Generations Michigan
Summer 2006
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HOME
CARE
A Boon for Raising Caregivers Grandchildren Also in This Issue: ■ Ask the Expert About Inflammation and Pain ■ A Look at Area Agencies Around Our State
Leo and Merelyn Sullivan of Petoskey, 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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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 Visit the AAA’s state website at www.mi-seniors.net
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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 8 of this issue. MI
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Michigan
Generations SUMMER 2006 Published quarterly
through a cooperative effort of Michigan’s Area Agencies on Aging. For information contact: Jenny Jarvis 248-262-9202 jjarvis@aaa1b.com
Editorial Project Development: JAM Communications, Atlanta, GA Design and Production: Wells-Smith Partners, Lilburn, GA Cover and feature photography: Green Frog Photography, Grand Rapids, MI
On the Cover: Leo Sullivan calls home-health care “a blessing” in offering help with his wife, Merelyn. The Sullivans are part of a growing trend, as caregivers throughout Michigan turn to a broad range of home services and assistance. See story, page 4.
Summer 2006, Volume 4, #1 © 2006 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.
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 aged 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 Co. Health & Community Services Dept. Region 3A 3B Burnham-Brook Region IIIB Area Agency on Aging 3C Branch-St.Joseph Area Agency on Aging IIIC
CAREGIVINGNews&Notes A Good Night’s
Sleep
Promising News On Treatment
Prostate
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alf of all older adults sleep fewer than seven hours a night, and a quarter of them say they have a sleep problem, according to a recent Gallup survey. If you are the caregiver for a person who has trouble sleeping, here are several health conditions that could be contributing to the problem: • Sleep apnea, an obstruction of the airway, which can cause a person to stop breathing repeatedly, • Restless legs syndrome (RLS), which can cause leg “tingles,” • REM behavior disorder, which can cause dream disturbances,
• Urinary problems, resulting in frequent trips to the bathroom, • Medications such as antidepressants, decongestants or high blood pressure drugs, which can have a stimulating effect on the brain. Review these conditions with a doctor. He or she will be able to provide guidelines for getting a better night’s sleep, such as getting on a new routine, changing the person’s diet or exercise pattern, restricting caffeine close to bedtime or trying a mild prescription sleep drug.
WORRYING About
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Probate
t is surprising how many seniors or caregivers worry about “avoiding probate.” In many cases, that concern is not justified — and it is often based on a misunderstanding of what “probate” means. Often, the process of probating an estate is relatively quick and inexpensive. Unfortunately, for several years there have been efforts to portray the probate process as slow and expensive. Often the people who make these claims are trying to convince the listener to hire them to create a so-called “living trust.” Although trust agreements are often a good way for seniors to plan their estates, they are not always necessary and usually involve higher fees up front. Individuals should always be concerned if the person trying to “sell them a trust” uses scare tactics about probate. This is especially true when the person selling the legal documents is not an attorney. The decision of whether a trust or will is appropriate should be something that is decided after consulting with a qualified attorney. Courtesy Douglas G. Chalgian, certified elderlaw attorney, and Amy R. Tripp, attorney at law. Summer 2006
IF YOU KNOW SOMEONE who has been diagnosed with prostate cancer, you’ll be interested to learn that some doctors are starting to use minimally invasive laparoscopic surgery to remove the prostate. Early research indicates this form of surgery may lead to less pain and shorter recovery times than conventional surgery. Other noteworthy news: A study in the journal Urology found that men with slow-growing prostate cancer who stuck to a vegetarian diet and exercised regularly actually lowered their PSA scores. However, the study only followed the men for one year, so additional follow-up is needed to determine long-term results.
6 Steps to Better Communication
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aregivers are often faced with the task of discussing a difficult situation with an older adult. Here are tips for communicating better: ■ Hold discussions in a quiet setting at a time of day that is best for the elder. ■ Listen to the older adult and acknowledge his or her opinions. ■ Stay positive. Use constructive suggestions instead of blanket statements. ■ Provide accurate information. Don’t tell “half-truths.” ■ Allow the older adult plenty of time to process the information. ■ Supplement your words with nonverbal cues and supportive body language.
Surfing the Net Each issue of Michigan Generations offers several websites of interest to older adults and their caregivers … right at your fingertips. www.medicinenet.com offers A to Z lists of diseases and conditions, symptoms, procedures and tests, news and tips for healthy living, all written by physicians and health professionals. www.wellspouse.org showcases Well Spouse Association, a national nonprofit that gives support to wives, husbands, and partners of the chronically ill and/or disabled. Look for more helpful websites in the next issue of Michigan Generations. 3
Home-health aide Angela Prince, right, offers caring support to Leo Sullivan and his wife, Merelyn.
Home Care: A Boon for Caregivers By Martha Nolan McKenzie
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EO SULLIVAN COULD CARE FOR HIS WIFE, MERELYN, BY
himself, but he prefers to have help. So an aide comes to Sullivan’s home in Petoskey every morning to help Merelyn (who suffers from dementia) get bathed, dressed and ready for her day. Twice a year, Sullivan takes a golfing trip with some buddies. Although his daughter comes and stays with Merelyn while he’s gone, Sullivan increases the aide’s visits to twice a day — two hours in the morning and t0wo hours in the evening to get Merelyn ready for bed — to give his daughter additional assistance during that time. “I’m in excellent condition, and I could do everything myself,” says Sullivan, 78. “But then I would run out of steam. Having an aide come in and help out makes it a lot easier on me. The home-health aide has been a blessing.” If you are a caregiver who, like Sullivan, needs extra help at home, you’re not alone. Sullivan is part of an important and growing trend. Caregivers throughout Michigan and across the nation are turning to a broad range of home services and assistance available in every community. In addition, seniors who years ago may have ended up in an assisted-living facility or a nursing home are able to remain in their own homes with the help of aides, nurses and therapists who make regular visits. Broadly called “home care,” this industry encompasses all health and social serv-
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ices delivered in a private residence. These services can range from personal services, such as companionship visits, help with activities of daily living (dressing, bathing, etc.), housekeeping, meal preparation and shopping, to health and skilled nursing services, such as medication management, physical therapy, injections and intravenous therapy. “Sometimes just a little bit of help in the home makes the difference between being able to live independently or going to a nursing home,” says Anne Zemlick, RN, program manager for the Care Management Program at the AAA Region 3A in Kalamazoo County. “So often it is minimal support, and it doesn’t even have to be daily, but it can make a huge difference in their lives.” The need for such services has swelled with the aging population. Ali Ucar has witnessed the boom firsthand. The vice president and CFO of Signature Home Care in Southfield has watched the number of clients his company serves jump from about 80 at the end of 2002 to upwards of 300 today. “Most of our growth has come in the areas of personal services and medication assistance,” says Ucar. “We expect continued strong growth as the population ages. I think families will do whatever they can to keep Mom and Dad out of a nursing home setting, so they will fuel the demand for personal services in the coming years, and for more technical nursing services as well.” Michigan Generations
Types of home care The types of services provided by home-care agencies can be divided into two areas: medical or home-health and social or personal. MEDICAL OR HOME-HEALTH SERVICES might include injections, intravenous therapy, wound care, medication management and physical therapy. These services are usually provided by registered nurses (RN) or licensed practical nurses (LPN), physical therapists, occupational therapists and speech language pathologists. Two types of home-health agencies generally provide skilled nursing care — Medicare-certified home-health agencies and private-duty agencies. The lion’s share of skilled nursing care in the home is paid for by Medicare. But there is a catch. “Medicare will only cover home skilled care for one hundred days post hospitalization, and the hospitalization has to qualify,” says Zemlick. “There is also the MI Choice Medicaid waiver program to help pay for services for low-income individuals, but to qualify you must be eligible for a nursing home level of care, your income level can be no higher than $1,809 a month and you cannot have assets over $2,000.” Private-duty agencies can offer skilled nursing services on a longer-term basis, but the client typically pays for these services out of pocket. The cost can run as high as about $40 an hour for an RN. SOCIAL OR PERSONAL SERVICES include assistance with activities of daily living, such as getting in and out of bed, bathing and dressing. They can also include companionship visits, transportation and help with household tasks and errands. “Very often, a son or daughter has been doing these things for their parent, but it’s either just become too much for them to do every single day or they simply want some extra help,” says Susan Molenaar, assistant administrator and director of marketing for United Nursing Service in Kalamazoo. “Many times their parent just needs a little help getting up and getting going in the morning and then a little bit of help getting ready for bed.” Personal services are generally provided by homecare aides, home-health aides, homemakers and volunteers. Medicare-certified home-care agencies and private-duty agencies typically offer these services, as do homemaker and home-care aide agencies. (See Accreditation Pull-Out at end of main article.) Often a private-duty agency will team up with a Medicare-certified agency to provide the entire array of home-care services. Consider Care Solutions Network in Southfield. Founded by several home-care professionals, Care Solutions Network is a consortium including a private-duty agency, a Medicarecertified agency, physicians, pharmacies and medical equipment manufacturers. Summer 2006
“It’s common for a client to need some of the services a private-duty agency offers and some that a Medicare-certified agency offers, and perhaps some others,” says Ucar of Signature Home Care, the private duty component of Care Solutions Network. “We created a network of all the home services someone might need, so the family member just has to call one number and we’ll coordinate the services with the various agencies, whether it’s medical monitoring, nursing, physical therapy, physician’s services or personal assistance.”
New directions in home care As the home-care industry has grown, the services offered have become more comprehensive and sophisticated. Here’s a look at some noteworthy home-care offerings: LIVE-IN SERVICES. Some seniors need more than a visit or two a day. They need an aide available 24/7, but they don’t want to go to a nursing home. That’s where live-in services come in. A caregiver will stay in the patient’s home 24 hours a day, helping with cooking, cleaning, personal care and errands. If the patient requires live-in care seven days a week, the agency will typically rotate two or three caregivers in the home. The bonds formed between the patient and caregiver can be quite strong in such an arrangement. “It’s amazing to watch how close they become after a time,” says Jeff Alisch, CEO of Home Care Assistance in Grand Rapids. “We’ve even had our caregivers go on vacation with their clients.” The cost for such care, however, is steep. “Our average is about $150 a day,” says Linda Coffell, administrator of Leelin Home Health Care in West Branch. “But it could go above that, depending on what the patient needs to have done. Live-in care is generally an out-of-pocket expense, although some long-term care policies will cover it.” TELEMONITORING. A growing array of gadgets that allow patients to electronically transmit vital data, such as weight, blood sugar and oxygen levels, to distant hospitals, doctors and nurses has led to a new angle in home care — telemonitoring. Other telemonitoring includes “Virtually There Care” and medication monitoring. “We currently have five clients who are using home monitoring equipment,” says Rosemary Mayes, director of professional health services for Metro 5
Home Health Care Services in Dearborn. “We can remotely LEGAL SERVICES. Another unmet need Masta discovered was monitor their weight, blood pressure and blood sugars, so we legal services. She saw clients who needed wills, wanted to only have to make a home visit twice a week instead of three set up trusts or establish advanced directives. So Masta hired to four times a week. Since we are able to get immediate infora health-care attorney (who happened to be her daughter), mation from the client, we can alert a doctor right away if a Megan Stiverson. problem starts to show up, which cuts down on “In the event a client with dementia starts mismanaging hospital re-admissions. The patients are able their funds, for example, we can help the family seek power of to stay in their homes, which is where attorney or guardianship over the parent,” says Masta. “We they want to be.” have worked with clients who were the victims of phone scams PSYCHIATRIC HOME CARE. Some to try to recoup their losses. We try to be a one-stop shop.” patients are homebound not because How to find a home-care provider of physical limitations but from psyBefore you start to look for a home-care provider, you chiatric ones — either their illness need to determine what types of services you need. If you renders them unable to leave their are not sure — and many caregivers aren’t — you can call home safely unattended or it maniyour local Area Agency on Aging. “We have a registered fests by a refusal to leave their home. nurse and social worker team go out to the home and do a Metro Home Health Care Services thorough assessment,” says Evelyn Richardson, Care Conoffers specialized home-care services for nections supervisor at the AAA of Northwest Michigan. “We such situations. look at their medical, psychosocial and financial needs to get “People with psychiatric illnesses, such as a full picture of their environment, their caregivers and the bipolar disorder, depression and schizophrenia, often supports they have in place. Then we work with them to fill are not good at complying with their medication regimen,” in the gaps so they can stay safely in their home.” says Mayes. “We have a psychiatric nurse specialist who can Your local AAA is also a good place to get names of homegive injections, draw blood to monitor medication levels, care providers in your area. “Before we contract with a evaluate drug side effects and intervene in a crisis. Our goal home-care agency, we make sure all their is to educate and support the family and policies and procedures are in place and allow the patient to remain in his own For helpful tips that they meet our service standards,” says home.” BOOKKEEPING. Many times seniors need Kathy Bogl, vendor quality assurance manon selecting a help with more than dressing and taking ager at AAA 1-B in Southfield. “We meet home-care provider, their medications — they need a little with our vendors twice a year to keep the turn to page 16. help with the checkbook. And the bills. lines of communication open, and we do And their taxes. Michelle Masta, president training for our vendors and health care of Home & Health Services Unlimited in Jonesville, saw workers. We recently conducted a training session on homethat need and added bookkeeping services to the company’s care code of conduct in which we discussed professionalism roster of home-care offerings. “If we see that our clients and behavior in the workplace.” need something, we try to find a way to provide it,” says To find the AAA office nearest you, look in the regional Masta. “And we saw that some clients were not able to section (pages 8–15) of this publication. maintain their checkbooks. They were not paying their bills Your physician or hospital discharge planner can also help correctly. So now we have staff who have bookkeeping and you find home-care providers in your area. If you are looking finance management backgrounds to provide in-home bookfor a Medicare-certified home-care agency, you can go to keeping services.” Medicare’s Home Health Compare website to get information about home-health agencies, including areas they serve and their quality of care compared to others in the state. Go to www.medicare.gov/hhcompare/home.asp. While a Medicare-certified agency has to be approved by Medicare, there is In addition, the National Association for no state licensure for the types of private agencies listed in this article. Such Home Care & Hospice (NAH) website offers a agencies can elect to become accredited by a group, such as the Commulocator service by zip code. Visit www.nahc.org. nity Health Accreditation Program or Joint Commission Accreditation. Finding the right home-care agency could “Getting accredited is a cost to the agency, so many don’t do it,” says Val be the answer to caregivers’ prayers. “Many of Bauer, vice president of Borgess Home Care in Portage. “But since there are the people we serve would either be living with no licensing requirements in Michigan, accreditation is the only way you can their children or in a nursing home if they know that a company has met a certain standard in providing care.” didn’t have home-care services,” says Richardson. “Giving them the ability to remain in their homes certainly adds to their quality of life.” MI
What Does “Accreditation” Mean?
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Michigan Generations
ASKtheExpert
Mark Gostine, M.D.
Inflammation and Pain Countering the Effects
Inflammation: Why is it a growing concern? A NUMBER OF RECENT STUDIES HAVE
shown the direct relationship that inflammation has not only with pain (in the form of arthritis and other joint-related pain) but with various forms of cancer and cardiovascular disease as well.
What causes inflammation?
I decided to run the Detroit Marathon. I attempted to conquer my hip pain in a natural fashion without the use of drugs. I developed a nutritional program to protect my joints and to prevent musculoskeletal pain. I ran the race to completion and, in April 2005, I accomplished a lifetime goal of running the Boston Marathon.
INFLAMMATION OCCURS WHEN CHEMicals from the body’s white blood cells are released into the blood or affected tissues to protect the body from foreign substances. This release of chemicals increases blood flow to the area of injury or infection and may result in redness and warmth. Some of the chemicals cause a leak of fluid into the tissues, resulting in swelling. This protective process may stimulate nerves and cause pain.
How did you develop your nutritional program? FIRST, I CREATED A REGIMEN THAT worked for me — intensifying my program of diet, vitamins and other supplements. I then completed extensive secondary research to thoroughly educate myself on the topic of inflammation and the relationship to pain.
What are signs of inflammation?
and affordable lifestyle changes people can make to reduce their “index of inflammation” and live healthier as they grow older. • Fish oil — Take five grams of fish oil per day. Make sure to get a brand that is high in EPA and DHA. • Minimize dairy except for yogurt — It provides bacteria that helps break down food in your digestive system, reducing food allergies that can contribute to arthritis and headaches. • Avoid red meat — You can get most of your protein from chicken and seafood, as well as the new eggs with high Omega-three oils that are now available in grocery stores. • Increase fiber — Incorporating fiber into your diet will reduce the risk of colon cancer and heart disease by binding the cholesterol in your stool and preventing reabsorption in the small intestine. Take Metamucil at least once a day.
ONE MAY EXPERIENCE REDNESS ,
swollen joints that are warm to touch, joint pain, joint stiffness and loss of joint function. Why did you develop a nutritional system to reduce inflammation? A FEW YEARS AGO, I HAD CUT BACK ON my running due to inflammation in my hip associated with arthritis. In 2002,
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.
Summer 2006
What can be done to counter the effects of inflammation? THERE ARE A NUMBER OF SIMPLE
• One alcoholic beverage a day — A little bit of alcohol each day is good for your cholesterol, but no more than one drink a day is recommended. • Green tea — Drink green tea instead of coffee. Green tea helps unlock your metabolism. It’s recommended to drink at least four cups per day. • Soy milk — Drink two glasses a day. Silk-brand vanilla flavor is tastiest and available at all grocery stores. • Seven helpings of fruits and vegetables a day — Fruits and vegetables are high in antioxidants, which help relieve inflammation. Apples, berries and dark greens like spinach are very beneficial. • Low-glycemic diet — We know that insulin causes inflammation. Try to eat just high-quality protein like chicken and seafood with fruits and vegetables, avoiding bread, pasta, white rice and potatoes. Nuts, beans and whole grains are excellent. Eating a handful of nuts twice a week reduces your risk of heart disease by about 40%. • Herb turmeric — Season your food liberally with turmeric, which is a yellow spice found in mustard. It has an earthy flavor like cumin and is used in curry, an Indian spice mixture. It has potent anti-inflammatory qualities. • Glucosamin sulfate — Take 1,500 mg of this supplement per day for joint protection. • Walk/exercise — Walk at least two miles per day. You may never run a marathon, but you will feel better. MARK GOSTINE, M.D., is a nationally recognized pain management specialist and co-founder of Michigan Pain Consultants, a comprehensive interdisciplinary pain management program. For information, call 616-940-2662 or 1-800281-3237, or visit www.michiganpain.com. 7
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.
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Detroit Area Agency on Aging Area Agency on Aging 1-B The Senior Alliance Region 2 Area Agency on Aging 3A Kalamazoo Co.Health & Community 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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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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S POTLIGHT O N …
NEMCSA Region 9 Area Agency on Aging Covering 12 counties of Northeast Michigan
Taking a Close Look at NEMCSA
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rea Agency on Aging Region 9 is fortunate to be a part of the Northeast Michigan Community Services Agency (NEMCSA). NEMCSA brings together federal and state grant funds as well as dollars from local, private and public sources. These resources are then directed into programs that aid the poor and otherwise disadvantaged throughout the age spectrum. NEMCSA has a variety of services that include food assistance programs, Low-Income Weatherization and Crisis Prevention Programs — namely Homeless Prevention and Utility Assistance. The childhood education programs 8
through NEMCSA are Early Head Start, Head Start Services (available in 21 counties), the Michigan School Readiness program, and a School Success partnership. Compass Youth and Family Guidance provides free crisis intervention and counseling services to youth and/or their families. NEMCSA’s Community Development Division provides technical assistance and training to county housing agencies. A matched savings program helps low-income families acquire assets to obtain housing. The aging programs include the Long-Term Care Ombudsman and the Medicaid/Medicare Assistance
Program, as well as funding for In-Home Services and Congregate Meals. Health care-related services include Care Management, MI Choice Waiver and Michigan Enrolls. Foster Grandparent, Senior Companion and Retired and Senior Volunteer programs round out the community-based care and volunteer programs. NEMCSA maintains the contract for Michigan Works! offices in 14 counties. Workforce Investment Act (WIA) Adult and Dislocated Workers, Welfare Reform and the Michigan No Wrong Door System are some of the focuses of Michigan Works! The Area Agency on Aging is happy to be the referral source within the NEMCSA organization. For more information on these programs, call 989-356-3474. Michigan Generations
Detroit Area Agency on Aging Serving Detroit, Highland Park, Hamtramck, Harper Woods and the five Grosse Pointes in Wayne County
Feeding Homebound Seniors on Easter: Mission Accomplished!
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Detroit Meals on Wheels when they offered staff members a chance to win a night in the company’s private suite for a Detroit Tigers game by simply donating a minimum of $10. “I am so thrilled with the outcome and support my fellow employees are showing,” says Katherine Hill, who organizes Meals on Wheels support efforts at DTE. Through the DAAA home-delivered meal program, which is federally and state-funded, meals are delivered to seniors five days a week. Unfortunately, there are no public funds to feed seniors during weekends and holidays. It was because of the dire need to expand the existing program that, in 1988, DAAA created the Detroit The new greeting card, which highlighted Meals on Wheels — Holiday Meals on a picture of a beautiful yellow tulip, sold Wheels program. very well. Several area churches took up HMOW is primaexclusive collections. rily supported through private and community funds. Currently, the Holi“The most important thing we can day Meals on Wheels program prodo for the citizens of Detroit is to vides hot nutritious meals on improve their health, and our goal is Thanksgiving, Christmas, Easter and to improve the health status in this Labor Day. Weekend meals and breakcommunity and the people we serve,” fast boxes are also delivered when explains Diane Byrd-Johnson, manager funds permit. of community affairs for Molina As one of sixteen Area Agencies on Healthcare of Michigan, an Easter Aging in Michigan, DAAA plans, coordiMeals on Wheels sponsor that has nates and develops numerous services always shown strong support to for the elderly, offers some direct DAAA and its causes. services, and funds and monitors DTE Energy far exceeded their nearly 40 community agencies, which $1,000 goal to raise money for t seems that “Ask and you shall receive” is becoming a standard practice for Detroit Meals on Wheels solicitors. Although there is still a long way to go, more and more Detroit area do-gooders are supporting this worthy cause. This Spring, the Detroit Area Agency on Aging (DAAA) put forth extra effort to ensure that homebound seniors receive nutritious home-delivered meals on holidays and weekends as well as every day of the week. For the Easter holiday delivery, various new programs were established, including a beautiful new greeting card that was sold by individuals, corporations and organizations. The new card, which highlighted a picture of a beautiful yellow tulip, sold very well. Several area churches took up exclusive collections. Community groups and businesses initiated special promotional efforts, and some companies made significant donations.
Summer 2006
provide most of the direct elder care services in our area. DAAA services an area consisting of almost 150,000 older adults residing in Detroit, Hamtramck, Harper Woods, Highland Park and the five Grosse Pointes. Holiday Meals on Wheels is funded primarily by DAAA’s annual golf outing and by the Holiday Card Program. The holiday greeting cards sell for $5 each, which covers the cost of the delivery of a meal to a homebound senior. But one card and one meal hardly make a dent in the thousands of seniors who go without company and without food every single holiday. Some don’t even see or talk to anyone other than the volunteers who deliver the meals. For more information on Holiday Meals on Wheels or the Holiday Card Program, call Beth Wheland, DAAA resource development manager, at 313-446-4444, ext. 5853. 9
Area Agency on Aging 1-B Serving the counties of Livingston, Macomb, Monroe, Oakland, St. Clair and Washtenaw
Don’t Miss These Events! Fairs Provide Valuable Information for Caregivers
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his Fall, the Area The programs Agency on Aging will include 1-B (AAA 1-B) will be expert presentahosting two free tions on a varievents for caregivers of ety of topics older adults. such as home • The 2nd annual health care St. Clair County options, the Caregiver Fair will spectrum of local be held on Saturday, services available, September 30, 2006, at guardianship, the Thomas Edison Inn Medicare and in Port Huron from Medicaid. Exhibi9:00 a.m. to 1:00 p.m. tors will also be • The 7th annual on-site to proAAA 1-B Resource Specialist Vikki Rochester assists a caregiver at the St. Clair County Caregiver Fair. Solutions for Family vide information, Caregivers Fair will be products and Heights, from 9:00 a.m. to 2:00 p.m. held on Saturday, October 21, 2006, at services for seniors, caregivers and perThese annual fairs will benefit peothe Best Western Sterling Inn Banquet sons with disabilities. ple who provide care for elderly or and Conference Center, located at For information, visit www.aaa1b.com disabled family members or friends. 34911 Van Dyke Avenue in Sterling or call us at 1-800-852-7795.
Program Provides Short-Term Assistance for Older Adults or Caregivers
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he Rapid Response Program provided by the AAA 1-B can offer quick access to short-term home care services for older adults or immediate help with caregiver relief for older adults or persons with disabilities. There are two Rapid Response Programs available: Rapid Response ShortTerm and Rapid Response Respite. Rapid Response Short-Term provides immediate short-term homemaking or personal care service due to an emergency situation, such as discharge from a hospital, or during a family crisis, for four to six weeks and no longer than 12 weeks. This program is available for adults 60 years and older. Seniors receiving assistance through Rapid Response Short-Term 10
AAA 1-B Care Manager Barbara Sims, RN, does an assessment with an AAA 1-B client.
are informed about the cost of the assistance provided and are asked to make an appropriate contribution according to their financial ability. Rapid Response Respite is available for adults 18 years and older with a disability or adults age 60 and over who need short-term or long-term caregiver relief. The program services include 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 the services received according to their financial ability. For more information on these two programs, please call the AAA 1-B at 1-800-852-7795 and speak with a resource specialist. Michigan Generations
Just for Fun: Five Ways to Improve Brain Fitness 1. Exercise gets the blood pumping, and that means better creativity, retention and reaction time. Studies show a 20% to 30% increase in mental ability with regular exercise. 2. Give your mind a workout. Finish a crossword puzzle; play charades; take up typing, dancing, swimming or a musical instrument, or learn a foreign language; balance a checkbook or estimate your grocery bill before paying. Visit a mental fitness gym at www.mybraintrainer.com for a stimulating workout. 3. Take up mediation. A recent study found that mediation thickened parts of the brain in those who engaged
in this activity 45 minutes a day, six days a week. Mediation can improve blood pressure, memory loss and relieve stress. 4. Listen to Mozart. Music perks up your creativity through the formation of neural pathways in the brain. It also trains your mind for higher forms of thinking like inventing and painting. 5. Enjoy aromatherapy. Stimulate your brain with essential oils of lemon, peppermint, cinnamon, eucalyptus, tea tree and cypress. Kick back and relax with lavender, chamomile, frankincense, jasmine and rose. Just place a couple drops into a cotton ball, and inhale for immediate results. Feed your mind positive messages for an added perk.
Help Is a Phone Call Away The Area Agency on Aging 1-B is the first resource for older adults, caregivers and persons with disabilities to call when looking to resolve problems or locate the resources they need to improve the quality of their life. When individuals call the tollfree service at 1-800-852-7795, they speak with a certified Resource Specialist who accesses a database of over 2,000 community agencies and mails the individual a complete listing of relevant services and providers.
Call us. We can help.
1-800-852-7795
Region 2 Area Agency on Aging Serving Hillsdale, Jackson and Lenawee counties
We Tackle Project Ramp!
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n March 2005 the Lenawee United Way and Volunteer Center decided that they could no longer coordinate the ramp program and asked whether the Lenawee Department on Aging would accept that responsibility. Knowing how important the program is, and with the knowledge that Project Ramp comes with no funding attached, we agreed. We took on the responsibility with the understanding that we would do our best to build ramps not just for those who are 60-plus but for persons of all ages. As soon as Project Ramp became ours, the requests began pouring in. That’s when we realized that building ramps could be very challenging. Our plan was to find volunteer builders who would be willing Summer 2006
to design and build the ramps and to find funding on a ramp-by-ramp basis. Well … that is easier said than done! Building a ramp involves measuring the homeowner’s property; having a person with a builder’s license submit a design that meets code to the building inspector; having the plan approved; and finding funding to pay for materials, which cost about $1,000. Finding builders who have time to build ramps proved to be nearly impossible. We found two who agreed to help, but neither followed through. Fortunately, we live near Holy Cross Children’s Services; they have been building ramps for years, and they offered their assistance. The outcome was that we had 32
requests, and we completed nine and repaired three others. Of the 32 requests, 21 were for older adults. Now that we have a year’s experience, we expect to be much more successful in 2006. Already, Holy Cross has committed to pay for and build 10 ramps; the Adrian Rotary Club will pay for and build one; Lenawee Community Mental Health has committed up to $5,000 for ramp materials to aid clients referred by CMH staff; and the Department on Aging has made their $5,000 an annual commitment. Our goal is to meet every request within a reasonable amount of time. We know it will take persistence and diligence, but the rewards will be great! For more information, contact Ginny Wood-Bailey at the Region 2 AAA, 1-800-335-7881 or 1-517-467-1909. 11
Kalamazoo Co. Health & Community Services Dept. Region 3A
Covering Kalamazoo County and its 24 municipalities
The Best Elder Care Questions
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lthough every elder’s situation is unique, callers to the Kalamazoo County Area Agency on Aging Region 3A are often encountering the older adult service system for the first time. A caller may be thinking about moving to a new kind of senior housing, or may have questions about the finer legal points of how to appoint someone who can make important medical decisions if they are not able to. The next most frequent information request is for any of a number of services that can enable an older person to remain safely and comfortably in their
home and “age in place.” This may initially involve having someone help with the yard, shopping or other chores, and may go on to assistance with personal care or setting up medications, and Meals on Wheels. Transportation is perhaps the number-one requested service after in-home care. Often a call for information is precipitated by a health crisis, when an adult child begins to think about how best to support the parent as they recover. If this is their first encounter with the elder service system, they Caregiver Resource Center . . . . . . . . . . . 269-978-0085 may not be aware 3A AAA Information & Assistance. . . . . . . 269-373-5173 of the range of
services that can help, and may feel overwhelmed. The information specialist can be a great help in suggesting not only possible solutions and services tailored to each family, but also the important questions to ask to find capable, qualified service providers. The AAA 3A’s Information and Assistance Service is your connection to information and community supports. The coordinator of the service, Peggy Sattler, MSW, has recently passed the Certification for Information and Referral Specialist for Aging (CIRS-A) examination, offered by the Alliance for Information and Referral Systems. The mission of AIRS is to advance the capacity of information and referral programs to better serve their communities. For more information, call the numbers listed at the left.
Branch–St.Joseph Area Agency on Aging IIIC Serving a two-county area surrounding Sturgis, Three Rivers, Coldwater and Quincy
Attention, Branch County Caregivers!
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re you caring for an older or disabled adult and need a break? The Branch County Commission on Aging/H. & C. Burnside Senior Center has just announced a special opportunity for caregivers to receive a grant-funded stipend to help: • Take a short vacation • Attend a wedding out of town • Tackle a large project • Or just take time for yourself Contact the Branch County Commission on Aging to see if you may qualify for their Overnight Respite Care Program.You can call 517-279-6565 and ask for Liz at extension 28. Some cost sharing may apply, depending on family income. 12
Funding is only available for a limited time. One of the best ways to care for your loved one is to care for yourself! The Branch-St. Joseph Area Agency on Aging’s mission is to provide an array of highquality services, programs and opportunities that support the independence and dignity of older adults and family caregivers across Branch and St. Joseph counties. For additional information on supports and services in your area, please call us toll-free at 1-888-615-8009.
Michigan Generations
Region IV Area Agency on Aging Covering Michigan’s Great Southwest including Berrien, Cass and Van Buren counties
Region IV Honors “Moms in the Middle”
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o celebrate Older Americans Month and Mothers Day in May, The Region IV AAA held a “Moms in the Middle” contest. Almost half of all women between 45 and 55 are caring for both a child and an older adult. This dual role usually leaves little time for “mom” to spend time on herself. The AAA gave husbands, sons, daughters or friends a chance to honor that special “mom” who always seems to be giving to others.To let her know how much she is appreciated, applicants submitted nominations in the form of essays highlighting the admirable work that “mom” does every day. As part of the celebration, the AAA also ran ads in local newspapers to
serve as a public awareness and education campaign about caregiving. The ads provided practical tips for caregivers, such as: “Ask for and Accept Help,” “Manage Your Time” and “Learn About Community Services.” One “Mom in the Middle” was selected and received the winning prize, a gift basket worth $500. The basket consisted primarily of gift certificates from local merchants, which the winner could use to pamper
herself with various goods and services. Along with the contest, the AAA will continue to let those special “Moms in the Middle” know more about local supportive services that they can access to make their caregiving role a bit easier and to take care of themselves. The original “Moms in the Middle” public awareness campaign was launched a few years back by the Eldercare Locator (1-800-677-1116 or www.eldercare.gov), a nationwide public service that provides connections to local resources and information about caregiver supports. For more information on Area Agency on Aging services, call the Senior Info-Line at 1-800-654-2810.
ValleyArea Agency on Aging Serving Genesee, Lapeer and Shiawassee counties
“Big Wheels Deliver Meals”
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ood nutrition tributes to a higher can help quality of life, lessen the effects of enabling older peodiseases prevalent ple to maintain among older peotheir independence ple, or improve the by continuing to quality of life in perform basic daily people who have activities such as such diseases — bathing, dressing Judy Garza and Ben Mata, both members of including osteoand eating. Inadethe VAAA Board of Directors, shared in the porosis, obesity, quate nutrition, on successful “Big Wheels Deliver Meals” event by bringing meals to area seniors. high blood presthe other hand, can sure, diabetes, heart prolong recovery disease, certain cancers, gastrointestifrom illness, increase the cost and incinal problems and chronic malnutrition. dence of institutionalization and lead Studies show that a good diet in to a poorer quality of life. later years helps both in reducing the The Valley Area Agency on Aging risk of these diseases and in managing (VAAA) and the Genesee County the diseases’ symptoms. This conCommunity Action Resource Depart-
Summer 2006
ment (GCCARD) cosponsored the first “Big Wheels Deliver Meals” event in May 2005 in Genesee County. The purpose of the event was to raise public awareness about senior nutrition issues. Fifteen elected officials from Genesee County participated in the event by delivering 40 home-delivered meals to area seniors. The first “Big Wheels Deliver Meals” event was such a success that VAAA is expanding the event to Lapeer and Shiawassee counties in 2006. VAAA is committed to increasing the public’s knowledge of the lifelong value of good nutrition. For more information on the “Big Wheels Deliver Meals” event, contact the Valley Area Agency on Aging at 810-239-7671 or 1-800-978-6275.
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Tri-County Office on Aging A consortium of Clinton, Eaton and Ingham counties and the cities of Lansing and East Lansing
Tri-County/AARP Partnership Offers Tax Assistance
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he Tri-County Office assistance in 2006. Volon Aging has partunteers were able to nered with AARP to provisit 518 seniors in vide the Tax Assistance their homes to comProgram for seniors in the plete their tax forms. tri-county area for over 25 The five assistance years. For the 2006 tax sites are located at the season, 30 trained volunTri-County Office on teers were available among Aging and in Okemos, five tax assistance sites, Mason, East Lansing Instructor Joyce LaFleur. all working under the and Charlotte. leadership of Joyce All seniors served LaFleur. Joyce has been the instructor by the AARP Tax Assistance Program and coordinator of the Tax Assistance have also been helped in applying for Program for six years, and previously the MI Property Tax and Home Heatshe was a volunteer tax counselor for ing Rebates. An average Homestead the program. With the aid of the proProperty Tax Credit for individuals was gram, 2,703 older adults received tax $700–$800.The program helped local
senior citizens to receive over two million dollars in credits/rebates. Many seniors depend on these rebates to pay for their property taxes for the present year. With the exception of Detroit, this AARP Tax Assistance Program completes the highest number of tax returns and has the lowest rate of errors in the state. On average, approximately 26 older adults were assisted per day at the Tri-County Office on Aging during the months of January through April. Nearly all tax returns were filed electronically, so the recipients received their refunds and/or rebates very quickly. For more information about the AARP Tax Assistance Program partnering with the Tri-County Office on Aging, call 517-887-1440.
Region VII Area Agency on Aging Serving Bay, Clare, Gladwin, Gratiot, Huron, Isabella, Midland, Saginaw, Sanilac and Tuscola counties
Meals on Wheels Are Rolling in Clare County
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n all 10 counties of Region VII, the home-delivered meal program is a great service to our seniors. These seniors are homebound for various reasons and are unable to travel to the congregate center, so the meals are delivered right to their doors. Sometimes the home-delivered service is only temporary until the senior is able to once again enjoy the meal, activities and social interaction at the congregate center. At the Farwell Senior Center, the day begins at 7:00 a.m. for the loving hands of the preparation crew. The meals are carefully regulated for content and temperature, then attractively assembled and packed for transport. The meals are 14
Volunteer Mary Eisele presents a meal to Virginia Willard. Now that Mary is retired, she provides to others the service that her mother received during the years when Mary was working.
personally delivered Monday through Friday, with frozen entrees provided for the weekend. The drivers and delivery people provide much more than meal transport.
They are the “eyes and ears” of the home base Aging Council, Commission or Division in their respective county. If the driver or delivery person notices that the senior is not well or has a special concern, he or she is able to report this finding for further follow-up.A meal is never left if the senior does not personally receive it. Thank-you notes are routinely sent by grateful family members who appreciate having their loved one receive a good meal along with daily personal contact. Everyone who contributes to the success of the homedelivered and congregate meal program is greatly valued! For additional information on programs and services, contact the Region VII Area Agency on Aging, 1615 S. Euclid Ave, Bay City, MI 48706, 1-800-858-1637, or visit our website at www.region7aaa.org. Michigan Generations
Area Agency on Aging of Northwest Michigan Offering information and funding senior services in the 10-county area of Northwest Lower Michigan
Board of Advisors Gears Up for 2nd Annual Senior EmPower Day
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n the heels of an overwhelmingly positive reception to their first-ever Senior EmPower Day, which convened last October in Traverse City, the Area Agency on Aging of Northwest Michigan (AAANM) Board of Advisors (BOA) is preparing to offer an even bigger and better event this Fall. The intention of Senior EmPower Day is to educate seniors and their caregivers about key issues that impact the lives of older adults. The BOA is currently seeking high-caliber speakers and securing a location to accommodate more guests for Senior EmPower Day 2006. They are also narrowing down the list of “hot topics” to be
Medicaid Assistance Program. addressed at the Thanks to event, selecting generous sponissues that they sorship from believe challenge Last year’s speakers were (at left) Dr. Donald L. local businesses Fraser, D.O., Medical Director of Hospice and older adults. Senior Palliative Care, Munson Medical Center, and last year, there EmPower Day will Robert Simpson, District Manager at the Social was no cost to again be designed to Security Administration,Traverse City. participate in offer guests accurate Senior EmPower Day 2005. The BOA information and critical insight, to is soliciting financial support again stimulate discussion and to empower this year and anticipates that sponthem to make informed decisions sors will enthusiastically agree to set about important issues in their lives. up displays and provide information In addition to seeing great presenbooths. ters, attendees will have the opportuFor more information about Senior nity to visit with a variety of business EmPower Day, contact AAANM at exhibits from around Northwest 1-800-442-1713 or 231-947-8920. Lower Michigan, as well as trained counselors from the Medicare/
Upper Peninsula Area Agency on Aging Serving all 15 counties of Michigan’s Upper Peninsula
Nursing Facility Transition Assistance Available Through AAA
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n January 2005, the Department of Community Health added a new service option for the MI Choice Waiver Program, operated by the U.P. AAA. The service is called “Nursing Facility Transition Initiative” (NFT) and is designed to assist current nursing facility residents to move back into the community. Frequently, individuals need the level of care and expertise offered by nursing facilities to address health issues following hospitalization or another medical crisis. Sometimes rehabilitation is short-term and the individual is able to return home to resume his or her previous lifestyle. Unfortunately, rehabilitation does not always follow Summer 2006
precise timetables, and by the time the person is ready to return home, many barriers have popped up, making discharge very difficult. Through NFT, MI Choice care managers work with nursing home residents and discharge planning staff to identify the barriers that are preventing an individual from returning home, and then set forth to resolve them. Sometimes the issue is identifying housing or modifying housing to accommodate the person’s disability. NFT resources can be used to access necessary household goods and appliances, address installation fees and service charges for utilities and phone service, or to simply install adaptive
items such as grab bars. In 2005, the Department of Community Health issued specific standards and policies to assist in making as many transitions as possible a reality. While a basic guideline is that a person must be a resident of a nursing facility for six months, MI Choice care managers can begin working with residents at any time. In addition, the person is not required to become a MI Choice participant. The U.P. AAA has teamed up with the Superior Alliance for Independent Living (SAIL) to facilitate as many U.P. residents wishing to return to the community as possible. For more information on the NFT program or to make a referral, contact SAIL at 1-800-379-7245 or the U.P. Senior Help Line at 1-800-388-7227, or simply dial 2-1-1. 15
How to Select a Home-Care Provider
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re you worried about hiring a stranger to come into your home — or the home of your elderly relative — and help with medical needs or personal tasks? For many caregivers or seniors, the idea is downright scary. “We live in an age where you can’t be too careful when you are having someone come into your home,” says Val Bauer, vice president of Borgess Home Care in Portage. “You need to know and trust the company you are dealing with.” The National Association for Home Care & Hospice suggests asking homecare agencies the following questions: • How long has this provider been serving the community?
• What kinds of services does this provider offer?
• What procedures does this provider have in place to handle emergencies? • Are caregivers available 24 hours a day, 7 days a week? • How does the provider select and supervise staff? • Does the provider bill directly to third-party payers? • Is the provider accredited by a quality review organization? • Are references available? • If this is a Medicare provider, how does its quality compare to others on the Medicare Home Health Compare website? • Does it protect its employees with written personnel policies, benefits packages and malpractice insurance?
SPONSORS Thanks to these companies and organizations for their generous support. Chalgian & Tripp Law Offices PLLC • Elder Law • Estate Planning • Special Needs Planning Offices in East Lansing, Jackson and Ithaca. 1-888-956-9600.
Health & Home Services Unlimited, Inc. Care, companionship and peace of mind. In-home or wherever your residence may be! We specialize in meeting your needs — from personal care to home maintenance. Insured and bonded. 1-800-314-8718.
Porter Hills Retirement Communities & Services Nine communities throughout West Michigan offering Residential & Assisted Living, Alzheimer’s/Dementia Care, Skilled Nursing and Affordable Housing. Porter Hills Services provides Home Health Care, Private Duty and Rehabilitation. To learn more, visit www.porterhills.org or call 616-949-4975.
Presbyterian Villages of Michigan Senior Living Communities Serving seniors of all faiths since 1945. To find out more, visit our website, www.pvm.org, or call 248-281-2020 for a brochure describing the variety of housing and services Presbyterian Villages of Michigan offers.
For more information on becoming a sponsor of Michigan Generations, please call Jenny Jarvis at 248-262-9202 .
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Michigan Generations