Prime Time 2018 by CJ Media

PRIME TIME S U N D AY, O C T O B E R 2 1 , 2 0 1 8

Find out why pickleball is the hottest sport in Topeka thanks to seniors, thumb through Medicare rankings and much more MAKING PLANNING EASY WITH OUR COMPREHENSIVE GUIDE OF AREA FACILITIES, INCLUDING A LISTING OF SERVICES AND AMENITIES

2 | Sunday, October 21, 2018

BUILDING HOMES:

Three projects adding senior housing options to Topeka market By Morgan Chilson morgan.chilson@cjonline.com

Projects in Topeka at various stages of development are creating additional homes and opportunities for area seniors. Cottonwood Villas at Brewster Place are nearing completion, with residents who have already committed to the development ready to move in by mid-October, said Claudia Larkin, vice president and chief operating officer. A project started last year, the 14 villas — now 13 because one tenant bought two spaces to combine — were designed to attract younger people who wanted a “lock the door and go” kind of lifestyle, she said.

Billed as spacious living on one floor, the villas appealed to 11 tenants, so just two remain available. Larkin said all of the people moving into Cottonwood in October are making their first moves from their homes. The project ran into some delays, mostly centered around weather issues and changes the tenants wanted to make to their spaces, she said. “Each of the two levels has a social space and underground parking,” Larkin said, adding that there is an exercise room there as well. On the other end of the spectrum, with projects in the beginning to mid stages of construction, lie affordable senior

housing being built by Cornerstone of Topeka and a 132-apartment complex by Calamar Inc., a New York-based senior living company, to be built at Topeka USD 501’s Kanza Education and Science Park. Cornerstone is in the midst of building a six-unit duplex project in three buildings in the 1300 block of S.W. Van Buren, said executive director Chris Palmer. It is the organization’s first senior housing project. The buildings create a horseshoe shape, with the three surrounding an area that will be a small courtyard, he said. “We’re probably three or four months away from

taking applications,” Palmer said. “It’s affordable senior housing, and it is 50 percent or below of the area median income for your household size.” Rent for the units will be $450 per month, and tenants, who must be 55 years of age or older, will pay their own utilities. Fifty percent of median area gross income for a two-person household is $27,050 and for one person, it is $24,050 or below, Palmer said. Cornerstone is excited about the project not only to be able to provide needed affordable senior house but also the opportunity to improve the neighborhood, he said. The project is funded by $500,000 from the Kansas Housing Resources Corp., $75,000 from the City of Topeka and $100,000 that will be a private loan to Cornerstone. Elderly affordable housing is needed in Topeka, Palmer said.

The Cottonwood Villas at Brewster Place are expected to be move-in ready for residents by mid-October. The larger units were designed to appeal to a younger group of people, offering a luxurious style of living. [THAD ALLTON/THE CAPITAL-JOURNAL]

Sunday, October 21, 2018 | 3

Renderings of a new Cornerstone of Topeka senior affordable housing project show the three buildings being built in the 1300 block of S.W. Van Buren. [SUBMITTED]

“It’s hard because the affordable housing sometimes there are duplexes up and down, and even a lot of the house that we do in-fill housing, sometimes it’s an up-and-down duplex because the lots are small. They’re not big enough for a side by side,” he said, adding that the design of these new units means they’ll be convenient for seniors. “There’s a need for affordable housing, period, but the need for senior affordable housing is even greater just because of the demographics of our society. People are getting older,” Palmer said. Calamar Inc. is a national developer that’s also recognized the need for senior housing. They have teamed with USD 501 to use land at the Kanza park, and are looking forward to a project that will facilitate

intergenerational activities between students and seniors living in the complex. “We’re super excited about Topeka. I don’t say this every time,” said Rick Lynam, project manager. “I’m excited about all my projects, but Topeka in particular, we are very excited about because the location and the interest of the community, especially the board of education and how it fits in with that whole campus. The location, we just see it to be ideal.” Lynam said there is not a specific date set yet to begin the three-story, 132-unit project, but ground will be broken in the next several months, probably after the first of the year. When the company originally announced the plans to build, a spokesman said they would shoot for a spring 2020 opening.

In September, buildings for a senior affordable housing development in the 1300 block of S.W. Van Buren were framed. It’s the first senior housing project for Cornerstone of Topeka. [THAD ALLTON/SPECIAL TO THE CAPITAL-JOURNAL]

4 | Sunday, October 21, 2018

READING THE RANKINGS:

Medicare’s Nursing Home Compare

ABOVE: Cindy Luxem, president and CEO of Kansas Health Care Association, talks about how Medicare ranks nursing homes and the changes the system is undergoing. RIGHT: Rachel Monger, vice president of government affairs with Leading Age Kansas, said checking out Medicare’s rankings is a good place to start when looking into nursing home facilities. [PHOTOS BY CHRIS NEAL/THE CAPITAL-JOURNAL]

By Katie Moore katie.moore@cjonline.com

Medicare quarterly releases rankings on health inspections, staffing and quality measures, which are “an excellent starting point,” according to Rachel Monger, vice president of government affairs with Leading Age Kansas. The rankings website includes nursing homes certified by Medicare and Medicaid, and displays information on more than 15,000 facilities nationwide. However the ranking system has been going through some changes.

“What’s unique about this year is there has been a lot of upheaval at the federal level regarding regulations and health quality surveys, and so it’s made the rankings a little bit iffier than usual and we’ll probably see that for another year,” Monger said. “It’s all for the best, but it’s just in a little bit of a transition.” One area that has been revamped is the way nursing homes submit staffing data. They now use the payroll-based journal system, which has caused a lot of confusion, Monger said. Errors in reporting and data entry have caused many places to drop to one star in that category.

As the system works out the glitches, the staffing rankings could change quarterly. “It’s that volatile,” said Cindy Luxem, president and CEO of Kansas Health Care Association. According to Monger, staffing is the No. 1 concern for senior care. “We are far, far short of the workers we will need in the coming decades, we know that,” she said. Luxem said one way to fill that gap is to support immigration policies that help the industry. “In a lot of places, about one in four workers are immigrants and we think that could even be more beneficial for us, if we can get the deciders help us break through some of those barriers,” she said. “Of course, with some of the current talk with the people in D.C. right now, we have some real concerns.” Linda MowBray, vice president of Kansas Health Care Association, said programs that have brought workers from the Philippines and parts of Africa have been beneficial. “We need more programs like that, not more barriers,” she said. Another resource for Kansans looking for information is the resident satisfaction ratings published by the Kansas Department for Aging and Disability Services. Nursing homes voluntarily submit responses annually.

Sunday, October 21, 2018 | 5

Area nursing homes 1

5 stars 4 stars 3 stars 2 stars 1 star

6 Westmoreland

Leonardville 4 5

Manhattan

Wamego

10 11

Rossville 2

Junction City

Alma

Topeka 19

14 18 16

335

4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18.

Overall Name rating Leonardville Nursing Home 4 stars Valley View Senior Life 4 stars Stoneybrook Retirement 5 stars Community Via Christi Village Manhattan, Inc. 2 stars Meadowlark Hills 5 stars Westy Community Care Home 2 stars Good Samaritan Society-Valley Vista 4 stars Alma Manor 4 stars Rossville Healthcare 3 stars & Rehab Center Aldersgate Village 3 stars Rolling Hills Health Center 5 stars Manorcare Health Services 2 stars Plaza West Regional Health Center 4 stars Tanglewood Nursing & Rehabilitation 1 star Topeka Presbyterian Manor 5 stars Lexington Park Nursing 5 stars Brighton Place West 3 stars McCrite Plaza Health Center 3 stars

Linda MowBray, vice president of Kansas Health Care Association, said immigration programs that allow employment in the health care ﬁeld have been helpful in addressing a stafﬁng shortage.

“It’s a really good indication,” Monger said, adding that on average 88 percent of residents and families would recommend the home they use. Both organizations say an on-site visit is the most important factor in choosing a facility. “No star or ranking is going be a

21 25 22 26

30 28

Tonganoxie 33

Lawrence

Eudora 35

Baldwin City

De Soto

Gardner Wellsville

10 miles

1. 2. 3.

17 20

Oskaloosa

19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35.

Name Brewster Health Center Brighton Place North Countryside Health Center Legacy on 10th Avenue Providence Living Center Hickory Pointe Care & Rehab Center Pioneer Ridge Retirement Community Brandon Woods at Alvamar Lawrence Presbyterian Manor Lawrence Memorial Hospital SNF Baldwin Healthcare & Rehab Center, LLC Legend Healthcare Medicalodges Eudora Wellsville Manor Hillside Village of De Soto Medicalodges Gardner Meadowbrook Rehabilitation Hospital LTCU

Overall rating 4 stars 5 stars 3 stars 1 star 2 stars 2 stars 5 stars 4 stars 5 stars 5 stars 4 stars 1 star 5 stars 5 stars 5 stars 4 stars 4 stars

replacement for a personal visit to that home,” Monger said. “Trust your senses — what does it smell look, what does it look like, what does it sound like.” MowBray echoed that sentiment. “Nothing is going to be more important than walking in the door yourself, seeing how it feels, seeing how the staff treats you, seeing how the residents that are there respond — you can feel a difference when you walk in the door,” MowBray said. Other important points to consider are staff and resident interactions and if nursing homes are using person-centered care. “The idea is to move away from institutional models into more resident-focused care,” Monger said. Offerings such as the dining options and activities may also be important factors, Luxem said, when making a placement decision for a loved one.

6 | Sunday, October 21, 2018

Home modifications can help seniors age in place By Samantha Foster samantha.foster@cjonline.com

Two decades ago, many aging seniors expected to move into retirement homes. Now, builders say, more people are realizing that with a few modifications, they can stay in their homes longer. It’s a concept that Mike Pressgrove said changed his whole way of thinking the first time he encountered it. Pressgrove, president of PDQ Construction, completed a large project for a retired doctor and his wife who lived near Potwin. It was an older house, and all of the bedrooms were on the second floor. The couple were in their early 80s, and they hired Pressgrove’s company to build an addition in the back of the house with a bedroom, master bathroom, office and back porch, all on the first floor. After finishing the project, Pressgrove recalled, he asked the doctor why the couple decided to invest so much in their home late in life. He replied that the cost for him and his wife to go to an assisted living facility would ultimately cost much more. The new addition enabled them to stay in their home for several more years, Pressgrove said. “The idea to them wasn’t necessarily the money — it was the familiarity, and liking where you live and liking your neighbors and liking your neighborhood, and they just didn’t want to go anywhere,” he said. “And that was their solution.” That build prompted Pressgrove to take an aging-in-place course offered by the National Association of Home Builders. It involved experiencing for himself — in a wheelchair, with special glasses and wearing things on his hands to mimic the effects of arthritis — the kind of problems seniors may encounter in their homes. The course is meant “to help remodelers and builders be able to understand some of the problems and be able to come up with answers and solutions to be able to keep people in their homes,” said Pressgrove, a certified aging-inplace specialist.

Mike Pressgrove, of PDQ Construction, says a lift like this one onto an extended platform can make a garage door zero-entry, removing the need to build a ramp. [2015 FILE PHOTO/THE CAPITAL-JOURNAL]

MOST POPULAR PROJECTS Home Advisors surveyed service providers to ask what aging homeowners are doing to stay in their homes. The top projects were as follows: • Adding grab bars • Adding a ramp to the entrance • Increasing the widths of doorways • Adding a bathroom on the main floor • Adding lever-handled doorknobs • Changing flooring to prevent injuries • Shifting master bedroom to first floor • Lowering electrical switches Source: Home Advisor

A walk-in tub in the master bathroom allows for easy entrance and exit, as well as molded seating for comfort while taking a bath. [2017 FILE PHOTO/THE CAPITAL-JOURNAL]

Mark Boling, owner and president of Mark Boling Construction, said homeowners want the ability to move around freely in their homes.

One of the biggest problems, he said, is being able to enter the house with zero entry — no steps. Indoor stairs can present a bigger

problem. While Pressgrove said stairlifts are popular and easy to install, Boling said his company will modify stairs so there is less of a rise. A 1- or 1.5-inch difference in height can make a lot of difference, Boling said. Many people are choosing engineered wood flooring, Boling said. It is easy to clean, and for people in wheelchairs or with walkers, it is easier to move around on than carpet.

Sunday, October 21, 2018 | 7

For Pressgrove’s clients, bathrooms present the main concerns. Walk-in showers with grab bars allow easier access and avoid the fall risk tied to tubs, he said. Houses built in the 1970s often have laundry facilities in the basement or tucked into a corner near the entrance from the garage, Boling said. That makes them less accessible for some aging homeowners. “More and more people are trying to make it where the laundry room is right off the master bedroom area,” he said. “That way they can ease access (from) the laundry to the master closet.” Aging-in-place projects are an increasingly larger part of Pressgrove’s business, he said, adding it is a good investment. “Some of the people who come to me have talked to their financial advisers and those people are starting to tell them, ‘Have you thought about trying to stay there and save money for when you really need to go?’" Pressgrove said. “And sometimes they can do minor modifications to their bathrooms, their kitchens, their entryways, just things like that to be able to keep them there, to make life easier so they don’t feel like they’ve got to go somewhere.”

BELOW: This closet has an electric hanger bar that rises and lowers, making it easier to reach clothes. [2017 FILE PHOTOGRAPH/THE CAPITAL-JOURNAL]

ABOVE: A lower kitchen sink with a recess can accommodate a wheelchair. Lever-style faucets also make it easier to control water for people with arthritis or varying skill levels. [2017 FILE PHOTOGRAPH/THE CAPITAL-JOURNAL]

8 | Sunday, October 21, 2018

Help is available for sometimes confusing Medicare enrollment process By Morgan Chilson morgan.chilson@cjonline.com

Topekan Susan Crist depends on four medications that cost more than $1,700 each per month, and when she became disabled, she didn’t know what she was going to do. Luckily, her approval for Social Security disability also meant that she eventually qualified for Medicare and Medicaid. “Without Medicare and Medicaid, I would be absolutely destitute,” she said. “I would be on the street. My medication is more than what I make in a year.” But when Crist went to sign up for Medicare, especially as she had to determine which plan best fit her prescriptions and needs, she struggled to understand the program. Her savior came in the form of Angie Duncan, a Valeo staff member trained as a Senior Health Insurance Counseling for Kansas certified counselor who helps Valeo clients find their way through the sometimes confusing Medicare quagmire.

Susan Crist, 56, qualified for Medicare because she receives Social Security disability. But the process of determining Part D enrollment, which is the prescription drug coverage part of the plan, led her to find help at Valeo from a trained individual who helps clients with Medicare. [THAD ALLTON/THE CAPITAL-JOURNAL]

Sunday, October 21, 2018 | 9

“ Without Medicare and Medicaid , I would be absolutely destitute. I would be on the street . My m e d i c a t i o n i s m o r e t h a n w h a t I m a k e i n a y e a r .”

— SUSAN CRIST “Before I met Angie, it was a total nightmare,” Crist said. “I didn’t know where to go. I didn’t know who to call. I didn’t know what I was eligible for.” For people with disabilities, she added, it’s very confusing, and having someone like Duncan to call and ask questions of can make all the difference. Multiple resources exist for Kansans unsure of the Medicare process. SHICK is a free program with trained counselors throughout the state to answer questions and help people follow the proper enrollment process. Susan Harris, executive director of the Jayhawk Area Agency on Aging, which is the SHICK coordinator for Shawnee and Jefferson counties, said the Medicare process can be challenging. Most people qualify for Medicare

either when they turn 65 years of age, if they’ve been receiving the monetary benefit from Social Security disability for 24 months, or if they have been diagnosed with ALS or are in end-stage renal disease, she said. People should start thinking and planning for Medicare enrollment at least three months in advance of turning 65. “There’s a time frame that’s called your guaranteed acceptance time frame, which is the seven months surrounding when you’re brand new to Medicare, be that when you’re 65 or that 25th month of the Social Security disability payment,” Harris said. “You have seven months — the three months before, the month you start and the three months after that you’re able to make selections regarding your supplemental insurance policies to where

those insurance companies cannot deny you coverage.”Harris said it was “vitally important” to stay within that sevenmonth window. The process doesn’t have to take that long, but just in case something unforeseen would happen, it’s better to be safe than sorry. If an individual would miss that time window of time, they would have to wait for the next open enrollment period, and their coverage could be delayed for months, Harris said. Medicare is split into two primary parts: Part A is hospital insurance coverage, and Part B is health insurance, which covers preventive care and medically necessary services. Medicare Part D is the prescription drug coverage plan. If an individual is still working and has insurance, they might opt to delay Part B enrollment, Harris said. Part B has premiums, but Part A has no cost to it if the person has worked enough in their lifetime to qualify, so many sign up for Part A and use it along with their employer-supplied health insurance. Once the person does retire and loses their employer insurance, they will have

63 days to enroll in Part B, Harris said. Duncan said choosing a prescription plan is the most challenging for her clients. Although online resources help people by letting them enter the prescriptions they take and outlining which of multiple plans are the most cost-effective for them, those plans sometimes change the drugs they cover and can leave patients forced into changing their medications or paying out of pocket, Duncan said. She said many of the Valeo clients she works with don’t understand how closely they need to watch those prescription plans. “Because the plan may become sanctioned, where it’s no longer available for the next plan year, and they’re automatically put in another plan,” she said. “Their prescription drug may fall off of the formulary and then come Jan. 1 of the following year and they go to get their prescription and it’s $2,500.” JAAA can be reached by calling (785) 235-1367. Numerous organizations have Medicare information online, including AARP and Medicare.gov.

10 | Sunday, October 21, 2018

PRIME TIME 2018: COMMUNITY RESOURCES GENERAL SERVICES AARP — Kansas Office Fights for health care, employment and income security, and protection from financial abuse for those age 50 and older. (866) 448-3619 states.aarp.org/region/kansas/ Eldercare Locator As a public service of the U.S. Administration on Aging, the Eldercare Locator connects individuals to services for older adults and their families. (800) 677-1116 eldercare.gov Elderly Services: A Community Action Program Helps low-income seniors maintain safe and independent living. (785) 235-9296 wefightpoverty.org/elderly-services/ Friendly Visitors and Ring-a-Day — Catholic Charities Available to homebound seniors and people with minor disabilities, regardless of faith. Seniors are paired with compassionate volunteers who are carefully screened and trained. Services are free, but contributions are welcome. (785) 233-6300, Ext. 1313, Topeka; (785) 8562694 or (888) 737-1137, Lawrence; Ring-A-Day, (785) 232-1137 Foster Grandparents Program Offers seniors age 55 and older opportunities to serve as mentors, tutors and caregivers for children and youth with special needs. Participants provide 15 to 40 hours of weekly service to community organizations, such as schools, hospitals and youth centers. (785) 296-5474 www.nationalservice.gov/programs/ senior-corps/senior-corps-programs/ fostergrandparents HealthWise 55 An organization sponsored by Stormont Vail Health for those 55 years of age and older who want to stay current on health information and health resources. (785) 354-6787 www.stormontvail.org/healthwise Kansas Advocates for Better Care Inc. Works to improve the quality of long-term care for the elderly at home and in nursing and assisted living facilities. (785) 842-3088; (800) 525-1782 kabc.org Kansas Department for Aging and Disability Services Fosters an environment that empowers Kansas’ older adults and individuals with disabilities to make choices about their lives, including providing information about Medicare and Senior Health Insurance Counseling for Kansas (SHICK). (800) 432-3535; (785) 296-4986 kdads.ks.gov Kansas Department of Health and Environment Provides information on KanCare and Medicaid. (785) 296-3512; (800) 792-4884 (for KanCare questions) http://www.kdheks.gov/hcf/Medicaid/default.

htm; kancare.ks.gov Kansas Elder Law Hotline/Kansas Legal Services Attorneys answer questions in civil cases for Kansans age 60 or older. (888) 353-5337 kansaslegalservices.org/node/1250/ services-seniors Kansas Foundation for Medical Care Inc. Empowers Medicare beneficiaries to be active participants in their health care. (785) 273-2552; (800) 432-0770 kfmc.org Kansas Insurance Commission Provides information on Medicare supplements and long-term care insurance plans. (785) 296-3071; (800) 432-2484 www.ksinsurance.org Kansas Long-Term Care Ombudsman Investigates and resolves complaints made by residents or on behalf of residents in long-term care facilities; provides education regarding long-term care issues; and identifies concerns and advocates for needed changes in long-term care policies, laws and regulations. (785) 296-3017; (877) 662-8362 https://ombudsman.ks.gov/ Kansas State Board of Mortuary Arts Offers a guide on pre-planning funeral arrangements and how to establish a memorial. (785) 296-3980 ksbma.ks.gov/ The Lift — Lift Service — Topeka Metropolitan Transit Authority Provides door-to-door transportation for individuals with disabilities, including the non-ambulatory. (785) 783-7000 (voice or TDD) https://topekametro.org/about-metro/ paratransit-service-the-lift/ Low Income Energy Assistance Program (LIEAP) Helps eligible households pay a portion of their home energy costs by providing a once-peryear benefit. (913) 279-7171, Atchison, Douglas, Johnson, Leavenworth and Wyandotte counties; (785) 296-2763, Brown, Coffey, Doniphan, Jackson, Jefferson, Marshall, Nemaha, Osage, Pottawatomie, Shawnee and Wabaunsee counties; (620) 272-5985, Dickinson, Lyon and Saline counties; (800) 432-0043 dcf.ks.gov/services/ees/Pages/Energy/ EnergyAssistance.aspx Older Kansans Employment Program Offers individuals age 55 or older assistance in finding employment or transitioning from one job to another, proving the older worker can bring mature judgment, excellent skills, loyalty and experience working with people to the workplace. Northeast Kansas: Let’s Help, Inc. / (785) 234-5248 / info@ letshelpinc.org Counties served: Douglas, Jefferson, Shawnee North-Central Kansas: North Central-Flint Hills Area Agency on Aging / (785) 776-9294

Counties served: Chase, Clay, Cloud, Dickinson, Ellsworth, Geary, Jewell, Lincoln, Lyon, Mitchell, Marion, Morris, Ottawa, Pottawatomie, Republic, Riley, Saline, Wabaunsee Project LIVELY — Lawrence-Douglas County Health Department A care coordination program that promotes the health, independence and well-being of older adults in Douglas County. (785) 856-5353 ldchealth.org/244/Project-LIVELY Red Carpet Library Services Provides library materials, services and access to older adults, individuals with special needs and their caregivers through personalized, individual and customized service. Delivers these services to congregate living sites, individuals in their homes and walk-in patrons on a consistent and regularly scheduled basis. (785) 580-4400 tscpl.org/services/red-carpet RSVP of Shawnee and Douglas Counties — United Way Topeka Engages people 55 or older in volunteer service to meet critical community needs and provide a quality experience that will enrich the lives of volunteers through community service work and personal development. (785) 228-5124 unitedwaytopeka.org/ Senior Health Insurance Counseling for Kansas (SHICK) Educates the public and assists consumers on topics related to Medicare and health insurance so they can make informed decisions. SHICK has counselors throughout the state who can assist people to stay informed on changing conditions in health care insurance and to cut through the confusion. The goal is to educate and assist the public to make informed decisions on what's best for them. (800) 860-5260; (785) 232-0062 kdads.ks.gov/commissions/ commission-on-aging/medicare-programs/shick Shawnee County Advocacy Council on Aging Serves as an advocate for older citizens by identifying their unmet needs and helping provide necessary services on a countywide basis. (785) 233-1365 crcnet.org/ shawnee-county-advocacy-council-on-aging/ Topeka Jayhawk Legal Services for Seniors — Kansas Legal Services Helps low-income Kansans meet their basic needs through the provision of essential legal, mediation and employment training services. (800) 723-6953 kansaslegalservices.org U.S. Social Security Administration Administers Social Security, a social insurance program consisting of retirement, disability and survivors’ benefits. (888) 327-1271, Topeka; (866) 698-2561, Lawrence; (877) 840-5741, Manhattan ssa.gov VIP 501 Club — Topeka Public Schools USD 501 Shows the schools’ appreciation to district patrons for their past and continued support of

public education in the community. Must be 65 years or older and reside within the boundaries of USD 501, or be 65 years or older and have one or more grandchildren enrolled in a USD 501 middle or senior high school. Retired USD 501 employees are eligible at age 62. (785) 295-3000 Westar Energy Project DESERVE Provides emergency assistance paying energy costs for people with a severe disability (children or adults meeting Social Security disability criteria), adults 65 years or older and income-eligible households. Center of Hope, (316) 219-2121; Westar Energy, (800) 383-1183 westarenergy.com/project-deserve-assistance

A R E A AG E N C I E S O N AG I N G East Central Kansas Aging and Disability Resource Center Administers and coordinates services for older adults in Anderson, Coffey, Franklin, Linn, Miami and Osage counties. (785) 242-7200 eckaaa.org Jayhawk Area Agency on Aging Inc. Administers and coordinates services for older adults in Shawnee, Jefferson and Douglas counties. (785) 235-1367; (800) 766-3777, TDD/TYY jhawkaaa.org North Central-Flint Hills Area Agency on Aging Inc. Administers and coordinates services for older adults in Jewell, Mitchell, Lincoln, Ellsworth, Republic, Cloud, Ottawa, Saline, Clay, Dickinson, Marion, Riley, Geary, Morris, Chase, Pottawatomie, Wabaunsee and Lyon counties. (785) 776-9294, Manhattan; (620) 340-8001, Emporia; (785) 823-1277, Salina; (800) 432-2703 ncfhaaa.com Northeast Kansas Area Agency on Aging Administers and coordinates services for older adults in Atchison, Brown, Doniphan, Jackson, Marshall, Nemaha and Washington counties. (785) 742-7152; (800) 883-2549 nekaaa.org Wyandotte-Leavenworth Area Agency on Aging Administers and coordinates services for older adults in Wyandotte and Leavenworth counties. (913) 573-8531; (888) 661-1444 wycokck.org/aging SENIOR CENTERS East Topeka Senior Center Provides direct services to individuals and supports the development of systems that deliver a full range of services to senior citizens and disabled adults. (785) 232-7765 easttopekaseniors.org/ LULAC Senior Center Inc. Provides senior computer classes, nutrition classes, O.T. , cooking classes and off-site activities. It’s the only full-time senior center in Topeka. (785) 234-5809; (785) 233-7498 topekalulacseniorcenter.com/

Sunday, October 21, 2018 | 11

Papan’s Landing Senior Center Provides services that will assist the elderly to remain independent and in their homes for as long as possible. (785) 232-1968 papanslanding.com/ Rossville Senior Center Provides nutrition, recreation and mobility to senior citizens in the Rossville area. (785) 584-6364 Silver Lake Senior Citizen Center Provides recreation, nutrition and mobility to senior citizens in the Silver Lake area. (785) 582-5371

M E A L D E L I V E RY Friendship Meals — North Central-Flint Hills Area Agency on Aging Provides meals to homebound older adults in Manhattan. (785) 776-9294 ncfhaaa.com Friendship Meals — Ogden Provides meals at noon Monday, Wednesday and Friday at Ogden Community Center and delivers meals to homebound individuals. (785) 537-0351 ogden-ks.gov/ogden-friendship-meals.htm Lawrence Meals on Wheels Delivers meals, including meals designed around specialized diets, to the homebound,

seniors and disabled individuals in Lawrence. (785) 830-8844 lawrencemow.org Meals on Wheels of Eastern Kansas Inc. Delivers meals and provides safety checks to the homebound, seniors and disabled individuals in Shawnee and Jefferson counties. (785) 295-3980 mowks.org Senior Resource Center for Douglas County Provides resources, information, opportunities and advocacy for older residents of Douglas County, including meal delivery, door-to-door transportation for medical, nutritional and personal purposes, and a caregiver support group. (785) 842-0543; (785) 727-7878; (877) 295-3277 yoursrc.org

VETERANS O R G A N I Z AT I O N S Kansas Commission on Veterans Affairs Office Meets the health care needs of veterans at two main facilities — in Topeka and Leavenworth — and nine community-based outpatient clinics. (620) 342-3347, Emporia; (785) 238-4522, Junction City; (785) 843-5233, Lawrence; (913) 682-2000, Dwight D. Eisenhower VA Medical Center in Leavenworth; (785) 587-0373, Manhattan; (785) 296-3976 and (785) 670-3372, Topeka; (785) 350-3111, Colmery-O’Neil VA Medical Center in Topeka

kcva.ks.gov; www.topeka.va.gov

D I S E A S E A D VO C A C Y O R G A N I Z AT I O N S Alzheimer’s Association — Heart of America Chapter Northeast Kansas Regional Office Eliminates Alzheimer’s disease through the advancement of research; provides and enhances care and support for all affected; and reduces the risk of dementia through the promotion of brain health. (785) 271-1844; (800) 272-3900 alz.org/kansascity Arthritis Foundation — Topeka Helps conquer everyday battles through lifechanging information and resources, access to optimal care, and advancements in science and community connections. (785) 272-8461; (800) 362-1108 arthritis.org/kansas/ Northeast Kansas Parkinson Association Provides information about Parkinson’s disease and works toward improving treatment options. (785) 478-9045; (785) 272-6397 nekpa.com

E D U C AT I O N / C L A S S E S Osher Lifelong Learning Institute Creates accessible and innovative learning environments throughout Kansas and the greater

Kansas City area, with special focus on participants age 50 and older, although anyone can participate. (785) 864-5823; (877) 404-5823 kupce.ku.edu/osher-home# Senior Adult Program — Shawnee County Parks and Recreation Offers classes in Senior Basketball, Shuffle Board, Art Show “Still Life,” Holiday Craft Show, Oil Painting, Gingerbread House Creations, Monarch & Pollinator Class and Beekeeper Class, as well as classes at the Topeka and Shawnee County Public Library, including Chapter Chat, Computerized Genealogy, The Visual Journal, Origami, Learn to Knit and Pomanders. (785) 251-6800 parks.snco.us

C A R E G I V E R I N F O R M AT I O N Caregiver Action Network Works to improve the quality of life of Americans who care for loved ones with chronic conditions, disabilities, disease or the frailties of old age. (202) 454-3970 caregiveraction.org CaringInfo — National Hospice and Palliative Care Organization Provides free information and resources to help people make decisions about end-of-life care and services before a crisis. (800) 658-8898 caringinfo.org/i4a/pages/index.cfm?pageid=1

12 | Sunday, October 21, 2018

Retirement communities try to address bullying By Luke Ranker luke.ranker@cjonline.com

Rude comments in the hall. Shunning in the cafeteria. This isn't middle school. Itâ&#x20AC;&#x2122;s retirement. Kameron Patrick, apartment director for McCrite Plaza, says people with strong personalities seek to be in charge in any social situation. In retirement, those people sometimes struggle to find creative outlets. Staff members at McCrite Plaza work to identify them and find outlets for them. [CHRIS NEAL/THE CAPITAL-JOURNAL]

Sunday, October 21, 2018 | 13

As we age, we think less about bullying and cliques, but they’re as common in the communal setting of a retirement home just as they were in school. About one in five seniors experiences bullying in a retirement community, studies suggest. Robin Bonifas, a social work professor at Arizona State University and author of the book “Bullying Among Older Adults: How to Recognize and Address an Unseen Epidemic,” told the Associated Press in May that anxiety about communal living and the stress of growing older leads some to turn to bullying to regain control. But area retirement communities are aware of the tendency toward cliques and are taking efforts to help seniors integrate into their new homes. “There’s definitely conflicts that arise in a group living situation. That’s just part of life,” said Sarah Duggan, community

relations director at Meadowlark Hills in Manhattan. “We have 350 residents, so you can imagine there’s a wide variety. We want everyone to find their group.” A 2017 study from the National Center for Assisted Living showed the traits of bullying vary from men and women. Men tend to be spontaneous in their bullying, verbally and physically aggressive, and direct with a superiority complex. Women turn to gossip, emotional manipulations and cliques. Bullying in a retirement community, like in a school, can take many forms, from dirty looks and negative comments to physical abuse and damaging property. Victims sometimes are those with physical or mental impairments, lone residents or those considered more vulnerable. Often they’re simply new to the community, according the NCAL study. Both Meadowlark, 2121

Meadowlark Road, and Topeka’s McCrite Plaza, 1610 S.W. 37th St., rely on a combination of staff and peers to help seniors adjust and resolve conflicts. At McCrite Plaza, an independent living community coordinator learns about the new resident and helps guide him or her to interests and activities the person may share with other residents, said Kameron Patrick, apartment director. Resident ambassadors, fellow retirees who help newcomers navigate the community, will get to know others over lunch or dinner, she said. “Sharing a meal with someone is the most social and natural thing you can do,” she said. “We find they (the resident ambassador) really helps them get to know others.” Meadowlark Hills staffs a full-time and a part-time social worker who help seniors adjust to their new community and work to

resolve disputes between retirees, Duggan said. But the community finds peer representatives are best resolving conflicts. Peer representatives meet monthly in a council to discuss concerns in the community. They’re also an outlet for residents to turn to if they have problems. “It puts the responsibility on the peers to work through conflict,” she said. Still, bullying can happen. In any social situation, there can be people with strong personalities who seek to be in charge. In retirement, it can be tough for those people to find outlets. Staff members at McCrite Plaza work to identify those people and find outlets for them, Patrick said. “Being able to redirect that need to be in control or in charge is key,” she said. “We have a lot of volunteer opportunities and other things people can do that meets those needs.”

Pets allowed?

Onsite banking?

Community computers available?

Deaf/hearing-impaired accommodations?

Elevators?

Onsite exercise facility?

Flexible lease terms?

Flexible scheduling for activities/meals?

Access to religious services?

Secure facility?

Transportation provided?

Wheelchair accessible?

Library?

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Planned social activities?

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Westy Community Care Home and Westy Assisted Living Apartments

Stoneybrook Retirement Community

Meadowlark Hills Retirement Community

Garden Grove Senior Apartments

Ascension Living -Via Christi Village in Manhattan

Vintage Park of Ottawa

The Windsor of Lawrence

Pioneer Ridge Health & Rehab

Neuvant House of Lawrence

Morningstar Care Homes of Baldwin

Monterey Village

Meadowlark Estates

Lawrence Presbyterian Manor Long Term Care & Rehabilitation

Lawrence Presbyterian Manor Independent Living

Lawrence Presbyterian Manor Assisted Living & Memory Care

Brandon Woods at Alvamar

Babcock Place

Arbor Court Retirement Community at Alvamar

Topeka Presbyterian Manor

Thornton Place

The Healthcare Resort of Topeka

The First Apartments

Tanglewood Health & Rehabilitation

Rose Villa

Rolling Hills Assisted Living

Plaza West Care Center

McCrite Plaza-Topeka

Martin Creek Place

Lexington Park Independent Living

Lexington Park Health & Rehab

Lexington Park Assisted Living

Legend at Capital Ridge

Legacy on 10th Avenue

Landmark Plaza Apartments

Kelly House 1 and 2 of Topeka

Homestead of Topeka

Brookside Retirement Community

Brookdale Topeka

Brewster Place

Atria Hearthstone

Arbor Valley Senior Homes

Arbor Court Retirement Community at Topeka

Aldersgate Village

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TOPEKA AREA

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Do you accept Medicare/Medicaid?

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14 | Sunday, October 21, 2018 Sunday, October 21, 2018 | 15

M A N H AT TA N A R E A

16 | Sunday, October 21, 2018

From auditing courses to meal deals, opportunities abound By Carolyn Kaberline carolyn.kaberline@gmail.com

Karon Gambrill jots down several notes as she listens to instructor Jia Feng discuss Latin America in the world geography class she’s taking at Washburn University. The notes are to help her remember the key points of the day’s presentation although she won’t need to use them for a homework assignment or to study for any tests. Instead, she and several other members of the class are taking part in Washburn’s 60+ Audit Program, which allows Kansas residents who are 60 years of age or older to take classes at the university tuition-free. “In a few cases, there may be a materials fee in connection with a course, but seniors are not assessed any tuition or the student fee,” said Steve Grenus, Washburn registrar. “Many courses are available across the university with some limitations, and availability is based on any excess capacity in a class after enrolling our degree-seeking or non-degree students who are taking courses for credit.” Coursework taken under the 60+ Audit Program is not transcripted and does not count for university credit, For Gambrill and others in the program, the credit is not important: It’s a chance to learn about a variety of subjects and interact with others. Gambrill, who is in her early 70s, began taking classes three years ago. “I heard about the program from my then 89-year-old neighbor who was taking classes so he could use the gym and swimming pool,” she said. “I lived near the campus, so I talked myself into it. I’ve met so many people. It’s a definite help to a social life; it keeps the mind active andgets me out of the house.” Since beginning classes in 2015, Gambrill has taken classes in art, religion, music and literature. This semester, in addition to the world geography class, she’s taking a literature class focusing on Jane Austen and a music class highlighting Broadway musicals. Grenus said the older adults tend to prefer history, political science, philosophy/religious studies, art and

Karon Gambrill audits a world geography class at Washburn University. Many seniors participate in the university’s 60+ Audit Program, which allows Kansas residents who are 60 or older to take classes at the university tuition-free. [THAD ALLTON/THE CAPITAL-JOURNAL]

More than 225 older adults participate in Washburn University’s 60+ Audit Program, where they interact with full- and part-time college students.

activity courses under kinesiology. Grenus said 229 students are in the 60+ Audit program for the fall 2018 semester. “Every class I’ve audited has had at least three or four auditors in it,” Gambrill said, adding that sometimes when she starts a new class she

worries about being the only senior. “However, the other students don’t mind us there, and the teachers seem to enjoy having us because of our life experiences.” “It really is a wonderful program, and we are pleased to be able to offer the opportunity to audit courses to

our senior community members,” said Grenus, adding that additional information can be found at washburn.edu/registrar. Another program that Gambrill takes part in is the CHAMPSS program, a meal program administered by Jayhawk Area Agency on Aging (JAAA) and funded partially through Federal Older American’s Act dollars and supplemented by participant donations — suggested donation is $3.50 a meal. “A lot of individuals look at the CHAMPSS (Choosing Healthy Appetizing Meal Plan Solutions for Seniors) program as a ‘discounted’ meal and in a sense it is,” said Susan Harris, executive director. “However, it is much more than that as well.” Harris said to be eligible a person must be 60 years or older or be married to someone 60 years or older. “There is no income guideline for the program as it is a program funded through Older American Act dollars,” Harris said. “The meal is intended to supply a third of the calories for the average senior based on the government’s recommended daily allowance for nutrition. CHAMPSS is really a program about getting older adults the nutrition they need more so than a ‘discounted’ meal.’” Harris said anyone wanting to participate in the CHAMPSS program must undergo an orientation to learn about the program and how it works. Those are on the first Wednesday of each month at 1:30 p.m. at the JAAA office at 2910 S.W. Topeka Blvd. and usually on the first Monday of the month at the Lawrence Public Library. Eighty-six-year-old Raul Alonzo said CHAMPSS is “a wonderful program.” While participants can select meals at breakfast, lunch or dinner, Alonzo often visits Hy-Vee for breakfast. “Everyone there knows me,” he said. “I like what they are serving, and the people who serve me are wonderful. While a regular restaurant would charge me $16 or $17 for a meal, I love the $3.50, the people and the food. Although I work 16 hours a week in addition to my Social Security, this helps me. I would recommend CHAMPSS to everyone.”

Sunday, October 21, 2018 | 17

Gambrill said one of the goals of CHAMPSS is to get people more social since the locations offering the program must have a place for the participants to sit and eat. “It’s well worth the price and the food meets nutritional standards,” she said. Other local discounts are available for seniors as well. Many banks offer accounts with no service charge and free checks, and many restaurants offer discounts or such free items. Some restaurants, such as Perkins and IHOP, offer senior menus. Numerous retail stores — C.J. Banks and Kohl’s, for example — offer senior discounts on all sales, while some offer senior discounts on certain days of the week or month. Discounts are available for travel, lodging and some entertainment, with senior discounts for movies extremely popular. While

most discounts start at age 60, some begin at 50. A list of establishments offering senior discounts can be found at www.seniorcitizendiscountlist.org/ kansas-ks-senior-citizen-discountlist-restaurant-retail-grocery-travel. However, interested seniors should always ask as to the availability of discounts at the stores of their choice. Carolyn Kaberline is a freelance writer in Topeka. She can be reached at carolyn.kaberline@gmail.com.

18 | Sunday, October 21, 2018

Activities available to help senior citizens keep fit By Tim Hrenchir tim.hrenchir@cjonline.com

“Kids 65 and up” particularly enjoy using the pickleball courts offered by Shawnee County Parks and Recreation, director John Knight told county commissioners last month. Pickleball, a weekly senior basketball gathering and yoga classes are among various options senior citizens here have for keeping fit. Pickleball, a paddle sport that

combines elements of badminton, tennis and table tennis, is the fastest-growing sport in the United States, said Mike McLaughlin, communications and public information supervisor for Shawnee County Parks and Recreation. Dean Wineinger, 76, and Bill Kitchen, 63, talked about the sport last month while taking a break from playing on one of 18 pickleball courts Shawnee County maintains in Hughes Park at 725 S.W. Orleans.

Pickleball is played on a court that’s about one-third the size of a tennis court, Kitchen noted. “It’s simply not as vigorous as tennis, and that’s why it’s very popular with seniors,” he said. Wineinger added, “You don’t have to move as far.” McLaughlin said that for $2, the public may also play pickleball from 1 to 3 p.m. Wednesdays at Crestview Community Center, 4801 S.W. Shunga Drive; from 9 to 11 a.m. Tuesdays and Fridays at Oakland

Community Center, 801 N.E. Poplar; and from 10 a.m. to noon Mondays and Wednesdays and 6 to 8 p.m. Thursdays at Garfield Community Center, 1600 N.E. Quincy. The county offers basketball competition for senior citizens for $2 per person from 6 to 8 p.m. Mondays at Crestview Community Center, 4801 S.W. Shunga Drive; and shuffleboard for $2 per person from 10 a.m. to noon Thursdays at Central Park Community Center, 1534 S.W. Clay.

Debra Nelson, left, and Andre Barber teamed up during a recent game of pickleball at Hughes Park, 725 S.W. Orleans. [THAD ALLTON/THE CAPITAL-JOURNAL]

Sunday, October 21, 2018 | 19

ABOVE: Charlie Bates goes for the ball during a pickleball game at Hughes Park, 725 S.W. Orleans. BELOW: There are 18 outdoor pickleball courts at Hughes Park. [THAD ALLTON/THE CAPITAL-JOURNAL]

Terry Wiechman hits the ball during pickleball play. [THAD ALLTON/THE CAPITAL-JOURNAL]

Starting in January, a free “walk and talk” program will be offered from 9 to 10:30 a.m. Mondays, Tuesdays, Thursdays and Fridays at Hillcrest Community Center. McLaughlin said people of all ages, including seniors, may also: • Use any of the 58 miles of trails the county offers. • Between Memorial Day and Labor Day weekends, use any of seven pools and aquatic centers. Fees vary from pool to pool. • Use outdoor fitness equipment free of charge at Hillcrest Community Park, 1800 S.E. 21st. • Take yoga classes available to those who buy “fitness passes,” which cost $20 for a five-punch pass, $40 for a 10-punch pass and $80 for a 20-punch pass. “Easy Does It Yoga” is offered from 5 to 6:30 p.m. Tuesdays and Thursdays at Crestview Community Center, 4801 S.W. Shunga Drive. “Gentle Yoga” is available from 10 to 11 a.m. Mondays through Fridays at Crestview Community

Center, 4801 S.W. Shunga Drive, and from 9 to 10 a.m. Tuesdays and Thursdays at Central Park Community Center, 1534 S.W. Clay. “Beginner Vinyasa Flow Yoga” is offered from 7 to 8 p.m. Thursdays, weather permitting, at Reynolds Lodge at Lake Shawnee, 3137 S.E. 29th. “Yoga” is offered from 5:45 to 6:45 p.m. Tuesdays and Thursdays at Shawnee North Community Center, 300 N.E. 43rd. McLaughlin said the public, including senior citizens, may also take advantage of wellness centers — featuring fitness equipment that includes weights and treadmills — at Oakland Community Center, 801 N.E. Poplar; Hillcrest Community Center, 1800 S.E. 21st; and Shawnee North Community Center, 300 N.E. 43rd. An annual membership costs $50, while park patrons who have bought a Fitness Pass may use that to access the equipment.

20 | Sunday, October 21, 2018

Range of resources available in northeast Kansas for those dealing with dementia By Katie Moore katie.moore@cjonline.com

Though a diagnosis of dementia can be daunting, resources exist for patients and their families in northeast Kansas. The Alzheimer’s Association Heart of America chapter reached more than 13,000 last year through direct services and education. Cindy Miller, a dementia care specialist, said the organization supports those with any type of dementia, of which there are more than 100. Alzheimer’s is the most common type with 60 percent to 80 percent of those with dementia having the disease. “Dementia is an umbrella term, which means loss of thinking and reasoning, so much that it impacts a person’s day to day life,” Miller said. All types of dementia are progressive and terminal. But Miller said it is important to focus on a person’s capacities instead of the disability. “We, as our community and also family members, need to stay connected to them,” she added. Diagnosis comes through exclusion and may include a physical, lab work, MRI or CT scan, and a memory screening. “The earlier the diagnosis, the better,” Miller said. Medications, which can help with thinking and reasoning, are more effective early on. An earlier diagnosis also gives the individual a chance to participate in legal and financial decision-making, and an opportunity for family members to learn more. “It’s an ongoing learning curve,” Miller said. Medical trials are also an option. At Stormont Vail Health, there are six clinical trials focused on treatment for Alzheimer’s disease. Potential candidates include those who have a memory concern but haven’t been diagnosed, those in the moderate stage and those in a later stage, said Mary Martell, director of research services. The current trials include oral medications and infusion therapy. There is no cost to participate once qualified.

Cindy Miller, a dementia care specialist with the Alzheimer’s Association Heart of America chapter, said it is important for family members and the community to stay connected to individuals diagnosed with dementia. [THAD ALLTON/ THE CAPITAL-JOURNAL]

“Dementia is an umbrella term, which means loss of thinking and reasoning, so much that it impacts a person’s day to day life.”

— CINDY MILLER, A DEMENTIA CARE SPECIALIST

Martell said Alzheimer’s trials are important because there isn’t a medication that slows or prevents the disease, though researchers are making exciting progress. The research team also offers free memory screenings. More information about the screenings and trials can be obtained by calling Stormont Vail at (785) 368-0744. Miller said in addition to free family consultations with the Alzheimer’s Association, there are four support groups in the area, one for those in the early stages of dementia and three for caregivers.

“It’s an opportunity to connect with others who are facing the same diagnosis,” she said. “It helps people cope, they can get ideas, more information.” Families should also have conversations about how they will handle care. “It’s better to have a plan and not to have to make a decision in a crisis,” Miller said. Some people may want in-home services and some will go into a nursing home. “That’s one of the hardest, most difficult decisions that they’ll make,”

she said. The organization provides a detailed checklist for those considering a placement with questions specific to dementia. Miller said the organization is also participating in an Alzheimer’s working group to develop a state plan that is expected to be completed by the end of the year. Other members include state agencies and the KU Alzheimer’s Disease Center. Martell said Stormont Vail is a sponsor for the Topeka Civic Theatre’s production of “Helium.” The play, which runs Nov. 9 to 18, tells the story of a woman with dementia. There will also be a panel discussion featuring research physicians, patients and caregivers. The Alzheimer’s Association 24/7 help line can be reached at 1-800-272-3900.

Sunday, October 21, 2018 | 21

EXPERT:

Hoarding, a problem among the elderly, starts in childhood By Stacey Burling The Philadelphia Inquirer (TNS)

Hoarding gets worse with age, which is why it’s often associated with older adults, but it usually starts in childhood. That’s what Patrick Arbore, founder and director of the Center for Elderly Suicide Prevention and Grief Related Services in San Francisco, told a group of professionals who work with seniors recently. He was one of the speakers at the annual Regional Conference on Aging hosted by Philadelphia Corporation for Aging. He said people whose homes later become overwhelmed with stuff often begin having dysfunctional relationships with things between ages 11 to 15. They may cling passionately to clothes that no longer fit or toys meant for much younger children. This is an opportunity for parents to teach them how to organize their possessions and discard items they no longer need, skills that are often deficient in adult hoarders. Arbore thinks much hoarding also stems from trauma or emotional pain. Hoarders fill the emotional holes in their lives with things that seem more trustworthy and comforting to them than their fellow human beings. He said he has had success at reducing hoarding by helping people address their underlying pain and learn better ways to cope. Overall, though, he presented a depressing picture of a condition that directly affects 6 percent of the population and causes much distress among families and friends. For the elderly, who are more likely to have dementia and physical problems, hoarding can also increase the risk of debilitating falls and isolation. The older population can be especially difficult to work with because their behavior is entrenched and they have a negative image of mental health treatment. Hoarders can be pack rats, compulsive buyers or more organized

collectors whose acquisitiveness has gotten out of hand. Eventually, they run out of room and wind up with narrow walkways and only a tiny place to sit amid what looks like trash to most people but is treasure to them. Some hoarders grab good deals on furniture they plan to fix someday, but never do. “I am a rescuer of things,” one woman told Arbore. “I save them.” Some hoarders have a similar attitude toward animals. “What do you see?” Arbore often asks hoarders. “I see Christmas time,” one woman told him as she surveyed the piles of debris in her room. “My cats are really flourishing,” another said, even though Arbore saw sickly animals, along with some smelly, dead ones. The cause of hoarding is unknown. Arbore sees elements of addiction and compulsion. The condition may also run in families. Many hoarders reject offers of treatment. “When you try to help guide them,” he said, “there is so much resistance.” Arbore said hoarding needs more study. There is currently no evidence-based treatment. While hoarders may seem obsessive, they do not respond well to treatments for obsessive-compulsive disorder, and anti-depressants have mixed results. Just clearing out their stuff for them doesn’t work. Most end up filling up the space again because they’re more comfortable amid clutter. He said one study found that about 70 percent of hoarders responded to cognitive behavioral therapy, a type of talk therapy that helps patients change their thinking patterns, when combined with skills training that strengthens decision-making and organization along with motivational interviewing. Professionals, he said, should think of hoarding as a chronic, relapsing disease. “Just like when we work with alcoholics, it can be exceedingly painful, and we can’t save everybody.”

City building inspector Lauren Mosely photographs the kitchen in May 2010 at a home in Chicago, where an elderly couple was found buried alive in the mess. [ALEX GARCIA/ CHICAGO TRIBUNE/TNS]

22 | Sunday, October 21, 2018

Respite care offers help for seniors aging in place By Samantha Foster samantha.foster@cjonline.com

Seniors who want to stay in their own homes as long as possible but may not be physically able to do everything they once did have options, though they may not be aware. Organizations like Visiting Angels and the Douglas County Visiting Nurses Association offer services for people who need assistance in their home, including meal preparation, shopping or light housekeeping, or even giving a family caregiver a break. “It’s just extra help for people who want to age in place,” said Debbie Ahlert-Caffey, director of clinical services for the Douglas County Visiting Nurses Association. Visiting Nurses Association caregivers mainly provide care for elderly people living on their own, before family members move them into their home or find them a place somewhere else, Ahlert-Caffey said. “We’re getting more and more calls for that,” she said. “People are living longer, and they’re not able to live alone at the very end. They just need a little assistance — especially when they can’t drive anymore.” Bob Bruns, executive director of Visiting Angels Topeka, says his organization’s caregivers help provide a safe place at home, often for people whose family members already are caring for them but can’t be there Monday through Friday because of their jobs. Respite care allows people caring for an aging relative to step away from caregiver duties. “If their family member is there with them, maybe they want their mom or dad back so they’re not always simply just caring for them, but they want to enjoy that conversation and have that ability to have hands off for a period of time,” Bruns said. “Then they just get to enjoy their mom or dad again.” Respite care also relieves caregiver fatigue, Ahlert-Caffey said. Often, she said, people are in their 90s and their children are in their 70s, and if the children aren’t in good health themselves, it is especially

Bob Bruns, executive director of Visiting Angels Topeka, says his organization’s caregivers help provide a safe place at home, often for people whose family members already are caring for them but can’t be there Monday through Friday because of their jobs. [CHRIS NEAL/THE CAPITAL-JOURNAL]

“ O u r c a re g i v e r s h a v e t o b e p a t i e n t , l i k e t h e p a t i e n c e o f J o b. T h e y h a v e t o b e k i n d , l o v i n g a n d c o m p a s s i o n a t e , a n d t h a t ’s w h o w e h i re .” — BOB BRUNS, EXECUTIVE DIRECTOR OF VISITING ANGELS TOPEKA

difficult for them to care for their parents. People in the earlier stages of dementia or Alzheimer’s disease can’t be left alone, but their family members want them to be able to stay in their own home longer, Bruns said. Knowing about the availability of such services can make the decision easier for family members, he said. “I think respite care, for some, is overlooked because they don’t realize

the real true energy it takes to care for a loved one as much as it really truly takes to care for a loved one,” Bruns said. “So when they start utilizing our services, they wonder what they did without us.” As people become less physically able to care for themselves, they may need help with bathing, shaving, grooming, doing laundry and light housekeeping to be able to remain in their home.

“Some of them don’t want to ask their family for help, so they would like someone to come in, because they don’t want to be a burden on their children,” Ahlert-Caffey said. Those care options are popular, she said. “It’s very popular, because everybody does want to age at home and stay in place, they don’t want to leave their home,” Ahlert-Caffey said. “It allows people to stay in their homes until they really can’t take care of themselves.” The caregivers who provide these services are special people, Bruns said. “Our caregivers have to be patient, like the patience of Job,” he said. “They have to be kind, loving and compassionate, and that’s who we hire.”

Sunday, October 21, 2018 | 23

H E A LT H T I P S F O R C A R E G I V E R S By Melissa Erickson More Content Now

The pressure of caregiving is not something that can be ignored, especially as the graying of our population continues. About 34.2 million Americans had provided unpaid care to an adult 50 or older in the past 12 months, according to the National Alliance for Caregiving and AARP’s 2015 Caregiving in the U.S. study. “More and more families are dealing with this issue because more and more people are being diagnosed with dementia,” said geriatric care manager Amanda Lambert, co-author of “Aging with Care: Your Guide to Hiring and Managing Caregivers at Home.” Caregiving is incredibly hard. “The chronic stress of caregiving can contribute to depression, anxiety and a general decline in health. Moreover, caregiving can exacerbate existing health conditions,” Lambert said. “Other pressures include the financial strain of caregiving, often as a result of having to take time off of work or even leave employment.”

Providing care to others can be draining and have health consequences. Caregivers can take steps to mitigate the stress, however. [MORE CONTENT NOW]

SOME SURVIVAL TIPS: Get organized

Making your caregiving duties as routine as possible will help smooth the transition to your new normal, especially if you’re working or have children to care for, too, said registered nurse and certified case manager Judith Sands, author of “Home Hospice Navigation: The Caregiver’s Guide.” Keep things predictable by setting up a schedule for when medications are given and tasks completed. See TIPS, Page 24

24 | Sunday, October 21, 2018

Seniors vital in Meals on Wheels deliveries By Phil Anderson phil.anderson@cjonline.com

Gabe and Juanita Escobar exemplify the saying that it is more blessed to give than it is to receive. The retired Topeka couple gives back to the community every Tuesday by volunteering with Meals on Wheels, delivering hot, nutritious lunches to about nine people on their route in southeast Topeka. The Escobars pick up the meals in large, insulated bags at Highland Park United Methodist Church, 2914 S.E. Michigan Ave. Then, they are out the door, on their way to making their deliveries. It takes them about an hour to complete their route, and a little longer if they “chit-chat” with the meal recipients, which they almost always try to do. “The reason we do this is we like helping people,” said Gabe Escobar, 60. “We enjoy the people we have on our route.” The Escobars are one of dozens of seniors who volunteer for various agencies and organizations in the Topeka area. The couple moved back to Topeka from Colorado about a year ago so they could be closer to Juanita’s parents and help them with some of their daily needs. At present, their volunteer efforts are limited to Tuesdays with Meals on Wheels, though both said they would like to do more to serve their neighbors in Topeka. Gabe said the couple “would like to volunteer a little bit more,” but added he and his wife have to be careful not to over-commit themselves, particularly as they want to leave plenty of time to provide support to Juanita’s parents. “I think it’s probably more of a blessing for us than for them,” Gabe said. “We feel blessed we can do it.” Juanita said she has always had a desire to provide help to older adults, and the Meals on Wheels volunteer opportunity allows her to do just that. The best part is getting to see the meal recipients each week, who are

TIPS, from Page 23 For example, showers or baths every other day, medical appointments only in the afternoon, visitors allowed from 2 to 4 p.m., Sands said. Keep a notebook or online record in case other family members or caregivers need information, Sands said. It should include: • All medications, amounts and what they are for • Doctor’s names and phone numbers • Hospital preference • A copy of advance directives • Preferences of the person (tasks and communication techniques) you are caring for in the event that someone needs to take over

Ask for help

Gabe and Juanita Escobar go over their delivery list on a recent Tuesday morning at their pick-up location at Highland Park United Methodist Church, 2914 S.E. Michigan Ave., as they prepare to take Meals on Wheels to Topeka-area residents.

Meals on Wheels volunteer William Luse, 82, loads containers containing lunches into his truck outside Highland Park United Methodist Church. [PHIL ANDERSON/THE CAPITAL-JOURNAL]

always appreciative of their efforts in delivering the meals, she said. Though the volunteer effort takes about an hour each week, Juanita said she looks forward to her Tuesdays and delivering the meals. “Just love it,” said Juanita, 65. “Enjoy it thoroughly.” Another Meals on Wheels volunteer is William Luse, 82, who also picks up his deliveries at the Highland Park United Methodist

church. “I’ve been volunteering probably six or seven years,” he said. “I’m on-call, which means I volunteer about once a week. I fill in for people who are sick and can’t get there.” Though he sees different people nearly every week, Luse said, the recipients are always glad to see him. His favorite part, he said, is seeing how the people react, “knowing you’re helping people that really need it.” He added that it “gives you a good feeling in your heart when you’re helping someone.” Chelsea Lassiter, Meals on Wheels volunteer coordinator, said the organization receives volunteer help from retired people and those who are still working. Some local corporations and businesses allow employees to take time once a week to make deliveries with Meals on Wheels. Lassiter said that while “all of our volunteers are phenomenal,” it would be hard to underestimate the importance of the many seniors who help deliver meals throughout Shawnee and Jefferson counties.

Look to family members, clergy, state aging services and respite services. “Be willing to give up control. Yes, you may be the best caregiver, but be willing to let someone else take over to give you relief,” Sands said.

Recharge

Take care of yourself by getting plenty of sleep, eating healthful meals, staying hydrated and connecting with others, Sands said. “Figure out how you can recharge yourself and allow yourself 15 to 20 minutes each day just for yourself,” Sands said.

Join a group

Support groups can be community, faithbased or disease-specific, Sands said. For help finding a group, visit your local Area Agency on Aging website. AARP has a variety of resources, including videos, at aarp. org/caregiving.

Safety first

Make the caregiving setting safer by doing simple things like getting rid of scatter rugs and electrical cords, Sands said. “Do trip-and-fall prevention. If someone compromised has a fall, it’s the beginning of the end,” she said.

You are not alone

“Talk to someone else who is going through what you are experiencing. Knowing you are not alone can be immensely supportive. It can also give you ideas and strategies on how to cope better,” Sands said.

Sunday, October 21, 2018 | 25

H O W T O AV O I D L O N E L I N E S S By Melissa Erickson More Content Now

Living alone is a reality for nearly one-third of older adults who reside outside of nursing homes or hospitals, according to the National Institute on Aging. Living solo doesn’t mean a person is lonely, but it can contribute to a sense of loneliness. Loneliness, depression and poor health are linked, said Sue Johansen, vice president of partner services at A Place for Mom, a senior-care referral service based in Seattle. A lack of interaction and connection with others can lead to below-average nutrition, Johansen said. An isolated person’s diet suffers. An individual thinks, “Why bother cooking?” and instead opts for packaged or fast food. That can lead to depression and then medication mismanagement, dehydration and even a trip to the emergency room, she said. Senior isolation can even increase risk of mortality, according to a study in the Proceedings of the National Academy

Loneliness can be crippling for many older adults, but steps can be taken to lessen the effects. [MORE CONTENT NOW]

of Sciences that found, “People who live alone or lack social contacts may be at increased risk of death if acute symptoms develop, because there is less of a network of confidantes to prompt medical attention.” See LONELINESS, Page 26

26 | Sunday, October 21, 2018

CRITICAL CARE T I P S YO U N E E D TO KNOW

• Sudden loss of vision in one or both eyes. • Uneven face (face droop) or uneven smile. • Sudden arm weakness. • Sudden slurred speech, trouble speaking or confusion. • Time is critical; call 911 immediately.

By Melissa Erickson More Content Now

When an older family member — someone 85-plus — is not feeling well, how does one know when it’s something to monitor versus an emergency? “Doing nothing and going to the emergency department, that’s two ends of the spectrum,” said Dr. Mattan Schuchman, medical director for the Johns Hopkins Home-Based Medicine program, which provides medical house calls for older adults in the East Baltimore area, as well as a geriatrician and clinical associate in Hopkins’ division of geriatrics and gerontology. If the symptoms are mildly concerning, waiting and watching is a good idea if you’re not sure what to do, Schuchman said. Don’t hesitate to be in contact with your loved one’s primary-care physician. Even after business hours, you can usually reach a health care professional who can offer advice and answer questions, Schuchman said. OUT OF THE ORDINARY

“If you notice any symptoms out of the ordinary for your loved one, it’s always a good idea to reach out to a health care professional or 911 if the situation seems dire,” said registered nurse and health practitioner

LONELINESS, from Page 25 “Loneliness and/or isolation is common in seniors,” said gerontologist Dr. Kori Novak, a senior fellow at University of Suffolk, United Kingdom. “For many people, retirement drastically changes their social habits and opportunities. While early in retirement, many people tend to stay relatively active, as the years roll by, particularly once a spouse or significant other is no longer involved, depression often sets in. Lack of social engagement and a culture where families and children are spread out geographically adds to the propensity that elders will experience loneliness.”

GOALS AND WISHES

Paying attention to health-related symptoms can prove life-saving. [MORE CONTENT NOW]

Lannette Cornell Bloom, author of “Memories in Dragonflies: Simple Lessons for Mindful Dying.” “If it hasn’t happened before, it’s something worth getting checked out.” For example, does the older person have a history of a particular problem such as a heart attack? Is she having symptoms? “It could be a red flag,” Schuchman said.

geriatrics and transitional care at Lahey Hospital and Medical Center in Burlington, Massachusetts. Be aware of what the symptoms looks like: HEART ATTACK:

The possibility of stroke and heart attack warrant a visit to the emergency department, said Dr. Wayne Saltsman, section chief for

• Crushing chest pain. • Pain in the upper body (arms, neck or jaw). • Shortness of breath • Nausea. • Sweating. • Lightheadedness. Stroke: Remember to BE FAST and look for these symptoms: • A sudden loss of balance.

MAKE A CONNECTION

ALONE IS OK

WHEN TO CALL 911

Staying involved in the community can give seniors purpose, Johansen said. They can engage at a senior center, join a group, volunteer, attend events or enroll in a class. “The hardest part is to take the initiative, especially if you don’t have a support system,” Johansen said. The easiest way is to start where the barrier to entry is the lowest, Johansen said. For example, maybe a person has stopped attending religious services or a club meetings. “Try that one thing. If they have success, it opens them up to more success,” Johansen said.

Feeling lonely? That’s OK. “One of the best cures for loneliness is just going outside, wave at people going by, bask in the sunshine or feel the breeze on your face. If you are unable to get outside, sit by a window,” Novak said. Do something pleasant. “Anything where you can even hear someone else talking may help,” Novak said. Turn on the radio or have someone help you find an interesting podcast. Listen to a book on tape. “If you are so inclined, pets are a wonderful way to alleviate loneliness and depression,” Novak said. Interaction with a pet can help lower

The medical community strives to provide “patient-centered care that is proactive not reactive,” Saltsman said. For that to happen, a plan of care needs to be in place. Have a conversation about what kind of care is wanted at a time that is not stressful or acute, Saltsman said. Talk about what will happen when a situation arises. If someone doesn’t want to go into the hospital, there needs to be a plan B, Saltsman said. “We want to take care of people how they want to be taken care of,” he said. WHAT TO BRING

If you do go for medical care, bring a detailed record of medications your loved one is taking. “This should include medication names, dosages, number of times taken per day, what time the dosage was taken and who gave them the medication,” Bloom said. Other items to log include alternative treatments, meals, daily living activities, any symptoms or complaints, and if you’ve noticed anything different about your loved one’s appearance, memory or routine, she said.

blood pressure and anxiety, boost memory and improve a person’s sense of well-being, she said. MAKE THE MOST OF MEALS

For a homebound senior or one who doesn’t have a strong local support system, check with a local Meals on Wheels. “Drivers not only bring hot delicious meals once a day, but also check on loved ones and provide a friendly face once a day,” Novak said. For people who like cooking, subscribe to a meal service, which can offer smaller portions for single diners. Or, invite someone over and take the opportunity to share a meal kit, Johansen said.

Sunday, October 21, 2018 | 27

CAREGIVING AND FINANCES By Melissa Erickson More Content Now

Caregiving doesn’t just require love, time, patience and work, it’s also a financial matter that can affect your retirement savings. Being financially tested by caregiving expenses is a common issue that will only continue to impact more people as the U.S. population is growing older, said certified financial planner and enrolled agent Shomari Hearn, managing vice president of Palisades Hudson Financial Group’s Fort Lauderdale, Florida, office. “The earlier you start to do research and plan ahead, the better off you’ll be,” he said. “Often families don’t explore their options until there’s a serious financial concern and they have already tapped into their retirement savings. By that time, it’s already become a drag on their financial security.” WHERE TO START

“Individuals are often thrown into caregiving responsibilities overnight. They often don’t know how to navigate the resources that are available,” said Lindsay JuristRosner, chief executive officer of Wellthy, a support program for families caring for aging parents or people who are critically injured or disabled. “A good place to look for additional resources is benefits that may be provided through the government, such as Supplemental Security Income and Social Security Disability Insurance,” said Tom Halloran, president of Voya Financial Advisors. The process and requirements to receive these benefits can be long and difficult to navigate. “In this situation, we recommend that everyone sits down with a financial advisor who can run through a checklist of the important questions you should be asking,” Halloran said. “For instance, do they have a long-term care policy? Are they eligible for veterans’ or other government benefits? Bringing in a third party does more than just help

people get organized. It can also help avoid a potential situation where a parent may feel like they’re being challenged or interrogated by their kids about their finances, which for many is a very private topic.” MAXIMIZE YOUR BENEFITS

Caregiving expenses are a major reason for employees to make early withdrawals from 401(k) accounts, Jurist-Rosner said. “If you are working, don’t forget to maximize the benefits you have through your employer, including life insurance, disability insurance and health savings accounts,” Halloran said. “And, make sure you’re taking advantage of your company’s 401(k) match if available to you. If your contribution to your 401(k) is less than your employer’s match rate, you’re leaving money on the table that could be used to help create the future you envision for your loved one.” For those with a 401(k), insurance policy or other asset, it’s best to avoid naming a loved one with

special needs as a beneficiary. “Leaving your loved one with as little as $2,000 could disqualify them from receiving key government benefits,” Halloran said. “Working with a financial advisor to create a special-needs trust can help you name the trust and the beneficiary to receive the proceeds. Funds within the trust can then be used to create the quality of life your loved one deserves without interfering with government benefits.” If you’re in a tight spot, check if your employer offers back-up care through Care.com or Bright Horizons, which is a way to help employees find interim solutions to emergency-care needs, JuristRosner said. Caregiving can drain financial resources. Planning ahead can help. [MORE CONTENT NOW]

SHARE THE EXPENSE

Caregiving requires many kinds of sacrifices. Ideally expenses should be shared, said Anne Sansevero, founder and chief executive officer of HealthSense, an Aging Life Carecertified management consulting practice, and a care manager with a nurse practitioner master’s degree in gerontology. “So if one family member is spending a lot of time caring, maybe the other family members can contribute if they have the resources to a financial pool of money so that hired care can be used for respite for the primary family carer,” Sansevero said. This is another instance where an outside professional can help offset family dynamics, she said.

28 | Sunday, October 21, 2018

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Home modifications can help seniors age in place