Choices for Mobility Independence

Independent – Active – Connected – Confident – In Control

Have you ever thought about what would happen if the transportation you use is no longer an option? How would you continue to maintain your independence so that you could continue with your daily routines? Who would you turn to for assistance? People often look to friends or relatives to assist with transportation – this may be a good option for you, but it is not always the most convenient for you or for them.

Thinking ahead to alternative transportation options can give you peace of mind should your current means of getting around in your community change in the future. This brochure will assist you to learn about various alternative transportation options and some things to consider to help you make confident decisions about which option would be best for you.

Keep in mind that not all types of transportation are available in every community. Several aging organizations can assist you in learning about the options in your community, such as your local Area Agency on Aging (AAA), Aging and Disability Resource Center (ADRC), and Indian Tribal Organization. Contact the Eldercare Locator at 800.677.1116 or www.eldercare.gov to identify these resources in your area.

Transportation Options

Depending upon your destination and physical needs, transportation choices in your area might include buses, vans, taxis, or even volunteer drivers from human service organizations. Listed below are descriptions of transportation resources and services for you to think about and explore as you look ahead:

* Volunteer Driver Programs: Local faith-based and nonprofit organizations frequently have a network of volunteers who offer flexible transportation for shopping, doctors’ appointments, recreation, and other activities. One-way, round-trip, and multi-stop rides are usually available; reservations are needed. These programs are provided free, on a donation basis, through membership dues, or for a minimal cost.
* Paratransit Service: Public transit, aging organizations, and private agencies provide door-to-door or curb-to-curb transportation using mini-buses or small vans (vehicles for less than 25 passengers). Paratransit service often requires users to make advanced reservations but still offers a degree of flexibility and personalization in scheduling. Curb-to-curb service provides for passenger pick up and delivery at the curb or roadside; door-to-door service offers a higher level of assistance by picking up passengers at the door of their homes and delivering them to the doors of their destinations. Paratransit and van services offer reduced fares for older adults and persons with disabilities, and some providers may operate on a donation basis.
* Door-through-Door (Escort) Service: Private agencies provide drivers or escorts who offer personal, hands-on assistance by helping passengers through the doors of their residences and destinations, as needed. This type of service includes several levels of assistance from opening doors and providing verbal guidance, to physical support. Persons with severe physical or mental disabilities typically use this service. Contact your local aging organizations to find out if this service is available in your area.
* Public Transit/Fixed Route Service: Public transit agencies provide bus and rail services along established routes with set schedules on a non-reservation basis – also referred to as “public transportation” or “mass transit”. Reduced rate fares and additional transportation services are available for older adults and persons with disabilities. Information about routes, schedules, fares, and special services are available through your public transit agency.
* Travel Training: Pubic transit agencies and local aging organizations provide free, hands-on instruction to help older adults and persons with disabilities learn to travel safely and independently within public transit systems. Topics discussed include the best routes to take to reach various destinations, hours of service, the cost of the trip (including available discounts), and how to pay for services (such as fare cards or tokens). Demonstrations on how to ride public buses and trains also are provided.
* Taxi Service: Passengers activate this service by calling a dispatcher to request a ride between locations of their choice. Trips usually can be scheduled in advance or on the spot. Some taxis are wheelchair accessible and meet ADA standards; inquire with your local taxi providers. Fares are charged on a per-mile or per-minute basis on top of a base charge for each trip, and may be payable through a transportation voucher program.
* Transportation Vouchers Programs: Area Agencies on Aging, Aging and Disability Resource Centers, and other social service organizations often provide fare assistance programs that enable qualified persons (usually economically disadvantaged older adults or persons with disabilities) to purchase vouchers for transportation services at a reduced rate. The vouchers are then used to pay for services from a participating transportation provider that can include public transportation, volunteer programs, or taxis and other private companies. Applications for these programs are required. Participants are responsible for reserving and securing the services they need.

In addition to the services described above, some communities have mobility managers who can guide you through the transportation resources and services that are available. Mobility managers know the community-wide transportation service network and understand how it operates. Their main focus is to assist consumers in choosing the best options to meet their individual travel needs. Contact your local aging organization or public transit agency to determine if a mobility manger is available in your area.

Key Considerations

Depending upon your lifestyle, one or more transportation options can keep you connected to all of your activities. Evaluate what your transportation needs are now or might be in the future — including necessary as well as social activities. When investigating transportation options, there are a few things to consider in order to make a confident decision about which options are best for you. Consider the following questions based on type of transportation provider:

* Eligibility:

o What, if any, requirements are there to qualify for the service?

o Is any evaluation needed prior to using the service?

o Are rides provided for wheelchair users or other persons with disabilities?

o If needed, can a family member serve as an escort?

* Affordability:

o What is the cost of the service?

o Are discounts available?

o How are costs calculated?

o Is there a membership fee?

o Is my income a factor for using this service?

o Can an account be set up in advance with the service?

o Will my insurance pay for rides by this service provider?

* Accessibility:

o What is the service area?

o What times does the service operate?

o Are door-though-door, door-to-door, or curb-to-curb services provided?

o Is a reservation needed, and how far in advance?

o Are rides provided in the evenings, on weekends, or on holidays?

o Are rides provided to social as well as medical or shopping appointments?

o Will driver provide assistance with packages and other carry-ons?

o Are vehicles wheelchair accessible?

o If other passengers will be riding at the same time, what is the maximum length of
time of the ride while others are being picked up or dropped/off?

Resources

Transportation options vary from community to community. Your community might offer additional options that are not included in this brochure and, as the need for alternative transportation grows, new options continue to be developed. Find out about the transportation options in your own community by contacting the two key resources listed below. Don’t delay – call or visit a website today!

Eldercare Locator
800.677.1116
The first step to finding resources for older adults in any U.S. community and a free national service of the U.S. Administration on Aging that is administered by the National Association of Area Agencies on Aging (n4a).
www.eldercare.gov

National Center on Senior Transportation
866.582.NCST (6278)
The Nation’s go-to resource for senior transportation information, research, and development is administered by Easter Seals, Inc. in partnership with the National Association of Area Agencies on Aging (n4a), through a cooperative agreement with the U.S. Department of Transportation, Federal Transit Administration, and with guidance from the U.S. Administration on Aging.
www.seniortransportation.net

Source: National Center on Senior Transportation Downloadable Brochure, www.SeniorTransportion.net

Provided by: The Staff at www.RetirementConnection.com
For more information: www.Eldercare.gov, www.SeniorTransportation.net
Copyright © 2008 RetirementConnection.com. All rights reserved.

Considerations when Arranging Transportation

If you are a caregiver in search of transportation for an older family member or friend, you may want to consider the following questions before deciding on a transportation option. Use these questions to gather more detailed information from the transportation provider you are considering in order to choose the best option for your loved one.

1. What is the service area?
2. Is there a limitation on distance?
3. How much will the service cost?
4. Will insurance pay for rides provided by the service?
5. Are there requirements to qualify for the service? If so, what are they?
6. Is there an evaluation that must take place prior to the first ride?
7. Is there a membership fee that must be paid before scheduling rides with the service?
8. How far in advance must reservations be made?
9. Are rides provided in the evenings, on weekends or on holidays?
10. Are rides provided to social as well as medical or shopping appointments?
11. Are door-through-door, door-to-door or curb-to-curb services provided?
12. Are rides provided to people who use wheelchairs?
13. Do riders stay in their wheelchair, or are they transferred to a seat during the ride?
14. Is there an escort or attendant in the vehicle with the driver?
15. Does someone stay with my family member during appointments?
16. Can a family member serve as an escort? If so, is there an extra cost associated?
17. Will there be a wait when picked up from home? If so, how long?
18. Will there be a wait when picked up for the return trip? If so, how long?
19. Will the driver or attendant come into the office/building for the return trip?
20. Will other passengers be riding? If so, what is the maximum length of time of the ride while others are being picked-up/dropped-off?

Source: US Dept of Health and Human Services, Administration on Aging, www.AoA.gov

Provided by: The Staff at www.RetirementConnection.com
For more information: www.aoa.gov
Copyright © 2008 RetirementConnection.com. All rights reserved.

Change a Life, Become an OASIS Inter-generational Tutor

A six-year old first grader recently reported to his father with excitement: “Papa, I read the words in my head!”. That explosion of excitement when a child discovers the power of reading and comprehension is almost palpable. OASIS Education Center in downtown Portland administers a program that allows adult volunteers to observe such excitement on a regular basis.

Through the OASIS Inter-generational Tutoring program, volunteers, your neighborhood schools, and OASIS team up to help children in kindergarten through fourth grade develop reading and language skills that will last a lifetime. The national OASIS Institute developed and refined its program during two decades of successful application in hundreds of schools all over the country. Once you have made a commitment to become an OASIS tutor, we schedule your training. Once completed, we coordinate your placement in the school of your preference. More than seven communities in the Portland/SW Washington metropolitan area are registered with OASIS.

You work with the same child once each week throughout the school year, in cooperation with his/her teacher. The child you tutor will enjoy getting to get to know you, and you will see a direct impact on his/her reading development. OASIS tutors often share their belief that they gain as much as they give in this mutual experience.

You will attend regular meetings to continue training and to share your successes and challenges with other tutors. Most of all, you will realize you are part of a national program, engaging more than 5,000 volunteers nationwide. According to a recent OASIS Institute report, teachers reported that 94 percent of their students in the tutoring program gain in confidence and 90 percent show improvement in academic performance. In 2006, the National Association of Area Agencies on Aging recognized the program with one of its Ten Best Volunteer Programs award.

Participation in this rewarding inter-generational program is simple: just contact the OASIS Educational Center, @ Macy’s Attn.: Tutor Coordinator, 621 SW Fifth Avenue Portland, OR 97204, or call 503-833-3636.

OASIS in Portland is part of a national nonprofit education organization dedicated to enriching the lives of adults over 50. Local sponsors include Legacy Health System, Macy’s Foundation, and Regence BlueCross BlueShield of Oregon.

Provided by: OASIS Educational Center
For more information: www.oasisnet.org/portland

Copyright © 2008 RetirementConnection.com. All rights reserved.

Assisted Living, A Guide to State Regulations & Terminology

Assisted Living Communities offer housing alternatives for older adults who may need help with dressing, bathing, eating, and toileting, but do not require the intensive medical and nursing care provided in nursing homes.

Assisted living facilities may be part of a retirement community, nursing home, senior housing complex, or may stand-alone. Licensing requirements for assisted living facilities vary by state and can be known by as many as 26 different names including: residential care, board and care, congregate care, and personal care.

A complete list of each state’s terminology and state regulations can be found at: http://aspe.hhs.gov/daltcp/Reports/04alcom.htm

What services are provided?

Residents of assisted living facilities usually have their own units or apartment. In addition to having a support staff and providing meals, most assisted living facilities also offer at least some of the following services:

* Health care management and monitoring
* Help with activities of daily living such as bathing, dressing, and eating
* Housekeeping and laundry
* Medication reminders and/or help with medications
* Recreational activities
* Security
* Transportation

How to choose a facility?

A good match between a facility and a resident’s needs depends as much on the philosophy and services of the assisted living facility as it does on the quality of care.
The following suggestions can help you get started in your search for a safe, comfortable and appropriate assisted living facility:

* Think ahead. What will the resident’s future needs be and how will the facility meet those needs?
* Is the facility close to family and friends? Are there any shopping centers or other businesses nearby (within walking distance)?
* Do admission and retention policies exclude people with severe cognitive impairments or severe physical disabilities?
* Does the facility provide a written statement of the philosophy of care?
* Visit each facility more than once, sometimes unannounced.
* Visit at meal times, sample the food, and observe the quality of mealtime and the service.
* Observe interactions among residents and staff.
* Check to see if the facility offers social, recreational, and spiritual activities?
* Talk to residents.
* Learn what types of training staff receive and how frequently they receive training.
* Review state licensing reports.

The following steps should also be considered:

* Contact your state’s long-term care ombudsman to see if any complaints have recently been filed against the assisted living facility you are interested in. In many states, the ombudsman checks on conditions at assisted living units as well as nursing homes.
* Contact the local Better Business Bureau to see if that agency has received any complaints about the assisted living facility.
* If the assisted living facility is connected to a nursing home, ask for information about it, too. (Information on nursing homes can be found on the Medicare website at http://www.medicare.gov/nhcompare/home.asp).

What is the cost for assisted living?

Although assisted living costs less than nursing home care, it is still fairly expensive. Depending on the kind of assisted living facility and type of services an older person chooses, the price costs can range from less than $10,000 a year to more than $50,000 a year. Across the U.S., monthly rates average $1,800 per month.

Because there can be extra fees for additional services, it is very important for older persons to find out what is included in the basic rate and how much other services will cost.

Primarily, older persons or their families pay the cost of assisted living. Some health and long term care insurance policies may cover some of the costs associated with assisted living. In addition, some residences have their own financial assistance programs.

The federal Medicare program does not cover the costs of assisted living facilities or the care they provide. In some states, Medicaid may pay for the service component of assisted living. Medicaid is the joint federal and state program that helps older people and those with disabilities pay for health care when they are not able to afford the expenses themselves. Additional information on financing can be obtained from the resources listed below.

Where can I learn more about assisted living?

Older persons who want to find out more about the assisted living option can start by contacting their local area agency on aging (AAA). Contact the U.S. Administration on Aging’s Eldercare Locator at 1-800-677-1116 or visit www.eldercare.gov to find the AAA office closest to you.

Source: www.eldercare.gov

Provided by: The Staff at www.RetirementConnection.com
For more information: www.eldercare.gov

Copyright © 2008 RetirementConnection.com. All rights reserved.

Assisted Living – A Housing Alternative for Older Adults

Assisted living facilities offer a housing alternatives for older adults who may need help with dressing, bathing, eating, and toileting, but do not require the intensive medical and nursing care provided in nursing homes. Assisted living facilities may be part of a retirement community, nursing home, senior housing complex, or may standalone. Licensing requirements for assisted living facilities vary by state and can be known by as many as 26 different names including: residential care, board and care, congregate care, and personal care.

What services are provided with Assisted Living?

Residents of assisted living facilities usually have their own units or apartment. In addition to having a support staff and providing meals, most assisted living facilities also offer at least some of the following services:

• Health care management and monitoring

• Help with activities of daily living such as bathing, dressing, and eating

• Housekeeping and laundry Medication reminders and/or help with medications

• Recreational activities

• Security

• Transportation

How to Choose a Facility?

A good match between a facility and a resident’s needs depends as much on the philosophy and services of the assisted living facility as it does on the quality of care.

More About Assisted Living

The following suggestions can help you get started in your search for a safe, comfortable and appropriate assisted living facility:

* Think ahead. What will the resident’s future needs be and how will the facility meet those needs?
* Is the facility close to family and friends?
* Are there any shopping centers or other businesses nearby (within walking distance)?
* Do admission and retention policies exclude people with severe cognitive impairments or severe physical disabilities?
* Does the facility provide a written statement of the philosophy of care?
* Visit each facility more than once, sometimes unannounced.
* Visit at meal times, sample the food, and observe the quality of mealtime and the service.
* Observe interactions among residents and staff.
* Check to see if the facility offers social, recreational, and spiritual activities?
* Talk to residents.
* Learn what types of training staff receive and how frequently they receive training.
* Review state licensing reports.

The following steps should also be considered:

* Contact your state’s long-term care Ombudsman to see if any complaints have recently been filed against the assisted living facility you are interested in.
* Empowering adults as they age with reliable information and access to the care they need
* Enabling individuals who are at high risk of nursing home placement to remain at home
* Building disease prevention into community living through the use of low-cost, evidence based programs

For More Information

AoA recognizes the importance of making information readily available to consumers, professionals, researchers, and students. Our website provides information for and about older persons, their families, and professionals involved in aging programs and services. For more information about AoA, please contact: US Dept of Health and Human Services, Administration on Aging, Washington, DC 20201; phone (202) 619- 0724; fax (202) 357-3523; Email: aoainfo@aoa.gov or contact our website at www.aoa.gov

* In many states, the ombudsman checks on conditions at assisted living units as well as nursing homes.
* Contact the local Better Business Bureau to see if that agency has received any complaints about the assisted living facility.
* If the assisted living facility is connected to a nursing home, ask for information about it, too. (Information on nursing homes can be found on the Medicare website at http://www.medicare.gov/nhcompare/home.asp)

Check Lists

Individuals may want to use one of the following checklists to help them see if a facility meets their needs:

The National Center for Assisted Living’s Consumer Guide to Assisted Living and Residential Care Facilities.
http://www.longtermcareliving.com/assess/al/

The Assisted Living Federation of America’s Consumer
http://www.alfa.org/i4a/pages/index.cfm?pageid=4317

The Consumer Consortium on Assisted Living’s Steps for Choosing Assisted Living Facility.
http://www.ccal.org/choosing_a_facility.htm

What is the Cost for Assisted Living?

Although assisted living costs less than nursing home care, it is still fairly expensive. Depending on the kind of assisted living facility and type of services an older person chooses, the price costs can range from less than $10,000 a year to more than $50,000 a year. Across the U.S., monthly rates average $1,800 per month.

Because there can be extra fees for additional services, it is very important for older persons to find out what is included in the basic rate and how much other services will cost.

Primarily, older persons or their families pay the cost of assisted living. Some health and long-term care insurance policies may cover some of the costs associated with assisted living. In addition, some residences have their own financial assistance programs.

The federal Medicare program does not cover the costs of assisted living facilities or the care they provide. In some states, Medicaid may pay for the service component of assisted living. Medicaid is the joint federal and state program that helps older people and those with disabilities pay for health care when they are not able to afford the expenses themselves. Additional information on financing can be obtained from the resources listed below.

Where Can I Learn More About Assisted Living?

Older persons who want to find out more about the assisted living option can start by contacting their local area agency on aging (AAA). Contact the U.S. Administration on Aging’s Eldercare Locator at 1- 800-677-1116 or visit www.eldercare.gov to find the AAA office closest to you.

Other Places to Check for Information:

Assisted Living Federation of America
http://www.alfa.org

Consumer Consortium on Assisted Living
http://www.ccal.org/

National Center for Assisted Living
http://www.ncal.org

Source: Administration on Aging, www.aoa.gov

Provided by: The Staff at www.RetirementConnection.com
For more information: www.AoA.gov
Copyright © 2008 RetirementConnection.com. All rights reserved.

Occurrence of Alzheimer’s & the Aging Process

The occurrence of Alzheimer’s disease (AD) is not a normal development in the aging process. Alzheimer’s disease is characterized by a gradual loss of memory, decline in the ability to perform routine tasks, disorientation, difficulty in learning, loss of language skills, impaired judgment and ability to plan, and personality changes. Over time, these changes become so severe that they interfere with an individual’s daily functioning, resulting eventually in death. While the disease can last from 3 to 20 years after the onset of symptoms, the average duration is 8 years.

Alzheimer’s disease affects as many as 4 million Americans. Most people diagnosed with AD are older than 65. However, it is possible for the disease to occur in people in their 40’s and 50’s. Recent research has shown links between some genes and AD, but in about 90% of cases, there is no clear genetic link.

Alzheimer’s Disease – The Symptoms

Alzheimer’s disease manifests itself slowly and subtly, with the first symptoms often appearing to be mild forgetfulness. From time to time, we all forget where we have put our keys, but people with early stage AD may notice that they tend to forget things more often. They may have trouble remembering recent events, names of familiar people or things. While these symptoms are bothersome, they are usually not serious enough to cause alarm. As the disease advances, the symptoms become serious enough to cause people with AD or their family members to recognize that things are not right and that help is needed. As the disease progresses further, people with AD eventually forget how to do simple tasks like brushing their teeth, or combing their hair. They begin to have problems speaking, understanding, reading or writing. Later on, people with AD may become anxious or aggressive and may wander away from home. Eventually, patients may need total care.

Diagnosis

Early and careful evaluation is important, because many conditions, including some that are treatable or reversible, may cause dementia-like symptoms. Examples of such treatable medical conditions are depression, nutritional deficiencies, adverse drug interactions, and metabolic changes.

There is no single test to identify AD. A comprehensive exam should be conducted by your physician including a complete health history and physical exam, neurological and mental status assessments, as well as other lab tests (like chest x-rays and blood tests). These will help rule out any other diseases which may look like Alzheimer’s but are not. Physicians are now able to accurately diagnose 80 – 90% of people who show symptoms of AD. A definitive diagnosis is possible, however, only through the examination of brain tissue at autopsy.

Treatment and Care

While there is no known cure for AD, scientists have found a few medications which may help control some of the symptoms. People with AD must work closely with their doctor to determine which drugs and activities are best for them because reaction to medications varies for each person. As researchers continue to learn more about the disease, new possibilities arise. Information about cutting-edge treatments and new scientific discoveries is available from physicians and the sources listed below.

Alzheimer’s Disease Demonstration Grant program funded by the Administration on Aging (AoA), new dementia-specific approaches to early identification, treatment, and community-based care have been developed. These projects have been especially successful in working with low-income, ethnic minority and rural families.

Additional Information

AoA recognizes the importance of making information readily available to consumers, professionals, researchers, and students. Our website provides information for and about older persons, their families, and professionals involved in aging programs and services. For more information visit www.aoa.gov.

National Alzheimer’s Association
www.alz.org

National Institute on Aging Alzheimer’s Disease Education and Referral Center
(ADEAR) http://www.alzheimers.org

Source: Administration on Aging, www.AoA.gov

Provided by: The Staff at www.RetirementConnection.com
For more information: www.AoA.gov
Copyright © 2008 RetirementConnection.com. All rights reserved.

 

 

Alternatives to Nursing Home Care

Nursing Homes serve as permanent residences for people who are too frail or sick to live at home or as a temporary facility during a recovering period. However, many people need a nursing home level of care but would prefer to remain in their own home with the help of their family and friends, community services, and professional care agencies. The Medicare program offers limited access to two unique programs for certain beneficiaries who need a comprehensive medical and social service delivery system.

The two programs currently available are:

1. Program of All-Inclusive Care for the Elderly (PACE)
2. Social Managed Care Plan

Program of All-Inclusive Care for the Elderly (PACE)

PACE is unique. It is an optional benefit under both Medicare and Medicaid that focuses entirely on older people, who are frail enough to meet their State’s standards for nursing home care. It features comprehensive medical and social services that can be provided at an adult day health center, home, and/or inpatient facilities. For most patients, the comprehensive service package permits them to continue living at home while receiving services, rather than be institutionalized. A team of doctors, nurses and other health professionals assess participant needs, develop care plans, and deliver all services which are integrated into a complete health care plan. PACE is available only in States which have chosen to offer PACE under Medicaid.

Social Managed Care Plan

A Social Managed Care Plan is an organization that provides the full range of Medicare benefits offered by standard Managed Care Plan’s plus additional services which include care coordination, prescription drug benefits, chronic care benefits covering short term nursing home care, a full range of home and community based services such as homemaker, personal care services, adult day care, respite care, and medical transportation. Other services that may be provided include eyeglasses, hearing aids, and dental benefits. These plans offer the full range of medical benefits that are offered by standard Managed Care Plan’s plus chronic care/ extended care services. Membership offers other health benefits that are not provided through Medicare alone or most other senior health plans.

Summary

There are some people, however, who require less than skilled care, or who require skilled care for only brief periods of time. In most communities, people can choose from a variety of living arrangements that offer different levels of care. Before deciding on a care setting, talk to a doctor or maybe a social worker about your care needs. Most people want to stay in their home for as long as possible. If you are considering staying at home make sure you know the amount of responsibility and work involved. If you cannot live independently, but don’t want to live in a nursing home, you may want to consider some of the other alternatives available.

Source: www.medicare.gov
Provided by: The Staff at www.RetirementConnection.com
For more information: www.medicare.gov
Copyright © 2008 RetirementConnection.com. All rights reserved.

A Social Managed Care Plan is an organization that provides the full range of Medicare benefits offered by standard Managed Care Plan’s plus additional services which include care coordination, prescription drug benefits, chronic care benefits covering short term nursing home care, a full range of home and community based services such as homemaker, personal care services, adult day care, respite care, and medical transportation. Other services that may be provided include eyeglasses, hearing aids, and dental benefits. These plans offer the full range of medical benefits that are offered by standard Managed Care Plan’s plus chronic care/ extended care services. Membership offers other health benefits that are not provided through Medicare alone or most other senior health plans.

Current Social Managed Care Plan Sites

There are currently four Social Managed Care Plan’s participating in Medicare and each Social Managed Care Plan has eligibility criteria. These Social Managed Care Plans are located in: Portland, Oregon; Long Beach, California; Brooklyn, New York; and Las Vegas, Nevada. Listed below are the four plans and the criteria for joining each plan.

1. Kaiser Permanente, Portland Oregon
   The enrollee must be 65 years of age or older, must have Medicare Part A and Part B, must continue to pay the Part B premium and must live in Kaiser Permanente’s Social Managed Care Plan service area. The enrollee cannot have end-stage renal disease, or reside in an institutional setting. In order to receive the long-term care benefit, an expanded care resource coordinator will visit you at home to determine if you qualify for nursing home certification based on criteria established by the State of Oregon Senior and Disabled Services. These criteria may include needing daily ongoing assistance from another person with one of the following activities of daily living: walking or transferring indoors, eating, managing medications, controlling difficult or dangerous behavior, controlling your bowels or bladder, or the need for protection and supervision because of confusion or frailty.
2. SCAN, Long Beach California
   The enrollee must be 65 years of age or older, must have Medicare Part A and Part B, must continue to pay the Part B premium and must live in SCAN’s service area. The enrollee cannot have end-stage renal disease. In addition, in order to receive extended home care services, members must have a Nursing Home Certificate which indicates that the members informal support system , such as a family member or care giver, is not sufficient to keep the member out of a nursing home.
3. Elderplan, Brooklyn, New York
   The enrollee must be 65 years of age or older, must have Medicare Part A and Part B, must continue to pay the Part B premium and must live in Elderplan’s service area. The enrollee cannot have end-stage renal disease. In order to receive chronic care benefits, the enrollee must meet state nursing home certifiable criteria.
4. Health Plan of Nevada, Las Vegas, Nevada
   The enrollee must be at least 65 years of age, or may under 65 if they are disabled. The enrollee must have Medicare Part A and Part B, must continue to pay the Part B premium and must live in Health Plan of Nevada’s service area. The enrollee cannot have end-stage renal disease. For the long-term care benefit, the beneficiary must meet certain criteria based on established medical, psychological, functional, and social criteria as well as needing to be medically necessary.

Your Cost

Each plan has different requirements for premiums. All plans have co-payments for certain services. To obtain cost and benefit information, please visit our Medicare Options Compare tool for specific details. Before making any health plan decisions, you should contact the plan directly using the phone number listed in the site.

Source: Medicare
Copyright © 2008 RetirementConnection.com. All rights reserved.

Anyone at any age can have a drinking problem. Great Uncle George may have always liked his liquor, so his family may not see that his drinking behavior is getting worse as he gets older. Grandma Betty was a teetotaler all her life-she started having a drink each night to help her get to sleep after her husband died. Now no one realizes that she needs a couple of drinks to get through each day.

These are common stories. The fact is that families, friends, and health care professionals often overlook their concerns about older people’s drinking. Sometimes trouble with alcohol in older people is mistaken for other conditions that happen with age. But alcohol use deserves special attention. Because the aging process affects how the body handles alcohol, the same amount of alcohol can have a greater effect as a person grows older. Over time, someone whose drinking habits haven’t changed may find she or he has a problem.

Facts About Alcohol and Aging

• Some research has shown that as people age they become more sensitive to alcohol’s effects. In other words, the same amount of alcohol can have a greater effect on an older person than on someone who is younger.
• Some medical conditions, such as high blood pressure, ulcers, and diabetes, can worsen with alcohol use.
• Many medicines-prescription, over-the-counter, or herbal remedies-can be dangerous or even deadly when mixed with alcohol. This is a special worry for older people because the average person over age 65 takes at least two medicines a day. If you take any medicines, ask your doctor or pharmacist if you can safely drink alcohol.
  Here are some examples:

• Aspirin can cause bleeding in the stomach and intestines; the risk of bleeding is higher if you take aspirin while drinking alcohol.
• Cold and allergy medicines (antihistamines) often make people sleepy; when combined with alcohol this drowsiness can be worse.
• Alcohol used with large doses of the pain killer acetaminophen can raise the risk of liver damage.
• Some medicine, such as cough syrups and laxatives, have a high alcohol content.

Effects of Alcohol

Even drinking a small amount of alcohol can impair judgment, coordination, and reaction time. It can increase the risk of work and household accidents, including falls and hip fractures. It also adds to the risk of car crashes.

Heavy drinking over time also can cause certain cancers, liver cirrhosis, immune system disorders, and brain damage. Alcohol can make some medical concerns hard for doctors to find and treat. For example, alcohol causes changes in the heart and blood vessels. These changes can dull pain that might be a warning sign of a heart attack. Drinking also can make older people forgetful and confused. These symptoms could be mistaken for signs of Alzheimer’s disease. For people with diabetes, drinking affects blood sugar levels.

People who abuse alcohol also may be putting themselves at risk for serious conflicts with family, friends, and coworkers. The more heavily they drink, the greater the chance for trouble at home, at work, with friends, and even with strangers.

How to Know if Someone Has a Drinking Problem

There are two patterns of drinking: early and late onset. Some people have been heavy drinkers for many years. But, as with great Uncle George, over time the same amount of liquor packs a more powerful punch. Other people, like Grandma Betty, develop a drinking problem later in life. Sometimes this is due to major life changes like shifts in employment, failing health, or the death of friends or loved ones. Often these life changes can bring loneliness, boredom, anxiety, and depression. In fact, depression in older adults often goes along with alcohol misuse. At first, a drink seems to bring relief from stressful situations. Later on, drinking can start to cause trouble.

Not everyone who drinks regularly has a drinking problem, and not all problem drinkers drink every day. You might want to get help if you or a loved one:

• Drink to calm your nerves, forget your worries, or reduce depression.
• Gulp down drinks.
• Frequently have more than one drink a day. (A standard drink is one 12-ounce bottle or can of beer or a wine cooler, one 5-ounce glass of wine, or 1.5 ounces of 80-proof distilled spirits.)
• Lie about or try to hide drinking habits.
• Hurt yourself, or someone else, while drinking.
• Need more alcohol to get high.
• Feel irritable, resentful, or unreasonable when not drinking.
• Have medical, social, or financial worries caused by drinking.

Getting Help

Studies show that older problem drinkers are as able to benefit from treatment as are younger alcohol abusers. To get help, talk to your doctor. He or she can give you advice about your health, drinking, and treatment options. Your local health department or social services agencies can also help.

There are many types of treatments available. Some, such as 12-step help programs, have been around a long time. Others include getting alcohol out of the body (detoxification); taking prescription medicines to help prevent a return to drinking once you have stopped; and individual and/or group counseling. Newer programs teach people with drinking problems to learn which situations or feelings trigger the urge to drink as well as ways to cope without alcohol. Because the support of family members is important, many programs also counsel married couples and family members as part of the treatment process. Programs may also link individuals with important community resources.

Scientists continue to study alcohol’s effects on people and to look for new ways to treat alcoholism. This research will increase the chance for recovery and improve the lives of problem drinkers.

The National Institute on Alcohol Abuse and Alcoholism, part of the National Institutes of Health, recommends that people over age 65 who choose to drink have no more than one drink a day. Drinking at this level usually is not associated with health risks.

Source: National Institute on Aging

Provided by: The Staff at www.RetirementConnection.com
For more information: www.nia.nih.gov
Copyright © 2008 RetirementConnection.com. All rights reserved.

Taking care of your aging parent is never easy – especially when he or she needs extra help recovering from a hospital stay. An important part of your loved ones’ recovery is making sure they get the proper care once they return home.

Visiting the hospital is a difficult time for both you and your parent. Whether your relative is in the hospital for a few days or for an extended stay, it will be easier if you know what to expect when they are ready to leave.

Below is a list of tips to help prepare you for your aging parents’ recovery:

1. Learn About Your Loved Ones’ Condition

• Find out as much as you can about their medical condition, treatment, and expected level of functioning after complete recovery.
• Ask about any signs or symptoms that you should watch out for and find out what you should do in case problems arise.
• Learn about your parent’s ability to do everyday activities such as climbing stairs, preparing meals, going to the bathroom, and other important daily tasks.

2. Plan Ahead for Their Return Home

• Make sure their home is set up to help with any physical limitations they may have, such as installing grab bars in the shower or lowering shelves in closets for wheelchair bound family members.
• Before leaving the hospital, write down the names and telephone numbers of health care professionals you can contact if you or your senior parent has any questions or their condition worsens.
• Arrange for an in-hospital assessment to determine Medicare or insurance eligibility for elder care services, such as visiting nurses or home care aides.

3. Get to Know Your Parent’s Medication

• Ask for a complete list of medications he or she will be taking at home and make sure you understand the directions for taking the medicine.
• Determine if there are any foods or beverages that should be avoided when taking medicines.
• Find out about the medication’s side effects, such as causing dizziness or an upset stomach, and what should be done if your parent experiences symptoms.

4. Find Out About Follow-Up Care

• If your loved one needs special equipment, such as a wheelchair or walker, make sure you and your loved one know how to use it, where to get it, and if it’s covered by insurance, Medicare, or other health plan.
• Ask for directions about physical exercises your parent may need to perform. Have a doctor, nurse, or physical therapist provide a written “plan of care.”
• Find out about any follow up doctors visits or tests that need to be scheduled and make sure transportation for your parents is in place.

As a reminder, be realistic about your caregiving abilities and remember to take care of yourself during your parent’s recovery. Don’t be afraid to ask for outside help – from other family members, a senior care agency, or local support groups.

There are also many helpful web sites and organizations available for family members who are taking care of their loved ones’ after a hospital stay. These include:

• Caring News, www.caringnews.com
• Administration on Aging, www.aoa.gov/caregivers
• National Alliance for Caregiving, www.caregiving.org
• AARP, www.aarp.org/families/caregiving
• Right at Home, www.rightathome.net

Source: Right at Home Managing Director, www.RAHcares.com 503-574-3674
Provided by: Right at Home Managing Director- Portland 2008
For more information: www.RAHcares.com, 503-574-3674

About Right at Home

Right at Home offers in-home supportive care and personal care assistance to seniors and disabled adults who want to continue to live independently. Right at Home directly employs all direct care provider staff, is bonded and insured, and carefully pre-screens all caregivers prior to their entering a client’s home. All ongoing care is monitored and supervised by local independent owners. Select offices provide skilled nursing home care as well. Right at Home’s national office is based in Omaha, NE with offices throughout the United States, including Portland. For more information on Right at Home, visit the company’s website.

Copyright © 2008 RetirementConnection.com. All rights reserved.