A Certified Senior Advisor is a professional who has received specialized training in aging and the important issues that affect seniors. CSA candidates must past a challenging national exam to demonstrate their comprehension of what is taught in the CSA curriculum. Typically, CSAs already have expertise in a professional discipline; and while many are licensed in a specific profession, it is only after they pass the exam, meet all the requirements and agree to live up to high ethical and professional standards that they may use the designation Certified Senior Advisor.
When you work with a professional who has added the CSA, designation to his or her credentials, you know you’re working with someone who has invested time and effort in learning about the things that are important to seniors. They have made a special effort to earn your trust, and are committed to CSA continuing education standards.
You now have the opportunity to work with a Certified Senior Advisor in the Lower Alabama region, Gina Germany, Owner, of Touching Hearts Senior Care, 251-445-4204. Please call Touching Hearts Senior for more information or visit www.touchingheartsseniorcare.com
Knowing When to Get Help
Wednesday, November 18, 2009
Tuesday, August 25, 2009
KEEP THE PRESSURE ON CONGRESS
Keep Up the Pressure on Congress! Reconnect With Your Legislators During August Recess and Press for Inclusion of LTSS and Project 2020 in Health Reform Encourage your Senators and Representatives to support long-term services and supports (LTSS) provisions including Project 2020 as part of health reform legislation.
The House and Senate will be in recess through Labor Day. The August recess is a perfect opportunity to reconnect with your legislators and their staff to urge them to support Project 2020 and do more to expand the availability of home and community-based services for seniors in the health insurance reform bills.
Thanks to those of you who have already contacted your legislators and customized and sent letters in support of Project 2020 to Congress. We need to keep up the pressure on Congress to pass Project 2020 during this critical recess period. Even if you have connected with your legislators before, it is critical that you reach out to them again over the month-long recess while they are back home holding “town hall” meetings on health reform and meeting with constituent groups. They must hear from you and the older adults who benefit from your agency’s programs and services. Without your voices, Project 2020 and other key LTSS provisions will not be included in health reform.
For a list of town halls and district events, visit: http://chn.org/pdf/2009/HealthTownHallsAug09.pdf.
Background: As detailed in previous n4a Advocacy Alerts, Project 2020 was introduced as S. 1257 by Senators Maria Cantwell (D-WA) and Debbie Stabenow (D-MI) and H.R. 2852 by Representatives Bruce Braley (D-IA) and John Sarbanes (D-MD). Working with our partners at NASUA, n4a is recruiting Members of Congress to sign on as co-sponsors of S. 1257/H.R. 2852 and to push for inclusion of Project 2020 provisions in the House and Senate health insurance reform packages currently under discussion. Health insurance reform remains front-and-center this recess. The House Democrats completed committee mark-ups on their tri-committee health reform bill just before leaving for recess and the Senate Finance Committee continues to work to negotiate a bipartisan agreement on its health reform package. n4a and NASUA are working closely with the Project 2020 bill’s congressional champions on amendment strategies for committee and floor consideration in September and we will keep you posted on these efforts. In the meantime, it is crucial that every single AAA and Title VI Native American aging program also weigh in directly (and/or indirectly through your advisory boards, community leaders, etc.) with your state/district’s congressional delegation.
Action Steps to Take:
Call the local offices of your legislators and request a meeting to discuss Project 2020 and health reform.
To find contact information for their state offices, visit their web sites, which you can find at: http://www.senate.gov and http://www.house.gov.
Introduce yourself to staff and identify what agency you represent; mention how critical the services included in Project 2020 would be to older adults in your community; and then ask your legislators to consider co-sponsoring the Project 2020 bill (S. 1257/H.R. 2852).
If you haven’t done so already, customize the sample Project 2020 letter on your agency’s letterhead and send it to your legislators’ DC offices via fax or email. Ask others to do the same! Urge colleagues, advisory board members, volunteers and clients to make calls and send faxes/emails to your agency’s House and Senate congressional delegation.
The more calls, faxes and emails, the more likely Project 2020 will be included in health reform. Resources: Not sure where to start? n4a’s Project 2020 Campaign Page http://www.n4a.org/advocacy/campaigns/?fa=project-2020 has all you need to craft your correspondence, educate others about the bill and ultimately persuade your Senators and Representatives to get on board.
Letters: We have developed state-specific sample letters that you can use to form the basis of your letter to your Senators and Representatives. Simply cut and paste the text into a new document and personalize as you see fit. But feel free to customize your correspondence, borrowing from other Project 2020 resources, like… Talking Points for Advocates Project 2020 Overview (Short and detailed) Documents to Share: If you already have a relationship with a Member’s office, please follow up on your letter with a phone call. Engage the staff member by offering to share more details on the bill, including… S. 1257/H.R. 2852 Bill Summary S. 1257/H.R. 2852 Bill Section-by-Section If they want more information on how the bill saves money, direct them to the Lewin Group report.Keep Up the Pressure on Congress! Reconnect With Your Legislators During August Recess and Press for Inclusion of LTSS and Project 2020 in Health Reform Encourage your Senators and Representatives to support long-term services and supports (LTSS) provisions including Project 2020 as part of health reform legislation.
Thanks for all your support! We have to stick together to help our elderly Age In Place.
The House and Senate will be in recess through Labor Day. The August recess is a perfect opportunity to reconnect with your legislators and their staff to urge them to support Project 2020 and do more to expand the availability of home and community-based services for seniors in the health insurance reform bills.
Thanks to those of you who have already contacted your legislators and customized and sent letters in support of Project 2020 to Congress. We need to keep up the pressure on Congress to pass Project 2020 during this critical recess period. Even if you have connected with your legislators before, it is critical that you reach out to them again over the month-long recess while they are back home holding “town hall” meetings on health reform and meeting with constituent groups. They must hear from you and the older adults who benefit from your agency’s programs and services. Without your voices, Project 2020 and other key LTSS provisions will not be included in health reform.
For a list of town halls and district events, visit: http://chn.org/pdf/2009/HealthTownHallsAug09.pdf.
Background: As detailed in previous n4a Advocacy Alerts, Project 2020 was introduced as S. 1257 by Senators Maria Cantwell (D-WA) and Debbie Stabenow (D-MI) and H.R. 2852 by Representatives Bruce Braley (D-IA) and John Sarbanes (D-MD). Working with our partners at NASUA, n4a is recruiting Members of Congress to sign on as co-sponsors of S. 1257/H.R. 2852 and to push for inclusion of Project 2020 provisions in the House and Senate health insurance reform packages currently under discussion. Health insurance reform remains front-and-center this recess. The House Democrats completed committee mark-ups on their tri-committee health reform bill just before leaving for recess and the Senate Finance Committee continues to work to negotiate a bipartisan agreement on its health reform package. n4a and NASUA are working closely with the Project 2020 bill’s congressional champions on amendment strategies for committee and floor consideration in September and we will keep you posted on these efforts. In the meantime, it is crucial that every single AAA and Title VI Native American aging program also weigh in directly (and/or indirectly through your advisory boards, community leaders, etc.) with your state/district’s congressional delegation.
Action Steps to Take:
Call the local offices of your legislators and request a meeting to discuss Project 2020 and health reform.
To find contact information for their state offices, visit their web sites, which you can find at: http://www.senate.gov and http://www.house.gov.
Introduce yourself to staff and identify what agency you represent; mention how critical the services included in Project 2020 would be to older adults in your community; and then ask your legislators to consider co-sponsoring the Project 2020 bill (S. 1257/H.R. 2852).
If you haven’t done so already, customize the sample Project 2020 letter on your agency’s letterhead and send it to your legislators’ DC offices via fax or email. Ask others to do the same! Urge colleagues, advisory board members, volunteers and clients to make calls and send faxes/emails to your agency’s House and Senate congressional delegation.
The more calls, faxes and emails, the more likely Project 2020 will be included in health reform. Resources: Not sure where to start? n4a’s Project 2020 Campaign Page http://www.n4a.org/advocacy/campaigns/?fa=project-2020 has all you need to craft your correspondence, educate others about the bill and ultimately persuade your Senators and Representatives to get on board.
Letters: We have developed state-specific sample letters that you can use to form the basis of your letter to your Senators and Representatives. Simply cut and paste the text into a new document and personalize as you see fit. But feel free to customize your correspondence, borrowing from other Project 2020 resources, like… Talking Points for Advocates Project 2020 Overview (Short and detailed) Documents to Share: If you already have a relationship with a Member’s office, please follow up on your letter with a phone call. Engage the staff member by offering to share more details on the bill, including… S. 1257/H.R. 2852 Bill Summary S. 1257/H.R. 2852 Bill Section-by-Section If they want more information on how the bill saves money, direct them to the Lewin Group report.Keep Up the Pressure on Congress! Reconnect With Your Legislators During August Recess and Press for Inclusion of LTSS and Project 2020 in Health Reform Encourage your Senators and Representatives to support long-term services and supports (LTSS) provisions including Project 2020 as part of health reform legislation.
Thanks for all your support! We have to stick together to help our elderly Age In Place.
Discussion on Capital Hill
Thank you for the opportunity to visit with you today about Long Term Care. My name is Gina Germany, and I am co-owner of Touching Hearts Senior Care in Mobile, AL. This position allows me to work with the elderly population and their families every day.
What I have learned… Our society is in denial when it comes to aging. We spend millions trying to avoid looking like we have grown older. Sooner or later, however, we have to deal with aging, particularly when it affects our parents. This raises the issue of elder care and long term care. Most people view life as a simple time line. You are born, your parents raise you, you become an adult and then you raise your own family. Most people do not factor in the subject of caring for their parents, nor plan for their retirement. When it becomes a necessity, it can be a huge wake up call from a financial, emotional and practical point of view.
I want to tell you a short story about an 80 year old man who was placed in a nursing home with a number of aliments. He had been in the hospital for 3 days and then transferred to a nursing home for rehab (which would last 21 days). Because of his terminal illnesses, he should have been put on hospice services. When I met his wife she was overwhelmed with all the information about Medicare, Medicaid, long-term insurance, and VA benefits, but the one thing that upset her the most was the quality of care her husband was receiving. She told me he was repeatedly left in his own feces for hours, even after he pulled the call switch. He should have been receiving physical therapy, but not once did a therapist see him and the facility charged his Medicare insurance for PT visits. This was a man who was not a millionaire, but had planned for a respectable retirement and had good insurance and plenty of money to pay for quality care. His wife told me that she was working with an elder law attorney who advised her to spend down their money to less than $2,000 to qualify for Medicaid – which would make them destitute. After listening and doing a complete assessment of the situation, I asked them both what they wanted to do. Their answer was to go home. I told them we could help them do that and within 24 hours the man was home with hospice services and caregivers in place, saving them almost $2,000 per month and receiving one on one care with his very own caregiver. This is just one example of the kind of situation our elderly population is faced with and how our Medicaid is being tasked. I see it over and over. I could tell you more stories, but I think you get the idea.
Due to funding cuts in public programs, the lack of consistent information, and the demands of our aging population, we have to focus on: 1) Educating our elderly and their adult children by providing consistent information about resources available at the community level. 2) To also educate our elderly and their adult children on disease prevention and health promotion. 3) Developing, identifying and supporting services that assist an elderly person to “Age in Place”.
The strategy, which has evolved out of the Project 2020 builds on the promise of home and community based services and will also generate significant savings for federal and state governments.
The three components of the project are:
EDUCATION
By making information readily available, our seniors and their caregivers will be empowered to make informed decisions about services that will affect their lives. Caregivers need to be educated on taking care of themselves to avoid burnout. Educating our seniors to plan early in their lives for retirement and their health care, as well as educating our young people while they have the time to make a future plan.
DISEASE PREVENTION AND HEALTH PROMOTION
Through this component, individuals will receive services by the Aging Services Network at the community level in areas such as fall prevention, physical activities, nutrition, chronic disease management and medication management.
NURSING HOME DIVERSION SERVICES
Eligible individuals will receive intense case management through the single point of entry system (Aging & Disability Resource Centers). This program component will provide prescreened individuals who will receive case management that will coordinate personalized services and support to allow them to “Age In Place”. Some of the services provided will be: Home-delivered meals, homemaker services, personal care, medical transportation, home modification, assistive technology and adult day care and more. Analysis has shown that by implementing these three components across the country, and utilizing the existing activities of the State Units on Aging (SUAs) and Area Agencies on Aging (AAA) while targeting the population in need, it will cost less in the aggregate than if the aging services community maintains the current patchwork approach to services. I am confident the strategy of Project 2020 is a good start to help our aging population and their family members understand what is necessary to retire with dignity and “Age In Place”. The estimated gross federal savings for the program over five years totals $2.7 billion!!!, with over 40 million served.
I ask that the state advocate for the passage of federal legislation, policies and funding to support Project 2020. And while we await a federal response, I ask that the state use its resources to support this model, including providing resources to the Area Agency on Aging serving the large metro areas of Mobile and Baldwin counties. Additional funds are needed to strengthen Information and Referral services, and become a fully operational Aging and Disability Resource Center.
What I have learned… Our society is in denial when it comes to aging. We spend millions trying to avoid looking like we have grown older. Sooner or later, however, we have to deal with aging, particularly when it affects our parents. This raises the issue of elder care and long term care. Most people view life as a simple time line. You are born, your parents raise you, you become an adult and then you raise your own family. Most people do not factor in the subject of caring for their parents, nor plan for their retirement. When it becomes a necessity, it can be a huge wake up call from a financial, emotional and practical point of view.
I want to tell you a short story about an 80 year old man who was placed in a nursing home with a number of aliments. He had been in the hospital for 3 days and then transferred to a nursing home for rehab (which would last 21 days). Because of his terminal illnesses, he should have been put on hospice services. When I met his wife she was overwhelmed with all the information about Medicare, Medicaid, long-term insurance, and VA benefits, but the one thing that upset her the most was the quality of care her husband was receiving. She told me he was repeatedly left in his own feces for hours, even after he pulled the call switch. He should have been receiving physical therapy, but not once did a therapist see him and the facility charged his Medicare insurance for PT visits. This was a man who was not a millionaire, but had planned for a respectable retirement and had good insurance and plenty of money to pay for quality care. His wife told me that she was working with an elder law attorney who advised her to spend down their money to less than $2,000 to qualify for Medicaid – which would make them destitute. After listening and doing a complete assessment of the situation, I asked them both what they wanted to do. Their answer was to go home. I told them we could help them do that and within 24 hours the man was home with hospice services and caregivers in place, saving them almost $2,000 per month and receiving one on one care with his very own caregiver. This is just one example of the kind of situation our elderly population is faced with and how our Medicaid is being tasked. I see it over and over. I could tell you more stories, but I think you get the idea.
Due to funding cuts in public programs, the lack of consistent information, and the demands of our aging population, we have to focus on: 1) Educating our elderly and their adult children by providing consistent information about resources available at the community level. 2) To also educate our elderly and their adult children on disease prevention and health promotion. 3) Developing, identifying and supporting services that assist an elderly person to “Age in Place”.
The strategy, which has evolved out of the Project 2020 builds on the promise of home and community based services and will also generate significant savings for federal and state governments.
The three components of the project are:
EDUCATION
By making information readily available, our seniors and their caregivers will be empowered to make informed decisions about services that will affect their lives. Caregivers need to be educated on taking care of themselves to avoid burnout. Educating our seniors to plan early in their lives for retirement and their health care, as well as educating our young people while they have the time to make a future plan.
DISEASE PREVENTION AND HEALTH PROMOTION
Through this component, individuals will receive services by the Aging Services Network at the community level in areas such as fall prevention, physical activities, nutrition, chronic disease management and medication management.
NURSING HOME DIVERSION SERVICES
Eligible individuals will receive intense case management through the single point of entry system (Aging & Disability Resource Centers). This program component will provide prescreened individuals who will receive case management that will coordinate personalized services and support to allow them to “Age In Place”. Some of the services provided will be: Home-delivered meals, homemaker services, personal care, medical transportation, home modification, assistive technology and adult day care and more. Analysis has shown that by implementing these three components across the country, and utilizing the existing activities of the State Units on Aging (SUAs) and Area Agencies on Aging (AAA) while targeting the population in need, it will cost less in the aggregate than if the aging services community maintains the current patchwork approach to services. I am confident the strategy of Project 2020 is a good start to help our aging population and their family members understand what is necessary to retire with dignity and “Age In Place”. The estimated gross federal savings for the program over five years totals $2.7 billion!!!, with over 40 million served.
I ask that the state advocate for the passage of federal legislation, policies and funding to support Project 2020. And while we await a federal response, I ask that the state use its resources to support this model, including providing resources to the Area Agency on Aging serving the large metro areas of Mobile and Baldwin counties. Additional funds are needed to strengthen Information and Referral services, and become a fully operational Aging and Disability Resource Center.
Monday, July 20, 2009
ELDER LIVING OPTIONS
For most of us independence and privacy is an important condition for a comfortable life. We each have our habits and methods of doing things, and life has a rhythm that just "fits" our personalities. But as people age and physical changes occur, we may find ourselves or loved ones dealing with those changes ineffectively. Sooner or later the question starts ringing in our heads, "When should I look for help?"
But then we think, "Oh, I don't need help. I don't want to be a burden to anyone." or "I can't tell Mom what to do - she'd never listen to me, anyway." Or "Dad would never accept help, he's too proud." or "It's not time yet, let's wait." As so we wait and do what we can ourselves, all the while still wondering, "When should I look for help?"
The good new is we don't have to guess. There are some common indicators that help us tell when it's time to get some help. We don't have to wait for a crisis situation to throw everyone into a panic. If fact, the goal should be to avoid a crisis, for everyone's benefit.
Here are some indicators to consider...
1. PHYSICAL CONDITION:
Have you or your loved one been diagnosed with a medical condition that affects their daily living? For example, dressing, grooming, shaving, toileting, or eating.
2. PERSONAL CARE:
Are baths/showers being taken regularly? Is there any body odor? Are teeth and hair brushed and washed regularly? Are incontinence products worn if necesary and changed regularly and correctly?
3. DRIVING?
Has driving become difficult, uncertain or scary? Have reflexes and decision making slowed? Have new dings, dents or scratches, appeared on vehicles?
4. NUTRITION:
Are you or your loved one's weight stable? Are you/they eating regularly and nutritiously? Is the refrigerator properly stocked with a variety of foods? Does all the food have current expiration dates? Is there spoiled food in the refregerator or on the counters?
5. HOUSEHOLD TASKS:
Are household chores being done regularly? For example, dusting, laundry, or vacuuming. Are bed linens changed regularly? Have household chores become frustraing, physically demanding, or time consuming?
6. SOCIALIZATION:
Do you or your loved one have moods of loneliiness, despair, depression, frustration, irritability, or anxiet? Is there fear or insecurity about going out of the house?
7. MENTAL HEALTH:
Are there memory lapses? Is there difficulty finding the right words? Is there inconsistency between words and action? Is anxiety or moodiness evident?
8. MEDICATION:
Are medications being taken regularly and on time? Are medications being refilled on scheduled? Does the senior understand what the medications are being taken for?
9. FINANCES, MAIL, PAPERWORK:
Is the senior having difficulty managing their checkbook, finances, bills and personal affairs? Are there past due notices arriving? Is mail piling up? Is there a reasonable amount of cash on hand? Are important documents or similar items like purses, wallets and keys being misplaced frequently or for long periods of time? Are they appearing in unusual places?
10. SAFETY, SECURITY AND SANITATION:
Are appliances being left on, such as the stove or coffee pot? Does the senior fall asleep with cigarettes burning? Is the house allowed to get too hot or too cold? Is the house always unlocked? Has the senior fallen in the past 6 months? Have there been multiple falls? Is there clutter on the floor? Is trash piling up in or around the house? Are toilets functioning properly? Is pet debris evident?
Family members often see the changes in the way a senior moves, acts, thinks, and responds to situations around them, but dismisses them until one of two things happen. Either the family beings to spend so much time helping the senior themselves that they have little time for their own responsibilities, or the senior experiences a physical or medical crisis. Both of these result in undue stress for the family and the senior. If you have a concern with even one set of indicators, it's time to acknowledge it, learn more about what is causing it and what options are available to overcome it. Speak openly, calmly, and honestly about the issue and the type of assistance needed to overcome it. Frequently, simple changes can make a big improvement. We encourage you to be proactive and avoid a crisis situation that throws everyone into an emotional reaction. Calm, rational transitions are easier on everyone than stressful ones.
Finally, keep your efforts as informal as possible. Rather than going through the house like an inspector with a checklist, make your observations through normal, casual interaction. Make a mental note when you see things that are of concern. Keep conversations non-threatening and cooperative. Make every effort to respect the seniors wishes while assisting with their needs.
For more information go to http://www.touchingheartsseniorcare.com/
But then we think, "Oh, I don't need help. I don't want to be a burden to anyone." or "I can't tell Mom what to do - she'd never listen to me, anyway." Or "Dad would never accept help, he's too proud." or "It's not time yet, let's wait." As so we wait and do what we can ourselves, all the while still wondering, "When should I look for help?"
The good new is we don't have to guess. There are some common indicators that help us tell when it's time to get some help. We don't have to wait for a crisis situation to throw everyone into a panic. If fact, the goal should be to avoid a crisis, for everyone's benefit.
Here are some indicators to consider...
1. PHYSICAL CONDITION:
Have you or your loved one been diagnosed with a medical condition that affects their daily living? For example, dressing, grooming, shaving, toileting, or eating.
2. PERSONAL CARE:
Are baths/showers being taken regularly? Is there any body odor? Are teeth and hair brushed and washed regularly? Are incontinence products worn if necesary and changed regularly and correctly?
3. DRIVING?
Has driving become difficult, uncertain or scary? Have reflexes and decision making slowed? Have new dings, dents or scratches, appeared on vehicles?
4. NUTRITION:
Are you or your loved one's weight stable? Are you/they eating regularly and nutritiously? Is the refrigerator properly stocked with a variety of foods? Does all the food have current expiration dates? Is there spoiled food in the refregerator or on the counters?
5. HOUSEHOLD TASKS:
Are household chores being done regularly? For example, dusting, laundry, or vacuuming. Are bed linens changed regularly? Have household chores become frustraing, physically demanding, or time consuming?
6. SOCIALIZATION:
Do you or your loved one have moods of loneliiness, despair, depression, frustration, irritability, or anxiet? Is there fear or insecurity about going out of the house?
7. MENTAL HEALTH:
Are there memory lapses? Is there difficulty finding the right words? Is there inconsistency between words and action? Is anxiety or moodiness evident?
8. MEDICATION:
Are medications being taken regularly and on time? Are medications being refilled on scheduled? Does the senior understand what the medications are being taken for?
9. FINANCES, MAIL, PAPERWORK:
Is the senior having difficulty managing their checkbook, finances, bills and personal affairs? Are there past due notices arriving? Is mail piling up? Is there a reasonable amount of cash on hand? Are important documents or similar items like purses, wallets and keys being misplaced frequently or for long periods of time? Are they appearing in unusual places?
10. SAFETY, SECURITY AND SANITATION:
Are appliances being left on, such as the stove or coffee pot? Does the senior fall asleep with cigarettes burning? Is the house allowed to get too hot or too cold? Is the house always unlocked? Has the senior fallen in the past 6 months? Have there been multiple falls? Is there clutter on the floor? Is trash piling up in or around the house? Are toilets functioning properly? Is pet debris evident?
Family members often see the changes in the way a senior moves, acts, thinks, and responds to situations around them, but dismisses them until one of two things happen. Either the family beings to spend so much time helping the senior themselves that they have little time for their own responsibilities, or the senior experiences a physical or medical crisis. Both of these result in undue stress for the family and the senior. If you have a concern with even one set of indicators, it's time to acknowledge it, learn more about what is causing it and what options are available to overcome it. Speak openly, calmly, and honestly about the issue and the type of assistance needed to overcome it. Frequently, simple changes can make a big improvement. We encourage you to be proactive and avoid a crisis situation that throws everyone into an emotional reaction. Calm, rational transitions are easier on everyone than stressful ones.
Finally, keep your efforts as informal as possible. Rather than going through the house like an inspector with a checklist, make your observations through normal, casual interaction. Make a mental note when you see things that are of concern. Keep conversations non-threatening and cooperative. Make every effort to respect the seniors wishes while assisting with their needs.
For more information go to http://www.touchingheartsseniorcare.com/
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