcare providers provide appropriate interventions to prevent adverse outcomes. Therefore, it is crucial to incorporate these screening tools into routine healthcare assessments for older adults to improve their mental health and overall well-being.

Article Provided by: adapt Integrated Health Care 541-440-3532

www.adaptOregon.org

Rehabilitation Facilities (See also Housing Grids pg #104-105)

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Veteran Services (continued)

Due to the large number, not all are listed in this guide This link provides a complete list: https://ltclicensing oregon gov

Housing Definitions:

Adult Day Care Programs offer a protective setting during the day for those who cannot be left alone due to health care and social needs. The structured program within a community setting offers: socialization, planned activities, care services, companionship, and meals. Adult Day Care provides daytime respite for the caregiver who typically works, needs time for other responsibilities, or simply to take a break. Some programs are designed for older adults with dementia and/or physical limitations. Day Care programs in senior housing communities that are listed in this guide must be able to accept non-residents to be included.

Adult Care Homes or Foster Care Homes are private residences that provide a home-like setting, and serve 5 or less residents. The caregiver may perform several functions such as personal care, housekeeping, activities, and group meals. There are three levels of Adult Foster Care Home licenses. The classification system is based on the level of care the Adult Foster Home may provide to residents who live in the home as well as the experience and training of the providers and their ability to assist residents with: personal hygiene, mobility, eating, dressing, toileting, and behavior management. Residents may require very light assistance or may be dependent with several care needs; it is best to ask individual locations for their specific policies and license.

Assisted Living Communities are state regulated rental properties where six or more residents may reside. Care assistance is available, including: medication management, bathing, dressing, toileting, and eating. Some may be fully self-contained private living units with a lockable door, private bathroom, and kitchenette facilities. Accommodations are typically in a home-like setting and may range from a shared bedroom with a common bathroom to private apartments with a kitchenette and a private bathroom. The fee schedule is regular monthly rent along with additional fees for specific services and amenities. Assisted living communities are best suited for individuals who want to remain as independent as possible and who are able to direct their own care. Pricing can vary greatly depending on the level of care provided and the size and amenities of each apartment.

CCRCs (Continuing Care Retirement Communities) also known as Life Plan Communities, include a continuum of care from independent living, assisted living, residential care, and skilled nursing services all on one campus allowing individuals to live within the same community as their needs progress through the spectrum of care. They typically offer the full selection of amenities associated with retirement living and an endowment fee, in addition to a monthly maintenance fee, can be expected.

Independent Living Communities provide residents an independent living setting without the burden of home ownership. Typically, residency is established on a monthly rental basis. Residents live in fully equipped private apartments or cottages from studios to large two-bedroom units that may be rental-assisted or market-rate depending on the community. Amenities and hospitality services such as housekeeping, linen service, transportation, and social and recreational activities may be included for an additional charge or may not be available at all. These communities do not provide assistance with activities of daily living or personal care.

Memory Care or Dementia Communities offer or provide care for residents with Alzheimer’s disease or other dementia in a home-like environment. These communities must receive an endorsement and are governed by additional regulations that are specifically intended to support individuals with dementia, including: a secure building that alerts staff if a resident has exited, a secure outdoor area that provides outdoor freedom safely, interior finishes that are non-glare and well lit, and visual contrasts between floors, walls, and doorways. Alzheimer’s units must also have programs, which include: gross motor, self care, social, craft, sensory enhancement, and outdoor activities.

Rehabilitation & Therapy is treatment for an injury, illness, or pain with the goal of restoring function, including nursing and therapy services. Rehab is ordered by a physician and services are provided by nurses and physical, occupational, and speech therapists. Examples include working with a physical therapist to help you walk and with an occupational therapist to help you get dressed.

Respite Care is short term relief for family caregivers to take a break from the caregiving responsibilities and allows for a healthier and better quality of life for both the caregiver and care receiver. Respite services include: companionship, personal care, recreational activities, and security. Respite care can be provided as short stay or for a longer period that allows the family caregiver to go on vacation or a business trip. Longer duration respite care is generally found at select senior housing communities although some Companion services may provide this service in the home.

Skilled Nursing Facility (SNF) or Nursing Homes are state licensed facilities that provide a safe therapeutic environment for individuals who require rehabilitative care or can no longer live independently due to functional or cognitive impairment. Nursing Homes offer 24-hour skilled nursing care and medical services by registered nurses and support professionals. This is the highest level of care that can be provided that is not hospitalization. Additionally, nursing facilities offer residents planned social, recreational, and spiritual activities. Nursing facilities are most appropriate for people who need 24-hour medical oversight and a protective/structured setting. Most residents must share their room, but residents are allowed to bring personal items to encourage a more home-like atmosphere.

Sources: Aging & Disability Services Department and Department of Health & Human Services.

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Cascades of Grants Pass, 1357 Redwood Cir, Grants Pass, 97527

103 Countryside Village, 1700 Kellenbeck Ave, Grants Pass, 97527

Foothill Retirement Center I, 2031 NE 'D' St, Grants Pass, 97526

Foothill Retirement Center II, 1997 NE 'D' St, Grants Pass, 97526

Golden Rain Apartments, 845 NE Victoria St, Grants Pass, 97526

Holiday Garden, 1051 E Park St, Grants Pass, 97527

Horizon Village, 3098 University Rd, Grants Pass, 97527

Jasmine Park I, 501 NE Anderson St, Grants Pass, 97526

Jefferson Court, 810 NE Victoria St, Grants Pass, 97526

541-471-6123 • • • • • 60 sliding Rivertree

Apartments, 224 SW Rogue River Ave, Grants Pass, 97526

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Canyonville, 97417

Riverview Terrace, 1970 W Harvard Ave, Roseburg, 97471

93 The Landing, 2490 NW Edenbower Blvd, Roseburg, 97471

JACKSON COUNTY

Alderwood, 131 Alder St, Central Point, 97502

Ashley Manor Arrowhead, 3853 Arrowhead Dr, Medford, 97504

Ashley Manor Brookhurst, 2146 Brookhurst St, Medford, 97504

IBC Avamere at Waterford, 760 Spring St, Medford, 97504

Bonaventure of Medford, 2530 E McAndrews Rd, Medford, 97504

Respite Care: Self-Health isn’t Selfish

Providing care for a loved one can become quite grueling for both the family caregiver and the patient. Caregivers may find themselves feeling burned out from the stress of consistent assistance, often falling into troubling sleeping patterns and neglecting their own self-care. Respite Care provides a mutually beneficial third party resource for caregiver and patient, in which additional short-term assistance is made available in forms such as adult day centers, in-home care and counseling services, or as recovery from a hospital stay. It’s clear that a family caregiver is only as effective as his or her own self-health, and as the emotional weight of an aging loved one persists, taking a break to relax and recalibrate becomes invaluable.

Where to Find Respite Care?

Short term stays at assisted living or nursing facilities, along with additional information including webinars and Medicaid/Medicare assistance can be found at the ARCH National Respite Network’s Respite Locator: https:// archrespite.org/us-map. By simply entering the age of the patient, along with the State, Zip Code, and preferred mile radius, you will find plenty of Respite options at your fingertips.

What does Respite Care Provide?

Respite care amenities may vary by community but will typically provide 24-hour supervision, bathing assistance, meals, and medication management. This resource can be for an afternoon or up to a couple weeks.

What are the benefits of Respite Care?

Respite care provides the necessary perspective into the reality of a caregiving situation. The emotional and physical toll of caring for a loved one can never be overlooked. Maintaining a special connection against the persistence of relentless dementia is profoundly draining. As a caregiver finds their own lives changing and slipping away from them, the quality of care often dwindles, as exhaustion and frustration can start to damage this relationship in the last couple years they have together.

Access to Respite as a temporary resource allows the caregiver to simply get back to their own lives for some time. From simple sleep and relaxation to going out with friends or running errands, this bit of freedom is a way to recharge the batteries and reassess the balance necessary to maintain their own self-health.

It’s hard to acknowledge that family caregiving is often a necessary undertaking in which all parties involved wished it wasn’t necessary. Respite provides a valuable outlet for the guilt a caregiver is prone to feel when they stop and think about themselves in these troubling times. The assistance of Respite care can assure that the threshold of caregiving remains an active task to help a loved one in their final years, as opposed to a burden.

Article Provided by: Retirement Connection www.RetirementConnection.com

Assisted Living Resources

Licensing requirements for assisted living facilities vary by state and can be known by as many as 26 different names including: residential care, board and care, congregate care, and personal care. A complete list of each state’s terminology and state regulations can be found at: http://aspe.hhs.gov/daltcp/ reports/04alcom.htm

Choosing A Community

A good match between a community and a resident’s needs depends as much on the philosophy and services as it does on the quality of care.

The following suggestions can help you get started in your search for a safe and appropriate assisted living community:

• What are your future needs and how will the community meet those needs?

• Is the community close to family and friends? Are there any shopping centers or other businesses nearby (within walking distance)?

• Visit each community more than once, sometimes unannounced.

• Visit at meal times, sample the food, and observe the quality.

• Observe interactions among residents and staff and ask questions.

• Ask about social, recreational, and spiritual activities.

• Ask about the type and frequency of staff trainings.

• Review state licensing reports.

These Steps Should Also Be Considered:

• Contact your state’s long-term care ombudsman to see if any complaints have been filed against the assisted living community you are interested in. In many states, the ombudsman checks on conditions at assisted living units and nursing homes.

• If the assisted living community is connected to a nursing home, ask for information about it too. (Information on nursing homes can be found on the Medicare website at http://www. medicare.gov/nhcompare/home.asp).

It is a good idea to review The Substantiated Facility Abuse Complaints at https://ltclicensing.oregon.gov

This website contains Facility Adult Protective Services (APS) investigations that constitute abuse as determined by Corrective Action Coordinators.

Article Provided By: Retirement Connection

1-800-462-1316 www.RetirementConnection.com

Source: https://ltclicensing.oregon.gov

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What Does Medicare Cover?

Skilled nursing facility (SNF) situations

Medicare covers skilled nursing facility (SNF) care. There are some situations that may impact your coverage and costs.

Medicare Part A: (Hospital Insurance) covers skilled nursing facility care for a limited time (on a short-term basis) if all of these conditions apply:

 You have Part A and have days left in your benefit period to use.

 You have a qualifying inpatient hospital stay.

 Your doctor has decided that you need daily skilled care. You must get the care from, or under the supervision of, skilled nursing or therapy staff.

 You get these skilled services in a Medicare-certified SNF.

 You need these skilled services for a medical condition that’s either: A hospital-related medical condition. A condition that started while you were getting care in the SNF for a hospitalrelated medical condition.

Your costs in Original Medicare

You pay this for each benefit period:

 Days 1 - 20: $0 coinsurance

 Days 21 - 100: Up to $200 coinsurance per day

 Days 101 and beyond: All costs

There's a 100-day limit of Part A SNF coverage in each benefit period.

What it is: Skilled care is nursing and therapy care that can only be safely and effectively performed by, or under the supervision of, professionals or technical personnel. It’s health care given when you need skilled nursing or skilled therapy to treat, manage, and observe your condition, and evaluate your care.

Medicare-covered services in a skilled nursing facility include, but aren't limited to:

 A semi-private room (a room you share with other patients)

 Meals

 Skilled nursing care

 Physical therapy (if needed to meet your health goal)

 Occupational therapy (if needed to meet your health goal)

 Speech-language pathology services (if they're needed to meet your health goal)

 Medical social services

 Medications

 Medical supplies and equipment used in the facility

 Ambulance transportation (when other transportation endangers your health) to the nearest supplier of needed services that aren’t available at the SNF

 Dietary counseling Things to know, situations that may impact your coverage and costs.

Observation services

Your doctor may order observation services to help decide whether you need to be admitted to the hospital as an inpatient or can be discharged. During the time you're getting observation services in the hospital, you're considered an outpatient—this time does NOT count towards the 3-day inpatient hospital stay needed for Medicare to cover your SNF stay. Find out if you're an inpatient or an outpatient.

Readmission to a hospital

If you're in a SNF, there may be situations where you need to be readmitted to the hospital. If this happens, there's no guarantee that a bed will be available for you at the same SNF if you need more skilled care after your hospital stay. Ask the SNF if it will hold a bed for you if you must go back to the hospital. Also, ask if there's a cost to hold the bed for you.

Meeting the 3-day inpatient hospital stay requirement

Here are some examples of common hospital situations that show if you've met the 3-day inpatient hospital stay requirement:

Situation 1: You came to the Emergency Department (ED) and were formally admitted to the hospital with a doctor’s order as an inpatient for 3 days. You were discharged on the 4th day.

Is my SNF stay covered? Yes. You met the 3-day inpatient hospital stay requirement for a covered SNF stay.

Situation 2: You came to the ED and spent one day getting observation services. Then, you were formally

admitted to the hospital as an inpatient for 2 more days.

Is my SNF stay covered? No. Even though you spent 3 days in the hospital, you were considered an outpatient while getting ED and observation services. These days don’t count toward the 3-day inpatient hospital stay requirement.

Refusing care

If you refuse your daily skilled care or therapy, you may lose your Medicare SNF coverage. If your condition won't allow you to get skilled care (like if you get the flu), you may be able to continue to get Medicare coverage temporarily.

Stopping care or leaving

If you stop getting skilled care in the SNF, or leave the SNF altogether, your SNF coverage may be affected depending on how long your break in SNF care lasts.

If your break in skilled care lasts more than 30 days, you need a new 3-day hospital stay to qualify for additional SNF care. The new hospital stay doesn’t need to be for the same condition that you were treated for during your previous stay.

If your break in skilled care lasts for at least 60 days in a row, this ends your current benefit period and renews your SNF benefits. This means that the maximum coverage available would be up to 100 days of SNF benefits.

Source: https://www.medicare.gov/whatmedicare-covers/skilled-nursing-facilitysnf-situations

Caregiver Checklist Protect this information by storing it in a safe place. Caregiver Checklist Protect this information by storing it in a safe place.

Personal Information

Name:

Birth Place:

Mother’s Maiden Name:

Social Security Number:

Driver’s License Number:

Medicare Number:

Medicaid Number:

Case Worker: Phone:

Health Insurance: ID #:

Monthly Income: Debt:

Health Information

Medical Conditions:

Caregiver Checklist

Records & Documents y n Location

Savings Accounts

Checking Accounts

Credit Cards

IRA’s

CD’s

Stocks/Bonds

Mutual Funds

Home Owner Insurance

Car Insurance

Life Insurance

Long-Term Care Insurance

Other Insurance

Real Estate

Mortgages

Deed to House

Car Title

Tax Records

Allergies:

Surgeries:

Pharmacy:

Primary Physician: Phone:

Physician #1: Phone:

Physician #2: Phone:

Dentist: Phone:

Health Care Records

Birth Certificate

Marriage Certificate

Will

Power of Attorney

Advanced Directives/POLST

Safety Deposit Box

Valuable Objects

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