POP-IN SERVICE

This is how the Pop-In Service works:

Aunt Mary Lynn wants to stay in her home for as long as possible. She is a little unsteady on her feet, and sometimes doesn’t bother to make herself a hot meal because it is too much trouble and easier to eat cold cereal. A Touching Hearts Senior Care Caregiver will pop-in for 30 minutes in the morning to help her out of bed and get a hot meal for a fee of $15.00. Each Pop-In Service is customized to each individual’s needs. The service guidelines are as follows:

· Requires a consistent, week-to-week schedule
· Is offered Monday – Friday between the hours of 8:00 AM & 9:00 PM
· Is available in increments of 15, 30, 60, or 90 minutes per visit
· Is typically used by clients who only require a short visit in situations like those below:

§ Check on a loved one and make sure s/he is okay
§ Ensure that a loved one is taking medications
§ Help with quick dusting, vacuuming, or other light cleaning
§ Help with a quick trip to/from the grocery story or an appointment
§ Take out the garbage, get the mail, heat up a quick meal
§ Provide peace of mind that a loved one is cared for
§ Help with or monitor bathing/showering
§ Help getting in and out of bed
§ Help putting on / taking off support stockings

Pop-In Service
15 minutes: $11.00
30 minutes: $15.00
60 minutes: $22.00
90 minutes: $27.00

Warning Signs that a Senior Might Need Help Managing Finances

The following is Provided by CSA: http://www.csa.us/

Even though many seniors have planned for their retirement by investing in IRAs and 401(k)s, paying off large debts such as cars and homes, and reducing their discretionary expenses, there is one factor that people tend to overlook: planning for the day when they turn their money management over to someone else.

Because seniors are living longer than ever, thinking about the possibility of a time when they need help with financial matters is increasingly necessary. For many independent seniors, the idea of turning over their money management is frightening, but advance planning can make the transition easier both for seniors and their adult children.

Where to Start
It's best to discuss finances before a problem arises. Once the money is running out or a medical emergency arises, it might be too late for a financial plan to be effective.

Signs that a senior might need help in managing his or her finances include the following:
• bounced checks
• piled up mail
• unpaid bills
• mounting credit card debt
• calls from creditors
• forgetfulness

Financial Document Checklist
In organizing a senior's finances, the caregiver must obtain a variety of information. The following financial information and/or documents should be located (or created), then stored in a safe place.

• Bank account numbers/brokerage statements
• Names and contact information for lawyer, broker and insurance agents
• Social Security cards
• IRA/401(k)/pension statements
• Tax returns for the past 3-5 years
• Deed to the house
• A list of debts (loans, etc.)
• Copies of all insurance policies
• Copies of wills
• Copies of all power-of-attorney documents and trusts
• Prepaid funeral contract

Tread Lightly
Children and other caregivers should raise the subject of finances during a stress-free time, and in a non-threatening manner. It's often helpful to include an attorney or financial advisor in this discussion. Focus on planning for financial security rather than sharing opinions about financial priorities.

A good first step is to get a firm handle on the senior's income and expenses. Remember to approach this stage in a non-judgmental manner, simply gathering information. Determine the following:
• Monthly income
• Monthly expenses
• How bills are paid (by written check versus automatically)
• Medical and other extraordinary expenses
• Outstanding debt
• Investments

Be sure to over-estimate how long the senior will need to live on his or her fixed income.

Other Considerations
In addition to financial records, the caregiver should obtain information about the senior's:
• Will
• Living Will
• Power of Attorney
• Insurance: life, medical, long-term care, disability
• Estate planning

Seniors often delay writing wills or planning for the disposal of their estate in the event of their death. But the best time to address these topics is while the senior is still fully cognizant and able to make sound decisions.

Get More Involved
Once the caregiver has a full picture of the senior's finances, a collaborative financial plan can be created. In the short term, the caregiver should be added to all of the senior's accounts (financial accounts, as well as household-type accounts). Adult children might need to monitor their parents' finances periodically, perhaps simply by regularly reviewing financial statements.

Over time, the caregiver can take over managing the senior's finances. Because this is a delicate transition, it's helpful to follow some guidelines:

• Maintain complete and accurate records.
• Approach the task with a professional attitude, rather than personal.
• Keep the senior involved and aware of his or her finances as long as possible.

Security in the Golden Years
Discussing finances with an aging parent can be difficult for adult children. Seniors can be reluctant to give up their independence, so it's helpful to let them maintain a sense of control over their financial situation. A shared approach is best at first, with a gradual transition of financial responsibility to the caregiver. The ultimate goal is to ensure the senior's financial security, to make the "golden years" as comfortable as possible.

EIGHT AREAS OF AGING

1. Brain: Memory and Alzheimer's Disease
Many people become anxious about developing memory impairments as they transition into being senior citizens and begin to worry that forgetting details is the first sign of Alzheimer's disease (AD). Confusion and loss of memory were thought to be inevitable parts of aging in the past, but we now know that people can still be able and alert despite aging. Senior citizens and those responsible for providing their elder care should be aware of these changes in memory and work to prevent, identify, and treat them.
Over the past several years, researchers have been looking at a type of cognitive change known as mild cognitive impairment (MCI). This is separate from cognitive changes related to aging and often progresses to AD over some years. Senior citizens with amnesic MCI have a specific memory difficulty and have ongoing problems with memory, but they do not develop other losses seen in AD like confusion, attention problems, and problems with language.
2. Bones and Joints
As we age, our bones and movable joints are subject to wear and tear. The most common conditions among senior citizens in this area of the body are as follows:
Osteoporosis. This is a disease that causes bones mainly in the hips, backbone, and wrists to weaken to the point of breaking easily. As people, especially women, age into their 40s and 50s, bones start to weaken, and the outer shell of the bone gets thinner.
Arthritis. This is not one type of disease; there are many types of arthritis, and each has different symptoms and treatments. In general, arthritis can become a problem in most any joint in the body. Osteoarthritis (OA) is the most common type in senior citizens. It begins when cartilage begins to wear away, and at its worst, all the cartilage in a joint is worn away, causing bare bones to painfully rub against each other. Conversely, rheumatoid arthritis (RA) is an autoimmune disease. People with RA have immune systems that attack the lining of their joints as if it were an injury or disease. It leads to inflammation in the joints, causing pain, swelling, and stiffness for hours.
Consuming enough calcium and vitamin D and including regular weight-bearing exercise in your lifestyle are extremely important in preventing weak bones in senior citizens. Methods of improving quality of life and reducing the symptoms of osteoarthritis include weight loss and exercises in light resistance and flexibility. In rheumatoid arthritis, the most effective treatment is drug therapy to modify the immune system response and decrease joint damage.
3. Eyes and Ears: Eyesight and Hearing Changes with Age
Eyesight usually declines around age 40, and cataracts and macular degeneration may develop around age 60. Hearing weakens with age.
Sight:
Presbyopia. This is a gradual loss of ability to see objects close to you or read small print. This condition is normal in senior citizens, and a usual treatment is simply to get a pair of reading glasses.
Cataracts. These are areas of cloudiness in the lens of the eye that cause loss of sight. Generally, these form slowly without symptoms, and some remain small and do not interfere with vision. Others may grow large or dense, harming vision. Cataract surgery, which is very safe and common, can be very helpful.
Glaucoma. This is a result of fluid inside the eye causing too much pressure. Gradually, this pressure can damage the optic nerve, leading to loss of vision and blindness. Often, senior citizens with glaucoma lack early symptoms of pain or pressure, but annual eye exams that include dilating your pupils can protect you from developing this disease.
Retinal disorders. These disorders are some of the most common causes of blindness in the United States. The most prevalent among senior citizens is age-related macular degeneration (AMD), which affects the area of the retina that provides sharp central vision. Treatment of AMD includes photodynamic therapy, which uses a drug and a strong light to delay the progress of the disorder. Another common retinal disorder is a degenerative disease that affects vision and is called diabetic retinopathy. It is important that senior citizens seek appropriate medical care, maintain a healthy lifestyle, and have frequent follow-ups to help reduce its prevalence.
Two new drugs, ranibizumab (Lucentis) and bevacizumab (Avastin), are now being used to treat neovascular macular degeneration in senior citizens.
Hearing:
Presbycusis. This is slowly progressing hearing loss caused by aging.
Tinnitus. This is a ringing, roaring, or other noise that may come with hearing loss. It may be caused by loud noise, hearing loss, some medicines, and other health problems like allergies or problems in the heart and blood vessels.
4. Digestive and Metabolic
Gastrointestinal problems are more common in senior citizens. Gastroesophageal reflux disease (GERD) is when the lower esophageal sphincter (LES) fails to close properly, causing the contents of the stomach to leak back-or reflux-into the esophagus. If this sensation of heartburn happens more than two times per week, it may be considered to be GERD, which can lead to more serious health risks.
Many senior citizens are pre-diabetic, which raises their risk of developing type 2 diabetes, heart disease, and stroke.
5. Urogenital
Incontinence. This is the term for loss of bladder control, from mild leaking to uncontrollable wetting, that is very common in senior citizens. It is not caused by aging alone; factors causing it may be urinary tract infections, vaginal infection or irritation, constipation, or certain medicines. Many cases of incontinence can be controlled or cured with treatment, so it is important to talk to a doctor or another involved in your elder care about this.
Benign prostatic hypertrophy (BPH). The urethra, which passes urine, is surrounded by the prostate gland. Since the prostate gland grows with age, it may begin to squeeze the urethra. Tumors in the prostate may also contribute to this problem. This growth or unrelated infections may cause problems with passing urine. Some men experience this symptom in their 30s or 40s, whereas others do not notice this until a later age.
Prostate cancer. This is the second most common type of cancer in men in the United States. Frequent check-ups are important in identifying and treating this disease.
6. Dental: gingivitis, periodontitis, loss of teeth
Tooth decay can occur regardless of age as long as you have natural teeth. It ruins the enamel that covers and protects the teeth. Plaque forms when you neglect your teeth and bacteria clings to them, forming a sticky, colorless film that can lead to cavities and tooth decay. Another factor in causing tooth decay is gum disease. Using a fluoride toothpaste can help protect your teeth, as it is just as helpful for senior citizens as it is for children.
Gum diseases. These are sometimes called periodontal or gingival diseases, and they are infections that harm the gum and bone holding the teeth in place. If plaque stays on the teeth for too long, it forms tartar, which brushing doesn't clean and which continues to damage the teeth. When plaque and tartar remain on the teeth, gingivitis is formed. Gingivitis can form areas in which your gums lift away from your teeth, forming easily infected pockets. This is called periodontitis, which, if not properly treated, can ruin the bones, gums, and tissue supporting the teeth. It could even loosen your teeth in time, warranting removal of those teeth.
7. Skin Care for the Elderly
Staying out of the sun is the easiest and least expensive way of avoiding skin damage. Sunlight is the main cause of our changing appearance as we age-including wrinkles, age spots, and dryness. Smoking can also increase the number of visible wrinkles because the chemicals in cigarettes damage elastin proteins in the skin. Skin changes with age; for example, you sweat less as you get older, leading to more dryness. Skin also loses fat, causing it to appear less smooth. Still, senior citizens can take steps to protect themselves from the sun's harmful effects.
Dry skin. This appears mainly on the lower legs, elbows, and forearms and affects many senior citizens. Skin may feel rough, scaly, and itchy. This could be aggravated by low humidity, which can be worsened by overheating in the winter and air conditioning in the summer. Dryness is also caused by the loss of sweat and oil glands that accompanies aging. Other things that may lead to dry skin are overusing soaps, antiperspirants, perfumes, and hot baths or dehydration, sun exposure, smoking, and stress.
Skin cancer. This is the most common kind of cancer in the United States. Three types of skin cancer are the most prevalent. These include basal cell carcinomas, the most common, which grow slowly and rarely spread; squamous cell carcinomas, which seldom spread but do so more often than basal cell carcinomas; and the most dangerous common skin cancer, melanoma, which can (often fatally) spread to other organs.
Shingles. This affects nerves, causing pain and blisters in senior citizens. It is caused by the same virus that afflicts people with chickenpox. After you recover from chickenpox, the virus remains in some of your nerve cells and, for reasons unknown, can become active again rather than remaining inactive. This regained activity produces shingles.
Senior citizens with shingles feel sick with a rash on their body or face. Shingles targets older people rather than children, and about 20 percent of people who have had chickenpox as children will develop shingles after the age of 50.
8. Functional Abilities
Senior citizens often suffer from injuries caused by falling. This may be caused by other changes, including loss of sight, hearing, muscle strength, coordination, or reflexes. Diabetes, heart disease, or complications with your circulation or nervous system may negatively affect balance, and some medicines can cause dizziness. Any of these could cause a senior citizen to be more prone to falling.
As with most problems experienced by senior citizens, the better you take care of yourself, the less prone you will be to falling. A test called a bone mineral density test can tell you how strong your bones are. If necessary, your doctor can use the results of this test to prescribe medications that will make your bones stronger and less likely to break.

Healthy Aging Tips

As you grow older, you experience an increasing number of changes, including retirement, the loss of loved ones, and the physical changes of aging. How you handle these changes is the key to aging well.

Healthy aging is about much more than staying physically healthy—it’s about maintaining your sense of purpose and your zest for life. While the specific ingredients of aging well are different for everyone, knowing the basic recipe for healthy aging will help you live with meaning and joy throughout your senior years.

Coping with change is difficult, no matter how old you are. The particular challenge for older adults is the sheer number of changes and transitions—including the loss of friends, family, your career, your health, and even your independence. It’s natural to feel those losses. But if that sense of loss is balanced with positive ingredients, you have a recipe for aging well.

Healthy aging means continually reinventing yourself, finding new things you enjoy, learning to adapt to change, staying physically and socially active, and feeling connected to your community and loved ones. Unfortunately, for many, aging brings anxiety and fear instead. How will I take care of myself? What if I lose my spouse? What is going to happen to my mind? However, many of these fears stem from myths about aging that are exaggerated or simply untrue. The truth is that you are stronger and more resilient than you may think.

Myths About Aging

MYTH: Old age means poor health and disability.
Fact: There are some diseases that are more common in older adults. However, getting old does not automatically mean poor health or that you will be confined to a walker or wheelchair. Plenty of older adults enjoy vigorous health. Preventive measures like healthy eating, exercising and managing stress can help reduce the risk of chronic disease and fall risk later in life.

MYTH: Memory loss is an inevitable part of aging.
Fact: You may eventually notice you don’t remember experiences as easily as in the past, and memories may take longer to retrieve. However, significant memory loss is not an inevitable result of aging. Brain training and new learning can occur at any age. And there are many things you can do to keep your memory sharp.

MYTH: You can’t teach an old dog new tricks.
Fact: One of the more damaging myths of aging is that after a certain age, you just won’t be able to try anything new or contribute things anymore. Quite the contrary. Older adults are just as capable of learning new things, thriving in new environments, and sharing their wisdom and experience with many generations. If you believe in yourself and have confidence in yourself, you are setting up a positive environment for change no matter what your age.

Healthy aging: Tips for coping with change

As you age, there will be periods of both joy and stress. It’s important to build your resilience and find healthy ways to cope with challenges. This ability will help you make the most of the good times and keep your perspective when times are tough.

Focus on the things you’re grateful for. The longer you live, the more you lose. But as you lose people and things, life becomes even more precious. When you stop taking things for granted, you appreciate and enjoy what you have even more.

Acknowledge and express your feelings. You may have a hard time showing strong emotions, perhaps feeling that such a display is inappropriate and weak. But burying your feelings can lead to anger, resentment, and depression. Don’t deny what you’re going through. Find healthy ways to process your feelings, perhaps by talking with a close friend or writing in a journal.
Accept the things you can’t change. Many things in life are beyond our control. Rather than stressing out over them, focus on the things you can control such as the way you choose to react to problems. Face your limitations with dignity and a healthy dose of humor.
Look for the silver lining. As the saying goes, “What doesn’t kill us makes us stronger.” When facing major challenges, try to look at them as opportunities for personal growth. If your own poor choices contributed to a stressful situation, reflect on them and learn from your mistakes.
Take daily action to deal with life’s challenges. When challenges seem too big to handle, sweeping them under the carpet often appears easier. But ignoring the problem doesn’t make it go away; it allows both the problem and your anxiety to build. Instead, take things one small step at a time. Even a small step can go a long way to boosting your confidence and reminding you that you are not powerless.

Depression is not a normal part of aging

The difficult changes that older individuals often face—such as the death of a spouse, retirement, or medical problems—can lead to depression, especially if you don’t have a strong support system. But depression is not a normal or necessary part of aging, and with treatment and support, you can get back to enjoying your golden years.

Healthy aging: Tips for finding meaning and joy

A key ingredient in the recipe for healthy aging is the continuing ability to find meaning and joy in life. As you age, your life will change and you will lose things that previously occupied your time and gave your life purpose. For example, you may retire from your career or your children may move far away. But this is not a time to stop moving forward. Later life can be a time of exciting new adventures if you let it.

Aging well means finding activities that you enjoy

Everyone has different ways of experiencing meaning and joy, and the activities you enjoy may change over time. If you’re not sure where to get started, try some of the following suggestions:

Pick up a long-neglected hobby
Play with your grandchildren or a favorite pet
Learn something new (an instrument, a foreign language, a new game)
Get involved in your community (volunteer or attend a local event)
Take a class or join a club
Go on a weekend trip to a place you’ve never visited
Spend time in nature (take a walk, go fishing, enjoy a scenic view)
Enjoy the arts (visit a museum, go to a concert or a play)
The possibilities are endless. The important thing is to find activities that are both meaningful and enjoyable. Whatever your preference, taking time to nourish your spirit is never wasted.
Better health through humor, laughter, and play
Laughter is strong medicine for both the body and the mind. It helps you stay balanced, energetic, joyful, and healthy. A sense of humor helps you get through tough times, look outside yourself, laugh at the absurdities of life, and transcend difficulties.

Healthy aging: Tips for staying connected

One of the greatest challenges of aging is how your support network changes. Staying connected isn’t always easy as you grow older—even for those who have always had an active social life. Retirement, illness, death, and moves can take away close friends and family members. And the older you get, the more people you lose. What’s more, getting around may be difficult.
But it’s important to find ways to reach out and connect to others. Loneliness and isolation are major threats to aging well. Having people you can turn to for company and support is a buffer against depression, disability, hardship, and loss.

The good news is that there are lots of ways to be with other people. It doesn’t matter what you do, so long as you get out of the house (if possible) and socialize:

Connect regularly with friends and family. Spend time with people you enjoy and who make you feel upbeat. It may be a neighbor who you like to walk with, a lunch date with an old friend, or shopping with your children. Even if you are not close by, call or email frequently to keep relationships fresh.

Make an effort to make new friends. As you lose people in your circle, it is vital to make new connections so your circle doesn’t dwindle. Make it a point to befriend people who are younger than you. Younger friends can reenergize you and help you see life from a fresh perspective.
Spend time with at least one person every day. You shouldn’t be alone day after day. Phone or email contact is not a replacement for spending time with other people. Regular face-to-face contact helps you ward off depression and stay positive.

Volunteer. Giving back to the community is a wonderful way to strengthen social bonds and meet others, and the meaning and purpose you find in helping others will enrich and expand your life. Volunteering is a natural way to meet others interested in similar activities or who share similar values. Even if you’re housebound, you can get involved by volunteering on the phone.

Find support groups in times of change. If you or a loved one is coping with a chronic illness or recent loss, it can be very helpful to participate in a support group with others undergoing the same challenges.

Healthy aging: Tips for boosting vitality

Don’t fall for the myth that aging automatically means you’re not going to feel good anymore. It is true that aging involves physical changes, but it doesn’t have to mean discomfort and disability. While not all illness or pain is avoidable, many of the physical challenges associated with aging can be overcome or drastically mitigated by eating right, exercising, and taking care of yourself.

It’s never too late to start! No matter how old you are or how unhealthy you’ve been in the past, caring for your body has enormous benefits that will help you stay active, sharpen your memory, boost your immune system, manage health problems, and increase your energy. In fact, many older adults report feeling better than ever because they are making more of an effort to be healthy than they did when they were younger.

Tips for eating well as you age

As you age, your relationship to food changes along with your body. A decreased metabolism, changes in taste and smell, and slower digestion may affect your appetite, the foods you can eat, and how your body processes food. The key is to figure out how to adapt to your changing needs. Now, more than ever, healthy eating is important to maintain your energy and health.
Load up on high-fiber fruits, vegetables, and whole grains. Your whole digestive system is slower, so fiber is very important. Consume fiber-rich foods such as whole grains, fruit, and vegetables. They will help you feel more energetic and give you fuel to keep going.
Put effort into making your food look and taste good. Your tastebuds aren’t as strong and your appetite may not be the same, but your nutritional needs are just as important as ever. If you don’t enjoy eating like you used to, put a little more effort into your meals, including the way you flavor, prepare, and present your food.

Watch out for dehydration. Because of physical changes, older adults are more prone to dehydration. So make sure you are drinking plenty of fluid, even if you don’t feel thirsty. If you’re not getting enough water, you’re not going to be as sharp and your energy will suffer.
Make meals a social event. It’s more enjoyable to eat with others than alone. Invite people over.

Tips for exercising as you age

Many older adults don’t exercise. However, exercise is vital for healthy aging. It helps you maintain your strength and agility, gives your mental health a boost, and can even help diminish chronic pain. Whether you are generally healthy or are coping with an ongoing disability or health problem, regular exercise will help you stay physically and mentally healthy and improve your confidence.

Check with your doctor before starting any exercise program. Find out if any health conditions or medications you take affect what exercise you should choose. Find an activity you like and that motivates you to continue. You may want to exercise in a group, like in a sport or class, or prefer a more individual exercise like swimming. Start slow. If you are new to exercise, a few minutes a day puts you well on the way towards building a healthy habit. Slowly increase the time and intensity to avoid injury.

Walking is a wonderful way to start exercising. Exercise doesn’t have to mean strenuous activity or time at the gym. In fact, walking is one of the best ways to stay fit. Best of all, it doesn’t require any equipment or experience and you can do it anywhere.

Getting quality sleep: Tips for seniors

Many older adults complain of sleep problems, including insomnia, daytime sleepiness, and frequent waking during the night. But aging doesn’t automatically bring sleep problems. Learning and practicing healthy sleep habits may be all you need to, once again, get a good night’s rest.

Healthy aging: Tips for keeping your mind sharp

There are many good reasons for keeping your brain as active as your body. Keeping your brain active and maintaining creativity actually may help to prevent cognitive decline and memory problems. The more you use and sharpen your brain, the more benefits you will get.

WHAT IS A CERTIFIED SENIOR ADVISOR?

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

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.

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.