Wednesday, February 20, 2008
Caregiver Support Group
If you are caring for an older relative, spouse or close friend and feeling isolated or overwhelmed, you are not alone. Come share experiences and practical support. The Caregiver Support Group meets the third Tuesday of every month at 6 p.m. at the Somerville Council on Aging, 167 Holland Street in Somerville. If you are interested, please contact Nancy O'Connor at 617-625-6600, ext. 2317.
Mass Home Care Rally at State House
February 26th at 11:00 AM in the Nurses Hall, followed by visits to legislators.
Join elder and disability advocates in rallying for Community Care for Older People and People with Disabilities. Let your legislators know you want to see the Equal Choice legislation that was passed become a reality in Massachusetts.
Limited Transportation available for seniors by calling:
Cambridge M.S.A.C. - 617-349-6220
Somerville-Cambridge Elder Services - 617-628-2601, x3153
Join elder and disability advocates in rallying for Community Care for Older People and People with Disabilities. Let your legislators know you want to see the Equal Choice legislation that was passed become a reality in Massachusetts.
Limited Transportation available for seniors by calling:
Cambridge M.S.A.C. - 617-349-6220
Somerville-Cambridge Elder Services - 617-628-2601, x3153
Nursing Home Alternatives - Community Options Increasing in Massachusetts
The state of Massachusetts has committed itself to a "Community First" philosophy, which means that care at home or in the community is the first resort, and nursing home care the last resort. There are many options these days to help you live at home. Knowing who to talk to is the place to start.
First it's important to understand that many people do need nursing home care. But for others, nursing home care is not necessary. 24% of the people in nursing homes in the Commonwealth can eat, bath, dress, walk and toilet by themselves. Massachusetts has a very high rate of institutionalization compared to the rest of the country. In 2006, 101,300 Massachusetts residents spent some time in a nursing home. Three out of four of these people were age 75 or over, and 68% were women. About 90% of the nursing home beds in this state are occupied, compared to the national average of 84%. Massachusetts has the 14th highest number of nursing home beds per person age 85+. We have the fifth highest percentage (30.2%) in the nation of people over the age of 85 who have had at least one stay in a nursing home. At the same time, 27 other states in the country spend a greater percentage of their money on community based care than Massachusetts. The Commonwealth is slowly trying to "rebalance" how it spends its tax dollars on long term care.
Even though the number of people spending some time in a nursing home has been rising slightly, the total number of "patient days" has been falling. The bed days paid for by Medicaid fell by -17% over the past five years. This is partly because more and more people are going in for shorter and shorter stays. They are coming back out with home care supports. More people are taking advantage of short-term rehabilitation, and then returning home.
Knowing whether nursing home care is right for a loved one involves talking with your local Aging Services Access Point (ASAP) agency. Every city and town has an ASAP. These agencies have staff who specialize in counseling families on what kind of long term care they need: everything from day care programs, to new residential options. In some circumstances, the state now allows family members (with the major exception of spouses) to be paid as a caregiver. Other programs allow you to hire your own worker. You can live in the home of another person, or have care brought into your home.
Begin by checking out your options before you need them by calling Somerville-Cambridge Elder Services, the ASAP for the two cities, at 617-628-2601. To find out about options in other communities, call your local ASAP at 1-800-Age-Info, and press "3." Or go to www.800ageinfo.com and click on "Age Info Centers" to see a map covering the entire state. When you call the ASAP, ask to speak with an Information specialist, and tell him or her you want to learn about alternatives to nursing homes. They can also help you search anywhere in the country.
First it's important to understand that many people do need nursing home care. But for others, nursing home care is not necessary. 24% of the people in nursing homes in the Commonwealth can eat, bath, dress, walk and toilet by themselves. Massachusetts has a very high rate of institutionalization compared to the rest of the country. In 2006, 101,300 Massachusetts residents spent some time in a nursing home. Three out of four of these people were age 75 or over, and 68% were women. About 90% of the nursing home beds in this state are occupied, compared to the national average of 84%. Massachusetts has the 14th highest number of nursing home beds per person age 85+. We have the fifth highest percentage (30.2%) in the nation of people over the age of 85 who have had at least one stay in a nursing home. At the same time, 27 other states in the country spend a greater percentage of their money on community based care than Massachusetts. The Commonwealth is slowly trying to "rebalance" how it spends its tax dollars on long term care.
Even though the number of people spending some time in a nursing home has been rising slightly, the total number of "patient days" has been falling. The bed days paid for by Medicaid fell by -17% over the past five years. This is partly because more and more people are going in for shorter and shorter stays. They are coming back out with home care supports. More people are taking advantage of short-term rehabilitation, and then returning home.
Knowing whether nursing home care is right for a loved one involves talking with your local Aging Services Access Point (ASAP) agency. Every city and town has an ASAP. These agencies have staff who specialize in counseling families on what kind of long term care they need: everything from day care programs, to new residential options. In some circumstances, the state now allows family members (with the major exception of spouses) to be paid as a caregiver. Other programs allow you to hire your own worker. You can live in the home of another person, or have care brought into your home.
Begin by checking out your options before you need them by calling Somerville-Cambridge Elder Services, the ASAP for the two cities, at 617-628-2601. To find out about options in other communities, call your local ASAP at 1-800-Age-Info, and press "3." Or go to www.800ageinfo.com and click on "Age Info Centers" to see a map covering the entire state. When you call the ASAP, ask to speak with an Information specialist, and tell him or her you want to learn about alternatives to nursing homes. They can also help you search anywhere in the country.
Monday, February 4, 2008
Depression and the Elderly
Depression affects more than 6.5 million Americans who are 65 years or older. In Massachusetts, roughly 161,000 seniors deal with depression.
Most older people with depression have been suffering from episodes of the illness during much of their lives. For others, depression has a first onset in late life. Depression in older persons is associated with dependency and disability, and causes great suffering for the individual and the family.
Depression is not a normal part of aging. Many older people and their families don't recognize the symptoms of depression, aren't aware that it is a medical illness, and don't know how it is treated. Others may mistake the symptoms of depression as signs of dementia. Also, many older people think that depression is a character flaw and blame themselves for their illness and are too ashamed to get help. Others worry that treatment is too costly. Older persons with depression rarely seek help.
Untreated depression has fatal consequences in terms of both suicide and non-suicide mortality. The highest rate of suicide in the U.S. is among older white men. Depression is the single most significant risk factor for suicide in that population. Many elders who commit suicide have reached out for help: 20% see a doctor the day they die, 40% the week they die, and 70% in the month they die.
Depression in older people is often characterized by memory problems, confusion, social withdrawal, loss of appetite, inability to sleep, irritability, and delusions and hallucinations. Older depressed individuals often have severe feelings of sadness, but these feelings frequently are not openly shown. When asked if they are "depressed", the answer from persons suffering from depression is "no". Some general clues that someone may be suffering from depression in such cases are persistent and vague complaints and help seeking, along with frequent calling and demanding behavior.
Clinical depression doesn't go away by itself, and lasts for months. It needs to be treated professionally. Any unresolved depression can impact the immune system, which makes the depressed individual more susceptible to other illnesses. This complication is often found in older individuals. Older women are at a greater risk because women in general are twice as likely as men to become seriously depressed. The stresses of maintaining relationships or caring for an ill loved one and children also fall more heavily on women, which could contribute to depression. 80% of clinically depressed individuals, including older persons, can be effectively treated by medication, psychotherapy, and other approaches.
Depression is a chronic disease. Getting well is only the beginning of the challenge, staying well is the real goal. The Aging Information Center at Somerville-Cambridge Elder Services can connect older individuals, their families, and caregivers with mental health and other aging resources in the area. Call 617-628-2601 ext. 3151 for more information.
Most older people with depression have been suffering from episodes of the illness during much of their lives. For others, depression has a first onset in late life. Depression in older persons is associated with dependency and disability, and causes great suffering for the individual and the family.
Depression is not a normal part of aging. Many older people and their families don't recognize the symptoms of depression, aren't aware that it is a medical illness, and don't know how it is treated. Others may mistake the symptoms of depression as signs of dementia. Also, many older people think that depression is a character flaw and blame themselves for their illness and are too ashamed to get help. Others worry that treatment is too costly. Older persons with depression rarely seek help.
Untreated depression has fatal consequences in terms of both suicide and non-suicide mortality. The highest rate of suicide in the U.S. is among older white men. Depression is the single most significant risk factor for suicide in that population. Many elders who commit suicide have reached out for help: 20% see a doctor the day they die, 40% the week they die, and 70% in the month they die.
Depression in older people is often characterized by memory problems, confusion, social withdrawal, loss of appetite, inability to sleep, irritability, and delusions and hallucinations. Older depressed individuals often have severe feelings of sadness, but these feelings frequently are not openly shown. When asked if they are "depressed", the answer from persons suffering from depression is "no". Some general clues that someone may be suffering from depression in such cases are persistent and vague complaints and help seeking, along with frequent calling and demanding behavior.
Clinical depression doesn't go away by itself, and lasts for months. It needs to be treated professionally. Any unresolved depression can impact the immune system, which makes the depressed individual more susceptible to other illnesses. This complication is often found in older individuals. Older women are at a greater risk because women in general are twice as likely as men to become seriously depressed. The stresses of maintaining relationships or caring for an ill loved one and children also fall more heavily on women, which could contribute to depression. 80% of clinically depressed individuals, including older persons, can be effectively treated by medication, psychotherapy, and other approaches.
Depression is a chronic disease. Getting well is only the beginning of the challenge, staying well is the real goal. The Aging Information Center at Somerville-Cambridge Elder Services can connect older individuals, their families, and caregivers with mental health and other aging resources in the area. Call 617-628-2601 ext. 3151 for more information.
Dr. Weil Takes On Aging Well
Dr. Andrew Weil, noted complementary care physician and author of best selling, 8 Weeks to Optimum Health, turns his attention to aging well in a book entitled, Healthy Aging: A Lifelong Guide to Your Physical and Spiritual Well-Being. Subject of a Time Magazine cover story in October of 2005, Weil’s book provides advice on accepting, rather than fighting the aging process, and adopting behaviors which maximize physical, emotional and spiritual health. The author takes a hard line on the "anti-aging" industry, seeing our culture’s fight against aging as counterproductive. Instead he provides inspiration and insight from his many years of practicing integrative medicine which seeks to combine the best of traditional medicine with alternative medicine. He also looks to cultures such as Okinawa and Sardinia where long life spans are common and "aging gracefully" is the norm. His "12-point program for healthy aging" focuses on proper nutrition, moderate exercise, stress reduction and rest. Weil wants us to view aging not so much as a battle, but an important journey. He writes, "Aging can bring frailty and suffering, but it can also bring depth and richness of experience, complexity of being, serenity, wisdom, and its own kind of power and grace."
Finding a Good Nursing Home
In Massachusetts, 80% of the people who enter a nursing home come from a hospital first. If a hospital discharge planner says your Mother must be out in 24 hours, and gives you a list of area nursing homes---you are suddenly under pressure to make a decision. But the goal in our state is to make nursing home care a last resort, so be sure to ask for home care alternatives as your first resort. And then:
- Extend your hospital stay: Use your appeal rights under Medicare to extend the hospital stay for two days. Ask for a "notice of non-coverage." That will buy you additional time.
- Check out alternatives: Call 1-800-Age-Info, press "3" to be connected to your local Aging Services Access Point (ASAP). Ask to speak with a nursing home screener. Somerville-Cambridge Elder Services is the ASAP for the two cities (617-628-2601 ext. 3151). If your relative is on MassHealth, inquire about the "community choices" program as an alternative to nursing home care, or the personal care assistance program.
- Get the names of local facilities: Your ASAP can give you a list of nursing homes and put you in touch with your local nursing home ombudsman. Ask that person about their experiences with area homes-good and bad.
- Look for report cards: The federal government maintains a "Nursing Home Compare" website at www.medicare.gov that will give you info on local homes. Also go to www.consumerreports.org and look for their "Nursing Home Quality Monitor."
- Check the ownership: Look first at the independent, non-profit homes, rather than at a for-profit chain. Non-profits or religious groups usually have a mission to help people, not just their bottom line. Ask if the home has changed owners multiple times. If the facility is part of a large chain, you may have a harder time complaining about bad care.
- Visit Several Times: If you’ve got one or two homes on your list, make unannounced visits. Stop by after breakfast to see how many people are still in bed. Visit at dinnertime and taste the food yourself. If residents are eating in their rooms, that’s not a good sign. Ask the nurse aides how many residents they each care for. The smaller the number, the better.
- Read the Reports: Ask for the home’s Form 2567. That’s the state inspection survey. If you have difficulty obtaining it, that’s not good. A survey with lots of violations indicates problems. Ask if the administrator and the director of nursing have worked at a facility for several years, that’s a positive sign. Frequent turnover of key staff can indicate bad morale or mismanagement.
- Talk to the administrator: What is his or her philosophy of care? Is this philosophy written down and given to families to read?
- Do advance research: Nursing homes are an expensive investment. Do some research before a family member needs care. Ask your ASAP about what alternatives exist in the community for people who might need nursing home care, and learn those options first.
Friday, February 1, 2008
Volunteer Medical Escorts Sought
Somerville-Cambridge Elder Services (SCES) is seeking caring, dependable people to accompany elders to medical appointments and other destinations. Escorts receive a stipend of $10 per trip ($15 for a trip that lasts 4 hours or more).
SCES is seeking escorts with and without cars. The organization is able to provide round-trip transportation to and from physicians' offices for some of the elders it serves. However, for other types of trips, SCES is seeking escorts who are willing to use their own car.
The escort service assists elders who have no family or friends to accompany them on these vital trips out of the house. Escorts are needed to act as a friendly companion and to offer a reassuring arm. If you are interested in helping elders remain safe and independent in the community, this may be a good opportunity for you.
For further information or to schedule an interview, please call 617-628-2601 ext. 3153. Additional information available at http://www.eldercare.org/.
SCES is seeking escorts with and without cars. The organization is able to provide round-trip transportation to and from physicians' offices for some of the elders it serves. However, for other types of trips, SCES is seeking escorts who are willing to use their own car.
The escort service assists elders who have no family or friends to accompany them on these vital trips out of the house. Escorts are needed to act as a friendly companion and to offer a reassuring arm. If you are interested in helping elders remain safe and independent in the community, this may be a good opportunity for you.
For further information or to schedule an interview, please call 617-628-2601 ext. 3153. Additional information available at http://www.eldercare.org/.
Looking for Coaches for Falls Prevention Program
Chances are you know someone who has fallen or who is afraid of falling. A Matter of Balance is a proven program designed to help people manage concerns about falls and increase physical activity. Somerville-Cambridge Elder Services is looking for volunteers to help provide this program, throughout the cities of Cambridge and Somerville.
This is an evidenced based program, adapted by MainesHealths' Partnership on Healthy Aging, from the clinical model developed by Boston University. It is conducted in 8 two hour sessions, using group discussion, problem solving strategies, videos and strength and flexibility exercise. Older adults learn positive coping methods to reduce fear of falling and remain active and independent.
Volunteer coaches need good communication skills, enthusiasm, dependability and a willingness to lead small groups of older adults. Coaches also need to be able to lead low to moderate level exercise. Coaches need to commit to doing two trainings per year, monitored by a Master Trainer. The time commitment for a year is only 38 hours inclusive of their certification training. All materials and training provided by Somerville-Cambridge Elder Services.
Falls are the number one cause of injury deaths in people 65 and older, as well as the most common cause of nonfatal injuries and hospital admissions for trauma. Falls don't just happen, they are preventable. Being a volunteer coach could help bring those numbers down in your community.
Anyone interested should contact Janet Hand @ 617-628-2601 ext.3153.
This is an evidenced based program, adapted by MainesHealths' Partnership on Healthy Aging, from the clinical model developed by Boston University. It is conducted in 8 two hour sessions, using group discussion, problem solving strategies, videos and strength and flexibility exercise. Older adults learn positive coping methods to reduce fear of falling and remain active and independent.
Volunteer coaches need good communication skills, enthusiasm, dependability and a willingness to lead small groups of older adults. Coaches also need to be able to lead low to moderate level exercise. Coaches need to commit to doing two trainings per year, monitored by a Master Trainer. The time commitment for a year is only 38 hours inclusive of their certification training. All materials and training provided by Somerville-Cambridge Elder Services.
Falls are the number one cause of injury deaths in people 65 and older, as well as the most common cause of nonfatal injuries and hospital admissions for trauma. Falls don't just happen, they are preventable. Being a volunteer coach could help bring those numbers down in your community.
Anyone interested should contact Janet Hand @ 617-628-2601 ext.3153.
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