Generations Michigan
Spring 2004
TM
A
New Light on
Depression Also in This Issue: ■ Care Management Services for Seniors ■ A Look at AAAs Around Michigan
Published quarterly by Michigan’s Area Agencies on Aging
Welcome to Michigan Generations Michigan is divided into 16 AAAs, each serving a different part of the state.
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They are:
AAAs— Gateways to Community Resources
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3A 3B
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3C
4 Region IV Area Agency on Aging 5 Valley Area Agency on Aging 6 Tri-County Office on Aging 7 Region VII Area Agency on Aging 8 Area Agency on Aging of Western Michigan 9 NEMCSA Region 9 Area Agency on Aging 10 Area Agency on Aging of Northwest Michigan 11 Upper Peninsula Area Agency on Aging 14 Senior Resources of West Michigan
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The services offered by Michigan’s 16 AAAs cover a broad spectrum of needs such as information and referral, case management, in-home services, home-delivered meals, senior centers, transportation and special outreach. To read more about each of Michigan’s AAAs and the services available, turn to page 10 of this issue. MI
1B
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1C
Michigan
Generations SPRING 2004 Published quarterly
through a cooperative effort of Michigan’s Area Agencies on Aging. For information contact: Jenny Jarvis 248-262-9202 jjarvis@aaa1b.com
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Editorial Project Development: JAM Communications, Atlanta, GA Design and Production: Wells-Smith Partners, Lilburn, GA
On the Cover: Today, depression among seniors is a highly treatable illness. For a detailed look at symptoms, diagnoses and treatment, turn to page 4.
Spring 2004, Volume 1, #4 © 2004 by the Michigan Area Agencies on Aging. The information contained herein has been obtained from sources believed to be reliable. However, the Michigan Area Agencies on Aging and JAM Communications make no warranty to the accuracy or reliability of this information. No part of this publication may be reproduced or transmitted in any form or by any means without written permission. All rights reserved.
Michigan Generations
MAP PHOTOGRAPHY COURTESY TRAVEL MICHIGAN
Whether you are an older adult yourself, a caregiver or a friend concerned about the well-being of an older adult, Area Agencies on Aging (AAAs) are ready to help. AAAs in communities across the country serve as gateways to local resources, planning efforts and services that help older adults remain independent. AAAs were established under the Older Americans Act in 1973 to respond to the needs of Americans age 60 and over in every community. The services available through AAA agencies fall into five general categories: information and consultation, services available in the community, services in the home, housing and elder rights. A wide range of programs is available within each category.
1A Detroit Area Agency on Aging 1B Area Agency on Aging 1-B 1C The Senior Alliance 2 Region 2 Area Agency on Aging 3A Kalamazoo Cty. Human Services Dept.Region 3A 3B Burnham Brook Region IIIB Area Agency on Aging 3C Branch-St.Joseph Area Agency on Aging IIIC
CAREGIVINGNews&Notes
Exercise facts VS fiction Test your knowledge of good exercise habits with this true/false quiz: 1. Recommended levels of activity decrease for individuals as they age. 2. Even with regular exercise, it is not possible for older adults to be as fit as young people. 3. A long, brisk walk each day is enough to stay healthy. 4. Before beginning an exercise program, you should consult your doctor.
The Risks of Colon Cancer Smoking is strongly associated with colon cancer, according to a study reported in the Journal of the American Medical Association. Inadequate intake of vitamin D and of dietary fiber is also linked to the disease. The study involved over 3,000 individuals age 50 to 75. Current smokers were at double the risk compared to non-smokers. On the positive side, factors that reduce the chance of colon cancer included having a diet rich in fiber and vitamin D.
1. False. Recommendations do not vary by age. Everyone who can should aim for moderate exercise daily and vigorous activity at least once a week. 2. False. If you stay fit, your body can perform even better than someone younger who is unfit. 3. False.Walking is good aerobic exercise, but research indicates you also need strength training and stretching to stay fit. 4. True.Your doctor should examine the state of your health and check for any limitations.
Surfing the Net Each issue of Michigan Generations offers several websites of interest to older adults and their caregivers … right at your fingertips. www.cornellcares.com offers information on emotional and mental health among older adults.The site was developed by the geriatrics division at Cornell University’s Medical College.
www.healthcarecoach.com is a “how-to” resource for caregivers that offers guidelines on subjects such as how to choose a doctor, questions to ask a surgeon and how to handle disputes with insurance companies.
10Lawyer QUESTIONS TO ASK A
Are you faced with a legal problem, but you’re intimidated by the thought of hiring a lawyer? If you find yourself in this situation, use this checklist of basic questions to determine which lawyer is right for you: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.
What is your experience in this field? Have you handled matters like mine? What are the possible outcomes of my case? What are my alternatives in resolving the matter? Approximately how long will it take to resolve? Do you recommend mediation or arbitration? What are your rates and how often will you bill me? What is a ballpark figure for the total bill, including fees and expenses? How will you keep me informed of progress? Can junior attorneys or paralegals in the office handle some of the administrative work at a lower rate?
Spring 2004
Look for more helpful websites in the next issue of Michigan Generations.
Job Opportunities forSeniors
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ere’s good news for older adults who feel the job market always favors younger employees: A recent study shows that more U.S. companies want older workers. Challenger, Gray & Christmas, an outplacement consulting firm, reports that an increasing number of firms are hiring older adults because they have valuable experience, a mastery of certain skills and a good work ethic. Older workers accounted for about 77 percent of net employment growth in October 2003, according to the study. Opportunities were noted in fields such as accounting, education, security and business administration. 3
a NEW
LIGHT on
By Martha Nolan McKenzie
Depression A Y E A R AG O, 7 6 -Y E A R- O L D Florence was plagued with anxiety and panic attacks. She lost her appetite, rarely ventured from her apartment and lost interest in activities she used to enjoy. Though at the time she did not realize it, all of these symptoms stemmed from depression.
The roots of Florence’s depression were not hard to trace. The St. Joseph woman had cared for a succession of loved ones, including her sister, sister-in-law and husband, only to watch them pass away. High blood pressure and hip problems plagued her physical health. And the apartliving burned to the ground
ment building where she was as Florence watched. While such tragedies would certainly bring anyone down, Florence was not able to shake her anxiety and listlessness. “I was so nervous, I could hardly handle it,” said Florence. “I’ve lost all my family, and I just felt so alone. Many times I just wished the good Lord would take me.” Happily for Florence, she was referred to a psychiatrist, who put her on an antidepressant, and a counselor, who helped her work through her feelings. Though she 4
still feels nervous at times, she claims to be happier these days. “I try to keep busy and do things to help others,” she said. “And no, I no longer think I want to die.” Like Florence, many seniors find their golden years tarnished by depression. Indeed, aging brings many challenges that can lead to depression — loss of loved ones, functional limitations, chronic illnesses and waning independence, to name a few. The good news is that depression is a highly treatable illness. About 90 percent of those who suffer from depression get better with medication and/or therapy. The bad news is only about 10 percent of seniors get the treatment they need. Seniors either don’t recognize what they are experiencing as depression, hide it as a shameful weakness or simply believe turning gray and feeling blue go hand in hand. The latter attitude is too often shared by their caregivers and physicians. “People think, ‘Well, you’re old, of course you’re depressed,’ ” said Dr. Suzann Ogland-Hand, director of the Center for Senior Care at Pine Rest Christian Mental Health Services in Grand Rapids. “But it’s like the story of the 81-year-old man who goes to his doctor with a sore left knee. The doctor listens to the man’s complaints and Michigan Generations
then says, ‘You know, you’re 81. You have to expect some aches and pains.’ The patient replies, ‘Well, my right knee is 81, too, and it feels fine.’ “Depression is not normal at any age,” continued Ogland-Hand. “The fact is, most seniors feel satisfied with their lives. And those who do suffer from depression can feel better with treatment.”
Factors in depression Despite the serious consequences, depression in seniors often goes undetected and untreated. One reason is that seniors rarely identify depression as a problem. “Someone under 65 will come in and say, ‘I’m feeling depressed and sad,’ ” said Sandra Plumer-Dickens, program director of geropsychiatry at Botsford Hospital in Farmington Hills. “But an elderly person will hardly ever come in with that complaint. Instead, their symptoms are typically aches and pains, sleep problems and generally not feeling good. So they go to their family doctor, who treats the physical problems but may not recognize the underlying depression.” Fortunately, that situation is changing. More and more doctors are recognizing depression for what it is — a serious medical problem that can be attributed to many factors, including: LOSSES. Old age inevitably brings losses. Loved ones move away or die. Careers are left behind, along with one’s sense of identity and social status. Activities that used to be possible are now out of reach. It’s easy to feel trapped in an ever-narrowing circle of isolation and limitations. Our society doesn’t make it any easier to cope with these losses. “We are so geared up for everything to happen quickly,” said Ogland-Hand. “It used to be, if you lost a spouse, you wore black mourning clothes for a year. Now if you’re still feeling blue after six months, people think you’re not coping.” MEDICAL PROBLEMS. Aging also often brings health problems, many of which can cause depressive symptoms. Menopause, hypothyroidism (low thyroid), heart disease, stroke, cancer, arthritis, Alzheimer’s and Parkinson’s disease are often associated with depression. While having a chronic illness is certainly Spring 2004
reason enough to feel depressed, in some cases the connection is even more direct. “Conditions such as diabetes, high blood pressure and elevated cholesterol affect the blood flow,” said Dr. Peter Lichtenberg, director of the Institute of Gerontology at Wayne State University in Detroit. “They may be causing microvascular changes in the brain, which are producing mood disturbances. There is a fair amount of evidence to support this.” Often, seniors with chronic conditions consider depression the least of their worries. “They really are not focused on whether they have depression or not,” said Lichtenberg. “They are too consumed with their health problems. But depression is an integral factor in their whole health.” Shirley, a 72-year-old retired schoolteacher in Vicksburg, suffered from depression brought on by chronic digestive tract problems and severe pain in her legs. Any time the slightest thing went wrong — a scheduling snafu, a disappointing lab result, a doctor’s negative tone of voice — she would cry uncontrollably. Her husband urged her to get treatment for depression, but she balked. “I was dealing with so many other things — battling the insurance company, going through all these tests and having severe pain,” said Shirley. “I told him I couldn’t deal with the depression until I wasn’t hurting so badly.” Today, Shirley is feeling much better. Treatments relieved her leg pain and digestive problems, and psychotherapy and an antidepressant lifted her mood. “I’m feeling pretty great right now, for the first time in a long time,” she said. MEDICATIONS. Seniors these days typically take a myriad of medications. While these drugs are a godsend for keeping heart disease at bay and arthritis pain checked, they can also bring an unwanted side effect — depression. Drugs used to treat high blood pressure, arthritis and thyroid problems, for example, can bring on depressive symptoms. And even if a drug is not associated with depression, it may react with other medications the senior is taking. “It’s very difficult to predict the effects when people are taking four to five medications a day, and some seniors are taking
A common — and dangerous — problem
M
ost people think of depression only as sadness or “the blues,” but clinical depression is a far
more serious condition. While everyone gets down now and then, those who suffer from clinical depression cannot shake their empty, sad mood and/or lost interest in the activities they used to love. Other symptoms include: • Sleep disturbance — insomnia or wanting to sleep all the time • Reduced appetite and weight loss or increased appetite and weight gain • Restlessness or irritability • Persistent physical symptoms that don’t respond to treatment, such as headaches, chronic pain, constipation or digestive disorders • Difficulty concentrating, remembering or making decisions • Fatigue or loss of energy • Feelings of guilt, hopelessness or worthlessness • Crying easily or for no reason • Thoughts of death or suicide Of the 35 million Americans over 65 years old, 2 million suffer from a depressive illness, and another 5 million have depressive symptoms that fall short of meeting the medical criteria for a disorder, according to the National Institute of Mental Health. “There is nothing minor about minor depression,” said Dr. Lichtenberg. “Any degree of depression can interfere with someone’s life, adversely affect health, delay recovery from an illness or injury and, in the worse case, lead to suicide.” 5
many more than that,” said Mick Pries, PhD, an elder specialist at Riverwood Center, a mental health center in Benton Harbor. “The result of all these drug interactions may be unforeseen.”
Treating depression When many of today’s seniors were growing up, there were few effective treatments for depression. Antidepressants came along in the 1950s, but they often brought on severe side effects. Psychotherapy was available, but the field of geropsychology was unknown. Today, depression may be the most treatable problem a senior has. The most common treatments are psychotherapy and/or antidepressant medications. Other treatments have also proven effective. Here is a look at the treatments: ANTIDEPRESSANT MEDICATIONS. Though they cannot cure depression, antidepressants help people feel better by controlling their symptoms. They work by restoring the chemical balance in the brain to improve mood, sleep, appetite, energy levels and concentration. They are not habit forming and do not change a person’s personality. The newer antidepressants have fewer and milder side effects than their predecessors. Most commonly prescribed are the serotonin selective reuptake inhibitors (SSRIs), which include Prozak, Zoloft and Paxil. Some people need to try several different medications before they find the one that works for them, and some may need to be on more than one at a time. “The medications that are out now are very good and can play a critical role in controlling depressive symptoms,” said Plumer-Dickens. PSYCHOTHERAPY. Many seniors who take a plethora of daily medications already are reluctant to add another pill to their arsenal. And those with mild to moderate depression may not need to. Psychotherapy — therapeutic discussions with a psychiatrist, psychologist, social worker, trained nurse or licensed counselor — can be just as effective as medications for many individuals. Through psychotherapy, seniors can change their pessimistic ideas, unrealistic expectations and critical self-image. They can develop better coping skills and work on resolving relationship
TREATING DEPRESSION Antidepressant medications Psychotherapy Social support Electroconvulsive (shock) therapy (ECT) Bibliotherapy. Light therapy Exercise therapy 6
Help for Caregivers
W
hile depression among seniors is a serious condition, it can be an equally serious problem among the loved ones who care for them. About half of all caregivers will experience an episode of major depressive disorder, according to Dr. Ogland-Hand. She estimates as many as 90 percent may suffer minor depressive symptoms. It’s easy to see why caregivers are at risk. They are typically watching a loved one deteriorate and they feel helpless to halt the decline. They may be juggling the demands of work, children and a spouse with their caregiving duties. And caregiving may place a strain on their finances and their own physical health. “Caregiving is a very stressful situation,” said PlumerDickens. “It’s like taking on another full-time job — one that’s filled with worry.” It’s critical that caregivers take care of themselves, or they won’t be able to care for their loved ones. If a caregiver begins to feel overwhelmed and depressed, he or she should contact a physician or a mental health counselor. The same treatments that can help a depressed senior can bring relief to the caregiver. Support groups can also help a caregiver recognize he or she is not alone and provide a safe place to share mutual concerns and frustrations.
conflicts. And simply having a caring, sympathetic counselor to listen to them can lift feelings of isolation and hopelessness. “Sometimes just having someone sit down and talk to them can make all the difference in the world,” said Dr. Ralph Hutchison, a clinical psychologist with Caring Alternatives in Monroe. He recently visited a retired farmer who suffers from Alzheimer’s and lives in a nursing home. The old man had been giving the nurses a lot of trouble, and they were at their wits’ end trying to deal with him. “I sat down and talked to him for a long time about farming,” said Hutchison. “I reminded him of the things he had done well in his life, like running a successful farm. I also talked to the nurses about giving him a job or something useful he could do so he could feel he was still able to make a contribution. You could see him start to feel better about himself and brighten up.” A big part of any therapy is to help people learn how to change the things they can and accept the things they can’t. The losses seniors experience can’t be reversed. Loved ones cannot come back. Abilities won’t reappear. But seniors can change how they perceive these losses. “First, you have to help the person acknowledge and verbalize the losses,” said Jim Loomis, a certified social worker and owner of Counseling at Home in Portage. “Then I try to normalize it. Point out that this is the normal course of life. But that doesn’t mean they have to give up everything.” Michigan Generations
For example, Loomis worked with one woman who was having a hard time with her children taking over control of things in her life, such as her finances and house maintenance. While she was out one day, her daughter, without asking her, painted one of her kitchen cabinets brown while the others were white. “I worked with her to help her see that she needed their help with her finances and house maintenance to enable her to stay in her home,” said Loomis. “But I also helped to empower her to stand up for herself and tell her children that decisions like painting her cabinets are hers to make, not theirs.” SOCIAL SUPPORT. Sometimes getting help with daily tasks goes a long way in combating depression. If a senior is feeling down because she can no longer keep her house as clean as she used to or is having trouble dressing and undressing herself, arrangements can be made for someone to come in to help clean or dress. It sounds like a small thing, but it can make a big difference in the person’s outlook. Connecting with other seniors can also help. “Just getting someone out of the house and to the senior center can make a huge difference,” said Hutchison. “Finding a role for them at their church, providing activities that get them out of the house, getting them together with another senior to talk — all of these things can be very effective.” ELECTROCONVULSIVE (SHOCK) THERAPY. While the majority of depression sufferers find relief with antidepressants and/or psychotherapy, some with severe depression don’t respond to either. For these people, electroconvulsive therapy (ECT) can be an effective treatment. With ECT, a patient is put under general anesthesia and a low, carefully monitored electrical current is delivered to the brain. Like antidepressants, ECT restores the brain’s moodregulating chemical balance. The patient generally wakes up in recovery five to 10 minutes after the procedure. ECT does not induce a seizure or render a patient catatonic. “ECT went through a period of bad press in the ’80s and ’90s — the whole One Flew Over the Cuckoo’s Nest Jack Nicholson thing,” said Loomis. “But that barbaric image of the movie is not the case at all. ECT is considered safe and quite effective for people with severe depression who don’t respond to other therapies. It can make for long-lasting changes.” ALTERNATIVE THERAPIES. Several therapies outside the mainstream have proven effective with some patients, either used in conjunction with antidepressants and/or psychotherapy or as stand-alone treatments. Among them: Bibliotherapy. In reading therapy, a person reads self-help books to address depression. While therapists have long encouraged patients to read motivational books in between therapies to speed up recovery, the effectiveness of stand-alone bibliotherapy was demonstrated in the mid-’90s by a series of studies at the University of Alabama. The researchers had groups of mildly and moderately depressed seniors read one of two books — Feeling Good by Dr. David Burns or Control Your Depression by Dr. Peter Lewinsohn. At the end of four weeks, two-thirds of the seniors no longer met the criteria for depression, and three years later, these people had not had a relapse of depression. Spring 2004
Light therapy. For some seniors, lack of sunlight brings on the blues. Seasonal Affect Disorder (SAD) is a specific type of depression induced by periods of reduced sunlight, such as Michigan’s long winter months. A special light box can deliver a measured amount of balanced spectrum light equivalent to standing outdoors on a clear Spring day. This therapy helps regulate the body clock and can elevate the mood. Exercise therapy. For many seniors, exercise can provide the same relief as other treatment for depression. A study by the National Institute of Mental Health found 30 minutes of aerobic exercise three times a week was as effective as antidepressant medication for some seniors with a major depressive disorder. In addition, researchers found improvement in cognitive function in the group who did the exercise therapy, leading the researchers to speculate that exercise might be able to offset some of the mental declines often associated with aging.
Brightening seniors’ tomorrows The world can be a challenging place for today’s seniors. They’ve witnessed mind-boggling changes during their lifetimes. They are living longer than they ever expected to. And they have no road map for what this new period of their lives should look like. “People are living so much longer,” said Pries. “A hundred years ago, life expectancy was about 45. Now it’s almost double that. We don’t really have models about how to be this old, so there is no clear path for today’s seniors. People start tuning in to what’s going wrong and the losses they’ve suffered. But it doesn’t have to be that way. Many seniors are still busy living their lives.” With today’s highly effective treatment options, many seniors can leave their depression behind and put the shine back into their golden years. MI
Resources For information about or help with depression, contact the following: National Alliance for the Mentally Ill 1-800-950-6264 or www.nami.org The National Institute of Mental Health Call or write for free brochures. 1-800-421-4211 or www.nimh.nih.gov/publicat/depressionmenu.cfm. The National Institutes of Health’s National Institute on Aging For a free brochure, “Depression: A Serious but Treatable Illness,” call 1-800-222-2225. National Mental Health Association Call 1-800-969-NMHA or visit www.nmha.org. To order brochures on depression, call 1-800-228-1114. To take a free confidential screening for depression, visit www.depressionscreening.org. To contact NMHA of Michigan, call 248-647-1711 or visit www.mha-mi.org. AARP Call 1-888-OUR-AARP or visit www.aarp.org.
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GUESTClose-Up ALZHEIMER’S DISEASE
Filling in Some
Missing Pieces By Dr. Peter Lichtenberg
O
n January 21, PBS ran a wonderful documentary about Alzheimer’s disease titled The Forgetting. I felt privileged to be part of a large team of volunteers who answered phones from viewers who were watching the show and wanting more information. Alzheimer’s disease has increased 10-fold from 500,000 to 5,000,000 in the United States during the past 15 years, and this includes over 200,000 Michigan citizens. Over the next 20 years the prevalence of Alzheimer’s disease will again double and include over 10 million citizens of our country. The average out-of-pocket cost per family to care for someone with Alzheimer’s disease is $25,000/year. The Forgetting followed three different families and victims of Alzheimer’s disease across many years. The show also followed two research leaders whose discoveries are crucial to unraveling the mystery of Alzheimer’s disease. Despite its many strengths, there are some important points that the show did not address at all. In Michigan we are fortunate to have a Michigan Dementia Coalition, which brings together concerned consumers, university educators, state government officials and major geriatric-oriented health centers to work on Michigan’s priorities for dementia. In the Fall of 2003 the Michigan Dementia Plan, a strategic threeyear plan for dementia, was published after 18 months of hearings and hard work by experts across the state. This plan detailed some critical aspects about dementia that were omitted by The Forgetting. FAMILY CAREGIVING PROGRAMS WORK: The Forgetting failed to include the progress that has been made in supporting family caregivers. Fifteen years ago there was no menu of options to assist family caregivers in trying to keep their loved ones at home. Real progress has been made in identifying the types of community support and programs that assist family members and other informal caregivers to keep their loved ones in the 8
community — the residence of choice for most of us. Support groups, learning to partner with health professionals, respite care options, home and community-based dementia support case management, estate planning and educational information about dementia are some of the major tools we have to help caregivers. DEMENTIA IS A CHRONIC CONDITION AND REQUIRES A PUBLIC HEALTH APPROACH: The Forgetting quoted
an expert saying that he believes the “cure” for Alzheimer’s disease is only five to 10 years away. This quote is reminiscent of what was said about cancer 20 years ago. Only this year did cancer experts state that the best approach to understanding cancer is a chronic disease model. Cancers cannot all be cured, but people can live long and fulfilling lives with treatment for the condition. Dementia is the same. I highly doubt Alzheimer’s disease will be cured in the next decade or two, but treatments are available and I believe the effectiveness of these treatments will only increase. The keys to effective treatments of chronic conditions are early detection, aggressive medical management, caregiver support and planning and an increase in options for access to the best care and medicines. All citizens need to know the “10 Warning Signs of Alzheimer’s Disease,” published by the Alzheimer’s Association. Call 1-800-272-3900 or visit www.alz.org. There are many factors that can modify risk for getting Alzheimer’s disease: Risks for chronic diseases need to be viewed from the more global to the more individual. Examples of more global risks include increased pollutions and environmental hazards from ozone loss, etc. Examples of personal risks include poorer health functioning of Michiganders (i.e. increased weight problems and chronic diseases such as high blood pressure, diabetes and high cholesterol). Reducing our risks for diseases such as Alzheimer’s is critical to our society’s coping with this growing epidemic. MI DR. PETER LICHTENBERG is the Director of the Institute of Gerontology and a Professor of Psychology at Wayne State University. He has authored many articles on dementia detection and evaluation. In 2003 Dr. Lichtenberg was the lead editor on the book Handbook of Dementia: Psychological, Neurological and Psychiatric Perspectives (John Wiley & Sons, Inc.). He is the current chair of the Michigan Dementia Coalition and can be reached at 313-577-2297 or email p.lichtenberg@wayne.edu. A copy of The Forgetting can be purchased by calling Warner Home Video at 1-800-364-6928. The cost is $19.95 plus shipping and handling. Michigan Generations
ASKtheExpert
Audrey North
Care Management
Provides Help
“I’m calling about my mother. She needs help at home, and I am wondering what’s available for her.”
including those offered through the Area Agency on Aging.
For those of us who respond to calls at the Area Agency on Aging, this is an all-toofamiliar question. Many family caregivers call when a crisis occurs. They are often unsure about what to do and don’t know how to go about getting the help they need. Working with your local Area Agency on Aging is beneficial because you can find the information you need to make decisions about care options, and the agency can also help direct the care you receive through its Care Management Program.
Who is eligible for care management? on Aging, care management is intended to assist those older adults, 60-plus, who are experiencing limitations of daily living that place them at risk of entering a nursing home. They usually require a moderate to high level of help with their personal and home care needs. Nursing home residents assessed as being able to return home if supportive services are available are also eligible for care management.
Who will pay for the services?
What is care management?
What is the first step?
CARE MANAGEMENT IS A PROGRAM of personal consultation to help people know and understand what choices are available when an older loved one has difficulty living independently. The program enables individuals to receive long-term care in their home rather than in a nursing home by providing realistic options. Through a team of qualified professionals, care management will provide assistance to help an older adult or their caregiver navigate through an array of services and programs available in the community,
CALL YOUR LOCAL AREA AGENCY ON AGING.
What happens to the information that is provided?
Do you have a caregiving question? Write or email your question to our “Expert” at: Jenny Jarvis,Area Agency on Aging 1-B, 29100 Northwestern Highway, Suite 400, Southfield, MI 48034; jjarvis@aaa1b.com.We will make every effort to answer your question in an upcoming issue of Michigan Generations.
Spring 2004
Families may accept or refuse all or any part of the plan, and can work with the care manager to determine what will best meet their individual needs and budget.
AS PROVIDED BY THE AREA AGENCIES DEPENDING ON THE INDIVIDUAL’ S
circumstances, services may be paid for in a number of ways as appropriate, including Medicare, private insurance, community programs, Medicaid or private pay. All persons eligible for the program are informed about the cost of the assistance and requested to make a contribution according to their financial ability.
All persons referred to care management receive a telephone interview to determine whether they meet the eligibility requirements for the program. When it appears that an individual qualifies, a registered nurse and social worker visit the client’s home for an in-depth needs assessment.
AREA AGENCIES ON AGING ARE REQUIRED
What can I expect from an assessment?
YOUR NEEDS ARE MONITORED BY THE CARE
THE COMPREHENSIVE ASSESSMENT,
performed by a nurse and social worker, is an evaluation of the older adult’s living environment, including health, emotional and social status. The assessment also reviews safety issues, support from family and the financial situation to determine how services will be paid.
What follows the evaluation? THE NURSE AND SOCIAL WORKER WILL WORK
with the older adult and their family to develop a plan of care. This plan may include services such as meals, personal care, medication monitoring and light housekeeping. Respite care for the primary caregiver can also be arranged if required. The nurse and social worker become the care managers of the older adult.
by law to maintain client confidentiality. Therefore, all information is kept confidential and will not be released without written permission from the client or their caregiver.
What happens if care needs change? manager through periodic in-home visits and telephone contacts. The plan of care is reviewed and adjusted as needed.
Will care management result in nursing home placement? SINCE THE CARE MANAGEMENT PROGRAM
is voluntary, it’s your choice as to where you receive long-term care services. The program is designed to allow you to remain in your own home and to assist you to live as independently and as safely as possible. To find out more information, contact your local Area Agency on Aging by referring to pages 10 to 19 of this publication. AUDREY NORTH is the Care Management Clinical Operations Supervisor for the Region IV Area Agency on Aging. 9
REGIONALNews In communities across the U.S.,
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Area Agencies on Aging (AAAs) serve as gateways to local resources, planning efforts and services that help older adults remain independent. Here are the programs and services offered by Michigan’s AAAs.
1A Detroit Area Agency on Aging 1B Area Agency on Aging 1-B 1C The Senior Alliance 2 Region 2 Area Agency on Aging 3A Kalamazoo Cty.Human Services Dept.Region 3A 3B Burnham Brook Region IIIB 3C Branch-St.Joseph Area Agency on Aging IIIC 4 Region IV Area Agency on Aging 5 Valley Area Agency on Aging
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10
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6 Tri-County Office on Aging 7 Region VII Area Agency on Aging 8 Area Agency on Aging of Western Michigan 9 NEMCSA Region 9 Area Agency on Aging 10 Area Agency on Aging of Northwest Michigan 11 Upper Peninsula Area Agency on Aging 14 Senior Resources of West Michigan
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14 6 4
1B
3A 3B 3C
2
1A 1C
S POTLIGHT O N …
Burnham Brook Region IIIB Serving Barry and Calhoun counties in Southwest Michigan
Transportation Program Helps Seniors Retain Independence
T
ransportation services are extremely important to older adults who can no longer drive. Burnham Brook Region IIIB has been providing transportation services to senior citizens for 10 years. It started with a small bus and volunteer drivers and has developed into a full-time program with a full-time director, three part-time drivers and a part-time assistant. The program currently serves about 250 seniors a year. Transportation is available Monday through Friday from 8:00 a.m. to 4:30 p.m. The transportation program is offered to Calhoun County residents age 60 and over. Transportation is provided for medical appointments; ongoing medical treat-
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tor of Support Services. “The program not only helps the senior citizen involved but ments; volunteer also supports family memactivities; personal bers who might otherwise errands such as have to take off work to grocery shopping, provide transportation.” banking and hair Eleanor Kipp uses appointments; and Burnham Brook’s transsocial events. Indiportation three times a viduals going to week from her home in medical appointMarshall to Southwest ments are given top Burnham Brook driver Rick HirleMichigan Rehab in Battle priority. There is no mann delivers Eleanor Kipp to a Creek. She says, “I don’t medical appointment in Battle Creek. cost to the clients know what I’d do without for the service, Burnham Brook’s transalthough donations are appreciated. portation. I am very grateful for this “Burnham Brook’s transportation service.” program enables seniors to maintain For more information, call social contacts and continue important 269-966-2540 or visit our website at health care,” says Jolene English, direcwww.burnhambrook.com. Michigan Generations
Detroit Area Agency on Aging Serving Detroit, Highland Park, Hamtramck, Harper Woods and the five Grosse Pointes in Wayne County
Seniors Transition from Nursing Homes Back into the Community
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ow many of you know of someone who is living in a nursing home simply because they need help such as bathing, cooking and housecleaning? If you know of someone in that situation, ask yourself this: If they had a choice, would they rather live in the comfort of their own home or remain in the nursing home? Now seniors living in a nursing home because they need assistance with activities of daily living do have a choice, and it’s called the Nursing Facility Transition Initiative, or NFTI. The Detroit Area Agency on Aging was awarded the Nursing Facility Transition Initiative Grant from the U.S. Department of Health and Human Services/Center for Medicare and Medicaid Services. Our collaborative partners on the project are Citizens for Better Care, Neighborhood Services Organization, Legal Aid and Defender Association, Inc. and Pat Lake and Associates. The goal of NFTI is to transition 12 clients from nursing homes back into the community between September 2003 and December 2004. Nursing home residents who are able to live safely and independently are eligible for the program. The program also provides assistance in obtaining suitable housing, household goods, arranging necessary supportive services and managing the clients’ ongoing care. NFTI is open to seniors who are Spring 2004
currently living in a nursing home and would like to move back into a community within Wayne County. After an initial interview to assess the client’s
Clients can move in with family members or friends, or they may live independently. Once housing has been secured and the client has been moved into the setting, support services are implemented based on the client’s needs. These services include longNFTI helps transition clients term care options back to more like MI Choice, a independent living. cost-effective, longterm option for Medicaid-eligible seniors and disabled adults. This program has allowed many people to stay in the comfort of their own homes while receiving home care services — similar to those provided by nursing homes. “This program is very empowering to the senior and the senior’s family,” says Paul Bridgewater, executive director of the Detroit Area Agency on Aging. “Through each step of the transitional process out of the nursing
This program has allowed many people to stay in the comfort of their own homes while receiving home care services — similar to those provided by nursing homes. eligibility for the program, NFTI workers will develop a person-centered plan with input from the client, their family members and/or caregiver. After the client has been assessed and deemed eligible for the program, NFTI workers will assist the client in locating suitable living arrangements.
facility and back into the community, the senior and the senior’s family members are making the decisions regarding their case management. We are just there to provide support and assistance.” For more information on the NFTI program, call 313-446-4444 or visit our website at DAAA1A.org. 11
Area Agency on Aging 1-B Serving the counties of Livingston, Macomb, Monroe, Oakland, St. Clair and Washtenaw
Everyday Miracles: The AAA 1-B’s Rapid Response Program
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AAA 1-B Macomb office, and she set the wheels in motion for me. Within a day, she had been out to visit me and arranged for someone to come in and help me with personal care and homemaking tasks.” Meals on Wheels brought him a hot meal each day. And soon he Larry O’Mara with Audrey Smith, care manager (right), and Peter Kovack, physical therapist (left). was struggling back on the road to recovery, letting nothing get in the way Now, three days a week, O’Mara of his goal to get better. works with his therapist, gradually That recovery couldn’t happen building up his strength. He’s so deterwithout physical therapy, and again, mined to get back to his normal Smith was able to assist. Despite activities that he’s already scheduled a O’Mara’s lack of insurance, Smith tee time for a game of golf. “But none arranged therapy services for him with of this would have happened without Peter Kovack at the First Choice the AAA 1-B’s help and that of my Physical Therapy Clinic. “Larry was so physical therapy team,” says O’Mara. motivated to get better that he got his The Area Agency on Aging 1-B doctor’s permission to drive the short offers two Rapid Response programs: distance to the clinic,” Smith says. Rapid Response Short Term and Rapid Response Respite. Rapid Response Short Term is designed for individuals age 60 and older who need immediate short-term homemaking or perThe Area Agency on Aging 1-B is the first resource for older adults, caresonal care services for four to six givers and persons with disabilities to call when looking to resolve problems weeks, but no longer than 12 weeks. or locate the resources they need to improve the quality of their life. Many times the need for this care folWhen individuals call the toll-free Information and Assistance (I&A) lows a hospital stay. Other times a service at 1-800-852-7795, they speak with a certified Information and family crisis may mean that a client Referral Specialist to determine what their needs some outside help. Many needs are and the services and assistance patients don’t meet the criteria for available to address those needs. Once the skilled care in a nursing home, but needs are determined, the specialist accesses the I&A database of over 2,000 can’t manage for themselves — for community agencies and mails the individual a complete listing of relevant example, after breaking an arm or a services and providers in their local community. leg. Sometimes there is no family to Call us. We can help. provide support, and often the
arry O’Mara believes in miracles, and one of them is the Rapid Response Short Term Program developed by the Area Agency on Aging 1-B. This innovative program can provide quick access to short-term home care services for older adults or persons with disabilities. At the end of October 2002, O’Mara was just months into a new job when he fell at work, severely injuring his back. After several months of treatment, O’Mara wasn’t better. The next step was surgery — an eight-hour procedure where doctors fused discs and added rods, pins, plates and screws to his back. Following surgery, the hospital discharge planner recommended that O’Mara, who lost his wife to cancer several years ago, go to a nursing home for recovery, since he had no one to help him at home. But without insurance, a nursing home stay wasn’t an option, so the 61-year-old went to live with his friend in a mobile home. O’Mara made one vital contact that has made all the difference in his recovery. He says, “I talked with Audrey Smith, care manager at the
Help is a Phone Call Away
1-800-852-7795
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Michigan Generations
individual can’t afford to pay the full cost of private care. Older adults receiving Rapid Response Short Term services are informed about the cost of the assistance provided and requested to make a contribution according to their financial ability. The AAA 1-B offers a second Rapid Response program — Rapid Response Respite. This program is designed to provide short-term relief for individuals who are long-term caregivers for individuals age 60 or older or for adults age 18 or older with a disability. Services consist of in-home respite, out-of-home respite and adult day services. Individuals receiving Rapid Response Respite are required to pay a percentage of the cost for their services received according to their financial ability. For more information on the Rapid Response programs and services, contact the Area Agency on Aging 1-B at 1-800-852-7795 and ask to speak with the Rapid Response Nurse for your county.
Questions About the New Medicare Benefit?
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he Area Agency on Aging 1-B will be holding several community forums on the new Medicare Prescription Drug Benefit. These forums are free to the public and will address the interim prescription drug card, how the new program will work, enrollment in the benefit, how much the new benefit will help with prescription costs and other changes to Medicare. The dates and locations of the community forums are listed below. Please call the Area Agency on Aging 1-B for more information.
Livingston County Livingston Education Services Agency, 1425 West Grand River, Howell; Friday, May 14, 2004, 2 p.m to 4 p.m.
Macomb County
Monroe County Monroe County Intermediate School District, 1101 S. Raisinville Road, Monroe; Tuesday, May 25, 2004, 10 a.m. to 12 p.m.
Oakland County Older Person’s Commission, 650 Letica Drive, Rochester; Monday, May 10, 2004, 10 a.m. to 12 p.m. Costick Center — Shannon Hall, 28600 Eleven Mile Road, Farmington Hills; Tuesday, May 18, 2004, 10 a.m. to 12 p.m.
St. Clair County The Council on Aging, Inc., serving St. Clair County, 600 Grand River, Port Huron; Tuesday, June 8, 2004, 10 a.m. to 12 p.m.
Washtenaw County
Macomb Department of Senior Citizen Turner Resource Clinic, 2401 Services,Verkuilen Building Auditorium, Plymouth Road, Ann Arbor; Tuesday, 21885 Dunham Road, Clinton TownMay 4, 2004, 1 p.m. to 3 p.m. ship; Wednesday, May 19, 2004, 10 a.m. to 12 p.m.
The Senior Alliance Serving caregivers and seniors in the 34 communities of southern and western Wayne County
Detroit Pistons Honor The Senior Alliance
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he Detroit Pistons honored The Senior Alliance for its work with seniors and caregivers. The ceremony took place at halftime of the Pistons February 18th home game against the Milwaukee Bucks, played at the Palace in Auburn Hills. While both teams warmed up prior to the second half, The Senior Alliance board members and staff walked to center court and were introduced to the sellout crowd. “We are very pleased to recognize an organization that provides so much to the community and to seniors as The Senior Alliance,” states Palace Sports & Entertainment Group Sales Representative, Jaclyn Immel. “We hope that by placing attention on The Spring 2004
Senior Alliance, we may be able to alert caregivers where to find help if they need it, and if people want to contact The Senior Alliance to make a contribution supporting senior programs, well, that’s okay too.” For the 2003-2004 NBA season, the Detroit Pistons along with The Senior Alliance coordinated a series of “Senior Nights at the Palace,” four evening basketball games with discounted ticket prices for lower bowl and upper bowl seating and a free Pistons’ visor for all seniors 60 or older along with their friends and family, regardless of age.
After the NBA season completes, Palace Sports & Entertainment plans to provide seniors with discounted packages to attend women’s basketball games featuring the WNBA World Champions, the Detroit Shock. “We are honored to be partners with the Palace on this special program for seniors,” states Senior Alliance Executive Director Mike Simowski. “Sports provides a great opportunity for families to get out and enjoy themselves.”
The Senior Alliance board and staff are honored by Detroit Pistons.
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Region 2 Area Agency on Aging Serving Hillsdale, Jackson and Lenawee counties
SEARCH: Serving Elders At-Risk in the Home
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he Jackson County Department on Aging and LifeWays received a grant from the Department of Community Health to provide support services to older adults living in Jackson and Hillsdale counties. The program was developed to address the mental health needs of seniors in our community. The Region 2 Area Agency on Aging has formed a partnership this year with the Department on Aging to offer these services to clients who are part of the Home-Based Community Waiver Program that the agency provides in the tri-county area. The SEARCH program provides services that are free to those who are 60 and older or disabled. The services are:
■ Screening services for memory, depression and substance abuse ■ Homebound supportive counseling for seniors living alone or their caregivers
problems and think that depression or memory loss is a normal part of the aging process; therefore, they don’t address their concerns with their primary physician. This program
The SEARCH program is free to those over 60. It provides the opportunity for seniors to meet with a social worker in their home to address their concerns. ■ Intensive elder case management ■ Community education through a training called “Partners in Health” — informing seniors on how to develop a partnership with their physician, which helps to improve care. Often seniors may be experiencing
provides the opportunity for seniors to meet with a social worker in their home or at the Department’s office to address their concerns. For more information about the above services, please call Ginny Wood-Bailey at 1-800-335-7881.
Kalamazoo Cty. Human Services Dept. Region 3A Covering Kalamazoo County and its 24 municipalities
affected. The service of inhome respite care is provided by every hy is it that many caregivers home care agency in feel guilty about taking a break the county. Trained from the constant care a loved one aides can stay with needs? Perhaps it’s because so many of your loved one for as us hold on to the myth that says it’s little as two hours or our personal duty to always be there. overnight. The Region The truth is, we all need a break 3A Area Agency on from our everyday routines, especially Aging provides funding if someone is a caregiver. Although we for two local agencies Caregivers need a break from their daily responsibilities. know that the care we give our loved that give priority to ones cannot be duplicated, there are caregivers who can give us a needed persons who need financial assistance many competent volunteer and paid break on a regular basis so we can (see box at left). recharge. Research indiContact the AAA 3A at 269-373-5147 cates that without these or the Caregiver Resource Center at Senior Services, Inc. . . . . . . . . . . 269-382-0515 breaks, sooner or later 269-978-0085 for information on other our physical and emoin-home respite care agencies, adult day ADL Home Care, Inc. . . . . . . . . . 269-373-5444 tional health will be programs or overnight respite care facilities.
Taking a Break: In-Home Respite Care
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Michigan Generations
Tri-County Office on Aging A consortium of Clinton, Eaton and Ingham counties and the cities of Lansing and East Lansing
Senior Refugees Receive Help
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he Tri-County Office on Aging (TCOA) is one of five sites in Michigan chosen to administer a grant through the Family Independence Agency to assist senior refugees in our tri-county area. The goal of the grant is to link senior refugees to existing senior services. TCOA’s brochure has been translated into the five languages prevalent in this community’s senior refugee populations. TCOA has identified isolation as an area of concern and has held social gatherings for the Cuban and Vietnamese elder communities. TCOA has also linked with Catholic Social Services/Refugee Services to do commu-
Refugees enjoy a social gathering and other outreach programs.
nity outreach to find senior refugees in need of assistance. TCOA has already helped 37 senior refugees obtain services and items that were otherwise unavailable to them. One
Haitian refugee was helped with an orthopedic bed because her back had been damaged when she was tortured in her home country. Other assistance has included such services as transportation, interpretation, help in paying medical bills, purchase of household items such as beds and furniture, assistance in paying immigration costs and the purchase of clothing. To be eligible for assistance, the client must be a refugee, 60 years of age or older, and there must be no other available source of funding to cover the need. For more information, contact the TriCounty Office on Aging at 517-887-1440 or toll-free at 1-800-405-9141.
Branch–St.Joseph Area Agency on Aging IIIC Serving a two-county area surrounding Sturgis, Three Rivers, Coldwater and Quincy
The Healing Power of a Brisk “Walkie Talkie”
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n recent years, studies have produced welcome news for older adults: Moderate physical exercise, including brisk walking, can improve overall health and increase energy levels. The “Walkie Talkies” exercise group in St. Joseph County has been feeling the healing effects of a brisk walk for the past year. At HealthTRAC (a recreation/athletic center located in Three Rivers), this group of 20 men and Geraldine Tase uses “ExerStrider” poles to assist her as she circles the track. In the background, Twila Jones and Maxine Milhahn keep up the pace.
women walk or cycle for an hour twice per week. The safety and security of walking indoors and having professionals available for assistance are what keeps them going. Also, the camaraderie of old and new friends exercising in this type of group has
them, as they say, “looking out for one another.” Over the past year, the group has seen an increase in energy as well as muscle tone, and some have even seen a few pounds melt away. The St. Joseph County Commission on Aging was able to negotiate a special rate with HealthTRAC to accommodate the group, and it has proven to be a great business partnership for each organization. As one member comments, “We’ll be doing this until the group gets so big the track can’t hold us — come on over and join us!” For further information, please contact the Branch-St. Joseph Area Agency on Aging (IIIC) at 517-279-9561 or toll-free at 1-888-615-8009. You may also visit our website at www.bhsj.org.
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Region IV Area Agency on Aging Covering Michigan’s Great Southwest including Berrien, Cass and Van Buren counties
SeniorNet Learning Center Offers Computer Classes
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omputer training for seniors is one of the services offered by the Area Agency on Aging. The Southwest Michigan SeniorNet Learning Center is a nonprofit computer classroom for adults 50 years of age and older. The age requirement applies to the volunteer teachers and coaches as well as the students. Courses currently offered at the Learning Center include: Beginning Computers, Intermediate Computers, Word Processing, Graphics, Genealogy, Spreadsheets, Windows and your PC, and Introduction to the Internet. Each of the two-hour classes meets once per week for eight weeks. The classroom accommodates
SeniorNet coordinator and instructor Dennis Bowen works at his computer.
12 students, and classes are “hands-on.” A video projection system displays the
instructor’s screen for all to see. SeniorNet is designed to be a low-pressure, enjoyable learning environment. Best of all … there are no tests. Our training center features the Windows XP operating system on all computers and has a highspeed Internet connection. The Learning Center is located at 211 Hilltop Road in the old Heath/ Zenith building in St. Joseph. The Area Agency on Aging provides the classroom and all of the equipment. To find out about classes or becoming a volunteer, call the Learning Center at 269-983-4232 or send an e-mail to snlc@qtm.net. Our website is at www.swmisnlc.org.
ValleyArea Agency on Aging Serving Genesee, Lapeer and Shiawassee counties
Blue Cross/Blue Shield — Partnering to Prevent Falls
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hrough a grant provided by Blue Cross/Blue Shield of Michigan, the Valley Area Agency on Aging (VAAA) has been able to assist approximately 50 seniors by providing safety equipment such as grab bars, handrails and nonskid strips. VAAA has also provided home modifications such as removing clutter and tacking down carpets that provide a fall risk. Falls account for 87% of all fractures for persons age 65 and over, and of those who fall, 20 to 30% suffer moderate to severe injuries that reduce mobility and independence, and increase the risk of premature death. As seniors grow older it is impor16
tant to look at their homes and see what can be done to prevent falls. This task is often difficult for seniors themselves, because they do not possess the expertise to determine what needs to be done and often lack the resources needed to implement the changes. The Blue Cross/Blue Shield grant has made it possible for VAAA social workers to assess seniors’ homes for fall prevention and purchase safety equipment when needed. Seniors often face giving up activities due to functional limitations; however, it is important to encourage them to continue as many activities as possible in a safe manner. Many seniors, for instance,
have reported giving up bathing in the tub or shower for fear of falling. Once VAAA equipped their bathrooms with grab bars and shower benches, they felt more secure and resumed bathing safely. You can obtain a home safety checklist for seniors at Miseniors.net, or call V AAA at 810-239-7671 ext. 243.
Tips for reducing falls ■ Maintain a regular exercise program. ■ Make living areas safer by removing tripping hazards and using nonslip mats and grab bars in the bathroom. ■ Have doctors review all of your medications. ■ Have your vision checked annually. Michigan Generations
Area Agency on Aging of Western Michigan Serving Allegan, Ionia, Kent, Lake, Mason, Mecosta, Montcalm, Newaygo and Osceola counties
Medication Management
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rescription drugs can be a miracle of modern medicine when taken properly, but a health hazard when not. To help make sure seniors are taking their drugs as prescribed, the Area Agency on Aging of Western Michigan funds a Medication Management Program in Kent, Mason, Lake and Newaygo counties. “Studies show that older adults account for more than half of all drug reactions that lead to hospitalization,” says Tom Czerwinski, director of the Area Agency on Aging of Western Michigan. “With just a little oversight, they can take them safely and remain at home.” The Medication Management Program helps a variety of people, including those who are blind, those with
dementia and those with little or no help from family. “We have found older adults may run out of medicine or they may take double doses,” says Charlotte Nickelson of Gentiva Health Services, which provides the nurses in Kent County. “We start out with weekly visits to set up the meds, then gradually drop down to once per month. Our goal is to teach them or a family member or friend to properly dispense the drugs. We try to get in, get out, but give as much help as they need while we’re there.” Some
clients, however, may need to remain on the program indefinitely. During the time someone is in the Medication Management Program, an RN or LPN will do a complete health check on the person. “We do a health assessment every time we go to the home. We look at the whole person and whether the person is eating properly. We will do quick, skilled checks like blood pressure tests,” says Nickelson. If the nurse sees something else the client may need, she will refer them on to other programs. For more information, call the Area Agency on Aging of Western Michigan at 1-888-456-5664.
Region VII Area Agency on Aging Serving Bay, Clare, Gladwin, Gratiot, Huron, Isabella, Midland, Saginaw, Sanilac and Tuscola counties
Services and Home Modifications Encourage Independence
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ow often have we heard someone say, “I just want to be home and be able to sleep in my own bed?” Most seniors prefer to receive services and care in the comfort of their own homes. Region VII AAA funds programs to help seniors receive care and maintain their independence while remaining at home. In-home services such as homedelivered meals, personal care, respite care and homemaking are key supports for seniors. The MI Choice Medicaid Waiver program offers assistance to seniors who meet both medical and financial eligibility. Region VII also supports programs Spring 2004
Helpful Region VII staff — Elaine, Mary and Wendy — waiting to take your call.
that modify the senior’s home to make it safer. Adding grab bars, providing a tub transfer bench, changing doorknobs to lever-style handles or replacing shelves with drawers in kitchen base cabinets can make everyday tasks easier. Lift chairs save caregivers from back strain and help the care receiver to be more mobile. Making home modifications and obtaining helpful equipment may be just the answer for seniors who wish to maintain their independence and safely remain in their own homes. For further information, contact the Region VII Area Agency on Aging, 1615 South Euclid Avenue, Bay City, MI 48706, or call toll-free at 1-800-858-1637. A brief overview of services is available on our website at region7aaa.org. 17
NEMCSA Region 9 Area Agency on Aging Covering 12 counties of Northeast Michigan
MI Choice Makes a Difference
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s a person’s health declines, they need to start looking at care options. This was the case for Naomi Thompson. Naomi has a heart condition and until recently had remained independent. Naomi was used to leading an active life. She worked at the local hospital for many years and then owned her own real estate company for 12 years. Once her health became worse, she found herself unable to do some things she used to handle easily. She turned to the MI Choice Program. The MI Choice Program helps the elderly and disabled at risk of nursing home placement remain in their homes. Once a referral is received, a Care Management team conducts an in-home assessment, develops a care
plan, arranges for services and provides follow-up with periodic reassessments. Services under MI Choice include homemaking, respite, adult day care, private duty nursing, home-delivered meals, personal care supervision, personal emergency response systems, chore service, counseling, home modifications, medical supplies/equipment and some training. Prior to his death, Naomi’s husband was receiving help through NEMCSA’s MI Choice Program. It was an easy transition for Naomi to seek assistance since she was familiar with the caregivers and services available. Although Naomi’s six children help out as much as possible, more assistance was needed. The children live out of
state or not conveniently close by — a situation similar to many families. With MI Choice, Naomi receives help with homemaking, bathing and meal preparation. Naomi still likes to do as much on her own as possible — such as managing her own finances, medications and so on. The physical tasks are most challenging, as she is on oxygen and not able to walk great distances. If you or someone you know needs help but is reluctant to ask, Naomi offers this bit of wisdom: “You’re not giving up your life; you’re simply making your life easier.” For more information, call NEMCSA at 1-800-219-2273 ext. 231.
Area Agency on Aging of Northwest Michigan Offering information and funding senior services in the 10-county area of Northwest Lower Michigan
Seniors Are “Dining Out” at Local Restaurants
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he innovative “Dining Out” Program in Region 10, which debuted in November 1999, has maintained its success over the past four years, providing senior citizens with more flexibility in dining times and meal selections. The program is a service of the Area Agency on Aging of Northwest Michigan (AAANM) and several Commissions on Aging in Region 10, in cooperation with area restaurants. The restaurant voucher program has helped to provide seniors who do not live near a traditional congregate meal site the option of receiving a nutritious meal that meets the meal standards of the Senior Nutrition Program. Seniors pick up “Dining Out” 18
suggested donation of $2.00 per voucher is appreciated but not required.Vouchers are currently limited to four per month per participant to insure program continuation throughout the entire fiscal year. Dale Millward, a long-time participant, says the program “promotes people to get out Dale and Evelyn Millward of Traverse City enjoy dining at the of the house and meet peoCottage Café, the first restaurant to participate in the “Dining ple” and that it fills “not so Out” Program. much a physical need, but rather an emotional need.” vouchers at AAANM and participating To learn more about “Dining Out,” Commissions on Aging, which exposes contact AAANM at 1-800-442-1713. them to valuable information on availability of additional services. A Michigan Generations
Upper Peninsula Area Agency on Aging Serving all 15 counties of Michigan’s Upper Peninsula
Community Corrections Program Benefits Seniors
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PCAP Services, Inc., is a multi-purpose, 501(c)3 nonprofit organization. In addition to its role as an Area Agency on Aging, UPCAP also administers a number of other programs that benefit the senior citizens of the Upper Peninsula. One rather unlikely program is the West-Central Regional Community Corrections Program. The Community Corrections Program provides safe, alternative sentencing options to judges for nonviolent offenders in our local communities. These options allow the offender to remain in the community while serving his or her sentence, instead of being placed in jail or prison. How does a Corrections Program
benefit seniors? The Corrections Program offers local nonprofit organizations assistance with any number of different jobs or activities through its Community Services Work Crew Program. Within UPCAP’s six-county program area, the three local Community Action Agencies take advantage of the program and utilize the work crews to assist with the monthly and quarterly distribution of commodities — unloading bulk supplies and packing them into smaller packets for actual distribution to low-income families and seniors. Senior centers and congregate meal sites also take advantage of the program for assistance with preparation and the serving of meals. In one
instance, a senior center had all of its computers upgraded and programs developed to meet monthly reporting requirements by a program participant with extensive computer training. UPCAP’s Care Management Program uses the Community Corrections Program too, utilizing work crews during the summer to help maintain the lawns of seniors and in the winter to keep sidewalks and driveways shoveled. Work crews have also been used to caulk and repair or put up and take down storm windows at the homes of seniors. During FY 2003, over 4,700 hours of service, with a monetary value in excess of $60,000, was generated by the program for the benefit of seniors. For more information on this program, contact Sue Young at 906-789-0511.
Senior Resources of West Michigan Located on the shores of Lake Michigan, serving the three counties of Muskegon, Oceana and Ottawa
Meals on Wheels: A Helping Hand for the Homebound and Their Families!
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here are many reasons why older adults need home-delivered meals. Some may not have enough money to pay bills, buy medications and buy groceries. Home-delivered meals can help stretch dollars with one or two nutritious meals a day. Maybe someone has a short-term medical need — like Rose in Holland, who says: “I really enjoy your meals. Since I cannot cook for myself for a while [due to a hip replacement], this really helps a lot and they are so nutritious.” Or maybe someone has a disability — like Clare in Hart, who is nearly blind and asked her driver, “What was that I had yesterday for Spring 2004
lunch?” Her driver explained it was quiche, and Clare said, “It was very tasty and a nice change.” In Muskegon, William takes care of his wife, who has Alzheimer’s. He says, “I just can’t seem to keep up with
everything; it is so helpful to know we have this meal taken care of each day.” And Katherine lives alone in Spring Lake while her family lives out of state. Her family says, “It is such a relief to know someone is checking on Mom everyday. The meals and visit mean so much to her and us.” Whatever the reason, Meals on Wheels is a program of Nutritional Services that truly impacts the quality of life for older citizens in our three counties. Volunteers and staff deliver hot meals, cold meals, special diets, frozen meals and liquid supplements. To find out about Meals on Wheels and other programs for seniors in this area, call 231-755-0434 or 1-800-4426769, or visit www.nutritionalservices.org.
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Geriatric Depression Scale (GDS)* Here is a sampling of questions that have been used extensively to determine depression among seniors. While the GDS is a useful screening tool, it is not a substitute for a diagnostic interview by mental health professionals.
1. Are you basically satisfied with your life?
13. Do you feel downhearted and blue?
2. Have you dropped many of your activities and interests?
14. Do you feel pretty worthless the way you are now?
3. Do you feel that your life is empty?
15. Do you worry a lot about the past?
4. Do you often get bored?
16. Do you find life very exciting?
5. Are you bothered by thoughts you can’t get out of your head?
17. Is it hard for you to get started on new projects?
6. Are you in good spirits most of the time?
18. Do you feel full of energy?
7. Are you afraid that something bad is going to happen to you?
19. Do you think that most people are better off than you are?
8. Do you often feel helpless?
20. Do you frequently get upset over little things?
9. Do you often get restless and fidgety?
* The Geriatric Depression Scale was created by Dr. Jerome Yesavage, director of the Aging Clinical Research Center at Stanford University School of Medicine.
10. Do you prefer to stay at home rather than go out and do things?
21. Do you frequently feel like crying?
11. Do you frequently worry about the future?
23. Do you enjoy getting up in the morning?
12. Do you feel you have more problems with memory than most?
25. Is it easy for you to make decisions?
22. Do you have trouble concentrating? 24. Do you prefer to avoid social occasions?
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Whirlpool Corporation Whirlpool Corp., the global leader in home appliances, proudly serves and sponsors agencies that help people live their lives to the fullest.
Thanks to these companies and organizations for their generous support. For more information on becoming a sponsor of Michigan Generations please call Jenny Jarvis at 248-262-9202 .