Getting Help Without the Push of a Button?

Seniors are living longer and remaining in their own homes.  At the same time, falls have become an epidemic problem that jeopardizes seniors’ chances to live independently. Every year in the U.S., one out of three people age 65 and over will fall. This statistic translates to 13.3 million people who will fall in 2010, or one person falling every 2.3 seconds on average.  And there is a 50% chance that if a senior falls they will do so again within a year.

Falls are the leading cause of nonfatal injuries and hospital admissions for trauma, as well as injury-related deaths among seniors and the primary reason that most medical alarms / Personal Emergency Response Systems (PERS) are purchased today.  Lying on the floor for an extended period of time can lead to serious complications, including pressure ulcers, muscle necrosis, dehydration, hypothermia and pneumonia.

Unfortunately, PERS pendants are not effective if one is unconscious, unable, or  unwilling to press the call button.  Studies have shown that in 4 out of 5 falls, manually activated medical alarms are never activated.  When the elderly fall they are often forget to push their button, won’t push their button because they feel they can manage the situation independently or are too embarrassed to call for help.

Recent technological advances have addressed this problem through the development of PERS devices that can detect when a fall has occurred and automatically contact a monitoring center so that assistance can be dispatched.  Briefly, multiple sensors within these devices constantly monitor the wearer’s movements and activities as they go about their daily routines.  In addition to measuring elevation and orientation to the horizontal position these devices also measure acceleration rates associated with changes in position.  When a rapid decrease in height is detected, followed by no vertical movement at all, a call for help is automatically sent.  The most advanced of these devices is small, lightweight and waterproof, and has been determined to detect a fall with 95% accuracy.

Receiving help quickly after a fall can reduce emotional distress and the potential effects of losing consciousness due, for example, to a stroke or insulin shock that can be experienced by a diabetic.  Rapid response can also significantly reduce the costs of extended treatment, rehabilitation or supported living.  The automatic call capabilities now available with some PERS systems ensure that a call for help will be made, even if the one in need cannot make that call themselves.

Article Provided by:
Columbia Medical Alarm
(503) 644-4736

Important Information for Persons With a DMV-Issued Disabled Parking Permit

The 2009 Legislature passed Senate Bill 937, which requires all persons applying for an original or renewalof a disabled person parking permit to submit certification from a medical professional that the applicant is a person with a permanent disability. In the past, only original applications required the certification form.
Medical professionals qualified to sign your application are licensed physicians, certified nurse practitioners, licensed physician assistants, or licensed optometrists. The medical professional must sign the certification within six months before the date of application. The medical certification must include the state-issued licensing number of the medical professional who signs.

If you hold a permanent renewable disabled parking permit, you will receive a form you can use for this purpose with your driver license or ID card renewal reminder. The form has your driver license or ID card renewal information on one side and a certification form for the medical professional to sign on the reverse side.

These renewal reminders will replace the postcard renewal reminder you have received in the past when it was time to renew your disabled parking privilege. Also, the necessary permit renewal certification forms are available on the DMV Web site, field offices and many doctors’ offices.

Will You Leave a “Negative Inheritance” for Your Children?

What is a negative inheritance? That’s what happens when the amount your children pay to
provide for your care exceeds what they will inherit.

If your assets may not cover the cost of care, that may mean your family pays out of their own
pockets. They may be willing to do so, but you may want to minimize that cost.

When a family comes to our elder law office with a health care crisis, our first approach is to
carefully manage both resources and care. Usually the goal is to stay safe at home. That may
mean a team approach involving an elder law attorney, a geriatric care manager and/or a financial
planner. Here are some options, among many, that the health care team might consider:

• Restructure your investments for maximum income, not growth. Now is the time you
  need to “cash in” on that investment and riskier growth investments are no longer appropriate.
• Reverse mortgage. If you are over 62, you can tap most of the equity in your home;
  terms have become very competitive and government regulated for safety.
• Care agreements to pay children for providing care. These should be carefully drafted
  with legal advice.
• Sale of the family home and a move into more financially sustainable or more safe and
  comfortable quarters — thus freeing some of the assets tied up in home equity.
• Long-term care insurance. The combination of marketplace dynamics and government
  regulation have worked to improve the quality of insurance policies. We recommend that buyers
  look into the policies in their 50s, not their 80s. If you are insurable but unable to afford
  premiums, it might make sense to have your children pay the cost of long-term care insurance.
  After all, it is their inheritance that you are trying to protect.
• Legacy trusts. Under certain circumstances it may make sense to transfer a portion of
  your assets to your children now if you are certain you can manage your care for at least 5 years
  into the future.
• Medicaid. Your long term care management team may help you position yourself to
  qualify for Medicaid sooner rather than later with significant savings to the family. Oregon’s
  long-term care Medicaid program covers care at participating nursing homes (skilled nursing
  facilities) as well as participating community based care facilities such as assisted living
  facilities, foster homes, residential care facilities and limited in-home care.

We may be able to help you protect your children’s inheritance from going negative — all the
while focusing primarily on your care and quality of life.

Tom Pixton
The Pixton Law Firm
503-968-2020
www.Pixtonlaw.com

What Does It Mean To Be A Self-Governed Community?

Due to some medical problems, my children suggested I think about moving closer to one of them. I was living in the Seattle area, and had a son near Portland and a daughter near Denver. Having grown up in the Portland area, and having no desire to move to Colorado, I elected Oregon. I also decided to look into retirement communities in the area. I did my research, and my sister flew out to assist me in this project. We looked at 14 different places before I reached a decision.

One of the many reasons I chose Terwilliger Plaza was because of the self governance factor. I came from a background where we had introduced the nursing staff of a hospital to the concept of self governance. It was interesting to see how they responded to making decisions which affected their practice. I had also lived in a condominium and served on the board for a number of years. Being someone who leans towards being a control freak, it was only natural that I would not be satisfied letting a large corporation make the decisions of my daily living.

The involvement of the members extends to the daily activities of the Plaza. The many activities available are all organized and run by the members. These include the Inquiring Mind, Current Issues, (2 discussion groups), Joy of Music, (the study of music and composers), Joyful Notes (a singing group), a Creative Writing Group, Bridge, a Computer Users Group, and many others.

Members often identify a need and respond by taking the necessary action. Two years ago, a booklet was developed “All the things you forgot to Ask”. A welcome bag was made up with the help of marketing. These are delivered to new members shortly after moving in, followed by a quarterly coffee for new members, giving them a chance to ask questions or make suggestions.

In my opinion this is preferable to having a paid Activity Director, as the activities are truly what the members are interest in. When you have the opportunity to participate, and be heard, you feel more empowered. Seniors have many life and career experiences and expertise in many areas. Retirement communities should capitalize on these valuable assets.

Article provided by
Beth Reid
Terwilliger Plaza Member, Chair, Board of Directors
503-299-4716 

Choices For End Of Life Care

There are many options available to you when facing end of life care. Where you choose to live will have a significant impact.

Adult Family Homes (AFH)

Adult Family Homes provide a home-like setting and accept 4-6 people. Inquire about the education, training, license and credentials of the staff. This will ensure your specific needs can be met. You and your family may benefit from choosing a facility with a nurse on duty who has Hospice Experience. A Registered Nurse on staff can anticipate and make nursing assessments as needed, thus preventing delays in care. Professional licensing and certifications vary greatly in each Adult Family Home. Nursing staff may live in the home and provide the resident care. Some homes have nurses available who direct certified care givers to provide the care. Staff are required to have CPR, First Aid and Fundamentals of Care Giving certificates.

Stay at home

Remain at your family residence with additional hired homecare up to 24 hours/day. Many agencies are available and licensed by the state. Costs usually start at $15.00/hr and vary depending of the certification and license of the caregiver and staff. Many who face end of life care will eventually need 24 hr care to meet their needs; hygiene, medications, nutrition, incontinence, and safety are only a few to keep in mind. Try to limit the number of different caregivers to maintain continuity among caregivers to help communication.

Nursing Homes

Nursing Homes care for the very frail who are dependent on full time care with licensed staff 24 hrs a day. In most instances you will have a shared room with a roommate. Tour the facility and meet possible roommates for a good match. Be certain it looks and feels like a place you can spend the remaining days of your life living. Be proactive and visit prior to a crisis.

Hospice Certified facilities

These facilities provide end of life care with licensed, experienced hospice trained staff 24 hrs a day. Hospice facilities are usually for more crisis situations. Certified Hospice Facilities generally admit patients who are assessed to be in the last 7-10 days of life. When visiting, ask yourself “Would my family feel comfortable visiting me here?” “Is this where I want to live the remainder of my life?” Select the most homelike environment, with the trained and experienced staff you deserve at such a vulnerable time in your life.

Article Provided by
Kim Main, RN
The Lodge, Adult Foster Home
360-263-6922

Exercise Can Ease Arthritis

Hiking the Columbia Gorge. Walking the coastline of Cannon Beach. Strolling the waterfront of downtown Portland. There are countless ways to keep active in your retirement in and around our beautiful city!

If the mention of these activities excites you, but you’re worried about the impact of joint pain on your ability to participate with your loved ones, you’re not alone. Greater than one-third of all people over 65-years old are affected by osteoarthritis. The joint pain and stiffness associated with this condition is the result of cartilage and bone degeneration, and has been found to be most related to five factors: excess body weight, prior joint injury, genetics, one’s occupation and age, in that order.

Aside from a total joint replacement, there is currently no cure for arthritis. But don’t despair—even small reductions in body weight can have a large impact on how much pain and physical disability you experience from arthritis. A study in Arthritis and Rheumatism (July 2005), demonstrated that each pound of weight loss yields a four-fold reduction in load exertion to the knee.

Next to moderate weight loss, another action you can take is to begin a low impact exercise routine to maintain your joint range of motion, and improve muscle strength. “Some patients think that aerobic exercise will worsen their condition,” says rheumatologist Emily Farrar of the Medical University of South Carolina in Charleston.

“But it’s not going to hurt your arthritis,” she says. “It may not take away all the pain. In fact, you might actually feel more pain for the first few days. But if you stick with it, you’ll experience less stiffness and discomfort.”

“If you increase the strength of the muscles around the joints, you can decrease the pain in those joints, the knees in particular,” says Farrar.

In short, if you are suffering from joint pain related to arthritis, you don’t have to accept a decline in your abilities as an inevitable result of aging. Maintain a healthy weight, and give yourself a new mantra: Strong and Flexible beats Weak and Stiff! And, if you would like professional guidance for exercises to help your arthritis, speak with a physical therapist. They are movement experts!

The mountains, rivers and seaside of our beautiful Northwest await. Get out and play!

Article provided by
Ben Musholt, PT
Beyond the Clinic
503-496-0385

Washington County Disability, Aging and Veteran Services provides options to help you stay independent, healthy, active, and involved in your community.

Veteran Services
The program ensures that veterans, their families and survivors receive all entitlements provided by Federal and State law. A Veteran Services Coordinator (VSC) serves as the advocate and assists in filing initial Federal VA claims for compensation, pension, and other benefits.

Family Caregiver Support
Program serves unpaid family caregivers who are caring for someone over the age of 60. Resources include paid respite services, medical equipment, one-on-one counseling, support groups, free basic caregiver training, and Powerful Tools for Caregivers classes.

Senior Health Insurance Benefits Assistance (SHIBA)
Service provides information about Medicare through educational seminars, Medicare 101 classes, and one-on-one counseling at community centers or private homes. Trained volunteers assist people in making informed choices for medical, prescription, claims and appeals.

Lifespan Respite
Program serves the unpaid family caregivers who are providing care to a person of any age who has care giving needs. Provides connections with trained respite care providers, information, and a one-time annual award to help pay for respite care.

Project REACH (Ready to Extend a Caring Hand)
Trained volunteers provide in-person, one-on-one support and assistance to seniors aged 60 years and over as well as family caregivers. Volunteers help individuals access and navigate resources, services and programs to meet their needs.

Information and Assistance
Service helps to increase the community’s access to information and assistance by helping to assess the needs of the client so that they may be linked with a range of services and resources.

Oregon Project Independence (OPI)
Provides limited in-home assistance to individuals over the age of 60, or under the age of 60 with a diagnosis of an Alzheimer’s type dementia. An in-home assessment and financial determination will determine the fee for service.

Nutrition Program
Program provides both on-site and home delivered meal options for Washington County residents. Both options are offered through Loaves and fishes Centers, which serves hot lunches at seven locations and also provides home-delivered meals through their Meals on Wheels program.

Volunteers! Program
Program recruits volunteers and interns for positions to help Washington County Disability, Aging and Veteran Services Division (DAVS).

Call (503) 503-846-3060 or visit www.co.washington.or.us/HHS/DAVS 

Good Nutrition Helps Preserve Independence

Undernourishment and malnutrition are serious problems for America’s growing 65 and older population. While estimates vary widely, the American Dietetics Association has reported that between 35 percent and 85 percent of seniors are at risk for being under or malnourished. The need for awareness about senior nutrition is growing by the day. America is getting older — the number of older adults will double in the next 30 years – so it is imperative we educate our communities about this problem to ensure the number afflicted by malnourishment does not keep pace with the dramatic increases in senior population growth.

What is Malnutrition?
Malnutrition is caused by a combination of a nutrient-poor diet, too little food and poor absorption, and can be compounded by physical, emotional and social problems. Malnutrition and under-nourishment in seniors are not always obvious, so caregivers and loved ones should pay special attention to the signs.

Here are some simple things you can do to help ensure your loved ones are getting the nourishment they need:

• Spend time with older loved ones during normal meals at home.
• If you have an older friend or family member in a hospital or long term care facility, make a point of visiting during mealtimes.
• Look for physical problems such as weight loss, easy bruising and dental difficulties. Keep in mind, not all seniors with nutrition problems are thin—in some cases, malnutrition occurs in seniors who are overweight.
• Pay attention to how medication affects appetite and digestion. Many commonly prescribed medications can reduce hunger and prevent nutrient absorption. Make sure an older senior takes medications as directed.
• Ask your loved one’s doctor to check certain protein levels, which can identify malnutrition.
• Pay attention to food safety considerations, such as the temperature of refrigerated items, and clean out dated foods on a regular basis.

Seniors can improve their quality of life and preserve their independence longer by making dietary changes. About 30 million older Americans live with chronic diseases that nutrition therapies can be effective in managing and treating. Seniors should choose foods that are low in fat and sodium, high in fiber and calcium, easy to chew, swallow and digest; and simple to prepare. Mealtime can become more enjoyable by trying new flavors and spices, making meals a social time, getting prepared meals from an outside source, such as Meals on Wheels.

Article provided by
Sandra Henriksen, RN
Comfort Keepers
503-855-4415

Oregon’s Long-Term Care Ombudsman Program

The Long-Term Ombudsman Program advocates for quality of life and care for residents in nursing homes, residential care, assisted living facilities, and adult foster care homes. Federal and state authority mandates ombudsmen to identify, investigate, and resolve complaints made by, or on behalf of, residents and to provide services to help in protecting health, safety, welfare and rights. Information and assistance in choosing the most appropriate living residence is also a valuable service provided.

Across Oregon, certified ombudsmen serve residents, their families and friends. Professional staff supervise the volunteers. All Ombudsman services are free and confidential. A 24-hour line is available at 1-800-522-2602 and more information is available at www.oregon.gov/lltco.

Resident Rights
Many people believe that once a person enters a long term care facility, they lose their rights or their rights are altered in some manner — this is not true. Residents have rights and those rights need to be protected.

Ombudsman Program staff and volunteers communicate with each resident and the program affirms the dignity and value of each resident. Communication is essential to maintaining the rights of all people and is absolutely critical to the more than 42,000 Oregonians in long-term care facilities.

Being an Ombudsman is a rewarding experience!
Certified volunteer ombudsmen: advocate for quality care for residents in Oregon nursing homes, residential and assisted living facilities and adult foster homes; provide information to residents and families about residents’ rights and help identify additional resources in or out of the facility; receive special training prior to certification and additional continuing education; identify, investigate, and resolve complaints by or on behalf of nursing home and long-term care residents; and work with the residents, families, friends, and facility staff to improve the quality of residents’ lives.

Certified Ombudsman volunteers must be over 21, pass a background check, attend training, and commit to one year of service and 16 hours a month. Volunteers enjoy a flexible schedule, opportunities to work with a partner or spouse, and the ability to make a direct and meaningful impact in their community.

Article provided by
Gretchen Jordan,
Ombudsman Volunteer Coordinator
503-378-6340 

4 Steps to Help Plan for Disability

No one likes to think about the possibility of their own disability or the disability of a loved one. However, statistics are clear that we should all plan for this possibility. The US Department of Health and Human Services estimates that 70% of Americans age 65 or older will need long term care during their lifetime. Not surprisingly, the likelihood of needing long term care increases with age. This is significant because Americans are living longer and care costs can quickly consume financial resources. A recent Harvard study indicates that 69% of single people and 34% of married couples would exhaust their assets after just 13 weeks in a nursing home.

There are four ways to pay for long term care:

1. Private pay. Though not realistic for everyone, this option offers the greatest number of choices in care.
2. Long term care insurance. If medically eligible and able to afford premiums, this is a good way to pay for some or all long term care costs.
3. VA Benefits. Many veterans and their spouses are unaware that pension benefits may be available to them. Benefits may not cover the entire cost of care, but can help significantly.
4. Medicaid. While not accepted by every care provider, Medicaid benefits can cover the entire cost of care for those who qualify. Always consult an experienced elder law attorney before beginning a Medicaid “spend-down.”

Here’s what you can do to be prepared:
Discuss options and plan early (while capacity is not an issue) so you and your loved ones can have peace of mind knowing they are prepared for whatever disability may come. Be aware of heightened health risks for those who work long hours caring for a spouse or family member, and include a paid care provider if possible.
Investigate insurance and VA benefits options that may be available. Consult an experienced elder law attorney, who will create a plan to safeguard personal wellbeing and property in the event of disability, and to allocate and protect assets that may be at risk of being depleted by out-of-pocket health care costs. Visitwww.pixtonlaw.com/rc for additional information about this topic.

Article Provided by
Christopher Young
The Pixton Law Group
503-968-2020