MIG10Sp PPrf ALL r5 by Wells-Smith Partners

Generations Michigan

Spring 2010

HOSPITAL to HOME Also in This Issue: n Ask the Expert n Caregiving News & Notes

How to ensure a smooth transition

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.

They are:

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.

7 5

3A 3B

Visit the AAA’s state website at www.mi-seniors.net

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

Generations Michigan

SPRING 2010 Published quarterly through a cooperative effort of Michigan’s Area Agencies on Aging.

For information contact: Jenny Jarvis 1-800-852-7795 jjarvis@aaa1b.com

Editorial Project Development: JAM Communications, Atlanta, GA Design and Production: Wells-Smith Partners, Lilburn, GA

2009

On the Cover: Discharge planning is a critical part of your loved one’s transition home, following a hospital stay. It can mean the difference between continued recovery and rehospitalization. Here’s everything you need to know about this important process. See story, page 4.

Spring 2010 Volume 7, #4 © 2010 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

AAAs —‑Gateways to Community Resources

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 Region IIIB Area Agency on Aging 3C Branch-St. Joseph Area Agency on Aging IIIC 4 Region I V 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

CAREGIVINGNews&Notes Keeping Your

in Tiptop Shape

eniors are known for their love of walking. But pounding the pavement, or even the walking trails, can take its toll on your feet. While sitting in a chair, try the following foot-friendly exercises. Marble Pickups — Strengthens muscles in the bottom of the foot and eases arthritic joints in mid-foot. Use your toes to pick up marbles from the floor. Drop marbles into a bowl. Arch Rolls — Eases heel pain and loosens tight arches. Roll a tennis ball or water bottle back and forth under each foot. Toe Writing — Maintains range of motion in your toes, feet and ankles. Raise one foot. Write the alphabet in the air with your toes, making big letters. Repeat other foot. Towel Scrunches — Strengthens mid-foot muscles and eases discomfort from fallen arches. Lay a hand towel on the floor. Use your toes to scrunch and pull the towel toward you.

Nest Egg

Your Retirement

etirees who have been carefully feeding their 401(K) and individual retirement accounts for years face a psychological hurdle when they have to switch gears and start withdrawing money. Financial planners give this advice: Plan for both sooner and later. The phases of retirement are often called the gogo years, the slow-go years and the no-go years. You should plan for your lifestyle during each of these periods — perhaps traveling and hobbies in the early years, followed by a slow-down during the next phase. Then expect spending to increase again because of health-care costs in your final years.

Surfing the Net Each issue of Michigan Generations offers several websites devoted to caregiving information and resources:

www.scambusters.org

alerts readers to a long list of Internet, phone and mail scams, as well as identity theft threats. www.centerforpositiveaging.org provides a complete range of information about housing and senior services to assist in positive, successful aging. Spring 2010

Why Keep

n i r i by your p As Bedside?

eart attacks can occur with various symptoms — or with no symptoms at all. Chest pain, a pain in the left arm, nausea or intense sweating are all warning signs. If chest pain wakes you up from a deep sleep, take these steps: • Immediately chew two aspirins and swallow them with water. They will get into your system faster by chewing before swallowing. • Call 911 and say that you may be having a heart attack. Say that you have taken two aspirins. • Unlock your door, sit down on a chair or sofa and wait for their arrival. Doctors believe that during the early stages of a heart attack aspirin — which is known for preventing blood platelets from sticking together — can prevent a clot from getting bigger.

What You Should Know About

Rehab

our family member may have been referred to rehab after being in a hospital due to illness, injury or surgery. Rehabilitation (or simply “rehab”) is treatment to help patients regain all or some of the movement and function lost because of current health problems. Patients often work with two or more rehab services. These include physical therapy (PT), occupational therapy (OT), speech therapy and psychological counseling (or simply “therapy”). Here are five important points to remember: The goal of rehab is to help patients be independent — doing as much for themselves as they can. Rehab is done with a patient, not to a patient. Your family member must be willing and able to work with rehab services during active treatment and, later, with caregivers or by themselves at home. The patient’s chronic (long-term) health conditions, such as high blood pressure or cholesterol, are treated during rehab, but they are not the reason the patient is in rehab. Most rehab services last weeks, not months. In general, you will find rehab has a “workout” atmosphere. Most insurance policies cover rehab when ordered by a doctor, but there will probably be extra costs. Excerpted from www.nextstepincare.org

1 2 3 4 5

HOSPITAL to HOME How to ensure a smooth transition By Martha Nolan McKenzie

aul, 86, is hospitalized for severe shortness of breath and is diagnosed with congestive heart failure. He is put on oxygen and new medications, and his condition stabilizes. In fact, the hospitalist okays his discharge. His wife, Karen, also 86, takes Paul home, along with a long and complicated-looking list of instructions. A few days later, Karen is struggling. She’s still trying to figure out how to help Paul get up and down the stairs, which medications he’s supposed to be taking now and where to get an oxygen machine. In short order, Paul’s condition worsens and he is rehospitalized. The above scenario is fictitious but alarmingly common. Having a loved one hospitalized is an unfamiliar, stressful situation. Many times you and your loved one are so focused on getting better and getting out of the hospital that you don’t pause to consider what comes next. Yet, discharge from a hospital does not mean the patient is fully recovered — it just means he no longer needs hospital-level care. “You can have great hospital care and you can have great home care,” says Linda Pekar, vice president of clinical services for the Visiting Nurse Association of Southeast Michigan in Oak Park. “But if there is no connection between the two, if they are fragmented, then the patient and family suffer.” A thoughtful, well-crafted discharge plan can bridge the gap between hospital and home, making the difference between continued recovery and rehospitalization. How will the patient’s condition be monitored once he is home? Does he understand how to take his medications, including new ones that were introduced in the hospital? Does he or his caregiver know the red flags that would indicate his condition is worsening? Has the necessary in-home care and

GONE HOME

equipment been put in place? Who can his caregiver call with questions or concerns? Knowing the answers to these questions and others is critical for a smooth transition from hospital to home. However, in these days of shorter hospital stays and understaffed facilities, discharge planning is often minimal at best. That means it’s up to the caregiver to be proactive, ask the right questions and insist on answers.

What is discharge planning? Medicare says discharge planning is “a process used to decide what a patient needs for a smooth move from one level of care to another.” Only a physician can authorize a discharge. The official discharge planner is often a nurse or social worker. However, it takes a multidisciplinary team to work out all the details of an effective discharge plan. “It truly is a team effort, and we work closely with all the disciplines, including nurses, physicians, physical and occupational therapists, dieticians, pharmacists, home health agencies and skilled nursing facilities,” says Sue Belknap, administrative manager in care management (internal medicine) at Beaumont Hospital in Royal Oak. “Social workers are also an integral part of the team, evaluating complex psychosocial cases. Before discharge we evaluate if the patient has an appropriate support system in place. Can he get to the doctor and can he get his medications? Can he function in the environment he’s going to? If not, there’s a good chance we’ll see him back in the hospital.” And all too often that’s just what happens. A full 20% of Medicare patients are readmitted to the hospital within 30 days of discharge, usually within just 7 to 8 days. Half of these Michigan Generations

patients have not seen their primary care physician for a follow-up visit before they are readmitted. About 42% of discharged patients have test results pending at the time of discharge, and 61% of physicians are unaware of the results of tests performed in the hospital. Michigan’s readmission stats are no better. “A study by Dr. Steve Jenks showed that Michigan had a 19.4% readmission rate, which put us in the 74th percentile,” says Sam Watson, senior vice president of patient safety and quality for the Michigan Health and Hospital Association (MHA) in Lansing. “However, we had a large variation — from 14.5% to almost 23% — so we believe there are regional factors within the state that bring about the higher risk for rehospitalization — maybe problems with the discharge planning process or lack of community resources to care for patients in outpatient settings. We’re trying to account for the variations.” Catherine Pirkola has some ideas. A social worker for Dickenson County Memorial Hospital in rural Iron Mountain, Pirkola contends patients are often sent home too early. “With shorter hospital stays, sometimes patients are discharged before they are ready — physically or emotionally,” says Pirkola. “Elderly patients, especially, may not have a strong support system at home and just get overwhelmed when they get there.” But whatever the reason, hospitals in Michigan, and across the country, have lots of room for improvement when it comes to discharge planning.

Role of the caregiver in discharge planning

In discharge planning, as in most areas of health care, the patient must assume more responsibility for his own care. For some, that’s good news. “Patients can be wary of me because they think I’m there to tell them what to do,” says Patty Switalski, director of case management at Cheboygan Memorial Hospital. “The patient is the boss. They have the right to make their own decisions regarding their discharge plan, and I provide assistance. I collaborate with their physician and the patient’s family if the patient allows. I give advice, but ultimately the patient is in control of the plan and who is included in that plan.” Many times, however, an elderly hospitalized patient is not in the best position to be his own advocate. He is ill, perhaps frightened and likely a bit overwhelmed. Thus, responsibility for the patient’s care often falls to the caregiver. Ideally, even if several members of the family are involved, one member should serve as the point person for the rest of the clan. “There really needs to be one person who is the central point of communication for the family,” says Bill C. Paskoules, senior Spring 2010

services program manager for Henry Ford Health System in Detroit. “If you think about it, if every doctor, nurse and case manager has to re-explain Mom’s or Dad’s condition every time they are contacted by a different family member, it would take away from the actual time they have to spend with the patient.” And in some cases, the caregiver can give a more reasoned assessment of the patient’s situation than the patient himself. “Very often the patient wants desperately to get back to their own home, so they can paint a rosy picture,” says Pekar. “When people start talking about the fact they may need help, they become afraid of losing their independence, so they say, ‘Of course I can handle it.’ So often it’s the caregiver who can give us a more accurate appraisal of their ability to cope with all the challenges they may be facing.” Just as the caregiver needs to give a realistic assessment of the patient’s capabilities, he or she needs to be clear on what they can and cannot do for the patient. As a caregiver, chances are you have other responsibilities — a job, children, health problems of your own, etc. If you cannot be available 24/7, let the discharge planner know that. The discharge team needs to know what tasks you can and cannot do so they can plan for any needed help. “We had an elderly mom caring for her adult son who still needed extensive wound care after he was discharged,” says Belknap. “The mother had never dressed a wound before, but she insisted on taking him home. A plan was created, teaching was accomplished and the patient was discharged with skilled home care visits arranged. The son was readmitted within a few days. The mother over estimated her abilities to provide the comprehensive care her son needed.” And sometimes the patient isn’t the only one who ends up hospitalized. “We admitted a patient yesterday and during the initial assessment it was noted that the patient’s wife (who was also his caregiver) was in need of care herself,” says Marie Doherty, director of care management for Beaumont Hospital in Royal Oak. “Sometimes it takes a hospitalization for families to face the reality that their loved ones need more assistance than they previously thought.” The caregiver also needs to make sure what is supposed to happen with a discharge plan does, in fact, happen. Discharge planning is supposed to begin on the day the patient is admitted to the hospital, but too often that is not the case. Sometimes instruction is given hurriedly at the time of discharge, making it all but impossible to absorb. If the discharge planner does not introduce himself early in the hospital stay, you need to go seek him out. Ask questions about your loved one’s condition, treatment and prognosis. Start watching how the

nurses administer his care so you’ll be more prepared to take it over. Ask for training in care techniques. The longer you have to prepare, the easier the transition will be.

Key elements of a discharge plan

While discharge plans are as unique as individual patients, certain basic elements are necessary for any plan to ensure a safe transition from hospital to home: Medication reconciliation. “Probably the No. 1 reason why patients are readmitted to the hospital is problems with medication reconciliation,” says Paskoules. “When patients are discharged, they are often on new medications, in addition to, or replacing ones they were taking before they were admitted. It can be very confusing. This is why it is critically important for patients and family members to bring in or give a list of home medications to the hospital doctor.” A caregiver can help by getting the answers to such questions as: If the patient was put on new medications in the hospital, how long should he take them? Does the medication have side effects? Should it be taken at meals or at certain times each day? Can it safely be taken with other medications the patient is using? A Medication Management Guide, which can help you organize your loved one’s medication information, is available on www.nextstepincare.org.

The discharge planner can help you identify which services the patient will need and identify resources that can meet those needs. Physician visit. “There is a sweet spot of about three days after discharge in which the patient needs to get in to see his primary care physician for a discharge follow-up appointment,” says Paskoules. “Two weeks out just isn’t good enough. Especially with senior patients, they could end up back in the hospital before that two weeks is up.” In fact, a post-discharge doctor’s visit is so important that some hospitals have begun to make the appointment for the patient while he is still in the hospital. At Bay Regional Medical Center, discharge planners will set up appointments for heart failure patients to see their regular physicians prior to discharge. “Heart failure patients represent our longest stays and greatest readmissions, so we are focusing on them first,” says Sandy Garzell, director of patient care services at the center. “We not only make the appointment for them, we follow up with another call after they are home to make sure they went to it.” Even before that doctor’s visit, however, the caregiver should notify the patient’s primary care physician about the hospitalization. Patients often assume hospitals do this automatically, but that is not necessarily the case. It’s a good idea for the caregiver to alert physicians about the hospi-

talization, keep them updated and make sure they get the results of any tests done in the hospital. Red flags. The patient and/or caregiver need to understand the red flags that would indicate the patient’s condition is worsening and what to do in that event. The caregiver should get a written copy of these red flags upon discharge. Contact number. A discharge plan should include a phone number the patient or caregiver can call 24/7 once they are home. Caregivers should make sure they know who they can call when they have questions, because they certainly will have them. Personal health record. This is a tool the patient manages that captures key health care information (all with phone numbers), including: primary care physician, specialists, pharmacy, home health agency, community services (such as Meals on Wheels), advanced directives, medical history, immunizations, red flags (see above) and medication list, including dose, reason and start date. The patient should take this record to every doctor’s appointment.

Going home or to a facility

If the patient is going to go back to his home once he is discharged, he may need additional equipment or services to support him. He may need help with personal care (bathing, eating, dressing, toileting), household care (cooking, cleaning, laundry, shopping), health care (medication management, physical therapy, injections, medical equipment and techniques) and/or emotional care (companionship, conversation). “What we’ve found is that for someone being discharged after an illness or surgery, medical services are most immediately important, but in the long run, most of the services needed are non-medical,” says Roy Schultheiss, owner of Comfort Keepers, a Bay City private duty agency. “For example, say the washer and dryer are down in the basement. Can the patient safely negotiate the stairs, especially carrying a laundry basket? They might need someone to come in to help with laundry.” The discharge planner can help you identify which services the patient will need and identify community resources that can meet those needs. Ideally, you want to have the services and equipment in place before the patient comes home, but all these decisions involve evaluating the choices — if you are going to use a home-health aide, do you want to hire an individual directly or go through an agency? If you need to modify the bath, what options are available? If you need a ramp, who will install it? The more time you have to weigh these choices, the more informed your decisions can be. Once you are home, if there are any snags, let the discharge planner know. In Tawas City, caregivers have an additional resource available — the St. Joseph Health System’s Faith Community Nurse Program. Although the volunteer nurses are not involved in the discharge process, they can help with health education, referrals, counseling or answering questions. “We believe in healing of body, mind and spirit and most of this is done by education that will then prevent problems if people are knowledgeable in preventing them,” says Kim Easterle, parish nurse coordinator Michigan Generations

for the program. “Parish nurses throughout the U.S. save millions of dollars a year in health care costs through education.” If the patient is being discharged into rehab or a nursing home, the planning process is a bit different. For one thing, you have to decide on a facility, which can be stressful in the best of times and overwhelming if done in a rush. You may simply be given a list of nearby facilities, but you’ll want to evaluate the quality of care they offer. Ask if a social worker can help you sort through the options. You can also consult with a geriatric care manager. These managers charge an hourly fee, but they keep up with the quality of local facilities, which ones have waiting lists and which ones have had problems. (To find a geriatric care manager, contact the National Association of Geriatric Care Managers at 520-881-8008 or www.caremanager.org.) As a caregiver, you still need to be involved to ensure continuity of care. Make sure the facility receives the current list of medications, test results, condition update, etc. And keep asking questions. You need to understand what type of care the patient is going to receive at the facility. Who is going to be in charge of his care in the facility? Who can you contact with questions? How long will he likely need to stay? There is often a lot of pressure to discharge the patient as soon as possible — the hospital needs to free the bed and the patient wants to go home. However, if you feel your loved one is not well enough to be discharged, you can appeal the decision. By law, the hospital must let you know how to appeal and explain what will happen. Make sure the hospital provides you with contact information for the local Quality Improvement Organization (QIO) that reviews such appeals.

Who pays for care after discharge?

Unless you have a specific long-term care policy (which very few people do), insurance will not pay for services and items that are needed at home unless they are deemed “medically necessary.” The discharge planner or social worker can help you decipher what things will and will not be covered. “Our case managers and social workers stay on top of all of it,” says Garzell. “They know what is covered by Medicare, what is paid for by private insurance, what the co-pays are. We’ll go the extra mile to help them when we can. We had one patient on IV antibiotics who had a co-pay of $1,000. We knew she couldn’t afford that, so we kept searching until we found someone who could supply it for about $60.” Even if someone tells you that Medicare or other insurance won’t pay, check it out yourself Spring 2010

through your State Health Insurance Assistance Program (SHIP). The Michigan SHIP is the Medicare/Medicaid Assistance Program of Michigan (MMAP) at 1-800-803-7174 or 1-517-886-1029 or the Medicare Rights Center (212-869-3850 or www.medicarerights.org).

Improving the system

Efforts are underway nationwide to improve the fractured, inconsistent nature of discharge planning. In Michigan, 15 hospitals are participating in a three-state initiative aimed at reducing avoidable rehospitalizations. Known as MI STAAR (Michigan State Action on Avoidable Rehospitalizations), the initiative is being coordinated by MPRO, Michigan’s Quality Improvement Organization, and the Michigan Health & Hospital Association (MHA). “We are trying to change how hospitals look at the discharge process,” says MHA’s Watson. “We want them to look at it more as a transition. ‘Discharge’ says ‘I’m done with you.’ ‘Transition’ implies I’m still involved.” Improvements in the discharge process will start with enhanced assessments upon admission. “Assessments are done concerning their needs at home, but they are often not as comprehensive as they could be,” says Watson. “For example, if a patient has congestive heart failure, we need to know if there is a clinic for that condition in his area. Can he afford to purchase his medications?” Hospitals are also starting to use the “teach back” method of educating patients about how to care for their conditions. “Typically the nurse gives the patient or caregiver the discharge instructions and asks if they understand them,” says Watson. “They say ‘yes’ whether they do or don’t. We are now asking them to teach what we have just told them back to the nurse so we can make sure they understand. That’s a major leap forward in terms of how we interact with our patients.” The MI STAAR initiative is working to ensure that patients have an appointment with their primary care physician before they are discharged and that they receive detailed, understandable instructions about their medications and how to take them. It is also formulating a statewide referral form to standardize and streamline patient information. “We are identifying what things are more important to know about a patient,” says Pekar. “It’s impossible to absorb the whole medical record, so we need to develop policies for what information is needed during transitions. “I think it’s important to remember that discharge planning is planning for the transition of a human being, and that goes beyond diseases and medication,” continues Pekar. “It is important to think about the safety and comfort not just of their body, but of their heart and soul as well.” MI

regionalNews In communities

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 Reg U1-C pper Peninsula / The Senior Alliance, Inc. Area Agency on Aging 14 Senior Resources of West Michigan

across the U.S.,

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.

S potlight O n …

10 Reg 1-A / Detroit AAA

Reg 1-B / AAA 1-B

Reg 2 / Reg 2

14 6 4

3A 3B

Reg 3-A / Kalamazoo Cty. Human Services Dept. (Region 3)

Reg 3-B / Burnham-Brook Reg IIIB

Reg 3-C / Branch-St. Joseph AAA (IIIC)

Reg 4 / Reg I

Region VII Area Agency on Aging Serving Bay, Clare, Gladwin, Gratiot, Huron, Isabella, Midland, Saginaw, Sanilac and Tuscola counties

PATH Program Teaches Management of Chronic or Long-Term Disease

Reg 5 / Valley AAA

ersonal Action Toward Health (PATH) is designed to help adults who have a chronic disease better manage their health conditions. PATH does not replace regular medical treatment, but provides workshops to teach techniques and strategies for the day-to-day management of chronic disease. The PATH program was developed by the Stanford University School of Medicine in California. Each PATH workshop is held for six weeks, conducted in two and a half hour sessions. Although PATH is intended to benefit adults with chronic or long-term health conditions, family members, friends and caregivers are also encouraged to

attend. The fun, interactive sessions include topics such as: • Ways to deal with frustration, fatigue and pain • Goal setting and problem solving • Managing medications 9 / NEMSCA Reg 9 AAA • How to plan visits Reg with a health care provider • Ways to talk with family and friends about a chronic condition • Using the power of mind to help manage symptoms For more information about the PATH program, or to place your name on a list for an upcoming workshop, please contact the Region VII Area Agency on Aging at 1-800-858-1637. For further information about services,

Reg 6 / Tri-County Office on Aging

Reg 7 / Reg VII AAA

Reg 8 / AAA

Reg 10 / AAA of Northwest MI

Reg 11 / Upper Peninsula AAA

Reg 14 / Seni West Michiga

Personal Action Toward Health contact Region VII, 1615 S. Euclid Ave., Bay City, MI, 1-800-858-1637, www.region7aaa.org. Michigan Generations

Detroit Area Agency on Aging Serving Detroit, Highland Park, Hamtramck, Harper Woods and the five Grosse Pointes in Wayne County

Economic Security Initiative Targets Detroit Area Older Adults

Reg 1-A / Detroit AAA

Photo by Julie Turkewitz

ith a grant from the National Council on Aging (NCOA), the Detroit Area Agency on Aging (DAAA) will partner with Elder Law of Michigan, AARP Michigan, Community Foundation of Southeast Michigan and other stakeholders to provide economic security case management services. The initiative targets low-income, During its annual conference in Chicago, NCOA older adults who are among those convened partners from 11 locations in the U.S., most impacted by Michigan’s unem- including the Detroit Area Agency on Aging, for ployment, foreclosures, bankruptcy a day-long meeting related to the new Economic Security Initiative. Each of the teams received a and credit card debt. $50,000 grant for this pilot project. In Detroit, the Program participants will be grant will jump-start the Detroit Economic Security assessed and provided with a perCollaborative Network, which is also supported by son-centered economic security a $25,000 grant from the Community Foundation plan, receive intensive wraparound of Southeast Michigan. services and be referred to financial literacy training. These services are designed to strengthen the capacity of communities to provide assistance to vulnerable older adults whose needs have stretched the limits of their personal resources. The goal of collaborative partners is to improve the economic security of participants by screening them for public and private benefits.

Silver Circle Programs at WCCCD to Enhance Adult Learning Opportunities

he Wayne County Community College District (WCCCD) is collaborating with the Detroit Area Agency on Aging and other partners to make financial literacy and other workshops available to older persons through its Silver Circle Senior Engagement Program. In a new series of workforce development and continuing education programs, WCCCD will combine scheduled classes and on-demand workshops to help low-income participants improve their knowledge, skills, abilities, attitudes and quality of life related to economic security. Referrals will come from DAAA and partner agencies. Silver Circle programs will cover such financial literacy issues as preparing for retirement, protecting assets, preserving purchasing power, estate planning, having an adequate income, and making money last. For information on WCCCD course offerings, visit www.wcccd.edu or call 313-496-2600. For information on the economic security initiatives mentioned here, contact: Detroit Area Agency on Aging, 313-446-4444 Spring 2010

Reg 1-B / AAA

“For the first time in the 30-year history of the Detroit Area Agency on Aging, economic security is as important to us as meeting

Reg 3-A / Kalamazoo Cty. Human

Services Dept. (Region 3) the health, wellness and

Reg 3-B / Burn

long-term care needs of our consumers.” —Paul Bridgewater, President & CEO, Detroit Area Agency on Aging Reg 5 / Valley AAA

Reg 6 / Tri-Cou

Employment and Training Services Expand with DAAA and City of Detroit Initiative

ixty or more low-income Detroit Reg 9 / NEMSCA Reg 9 AAA residents, age 45 years and over, will be eligible for new employment and training services through the Detroit Area Agency on Aging and its Mature Workers program. After appropriate screening and assessments, candidates will be trained for one or more positions in office, health or long-term care professions, including: Office Professional I and II, Certified Nurse Assistant, Home Health Aide, Long-Term Care Consumer Advocates, and Long-Term Care Navigator. The $250,000 grant will come from the City of Detroit’s Department of Human Services after approval by the Detroit City Council.

Reg 10 / AAA

Area Agency on Aging 1-B Serving the counties of Livingston, Macomb, Monroe, Oakland, St. Clair and Washtenaw

Medicaid Program Provides Support in the Home

eborah (Debbie) was born with Down syndrome in 1951. She was the oldest of six children, and her parents vowed she would always be taken care of. When Debbie’s mother passed away a few years ago, care for Debbie was passed to her brothers and sisters. A happy and vivacious person, Debbie functions at the level of a five- or six-year-old, so she requires constant care and supervision. Through the Home and Community Based Medicaid Waiver Program, Debbie now resides with her brother Steve and his wife, Trish, who is also Debbie’s care provider. As a direct care worker employed

Steve, Debbie (center) and Trish.

through a funded health care provider of the Area Agency on Aging 1-B, Trish is paid for the services she provides to Debbie.

Steve and Trish are Reg 1-B / AAA 1-B very grateful for the Medicaid Waiver Program. Steve says, “If it wasn’t for the AAA 1-B helping out, Debbie would have ended up in an Adult Foster Care Home” — as Trish would have needed to return to the workforce, and they would have been unable to afford the level of care DebReg 3-A / Kalamazoo Cty. Human Reg 3-B / Burnham-Brook Reg IIIB would need during the day. Services Dept.bie (Region 3) Debbie enjoys watching television, rug hooking, puzzles, and going to church every Sunday, and loves the summer, when she can go outside and play. Her favorite foods are ice cream and milkshakes. Surrounded by the love of Reg 5 / Valley AAA Reg 6 / Tri-County Office on Aging her family and the two family dogs, Candy and Shadow, Debbie is safe and secure in the comfort of her home. Reg 1-A / Detroit AAA

Area Agency on Aging 1-B Services

Reg 9 / NEMSCA Reg 9 AAA

Resource Center The AAA 1-B Resource Center, staffed by certified Alliance of Information and Referral Systems (AIRS) Resource Specialists, provides comprehensive information, assistance and outreach regarding services for older adults, people with disabilities and their families. To speak with a Resource Specialist, call 1-800-852-7795 or complete an email form on our website at aaa1b.com. MI Choice Home and Community Based Medicaid Waiver Program The Medicaid Waiver Program provides services for adults age 65 and over and younger persons over age 18 with disabilities, to help them remain 10

Reg 10 / AAA of Northwest MI

living in the community instead of a nursing facility. Individuals must meet Medicaid income requirements and qualify medically for nursing home admission. Nursing Facility Transition Program This service helps provide options for eligible nursing facility residents to transition from a nursing facility back to the community and is available to all nursing home residents who are current or potential Medicaid recipients.

are at risk of being placed in a nursing home but do not financially qualify for the MI Choice Home and Community Based Medicaid Waiver Program.

Community Care Management The Community Care Management program helps provide in-home services such as personal care and homemaking to help older adults who

Out of Home Respite Program The Out of Home Respite Program provides family caregivers access to 24-hour care for their older or disabled loved one in a licensed Adult Michigan Generations

Reg 1-C / The

Reg 3-C / Bra (IIIC)

Reg 7 / Reg V

Reg 11 / Uppe

Foster Care Home or Home for the Aged. Caregivers can make reservations for their loved one up to two weeks at a time, twice a year. The caregiver or care recipient must be age 60 or older, and the care recipient must reside in the Region 1-B service area and require assistance with two or more activities of daily living, such as personal care, eating or bathing. Medicare Medicaid Assistance Program (MMAP) MMAP is Michigan’s State Health Insurance Program and is funded through grants from the Centers for Medicare and Medicaid Services. Local MMAP counselors help Medicare beneficiaries or their families understand Medicare and Medicaid, compare or enroll in Medicare Prescription Drug Coverage, review Medicare supplemental insurance needs, understand Medicare health plans and apply for Medicaid or the Medicare Savings Program.

Your Thoughts are Valuable

ach year the Area Agency on Aging 1-B (AAA 1-B) develops an area plan that outlines how approximately $20 million of state and federal funding will be used to help older adults remain living in their home or community for as long as possible. We are very interested in hearing from older adults, their caregivers, service providers and other individuals about how these funds are being used. The AAA 1-B would also greatly appreciate learning more about needs of seniors that are currently not being met. To give interested parties an opportunity to provide thoughts

For more information on AAA 1-B services call

and input on the 2011 area plan, the agency will be holding a public hearing on Tuesday May 25 from 1:00 p.m. to 3:30 p.m. at the Area Agency on Aging 1-B office located at 29100 Northwestern Highway, Suite 400 in Southfield. A draft of the plan will be available on the AAA 1-B website (www.aaa1b. org) by early May. If you are unable to attend the hearing, comments can also be submitted to the Area Agency on Aging 1-B by e-mail to asmyth@aaa1b.com, or through our website. For more information please call Amy Smyth at the AAA 1-B at 248-213-0545.

1-800-852-7795

Region 2 Area Agency on Aging Serving Hillsdale, Jackson and Lenawee counties

Our Community Loves Seniors

hristmas is a special time when we get together as a family, church congregation, neighborhood or group of friends. We remember others, giving gifts and sending salutations. During this time, our sense of community is heightened. This past Christmas, employees and businesses in Jackson, Hillsdale and Lenawee counties gave generously to help seniors feel the spirit of the holidays. The community bonded together and collected almost $2,000 to bring cheer and goodwill to more than 60 seniors! The Area Agency on Aging’s Sunshine Committee worked with the community to collect supplies, gift certificates, gift baskets and food to deliver during the Christmas season. Spring 2010

Applebee’s restaurant coupon was likeInc.going Reg 1-A / Detroit AAA Reg 1-B / AAA 1-B Reg 1-C / The Senior Alliance, Reg 2 / Reg 2 AAA on their first date again. Seniors were overwhelmed with We are all part of a community. It gratitude, saying, “I had something to defines who we are, what we believe open on Christmas day” and “It’s the in and what we value. How we treat best thing I got!” One woman was so others reflects on us all, and can excited that she asked if the volunhave a healing impact. The charitable teers could stay and sing a few carols spirit shown by individuals this holiday with her. One couple said that their season speaks well of the local business environment, and we Reg 3-A / Kalamazoo Cty. Human Reg 3-B / Burnham-Brook Reg IIIB Reg 3-C / Branch-St. Joseph AAA Reg 4 / Reg IV AAA Services Dept. (Region 3) (IIIC) applaud all efforts that go toward appreciating and helping our seniors. After all, they are the ones who taught us in our youth what it means to be a community. For more information, contact Barbara Stoy Reg 5 / Valley AAA Reg 6 / Tri-County Office on Aging Reg 7 / Reg VII AAA Reg 8 / AAA of Western Michigan at the Region 2 AAA at Local businesses, like TLC Community Credit Union, gave generously so seniors could enjoy the Christmas holiday. 1-800-335-7881. 11

Region IV Area Agency on Aging Covering Michigan’s Great Southwest including Berrien, Cass and Van Buren counties

Are You a Caregiver?

Reg 3-A / Kalamazoo Cty. Human Services Dept. (Region 3)

Reg 3-B / Burnham-Brook Reg IIIB

any people slip into the role of caregiver over time as they begin to help their loved one more and more. If you provide support for a family member or friend, you can ask yourself these questions: Do you… • Feel responsible for the care of a loved one? • Run errands, or drive loved ones to their errands? • Provide housekeeping or home maintenance? • Make appointments and go with your loved one? • Manage the finances? If you answer yes to any of these questions, then you are a caregiver. One way the Area Agency on

Aging is AAA able to support Reg 5 / Valley Reg 6 / caregivers Tri-County Office onis Aging through a monthly newsletter, packed with quick tips and resources to make the job of caregiving easier. Subscribers use the information to learn to develop better coping skills or gain new insights. The publication is filled with uplifting, practical content in an easy-to-read format peppered with illustrations self-care Reg 9 / NEMSCA Reg and 9 AAA caregiver Reg 10 / AAA of Northwest MI tips, and includes feature articles and links to key resources.

Articles cover how to avoid stressReg 4 / Reg IV AAA Reg 3-C / Branch-St. Joseph AAA (IIIC) and burnout, encouraging use of backup care; communication with the family and care team; coping techniques; health and well-being; advice from experts; local resources; and more. The Area Agency on Aging knows the challenges and joys of caring for another person. The caregiving newsanyone for Regletter 7 / Reg VIIis AAAoffered to Reg 8 / AAA oflooking Western Michigan Reg 1-A / Detroit AAA Reg 1-B / AAA 1-B ideas about how to balance, restore and rejuvenate life. If you wish to subscribe by mail, call the Info Line for Aging and LongTerm Care at 1-800-654-2810. The newsletter is also available on the Area Agency on Aging’s website at www.AreaAgencyOnAging.org. theof Reg 11 /For Uppermore Peninsulainformation, AAA Reg 14 /contact Senior Resources West Michigan Region IV AAA at 269-983-0177 or Reg IIIB Reg 3-A / Kalamazoo Cty. Human Reg 3-B / Burnham-Brook Services Dept. (Region 3) 1-800-442-2803.

Reg 1-C / The

Reg 3-C / Bra (IIIC)

Tri-County Office on Aging A consortium of Clinton, Eaton and Ingham counties and the cities of Lansing and East Lansing

Tri-County Office on Aging Serves the Elderly

Reg 5 / Valley AAA

“P

romote and Preserve the Independence and Dignity of the Aging Population” is the Tri-County Office on Aging’s (TCOA) mission statement. TCOA has many programs that work toward that mission, including Information & Assistance and Crisis Services for the Elderly. For over 35 years, Information & Assistance has been an important resource in the community and is continually expanding. Bill was referred by his doctor to TCOA for Medicaid assistance. Bill’s wife had always helped him with paperwork and record keeping, but she recently passed away. TCOA assisted him in completing the application. During that process it became apparent that Bill was not 12

Reg 6 / Tri-County Office on Aging

receiving food Lansing area stamps — so he when there agreed to apply, are no other and is now getresources availting $200 a month able to help. in food stamps. Trained volunTCOA also helped teers assess the Reg 9 / NEMSCA Reg 9 AAA Reg 10 / AAA of Northwest Bill to make an situation andMI appointment with help arrange AARP tax volunnecessary TCOA staff member Judy Christie assists Bill with his Medicaid paperwork. teers to look at services, with home heating and the individual’s property tax credits that he had never consent. There is no cost for Crisis applied for. Services for the Elderly, but donations Crisis Services for the Elderly is are accepted. available 24 hours a day, seven days For more information about these a week. It provides response to and other TCOA programs, please call non-medical emergencies in need of 517-887-1440 or 1-800-405-9141, or immediate assistance in the Greater visit our website at www.tcoa.org. Michigan Generations

Reg 7 / Reg V

Reg 11 / Upp

NEMCSA Region 9 Area Agency on Aging Covering 12 counties of Northeast Michigan

Arenac and Iosco County Highlights

unrise Side Senior Services, located in Arenac County, offers a number of programs to seniors, but they are especially proud of their adult day center, Pleasant Days. Housed within the Omer Senior Center, Pleasant Days Adult Day Caring offers family caregivers and their loved ones a break from their daily routine. The adult day center provides a safe environment and failure-free activities for seniors struggling with symptoms of dementia or diminishing physical abilities. The staff enjoys the opportunity to reminisce with the adult day center participants and encourages them to get to know each other and share their commonalities. Pleasant Days is open five days

Reg 1-A / Detroit AAA

aa week from 8 a.m. to 2 p.m. Transportation arrangements are available if needed. Lunch and a snack are provided. For more information, contact director Karen Pitylak at 989-653-2692 or toll-free 1-888-370-7184.

Reg 3-A / Kalamazoo Cty. Human

Services Dept. (Region 3) he Iosco County Commission on Aging’s (ICCOA) purpose is to promote the health, welfare and independence of seniors in its area. ICCOA offers services such as homedelivered meals, respite care, homemaking and personal care. Congregate meals are held at four sites: Hale, Oscoda, Sand Lake andRegTawas. Each 5 / Valley AAA site offers a number of daily activities

Reg 9 / NEMSCA Reg 9 AAA Reg 1-B / AAA 1-B

Reg 10 / AAA

Reg 1-C / The Senior Alliance, Inc.

that might include tackling a new craft project, taking part in a spirited card game, presentations on health-related topics or an afternoon at the movies. Services are provided for individuals age 60 and older, but anyone can take part in the congregate meals. Each hot, well-balanced meal provides one of the recommended dailyAAA Reg 3-B /third Burnham-Brook Reg IIIB Reg 3-C / Branch-St. Joseph (IIIC) requirements for nutrition. An added bonus of the meals is the opportunity to socialize with others in the community. For more information, contact the ICCOA main office at 989-728-6484. For other county referrals and information, call 1-800-219-2273, ext. 216. Office on Aging Reg 7 / Reg VII AAA Reg 6 / Tri-County

Reg 2 / Reg

Reg 4 / Reg

Reg 8 / AAA

Upper Peninsula Area Agency on Aging Serving all 15 counties of Michigan’s Upper Peninsula

The U.P. Area Agency on Aging Needs Your Input

PCAP, in its role as the Upper Peninsula Area Agency on Aging (UPAAA), carries out a wide range of functions and systems that are designed to assist older persons in leading independent, meaningful and dignified lives in their own homes and communities for as long as possible. As part of this mission, the UPAAA is required to develop and implement an Area Plan each year. The Area Plan provides a blueprint for helping to make the U.P. a great place in which to grow old — a place where older adults can live life on their own terms with dignity and a sense of purpose. As part of the development of the 2011 Area Plan, the UPAAA is Spring 2010

Reg 9 / NEMSCA Reg 9 AAA

conducting a public hearing. This hearing will allow older adults, their caregivers, service providers, and the general public to voice their opinions, concerns and preferences about the

Seniors and caregivers are invited to attend a public hearing. types of services and programs that may be funded by UPCAP. We are particularly interested in hearing comments that focus on unmet needs, long-term care and current services that may be a priority to older adults living in the U.P.

Anyone wanting to provide input into the 2011 Reg 11 / UpperArea PeninsulaPlan AAA is invited to attend the public hearing on Friday, April 23, at 1:00 p.m. The hearing will be held in the UPCAP conference room located at 2501 14th Avenue South in Escanaba. UPCAP encourages anyone who wants to be a part of the planning process to attend this session. We specifically appreciate hearing from seniors and their caregivers about issues and services important to them. Individuals who are unable to attend the public hearing may submit written comments to: Executive Director, U.P. Area Agency on Aging, P.O. Box 606, Escanaba, MI 49829. For more information about the UPAAA’s Area Plan, call UPCAP at 1-800-338-7227, or dial 2-1-1.

Reg 10 / AAA of Northwest MI

Reg 14 / Sen West Michig

ASKtheExpert

Jamie M. Verdi

A Closer Look

at Caregiving

What does the term “caregiver” mean? the term “caregiver” has a wide range of meanings. It is typically associated with someone who assists an elderly person who needs mental, emotional or physical support. A caregiver can be someone who regularly visits an elderly person, someone who has taken on responsibility for overseeing the welfare of an elderly person, or someone who is the power of attorney or guardian for an elderly person.

Who is a typical caregiver? caregivers are usually family

members. But other people such as close friends, privately hired nurses, designated patient advocates or courtappointed guardians also can have caregiver roles.

What can a caregiver do if someone they are caring for is not getting good care in their nursing home or hospital? concern over quality of care is

something that caregivers often face, but usually do not know how to effectively address. Caregivers may feel timid about raising concerns with nursing home or hospital staff and management. They may feel like they do not have the expertise to second-guess facility staff

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

when obvious problems arise, or that the facility may retaliate against them. If the caregivers do raise concerns, nursing home or hospital staff may react negatively, which often further increases the caregiver’s stress level. There are, however, practical steps that every caregiver can take when a problem with quality of care arises. Typical problems can include simple concerns like dirty or un-kept rooms, or serious issues such as the development of bedsores, dehydration, improper nutrition, a lack of safety rails, or failure of care coordination among physicians and facility staff. One of the most effective measures is to make frequent visits on irregular schedules. If a caregiver visits at the same time of the day or week, the facility staff may start to predict the caregiver’s schedule and put things in order in anticipation of the visit. Arriving at irregular times can help a caregiver gain a true understanding of the typical quality of care that the facility provides. Another important measure is to take photographs of the facility living conditions. Photographs can help document assessments and add credibility to formal complaints that a caregiver may raise. If a caregiver cannot get resolution of their concerns from a facility’s staff, another option is to contact the local Area Agency on Aging and ask for an ombudsman to help resolve the issues. Ombudsmen provide an unbiased analysis of a caregiver’s concerns and can help to facilitate open communication between a facility and a caregiver.

complaints about quality of care. For example, a caregiver recently attempted to work directly with a nursing home to increase the quality of care her mother was receiving. The nursing home was aware that her mother was diabetic and was not to be given food with high sugar content, but the staff continually fed her mother honey at meals. It was necessary to emphasize to the staff that the mother’s care plan specified her dietary requirements. Posting these instructions directly above her bed helped the staff become aware of her diabetic condition. Another example occurred when a caregiver was searching for a nursing home for her mother-in-law that was close to her family in Oakland County. The mother-in-law was in the process of applying for Medicaid after a hospital stay, and the hospital social worker told the family that the only available nursing home was in Wayne County. After additional research on nearby facilities, the family was able to coordinate with Medicaid to place the woman in an Oakland County nursing home where her family could visit her daily. Medicaid initially said that they had lost the woman’s original application, but they finally agreed to expedite a new application since the mother-in-law was close to death and needed to remain close to her family. A word of advice: Ever y caregiver needs to speak up if they sense something is wrong and not accept substandard care under any circumstance.

What are some examples of real problems that caregivers might face?

Jamie M. Verdi is a health care and elder law attorney who regul a rly rep resent s ca regive rs. Yo u can reach her at 248-410-4945 and www.mipalhealth.com.

effort to answer your question in an

often caregivers lack the expertise

upcoming issue of Michigan Generations.

to solve problems easily on their own, or they may feel uneasy about raising

Michigan Generations

RESOURCE GUIDE

for Michigan Caregivers and Seniors Clip and Save this list of important statewide and regional resources and services. STATEWIDE RESOURCES

tri-county office on aging (region 6):

Bureau of Health Services (nursing home complaints) . . . 1-800-882-6006 Department of Consumer Industries (adult foster care complaints) . . . . . . . . . . . . . . . . . . 1-866-685-0006 Medicare/Medicaid Assistance Program (MMAP) . . . . . . . 1-800-803-7174 Michigan Office of the Attorney General . . . . . . . www.seniorbrigade.com Michigan Office of Services to the Aging . . . . . . . . . . . www.miseniors.net

Information and Assistance — Clinton, Eaton and Ingham Counties . . . . . . . . . . . . . . . . 1-800-405-9141 or 517-887-1440; www.tcoa.org Project Choices . . . . . . . . . . . . . . . . . . . . 1-800-405-9141 or 517-887-1440 For in-home service assistance and the Medicaid home/ community-based services waiver (MI Choice)

Regional Resources

Greater Lansing . . . . . . . . . . . . . . . . . . . . . . . . 517-887-1460 or 1-800-405-9141 Clinton County . . . . . . . . . . . . . . . . . . . . . . . . . 989-224-3600 or 1-888-224-3030 Eaton County . . . . . . . . . . . . . . . . . . . . . . . . . . 517-541-2330 or 1-866-541-5444 Rural Ingham County . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 517-676-2775 Senior Dining Site Information . . . . . . . . . . . 517-887-1393 or 1-800-405-9141 AARP Tax Assistance . . . . . . . . . . . . . . . . . 517-887-1440 or 1-800-405-9141

detroit area agency on aging (1a):

Information and Assistance . . . . . . . . . . . . . . . . . . . . . 313-446-4444 Outreach & Assistance

Bridging Communities — Detroit . . . . . . . . . . . . . . . . . . . . . . . Detroit Senior Citizens Department — Detroit . . . . . . . . . . . Neighborhood Legal Services Michigan — Redford . . . . . . . Services for Older Citizens — Grosse Pointe . . . . . . . . . . . .

313-361-6377 313-224-1000 313-937-8291 313-882-9600

Senior Centers

Association of Chinese Americans, Inc. . . . . . . . . . . . . . . . . . Delray United Action . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Latino Family Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . North American Indian Assn. of Detroit . . . . . . . . . . . . . . . . . St. Patrick Senior Center . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . St. Rose Senior Citizen Center . . . . . . . . . . . . . . . . . . . . . . . . . Virginia Park Citizens Service Corp. . . . . . . . . . . . . . . . . . . . . . Reuther Older Adult & Wellness Services . . . . . . . . . . . . . . . .

313-831-1790 313-297-7921 313-841-7380 313-535-2966 313-833-7080 313-921-9277 313-894-2830 313-831-8650

area agency on aging 1-b:

Information and Assistance . . . . . . . . . . . . . . . . . . . . 1-800-852-7795 Catholic Social Services of Washtenaw County . . . . . . . . . . . 734-971-9781 Deaf and Hearing Impaired Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . 248-473-1888; TTY: 248-473-1875 Greater Detroit Agency for the Blind & Visually Impaired . . 313-272-3900 Livingston County Catholic Social Services . . . . . . . . . . . . . . . 517-545-5944 Oakland Livingston Human Service Agency (OLHSA) Oakland . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 248-209-2600 Livingston . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 517-546-8500 The Council on Aging, Inc., serving St. Clair County . . . . . . . 810-987-8811 The Macomb County Dept. of Senior Citizen Services . . . . . 586-469-6313 The Monroe County Commission on Aging . . . . . . . . . . . . . . . 734-240-7363 region 2 area agency on aging:

Information and Assistance . . . . . . . . . . . . . . . . . . . . 1-800-335-7881 MI Choice Medicaid Waiver Program . . . . . . . . . . . . . . . . . 1-800-335-7881 Hillsdale County Senior Services Center . . . 517-437-2422 or 1-800-479-3348 Jackson Department on Aging . . . . . . . . . . . 517-788-4364 or 1-800-788-3579 Lenawee Department on Aging . . . . . . . . . . . . . . . . . . . . . . . . 517-264-5280 Legal Services of South Central Michigan . . . . . . . . . . . . . . . . 517-787-6111 region iv area agency on aging:

AAA Info-Line . . . . . . . . 1-800-654-2810; www.AreaAgencyOnAging.org Custom Care — Care Connections of Southwest Michigan . . . . . . . . . . . . . . . . . 1-800-442-2803; www.AreaAgencyOnAging.org Elder Care Locator . . . . . . . . . . . . . . . 1 -800-677-1666; www.eldercare.gov Senior Nutrition Services . 1-800-722-5392; www.seniornutritionregiv.org Senior Volunteer and Intergeneration Programs . . . . . . . . . . . . . . . . . 1-877-660-2725; www.AreaAgencyOnAging.org Spring 2010

Meals-On-Wheels

region vii area agency on aging:

Information and Assistance . . . . . . . . . . . . . . . . . . . . . 1-800-858-1637 Alzheimer’s Association of Mid-Michigan . . . . . . . . . . . . . . . 1-800-337-3827 Citizens for Better Care (Nursing Home Advocacy Ombudsman) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-800-284-0046 Lakeshore Legal Aid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-866-552-2889 MI Choice Medicaid Waiver Program . . . . . . . . . . . . . . . . . . 1-800-858-1637 Bay Co. Division on Aging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 989-895-4100 Clare County Council on Aging . . . . . . . . . . . . . . . . . . . . . . . . 1-800-952-3160 Gladwin County Council on Aging . . . . . . . . . . . . . . . . . . . . . . 1-800-952-0056 Gratiot County Commission on Aging . . . . . . . . . . . . . . . . . . . 989-875-5246 Human Development Commission (Huron, Tuscola and Sanilac counties) . . . . . . . . . . . 989-673-4121 or 1-800-843-6394 Isabella County Commission on Aging . . . . . . . . . . . . . . . . . 1-800-878-0726 Midland County Council on Aging . . . . . . . . . . . . . . . . . . . . . . 1-800-638-2058 Saginaw County Commission on Aging . . . . . . . . . . . . . . . . . 1-866-763-6336 nemcsa region 9 area agency on aging:

Information and Assistance . . . . . . . . . . . . . . . . . . . . . . 989-356-3474 Long-Term Care Ombudsman . . . . . . . . . . . . . . . . . . . . . . . . 1-866-485-9393 Multi-purpose Senior Centers

Alcona County Commission on Aging . . . . . . . . . . . . . . . . . . . . Alpena Area Senior Citizens Council . . . . . . . . . . . . . . . . . . . . Arenac County Council on Aging . . . . . . . . . . . . . . . . . . . . . . . Cheboygan County Council on Aging . . . . . . . . . . . . . . . . . . . . Crawford County Commission on Aging . . . . . . . . . . . . . . . . . Iosco County Commission on Aging . . . . . . . . . . . . . . . . . . . . . Montmorency County Commission on Aging . . . . . . . . . . . . . . Ogemaw County Commission on Aging . . . . . . . . . . . . . . . . . . Oscoda County Council on Aging . . . . . . . . . . . . . . . . . . . . . . . Otsego County Commission on Aging . . . . . . . . . . . . . . . . . . . Presque Isle County Council on Aging . . . . . . . . . . . . . . . . . . . Roscommon County Commission on Aging . . . . . . . . . . . . . . .

989-736-8879 989-356-3585 989-653-2692 231-627-7234 989-348-7123 989-728-6484 989-785-2580 989-345-5300 989-826-3025 989-732-1122 989-766-8191 989-366-0205

upper peninsula area agency on aging/upcap:

Information & Assistance . . . . . . . . . . . . . Dial 2-1-1 or 906-786-4701 Outside the U.P. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-800-338-7227 U.P. Long Term Care Ombudsman . . . . . . . . . . . . . . . . . . . . . 1-866-485-9393 UPCAP Care Management/Field Offices

Escanaba . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Houghton . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Iron Mountain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Marquette . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Sault Ste. Marie . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

906-786-4701 906-482-0982 906-774-9918 906-228-6169 906-632-9835 15

Take a Stand for Senior Services On Thursday, June 10, 2010, hundreds oF SENIORS will gather in Lansing for the 3rd annual Older Michiganians Day Rally. Participants will gather on the lawn of the Capitol and urge legislators and the governor to: • Protect services for the most vulnerable. • Invest in prevention programs that work and save money. • Make Michigan a retirement destination of choice. • Close tax loopholes, reform government and restructure taxes to raise needed state revenue. We encourage seniors to get involved a nd pa r t icipate in this event. For more information on how to be part of Older Michiganians Day, contact your local A rea Agency on Aging or visit www.oldermichiganiansday.com. This event is proudly sponsored by:

SPONSORS American House

J & B Medical Supply

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• Diabetes Supplies • Incontinence Supplies • Home Delivery & Quality You Can Trust We are your solution for all your medical supply needs. Call 1-800-737-0045 or visit our website www.jandbmedical.com For more information on becoming a sponsor of Michigan Generations, please call Jenny Jarvis at 248-262-9202 .