Sleeping Giant Awakens

By John Stauffer

John Stauffer writes about the Sleeping Giant - the Boom GenerationIt is clear to me that the Boom Generation is a sleeping giant that is beginning to awaken…and it is cranky! For too long the needs of the families of the baby boomers have faced some daunting care circumstances. They are often faced with the care of aging/ailing parents and in some cases still raising children of their own – some with lifetime disabling conditions.  Organizations like ours dedicated to providing respite care across that very broad age spectrum are uniquely positioned to help, and also to feel the pain of an often-inadequate health and care system.

Each year I attend at least one industry-specific event. This year I attended NADSA the National Adult Day Services Association conference in Indianapolis. My trip was eventful for several reasons. First, and most important, was receiving the latest research aggregated in a report from the Centers for Disease Control (CDC).  The data shared in that report coupled with the changing trends in the health care industry had my head spinning.   Maybe that is why I had a fender-bender while going to the conference.  (Good news, no long term physical damage and the car was repaired in record time.)

I know you have heard the statistic about the number of boomers in America turning 65 each day (10,000!) and that fully one/third of them will need help to remain safely in their homes. But the stats that really got to me in this latest report were:

  • In 2017 50% of our population will be over the age of 50
  • Among seniors, better socialization reduces the incidence of stroke by 71%
  • Improved sleep reduces the incidence of stroke by 58%
  • Extreme loneliness is equal to the impact of smoking 15 cigarettes a day and reduces life expectancy by 8 years
  • 60% of those in long term care or senior assisted living facilities NEVER get a visitor

This tells me that the need for Adult Day programs is greater than ever.  Additionally, there was a law passed by the Feds in 2014 called the Impact Act which is fundamentally changing the way major health care organizations are operating.  The Impact Act relates to how Medicaid dollars are used. Prior to 2014 all of the Medicaid dollars were funneled to the large conglomerate health care providers which inspired many health organizations to create mega- operations with traditional hospital care, rehab care, adult day care all under one roof, effectively shutting out many smaller organizations like Helping Hands Respite Care.  Now large health care organizations must prove that those Medicaid dollars are being spread out.  The government is saying the Medicaid dollars are supposed to be used for the best care for the individual regardless of the size the organization.Comparison Chart showing cost and features for Adult Day programs versus Home Care, Assisted Living or Nursing Home

The Impact Act of 2014 further complicated things for major health care organizations by regulating the amount of dollars in the Medicaid “bucket” for an individual.  This has meant that hospitals are being financially penalized for repeat visits to the hospital or emergency room by the same patient. These limitations are forcing managed health care organizations to re-evaluate how to best utilize the Medicaid dollars and who to collaborate with to maximize the health outcome for individuals.

What does this mean for Adult Day Service programs like ours?  In Michigan, there are no licensing regulations for Adult Day programs, yet statistics support the statement that Adult Day programs offer the lowest cost and the highest value.

Now is the time for Adult Day programs to create viable partnerships with health care organizations and family medical practitioners.  The facts in the chart give some great reasons why!  It is conceivable that our organization could help save our hospital partners millions of dollars over time.

John Stauffer is the Executive Director of Helping Hands Respite Care in East Lansing, Michigan and is the current President of the Michigan Adult Day Services Association. He and several members of MADSA are working on a common language and reporting procedure to support the efficacy of Adult Day programs in Michigan.  Helping Hands Respite Care operates an Adult Day Services program with a positive track record for over 30 years. Originally established by a group of nurses, the program continues to have a staff nurse in attendance daily.

 

Driving and Dementia

Senior man behind the wheel. We explore driving and dementia

Learn about driving and dementia in the helpful article:

Living with Dementia: When Does Driving Become Unsafe?

By Ava M. Stinnett

A friend or loved one is diagnosed with dementia. Among the many concerns for caregivers and family members is determining when it’s no longer safe for the individual to drive. There are various signs to look for when assessing whether it’s time to give up the car keys; however, something just as important as safety is what the loss of autonomy will mean to your friend or loved one.

Try to imagine what it would be like if you could no longer drive. To most of us, driving means freedom and self-reliance. It’s a natural part of being an adult. Losing the independence that comes with driving may be upsetting. Having to rely on others to get around may feel uncomfortable for the person with dementia or Alzheimer’s. Keeping all of this in mind, how and when should you intervene?

A family member with dementia often adjusts better if they are involved in discussions about making the transition from driver to passenger. Some people, aware of the risks, will give up driving easily. Others may refuse to discuss the topic of driving, or they may exhibit resentment or anger when you start the conversation. You’ll want to be patient and acknowledge these feelings. The goal is to allow your loved one to maintain the highest level of independence and mobility while avoiding traffic risks. In some cases, it may be necessary to ask a physician or your family attorney to reinforce the message about safe driving.

When first diagnosed, a person with dementia or Alzheimer’s may still possess the skills necessary for safe driving. But because the disease is progressive, eventually driving skills will decrease and they will have to give up driving. Look for some of the following signs that indicate it’s time to limit or stop driving:

  • Loss of coordination getting in and out of the vehicle
  • Difficulty judging distance and space (e.g., parks inappropriately, hits curbs, drifts into other lanes of traffic)
  • Forgetting how to locate familiar places; returning from a routine drive later than usual; unexpected dents in the car
  • Difficulty seeing pedestrians, objects, or other vehicles
  • Making errors at intersections; difficulty with turns, lane changes, or highway exits
  • Failing to observe traffic signs
  • Stops in traffic for no reason
  • Driving at inappropriate speeds
  • Becoming increasingly irritated, confused, or nervous when driving

Once it’s determined that driving poses a hazard on the road, arrange for other forms of transportation such as friends or family members, taxis, public transportation, or special transportation services for older adults. (Note that taxis and public transportation work best for those in the early to middle stages of dementia.) In addition to transportation needs, the Alzheimer’s Association (800-272-3900) and the Eldercare Locator (800-677-1116) can help you find local resources and community services for having prescription medicines, groceries, or meals delivered to the home.

Bringing up the topic of turning over the car keys is a process. Over time, caregivers and doctors will need to begin the discussion and may need to return to it several times. Just as critical is knowing whether state laws require doctors to report any medical conditions that may affect their patients’ ability to drive safely. It’s never too soon to start planning a strategy to ease a loved one’s transition to becoming a non-driver.

New Rate Structure for ADS Program

Important news about the Rate Structure of the Adult Day Services (ADS) program. Helping Hands Respite Care’s (HHRC) fiscal year runs from October 1 through September 30. About two months ago HHRC’s board requested an examination of the viability of raising our rates at the Adult Day Services (ADS) program.

It has been three years since the last time we examined our rates. It was discovered that for the level of care and the services we provide to our members and their families, the program was a “little” underpriced. However, an across the board price increase seemed unfair. Instead, a new rate program based upon the level of care each member needs while in attendance was proposed.

The Board agreed on this pricing strategy, and we have been working towards creating an assessment form that helps us determine the different levels of care to put in place. By the time you read this the final touches will be made on this assessment tool, and will be put it into practice as of October 1st of this year.

This assessment tool will be sent home with each participant over the next week or so, and we can share with you that the new rates will be as follows: Level one care (which is MOST of our participants) will remain at $13 dollars an hour. Level two will be at $15, level three $17, and level four will be $20 per hour.

The good news is that for anyone who is already in our system your rate will not go up more than one level as of October 1st. We realize money is tight for almost everyone, so even if we assess your loved one as a level four, because they have been a member in good standing at our Adult Day Services program, their cost will only go to $15 dollars an hour. We hope you appreciate our desire to keep our services affordable. Your trust in allowing us to care for your loved one is deeply appreciated. Thank you for your understanding and patience as we implement this new rate process.

Volunteer Opportunities at Adult Day Services

Two ladies exploring volunteer opportunities

If your interest is helping older adults, we have some wonderful volunteer opportunities in our Adult Day Services (ADS) program. We are proud to have a program which is a well-planned schedule of individual and group activities which meet the varied needs of our member participants.

We would like to suggest a volunteer opportunity where you and a friend commit to coming on the same day (or days) for at least 3 hour shifts. In this way you will get to know our members better and faster. By committing to a regular schedule you will become a reliable partner in care.

Go to our website www.helpinghandsrespite.care navigate to the Get Involved Tab and go to the Volunteer section in the drop down menu to download the Volunteer Application packet.  Or, email ADS supervisor Alison Sarkozy to request a packet. alison@helpinghandsrespite.care

Meet Leah Gavin – MSW Intern

Leah Gavin shown with ADS member Lucille during end of the day sing-along.

My name is Leah Gavin and I am a native of Detroit, Michigan. I attended Adrian College where I received my Bachelor’s in Social Work in 2015. During my time at Adrian, I realized that I would love to work with older adults. I was able to have my internship at the Lenawee County Department on Aging where I gained experienced in working at adult day services and conducting needs assessments for older adults. After graduation, I moved on to attending Michigan State University’s Advance Standing Masters of Social Work Program. My concentration is in Organization and Community Leadership with a focus in gerontology.

I have always felt interest towards working with older adults. I see that there is great need within the elderly population and I wish to make an impact on helping older adults and families receive the resources and services they need to cope with the many changes in life. I am very passionate about elder abuse prevention, Alzheimer’s disease, and providing programs and services for older adults. I would like to one day start up my own adult day service program and also oversee a non-for-profit agency for older adults in the community.

 

Leah will be an intern at Helping Hands Respite Care adult day services (ADS) for the 2016-2017 school year. In addition she will gain experience in learning the administrative and leadership aspects of working in an organization.

Benefits of Social Wellness to Seniors

Social Wellness demonstrated with senior interacting with grand children

July is Social Wellness Awareness Month. Social wellness is defined as nurturing yourself by building healthy, supportive relationships with others. Making genuine connections with those around you is critical to physical and psychological health.

Research shows that the physical risks of being socially isolated are comparable to the risks associated with heart disease, cigarette smoking, high blood pressure, and obesity. However, for people with healthy relationships, their heart and blood pressure respond better to stress. Having a healthy social network can also enhance the immune system’s ability to fight off infectious diseases and speed healing. Maintaining relationships—giving and receiving emotional support—ensures that you have a network of friends, family, and others to turn to in times of need. Why is social wellness important for those with dementia-related diseases and their caregivers?

Benefits of Social Wellness for Memory Care

Perhaps a friend or loved one has displayed intermittent symptoms of mild cognitive decline such as forgetfulness, difficulty driving, word searching, or trouble concentrating and problem solving. Having a group of close friends or family members may help them maintain their independence and adjust to their changing needs. If you’re a caregiver, being able to discuss your concerns with others can provide you with a broader perspective and, perhaps, helpful resources.

In early-stage dementia or Alzheimer’s disease, signs of mental impairment become more visible. It’s not unusual for the person affected by the disease to become moody, to express negative emotions (e.g., anger, frustration, anxiety, depression), or to withdraw socially. A study published in the American Journal of Geriatric Psychiatry found that seniors who were housebound or socially isolated were not only more likely to develop Alzheimer’s disease but experienced more rapid cognitive decline than seniors who got out and interacted more with others.

According to lead author Bryan D. James, “People who don’t leave their home as much aren’t engaging with their environment and meeting new people. They may not be using their minds as much.” The study does not conclude that social isolation causes Alzheimer’s or dementia; however, it does indicate a potential connection between social isolation and the development of cognitive decline and Alzheimer’s. Social wellness involves being present as the friend, colleague, or loved one learns to navigate the impact of the physical, emotional, and cognitive changes as they occur. It also involves encouraging a loved one’s continued interaction with others.

Written by: Ava Stinnett

Photo Courtesy of FreeDigitalPhotos.net

Dementia and Using Clocks

Photo of a memory clock - Dementia and using clocks.

Losing Track of Time:The Benefits of Using Clocks for Dementia
An article for the Alzheimer’s Association by Ava M. Stinnett

How did it get so late so soon? It’s night before it’s afternoon. December is here before it’s June. My goodness how the time has flewn. How did it get so late so soon? (Dr. Seuss)

What can we learn about dementia and using clocks? We know that aging and dementia-related disorders such as Alzheimer’s disease can cause confusion, memory loss, and difficulty performing everyday activities. Another symptom of Alzheimer’s disease involves losing track of time, dates, and seasons of the year. As the disease progresses, it may also be more difficult to differentiate between night and day.

Although calendars may help those affected, it’s important to keep in mind that a person with Alzheimer’s not only forgets to look at the calendar but they often forget how to read a calendar. For example, the person with Alzheimer’s might suppose that the sixth day of the month on the calendar refers to the sixth month of the year. When it comes to keeping track of time, a large easy-to-read clock may seem like a good idea. But your loved one may not know how to interpret what the hands on the face of a clock mean. They may ask you repeatedly what day or what time it is, perhaps because they forgot that they’d just asked you.

If a loved one can’t determine what day it is, what year it is, or even what time of day it is, how can they be expected to remember whether they’ve taken the day’s medication or if they have a medical appointment or plans for a visitor to stop by? As caregivers, we may not realize that it’s common for those with Alzheimer’s to feel confused or too embarrassed to admit that they can no longer read or make sense of a calendar, a clock, or a watch.

Fortunately, there are a variety of clocks on the market that are designed specifically to help people with dementia and using clocks. Sometimes referred to as “Alzheimer’s clocks” or “dementia user-friendly clocks,” they help those affected by the disease keep track of dates and times in a way that helps them maintain the routine, structure, and focus they need to ease confusion and anxiety.

When shopping for a clock, look for the following features:
• Clear and simple display of time, day of the week, month, and year
• Images to indicate whether it is morning, afternoon, evening, or night
• Clearly visible at night without being too bright
• Easy to set up
• Tamper-proof buttons to avoid accidental interference

There is an increasing amount of evidence about the benefits of using clocks for dementia. An understanding of the correct time, day, and date can reduce stress and help those with dementia feel less alone or lost in the past. When they are able to stay anchored in the present, independence is improved and, perhaps, they will feel as if they are functioning the same way as everyone else.

Extraordinary Program ADS Value

Participants in Adult Day Services , program ads value to life

Did you know that among the Adult Day Services programs in the State of Michigan there are just a handful that have an on-site nurse? Helping Hands Respite Care is one of those programs. Did you know that because Helping Hands Respite Care Adult Day Services (ADS) has an on-site nurse which means we are capable of offering care to individuals who might not qualify in another program because of complex medical conditions? This means that the Helping Hands Adult Day Program has an average age of participant of 82 years – the oldest in the state.

When you are thinking about an Adult Day Services Program do you ask for the care ratio of caregivers to clients? You may have found care ratios of 5, 6, 7, or even 8 clients to 1 caregiver. At Helping Hands our average caregiver ratio is 3 to 1, and when you factor in volunteers or student interns the ratio is as low as 2 to 1.

Have you been concerned about the cost of transporting your loved one to an Adult Day program? No worries, here at Helping Hands Respite Care we have transportation services available from across Ingham, Eaton and Clinton Counties to our Adult Day Services program. The cost of transportation is included in our fee structure and represents no additional cost to families.

Oh, by the way, were you concerned about the cost of food? Did we mention that Helping Hands is an authorized meal site for the Meals on Wheels program of the Tri-County Office on Aging and the cost of daily meal is baked into our hourly rate?

How this Program ADS Value

So let’s recap the value proposition of Helping Hands Respite Care ADS program:
– On – Site Nurse overseeing and monitoring health of all participants
– More clients with complex health issues may attend
– Average age of participants at Helping Hands ADS is 82, a very young 82.
– Client to Caregiver Ratios at 3 to 1 and often 2 to 1.
– Transportation to ADS program across three counties Ingham, Eaton and Client
No additional cost.
– Nutritious meals daily from the Tri-County Office on Aging Meals on Wheels program
– The hourly rate at Helping Hands ADS program is just $13 per hour, average daily visit is 3 to 5 hours.

Last, but certainly not least, if you have a loved one over the age of 60 , the Helping Hands Respite Care ADS program currently has grant funds available to provide either FREE or reduced cost to participate in the program.

For more on this extraordinary value contact: ADS Supervisor Alison Sarkozy at 372-6671, ext 107 or Alison @helpinghandsrespite.care

New Schedule More Access for Families

new schedule for supervisors, image of clock on red background

New schedule designed to provide more access for families.

Frustrated because you can’t reach a supervisor in one of our in-home programs or the ADS program? In an effort to provide more consistent coverage and access to our supervisors who are reached at our administrative offices Monday through Friday we are experimenting with a flex schedule which will guarantee a supervisor will be present every day of the week from 8am to 5pm. In the past, there were too many hours at the end of the day with no supervisor present. Supervisors Alison Sarkozy, Jeff Nunham and Tarra Boris will be working four day weeks with longer daily schedules in order to provide full day coverage throughout the week.

To reach our Respite House Supervisor Dawn Todd, plan on calling our administrative office on Monday or Friday, and Breaking Barriers Today Supervisor Kathryn Green is available daily at 372-6671 extension 106, leave a message and she will get back to you as soon as possible.

Please let us know if we are on the right track.

Hearing Aids Not Working?

hearing aid not working, close up of ear without hearing aid

If you have hearing aids which are not working and you are hesitating because of the high cost of replacement, we are pleased to let you know that there are hearing aid repair options. Soma Hearing Aid Repair has an alternative solution to the costly practice of replacing broken hearing aids. Prices for repair may range from $199 to $299 and can be a reasonable alternative to the thousands of dollars for replacement.

In a recent report in the AARP magazine there is a story about hearing loss being linked to memory loss and dementia. Don’t resist repairing your hearing aid because you may be at risk of losing cognitive ability without the aids.

This article is not an endorsement but an alternative worth pursuing. For Hearing Aid Repair contact Jeremy Nordquist at 248-719-3241 or email Jeremynordquist@yahoo.com