ProAging Information Network

Dear Friends of Baltimore County,

In Baltimore County, we understand how important it is to ensure that our senior citizens continue to be active and vital parts of our communities. However, memory disorders can make it very difficult for older adults to continue to live in their own homes and maintain their independence. That is why I am pleased to inform you about an important study aimed at improving the lives of seniors who experience memory problems.

Maximizing Independence at Home (MIND at Home) is an 18 month intervention study being conducted by the Johns Hopkins University School of Medicine, in collaboration with THE ASSOCIATED and the Baltimore County Department of Aging. The purpose of this study is to determine the extent to which a program that assists in finding appropriate care can support older adults with memory problems so that they can continue to live in their own homes with safety and dignity.

The study has recently expanded its enrollment to include seniors with memory disorders who reside in their own homes in the following North/Northwest Baltimore area zip codes: 21022, 21030, 21031, 21065, 21093, 21094, 21117, 21133, 21136, 21139, 21153, 21204, 21207, 21208, 21209, 21210, 21211, 21212, 21215, 21234, 21235, 21239, 21241, 21244, 21252, 21284, 21285, 21286.  Approximately 300 seniors will be enrolled. In order to study the effectiveness of the interventions, some participants will be randomly selected to receive assistance in obtaining care and services that may benefit them. All participants will be compensated for their time and will receive the results of the evaluation, as well as any recommendations for needed care.

I am asking for your help in making this important study a success. If you or someone you know is interested in participating in or learning more about the project, please contact Chris Lyman, Study Coordinator, at 410-502-0773 or clyman3@jhmi.edu.

It is our sincere hope that the knowledge gained from this study will significantly improve the care and support for all of our seniors affected by memory disorders.

Yours Sincerely,

Jim Smith

Baltimore County Executive

 

First-hand social work experience informs Senator’s social work legislation

WASHINGTON, D.C. – U.S. Senator Barbara A. Mikulski (D-Md.), a trained social worker, last night introduced two social work bills, the Dorothy I. Height and Whitney M. Young Jr. Social Work Reinvestment Act (S. 686), and the Clinical Social Work Medicare Equity Act of 2009 (S. 687). These bills address the nationwide shortage of social workers and ensure clinical social workers are properly reimbursed under Medicare for the mental health services they provide.

The nation is facing unprecedented levels of social service and health care needs, while at the same time facing a shortage of social workers to address them.  Approximately 30,000 licensed social workers specialize in gerontology today but it is estimated that 60,000 to 70,000 who specialize in gerontology will be needed by 2010. The Dorothy I. Height and Whitney M. Young Jr. Social Work Reinvestment Act will review current social workforce shortage challenges and determine how it will affect the communities served by social workers.

Social workers support physical, psychological and social needs. They provide mental health therapy, caregiver and family counseling, health education, program coordination, and case management. 

“We must have the workforce in place to make sure that our returning soldiers have access to mental health services, our elderly maintain their independence in the communities they live in, and abused children are placed in safe homes.  In these tough economic times social workers can play a critical role in keeping communities together and helping individuals and families cope with the new stresses they are facing,” Senator Mikulski said.  

The Social Work Reinvestment Act makes investments in the social work profession by:

•           Establishing grant programs to address workplace improvements, research, education and training, and community-based programs of excellence.

•           Creating a commission to study services provided by social workers, recruitment, retention and compensation, safety, and state-level licensing reciprocity.

•           Opening a National Coordination Center to work with education, advocacy and research institutions, as well as gather and distribute information on social work research.

•           Urging the Senate to recognize March as Social Work Awareness Month.

•           Creating a media campaign promoting social work.

The Clinical Social Work Medicare Equity Act of 2009, also introduced by Senator Mikulski, and  cosponsored by Senators Debbie Stabenow (D-Mich.) and Patty Murray (D-Wash.), will ensure clinical social workers receive Medicare reimbursements for the mental health services they provide in skilled nursing facilities. The legislation will allow clinical social workers to bill Medicare directly for the mental health services they provide to nursing home residents. Under the current system, psychologists and psychiatrists, who provide similar counseling, are able to separately bill Medicare for their services, but social workers cannot.

“Clinical social workers are the primary providers of mental health care to the residents of nursing facilities,” Senator Mikulski said. “Health care is not just about pills and paperwork, it is about the people who make a difference in the everyday lives of their patients. This bill is about equal access to Medicare payments for the equal and important work done by clinical social workers. It is about providing our seniors with high quality, affordable mental health care.”

“We need to prevent inequities in our health care system, especially those that reduce the quality of care. Without skilled clinical social workers, many nursing home residents may never get the counseling they need when faced with a life threatening illness or the loss of a loved one. This legislation will make sure that does not happen,” Senator Mikulski added.

Approximately 20 percent of the elderly suffer from mental disorders. Among nursing home residents, the prevalence of mental disorders is as high as 80 percent. These mental disorders, which include severe depression and debilitating anxiety, interfere with the person’s ability to carry out activities of daily living and adversely affect their quality of life. Social workers are trained and licensed to provide mental health diagnostic and treatment services. They are often the only providers of mental health care for seniors that live in rural and underserved areas.

“As a social worker, I have been on the frontlines of helping people cope with issues in their everyday lives.  I started off fighting for abused children, making sure they were placed in safe homes.  Today I am a social worker with power.  I am proud to continue to fight every day for the long range needs of the nation on the floor of the United States Senate and as Chairwoman of the Aging Subcommittee of the Health, Education, Labor and Pensions Committee,” concluded Senator Mikulski, who earned her master’s degree in social work from the University of Maryland School of Social Work. 

 

ProAging Members:

I’m helping a senior client sell this vehicle, and I am hoping you can help. He had a stroke 10 years ago and she has dementia and they are preparing to move to St. Louis to be nearer to their family.  He really wants it to go to a senior in need!

It is a 2003 Town & Country with less than 20k miles. In excellent condition. Leather interior. The lift puts the scooter inside the van, and the scooter can be included for free, if the interested party wants it. He is asking $8500 for the whole package.  The van is located in Leesburg, but I can take it anywhere locally!



Thanks! I hope you can help us! Email me for more information linda@movingforseniors.com



Linda Edwards



 

   CarFit, a free, nationwide program that helps older adults adjust their car for safer driving, is coming to Fairfax County on Tuesday, April 21, 1-4 p.m. at the Fairfax Corner satellite parking lot (corner of  Monument Drive and Government Center Parkway), Fairfax.

      CarFit helps older adults determine how the “fit” of a car affects their driving and how to adapt the car to their changing needs. CarFit staff members conduct 20-minute individual assessments. Proper fit includes:

• ·        proper mirror adjustment to minimize blind spots,


• ·        correct foot positioning on the gas and brake pedals to decrease fatigue,


• ·        seat belt and headrest adjustments, and


• ·        seat adjustment allowing for at least 10 inches between the driver and steering wheel.

      Appointments are necessary. For more information, to set up an appointment, or to request ADA reasonable accommodations call Sharon Lynn at 703-324-5425, TTY 703-449-1186. 

      Fairfax Area Agency on Aging Director Grace Starbird encourages older drivers to sign up for an appointment. “All of us want to continue driving as we get older,” she said. “This is an opportunity to ensure your car is adjusted for comfort and safety.” 

      The event is sponsored by the Department of Family Services’ Fairfax Area Agency on Aging, the Fairfax County Police Department, and the American Automobile Association Mid-Atlantic Region. CarFit was created by the American Society on Aging in collaboration with the American Automobile Association, AARP, and the American Occupational Therapy Association. The Virginia Department for the Aging GrandDriver program also supports the event 

      The event implements the Fairfax 50 Plus Action Plan’s imperative to provide transportation options that “ensure independence” of older adults.” The Fairfax County Board of Supervisors adopted the plan in October 2007.

      Fairfax County is committed to nondiscrimination on the basis of disability in all county programs, services and activities. To request this information in an alternate format, call 703-324-5411, TTY 703-449-1186.

(Veteran’s Directed Home and Community Based Care Program)

On February 17, 2009, Western Michigan Area Agency on Aging entered into a relationship with Bottle Creek Veterans Administration to offer Nursing Home Diversion services for their County based on a new Veteran benefit (Veteran’s Directed Home and Community Based Care Program).  As each of us know, Nursing Home Diversion grants have been awarded across the U.S. to 20 states.  Second year funding has also been awarded to the following 10 states:

 

 

• Arkansas 

• Connecticut

• Florida

• Massachusetts

• Michigan

• New Jersey     

• New York

• Texas

• Virginia

• Washington

 

These states are currently working with the Veterans Administration (VA) on this new initiative entitled, “Veteran’s Directed Home and Community Based Care Program.”  This program has been added as another option to traditional Veteran Affairs Medical Centers extended care provider arrangements and homemaker/home health services.

The VA and our Administration on Aging (AoA) have coordinated an outreach to Area Agencies on Aging (AAA) and/or Adult Disability Resource Center (ADRC) throughout the U.S. to begin exploring and establishing a partnership of care.  This unique opportunity will be provided locally utilizing VA and AAA negotiated provider agreements to purchase a product of services.  The Lewin Group, hired by AoA, is helping to facilitate these agreements nationwide. The agreement will utilize a VA form 10-1170 as the application starting point for AAA’s to engage in service.

The VA is working toward a goal of 109,362 veterans to be enrolled in the Veteran’s Directed Home and Community Based Care Program by 2011-2013.  The VA is looking to increase the current number of slots from its home maker/home care program from the current level of 50,000.

The VA has projected that by 2050 nursing home placement among veterans could triple. However, no additional beds will be approved by the VA.

As this project roles out nationally, it is anticipated that ten additional states will be asked to work with the VA in the near future:

 

• Georgia

• Illinois

• Kentucky

• Louisiana

• Maryland

• Minnesota

• New Hampshire

• Ohio

• Vermont

• West Virginia

 

In Maryland, there are five counties enrolled in the Nursing Home Diversion program:

• Baltimore City

• Baltimore County

• MAC, Inc. (Dorchester, Somerset, Wicomico, & Worcester Counties)

• Prince Georges County

• Washington County

The VA is coordinating agreements with AAA’s. The list of services that may be provided under the purchase of product agreement is as follows:

• Personal Care (physical or verbal assistance with eating, bathing, dressing, grooming, transferring)

• Home Maker (cleaning, laundry, meal planning and preparation, shopping)

• Adult Day Care

• Assistive Technology (emergency response, pill dispensers)

• Home Delivered Meals

• Caregiver Support (counseling, training)

• Respite Care

• Environmental (yard care, snow removal, cleaning)

• Other (grab bars, lift chairs, ramps, small appliances)

• Assessment

• Options (counseling including care management)

• Fiscal Management Services

The VA is proposing to coordinate and conduct the veteran health status assessment process.  The following personnel will determine the needs and the services from the above list.

• Physicians (medical orders)

• Nurses, (ADL’s)

• Social worker (IADL’s)

(Please note the AAA’s will also be able to be involved in the assessment process and negotiate the needs of the clients/veterans)

The package of services will then be bid by the AAA’s based on monthly service fees, and/or basic subsets or categories for basic and intermediate care.  These will be classified in 3 ways:

• Basic

• Intermediate

• Extensive (Individually Priced Out)

Currently, the AAA’s listed below have submitted the following product agreement rates:

   * Michigan has proposed the following rates to the VA:

• Basic - $3500 per month

• Intermediate - $4500 per month

   * New Jersey has proposed the following rates to the VA:

• Basic - $2200 - $3200 per month (Low and High)

• Intermediate - $3200 - $6800 per month (Low and High)

* These bids from Michigan and New Jersey have not yet been accepted by the VA, but   

   negotiations are in process. Variances of the fee structure by localities can be very    

   different based on geography, regional cost of living, access to providers, etc.

AAA’s will be responsible for the following:

• Develop Support Mechanism

• Arrange Fiscal Management

• Structured Case Management

• Assess Service Needs

• Develop Budgets

• Develop Non-Traditional Services

Support mechanism and services may be rendered for the veteran by family members, friends, neighbors, etc.  The decision of the veteran or their surrogate decision maker will include who renders the service, where, when, how and at what rate.  An integral part of this program will require a fiscal agent to work on issues concerning tax withholdings, check issuance, budget and accountability reports.

The Cash and Counseling model (www.cashandcounseling.org) can be a useful tool/model in helping to create Fiscal Employer Agents (Fiscal Intermediaries). Currently, only 2 national organizations (located in Massachusetts and Utah) offer fiscal intermediary services and one region in Connecticut has a relationship.  Fifteen states utilize cash and counseling. New Jersey, Arkansas and Florida were the first with replication in the other twelve states.  The cash and counseling model will be needed to allow flexibility in hiring staff by veterans including family members, neighbors and friends in order to stretch the service budget dollars.  This creates flexibility for a veteran center hiring approach. Management by the veteran or their designee becomes the corner stone of service delivery.  I have provided a pamphlet and a CD concerning cash and counseling to the five Maryland counties participating in the Nursing Home Diversion.

A flow chart is attached displaying the flow of decision-making regarding this program as part of this report.

Financial management tools that may be used, other than cash and counseling, include Government F/EA, Vendor F/EA, Agency with Choice (AwC) and Fiscal Conduit. 

(see other attachment for additional details)

Please note, it is important to understand that some of these other options consider the agency as the primary employer and some consider the participant or veteran as the managing employer.  Inconsistencies, training, remittance of W2’s or tax liability consequences, can create problems for case managers, participants or your organization. For example, spouse, children and parents are exempt from FICA withholdings (social security) and Federal Unemployment Tax Act (FUTA) and in some states, State Unemployment Tax Act (SUTA).

Non-payment issues of taxes by the agents can cause liability concerns.  It is suggested that Cash and Counseling, a model that has worked, be the choice for handling this issue.

Sincerely,

Arnold J. Eppel

Director

Baltimore County Department of Aging

 

Gain Expert Knowledge about Montgomery General Hospital

• April 22nd 2009


• 11:30 a.m. to 1 p.m.


• 18101 Prince Philip Drive    


• Olney, MD   20832 

2nd floor Community Learning Center A&B

Box Lunch Sponsored By Kensington Nursing and Rehabilitation, Deidra Robinson (301) 933-0060

Speakers

Ed Silverman PhD.

Director of Resource Management and Medical Staff Services

Patient-flow and Discharge Issues.

Moderated by Steve Gurney, Publisher of Guide to Retirement Living

________________________________________________________________

Agenda:

• 11:30 am – 12:00 pm Networking


• 12:00 pm -1:00 pm Program and Lunch

Seating is limited

_______________________________________________________________

This professional education forum is brought to you by Right at Home  with support from the Guide to Retirement Living.

Introduce someone you care about to someone you trust…Right at Home

Registration required.  Please register by going to  www.rightathomemd.net/events

Care for You, Inc. is moving to new offices. As of March 30, the new address is:

817 Silver Spring Avenue, Suite 400

Silver Spring, MD 20910

Care for You, Inc. provides an integrated spectrum of services dedicated to keeping the elderly and disabled in their homes. As 90 percent of the needs of people are non-medical, Care for You’s Companion and CompanionPlus Programs are designed to provide physical safety and security, stimulate the intellect, and help prevent loneliness, anxiety and depression, thereby increasing resistance to common ailments, preventing medical incidents and prolonging health and well-being.

Care for You, created in 1996, is bonded and insured and provides services in the greater Washington area. Support is available 24/7/365, from hourly to live-in. All Companions are W-2 employees, with tax, social security and Medicare withholding; criminal background, driving record and reference checks; T.B. tests; regular training and on-going supervision in the field.

For further information, go to the web site www.careforyou.us, email at info@careforyou.us, or call 301-650-4169 or 703-839-2545.

NEW YORK, March 23 /PRNewswire-USNewswire/ – Imagine not being able to read the small print on a W-2 or 1040. That is the reality for the millions of Americans experiencing age-related vision loss. To make tax season easier for people with vision problems due to conditions such as macular degeneration, glaucoma, or cataracts, the American Foundation for the Blind (AFB) has released a Tax Guide filled with helpful tax filing tips and resources. You can read the full Guide at www.afb.org/seniorsite/taxguide.

"Tax season is stressful for everyone, but there’s added anxiety when you can’t read the tiny print on receipts, tax forms, or other financial documents – especially when you’re dealing with private financial information," said Judy Scott, Director of the AFB Center on Vision Loss. "The good news is that with the right magnification devices and resources, it is possible to independently manage your finances and complete your tax return."

The Tax Guide covers everything from how to prepare for tax time, to filing and checking on the status of a return. Some of the tips found in the Tax Guide include:

  –  Invest in a magnification device.  Handheld lighted magnifiers,

      available from a doctor specializing in low vision rehabilitation, or

      electronic magnification devices called video magnifiers, can help you

      read small print that is typically found on receipts and IRS forms.

  –  Visit the IRS web site to download tax forms and instructions in the

      format that’s easiest for you to read, whether that’s large print,

      braille, or text.

  –  If you are legally blind, indicate that on your tax form since you may

      qualify for a higher deduction.

  –  If you are working with an accountant, ask him or her to prepare your

      taxes using large print forms, or another accessible format, so that

      you can review your return before you sign it.

  –  If you owe money in taxes, and need to write a check, ask your bank if

      they carry raised-line or large-print checks. If the bank does not

      have them, they can be ordered.

In addition to the Tax Guide, AFB Senior Site(R) offers a number of tips and tools to help people with vision loss independently manage their finances – from paying bills, to creating a home office, to banking. You can find the complete set of resources at www.afb.org/seniorsite/finances.

The American Foundation for the Blind (AFB) is a national nonprofit that expands possibilities for people with vision loss. AFB’s priorities include broadening access to technology; elevating the quality of information and tools for the professionals who serve people with vision loss; and promoting independent and healthy living for people with vision loss by providing them and their families with relevant and timely resources. AFB is also proud to house the Helen Keller Archives and honor the more than forty years that Helen Keller worked tirelessly with AFB. For more information visit us online at www.afb.org.

 

Source: http://www.foxbusiness.com/story/markets/industries/media/new-survey-reveals-seniors-avoiding-assistive-devices-risk-injury/

 

  VANCOUVER, Mar 23, 2009 (Canada NewsWire via COMTEX) —-National PSA featuring "Charlie Farquharson" uses humour to tackle issue

A recent IPSOS-Reid survey commissioned by the BC Institute of Technology’s Living Laboratory, found that seven-in-ten Canadian seniors report having a mobility or health issue that reduces their quality of life due to a physical limitation and that in many cases increases their risk of falling. However, 46 per cent of them do not use an assistive device (cane, walker, scooter, etc).

Most notably, while 96 per cent of all seniors surveyed felt that assistive devices (ADs) are a good way to prevent falls, the majority (63%) of those who reported having a fall in the past year (20%) do not use an AD. Falls are known to reduce life expectancy for seniors by 25 per cent and cost the Canadian health care system an estimated $1 billion annually (Public Health Agency of Canada).

The results reveal there is a significant discrepancy between seniors’ need to adopt ADs when early warning signs appear and their willingness to do so.

"In our work with seniors, we’ve observed that they often delay using assistive devices too long even when it is clear that they need them because they fear the device will stigmatize them as being old and vulnerable," affirms Christine Flegal, Research Head, BCIT Living Laboratory.

The survey indicated that two-thirds of seniors believe AD usage is a threat to their security. However, according to Statistics Canada, seniors are in fact, the least likely to be targeted for crime. In 2004, 9.5 per cent in the 65-plus population as opposed to 28 per cent in the 15 to 24 years of age population were victims of at least one reported crime.

A third of seniors also believe that using ADs makes them appear "old and frail", and indicates that they are "losing their independence". Even among those seniors who have a medical condition that could affect their mobility, only 25 per cent currently use an AD (20% of the overall Canadian senior population).

To combat the stigma seniors feel about AD usage, BCIT’s Living Lab is launching this month a new 30-second Public Service Announcement featuring one of Canada’s most recognized and beloved seniors, Don Harron in character as his alter-ego "Charlie Farquharson". Made famous on the long-running US Television show "Hee Haw", Charlie’s appeal is strong with this audience and he delivers to fellow seniors a ‘tough love’ message with humour intended to help keep them mobile, independent and safe. The PSA also offers a free phone number (1-888-441-0771) and a web site where seniors and their families can access more information. It is www.bcit.ca/mobility.

"We wanted to tackle this problem head-on by enlisting the help of a well-known senior who can bring the topic of stigma out into the open," said Flegal. "Using Charlie’s ‘tough love’ message delivered with humour, the goal of this campaign is to help seniors access the right information and most importantly to help them embrace their age and take the necessary steps to maintain their independence, safety and quality of life for as long as possible."

Flegal, a gerontologist is visiting the following cities to talk about the Mobility: Now you’re going places program and the PSA:

MCLEAN, Va., March 23 /PRNewswire/ – Sunrise Senior Living, Inc. (NYSE: SRZ) today announced it has agreed with its lenders to an eleventh amendment to its Bank Credit Facility, further waiving compliance with certain financial covenants until April 30, 2009. The purpose of this eleventh amendment is, among other things, to provide the Company and its lenders with an additional period of time to negotiate the terms of a twelfth amendment to the Company’s Bank Credit Facility that would comprehensively address any remaining issues between the parties with respect to the Bank Credit Facility through the current stated maturity date of December 2, 2009. The common desired objective is to execute such twelfth amendment prior to the close of business on April 30, 2009.

"We are pleased that our bank line group has extended us this additional time. We have announced previously that we are working to reach negotiated settlements with our lenders to preserve our liquidity," said Mark Ordan, Sunrise’s chief executive officer. "While the outcome of our efforts remains uncertain, we believe this extension is very beneficial to this process."

The Company’s Bank Credit Facility contains various financial covenants and restrictions, including provisions that require the Company to meet certain financial tests. The eleventh amendment to the Bank Credit Facility suspends the applicability of such covenants through April 29, 2009. Based on revised cash flow forecasts as well as a result of the cash proceeds from the March 18, 2009 sale of the Company’s Greystone subsidiary described below, Sunrise currently expects that its cash balances and expected cash flow will be sufficient to operate the Company and meet its obligations through April 30, 2009. However, Sunrise does not expect to be in compliance with the financial covenants in the Credit Agreement on April 30, 2009, which is the day following the date on which the waiver of certain financial covenants set forth in the Credit Agreement expires.

As previously disclosed, the Company is seeking to restructure its Bank Credit Facility and is exploring other potential sources of capital with other third parties. Additional financing resources will be required to refinance existing indebtedness that comes due within the next 12 months. Also as previously disclosed, the Company is in the process of seeking waivers and discussing a comprehensive restructuring plan with the lenders to its German communities, the lender to the Fountains portfolio, the Company’s venture partner in the Fountains portfolio and certain other lenders. The Company believes it is in the best interests of all of its creditors to grant such waivers or reach negotiated settlements with Sunrise to enable the Company to continue operating. However, there can be no assurance that such waivers will be received or such settlements will be reached.

Today, the Company also announced that, on Wednesday, March 18, 2009, it completed the sale of its Greystone subsidiaries and related seed money investments in five CCRC developments to two senior Greystone executives and other investors. Sunrise had previously announced it was exploring strategic options for Greystone and would no longer provide seed capital due to poor bond financing markets. For further details on this transaction, see the Company’s Current Report on Form 8-K filed with the U.S. Securities and Exchange Commission on March 11, 2009.