Milestones eNews
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Elder Care

Click on the headline to read the full article.


 Caregiving edition


 City of immigrants


 Pets make their day


 Walkability matters


 Care for caregivers


 Heat can be deadly


Link to aging and disability resources

By Alicia M. Colombo
Pennsylvania now has a coordinated approach to providing information and access to long-term services and supports for people with disabilities, regardless of their age: The Pennsylvania Link to Aging and Disability Resources (the PA Link).

“As a senior, aged 60 or older, in Philadelphia, PCA would be the first place to call as the Area Agency on Aging for Philadelphia. The PA Link is an option for a person with a disability under age 60,” said Julie McNair, Link coordinator for the Philadelphia region at Philadelphia Corporation for Aging (PCA). “I hear calls every day from people who are not yet old enough to qualify for PCA services. It’s great to give people another resource to turn to for help.”

The PA Link is an Aging and Disability Resource Center (ADRC) that helps connect people with disabilities and caregivers with local health and human service entities to access information. ADRCs seek to improve access to services and supports through a coordinated network of community partners committed to expanding the use of community-based solutions, promoting consumer-directed decision making.

“The program is designed to be cross-age and cross-system. Regardless of your age, physical or developmental disability, and income, you can contact the PA Link for assistance,” said McNair. “We work to help consumers and caregivers understand and determine their service and support options. It is a person-centered approach. Through counseling and assistance, we help individuals explore their options and identify what services and supports they need to live well. Counselors assist individuals in making informed decisions about appropriate services based on their needs and preferences,” said McNair.

Partner agencies collaborate to serve people who need home- and community-based services and supports. “There are currently more than 60 community partners in our local service area,” said McNair. PCA is a core partner for the Link in Philadelphia County, along with JEVS Human Services, Inglis Foundation, Homemaker Service of the Metropolitan Area and Liberty Resources.

Among the services provided are information, referral and awareness; streamlined eligibility determination for public programs; and transition support. “By calling the Link, people can access across-the-board screening for programs and receive individual assistance with the entire process. People can also get help navigating moves between settings and systems, such as transitioning from nursing homes to community living or from the hospital back home,” said McNair.

No Wrong Door

The goal of PA Link is to make it easier for anyone to enter the long-term services and supports system. “No Wrong Door” is a collaborative effort of the Administration for Community Living, the Centers for Medicare & Medicaid Services, and the Veterans Health Administration to streamline access to services for older adults and people with disabilities. “A person seeking information about services or resources will encounter fewer obstacles,” McNair said. “It’s about breaking down barriers. The goal is to reduce fragmentation, inconsistencies and duplication within the general social services systems. The end result is to promote better health and well-being,” said McNair.

For assistance, call the PA Link (toll-free, within Pennsylvania) at 1-800-753-8827. In Philadelphia, you can also call the PCA Helpline at 215-765-9040 (1-888-482-9060, toll-free outside Philadelphia) or go to
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Managed care in PA: Info session Oct. 23

Learn more about Community HealthChoices
Liberty Resources will host an information session on Friday, October 23 focusing on Community HealthChoices, Pennsylvania’s new managed long-term supports services program (MLTSS). The session will take place from 1 to 3 p.m. at the agency, which is located at 714 Market St, Suite 100 (Wade Blank Rooms). Jennifer Burnett, deputy secretary of Pennsylvania’s Office of Long Term Living and Kevin Hancock, the office’s chief of staff, will provide information and address consumers' questions, expectations and concerns about these about changes in the state’s long-term care system. For more information: call 215-634-2000 or visit
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Knock, Knock... Do You Know Who's There?

Over the past year, the Philadelphia Police Department has received reports of individuals posing as utility service workers to gain access to senior citizens’ homes. In some instances, when the individual was allowed in, money or valuables have been stolen from the home.
“This type of crime, that victimizes some our most vulnerable citizens, is disturbing,” said Police Commissioner Charles Ramsey. “These imposters not only violate citizens by stealing from them, but could easily become violent, and result in a senior citizen being hurt or even killed.”        

Ramsey and Deputy Commissioner Kevin Bethel invited local utilities and Philadelphia Corporation for Aging to work with the Philadelphia Police Department in addressing the problem. The result is both a public service campaign, “Be Sure Before You Open the Door;” and a procedure to help seniors find out if the individual at the door is legitimate, by dialing 9-1-1. 

The 9-1-1 operator will have dedicated numbers for PECO, the Philadelphia Water Department and the Philadelphia Gas Works, to check on crews in the caller’s area, and verify whether or not the person at the door is a utility worker. 

“This is an innovative collaboration between the police department and the utility companies, designed to protect our citizens,” Ramsey said. “We are pleased that the utilities have worked with us to develop a streamlined, practical and safe resource for seniors who are faced with someone they aren’t sure should be at their door.” 

A public service announcement will be sent to all of the local television stations for airing, he said. “We hope this campaign can help prevent victimization of senior citizens,” Ramsey said. 
“Be Sure Before You Open the Door” Safety Tips: 

- Keep your doors locked at all time

- Close and lock first-floor windows when you go out, and when you go to bed

- Do not open the door for anyone you are not expecting

- Say you will call 9-1-1 and then do so.
Common ruses to get you to open the door include:

- Claiming the car has broken down

- Claiming that someone is injured, lost or stranded

- Claiming to know a relative of yours who needs help

- Asking to use the phone

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Older Americans Act, Medicare, Medicaid turn 50

By Linda L. Riley          
This year marks the 50th anniversary of both the Older Americans Act (OAA) and legislation that created Medicare and Medicaid. These programs have had a tremendous impact on the quality of life for seniors in America. All were part of President Lyndon B. Johnson’s “Great Society,” which took aim at a broad range of social issues, including racism, poverty, health care, education and affordable housing. 

In signing the OAA, Johnson said it “clearly affirms our nation's sense of responsibility toward the well-being of all of our older citizens. But even more, the results of this act will help us to expand our opportunities for enriching the lives of all of our citizens in this country, now and in the years to come.”

Today,  one in five older adults nationwide – 11 million people – receive services from an OAA program, according to the AARP Public Policy Institute.
The 1965 OAA established the Administration on Aging within the Department of Health, Education and Welfare, but it was several years before a clear direction for provision of aging services was established. 

By 1972, concern had grown about hunger and malnutrition among the elderly, and funds for a national nutrition project were incorporated into the OAA. This ultimately became the congregate meal program, which continues to be a vital nutritional resource for senior citizens. In Philadelphia alone, almost half a million meals are served at senior community centers each year. 

Amendments to the OAA in 1973 provided for the establishment of Area Agencies on Aging (AAA) all over the country, with a mandate to provide “a full range of efficient, well-coordinated and accessible services for older persons.” Philadelphia Corporation for Aging (PCA) was among them, and quickly began planning and coordinating services which initially included nutrition programs; transportation services; and an information and referral program. 

Over the years since, a wide range of services have been authorized and funded through the OAA as it has been amended and expanded. Today, senior centers serve as a lifeline for many, providing a broad range of social services, health screenings and education, exercise classes, benefits counseling, and socialization, in addition to congregate meals.

Other OAA-funded programs and services include care management, protective services, ombudsman, family caregiver support and employment programs. OAA funds, in combination with funding from the Pennsylvania Lottery and Medical Assistance, enable PCA to provide services and programs which touch the lives of more than 100,000 people a year. 

But, along with celebration of this golden anniversary, there is cause for concern. In fiscal year (FY) 2014, OAA federal funding was $1.88 billion, just 4% more than it was in FY 2004; but the population of those age 60 and older grew by approximately 30% over that decade. 

Compounding concerns among advocates for the elderly is the uncertainty surrounding the OAA itself, which was due for reauthorization in 2011, and is now four years overdue. Reauthorization has failed to win bipartisan support in the contentious atmosphere now dominant in Washington. Although Congress has continued to make appropriations to support existing programs, there is no guarantee that will continue.
Debates have raged over Johnson’s tactics, and over the success or failure of the Great Society. But some of the facts cannot be contested. According to the Pew Research Center, in 1966, 28.5% of Americans ages 65 and older were living at or below the poverty level; by 2012 just 9.1% were. And, unlike the impoverished elderly of 1966, through Medicare and Medicaid they have access to health care. 

Johnson first used the term Great Society in a 1964 commencement speech at the University of Michigan. While outlining the ambitious program he would soon propose, he also stressed that these were not, by any means, final solutions. “The Great Society is not a safe harbor, a resting place, a final objective, a finished work. It is a challenge constantly renewed,” Johnson said.
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Caregiver is guided by family values

By Constance Garcia-Barrio
When Isaiah Jenkins was 88, he fell down the steps so hard that his nose had to be reconstructed. “We don’t know if he tripped when he got up to fix himself a snack during the night,” says his daughter Yvonne Keitt, 64, of Mt. Airy, “but Mom found him at the foot of the steps in the morning.”

Her dad’s fall in March, 2011, left him unable to walk and launched Keitt on an odyssey to seek care for him. Following a stay at Capital Health Systems Hospital in Trenton, N.J., he was moved to Lawrenceville Rehabilitation Center. After discussion with the social worker concerning her parents’ situation, she decided to apply for Medicaid and look for a care facility for her father. 
“Daddy wanted to return home, but there was no way to add a bath- room downstairs,” Keitt says. “A nurse could have come a few hours a day, but my brother and I wanted more help for him.”
She drew on good memories and her upbringing to steer her through making arrangements for her father and meeting the needs of her mother, who suddenly found herself alone.

“My parents were from South Carolina,” Keitt says. “They came to New Jersey to find work, but they instilled values from down home in me: to do my best, keep my word and have faith in God.”

Remembering her mother’s wonderful baking helped. “Mom used to make delicious jelly cakes, six thin layers of pound cake with apple jelly between them.”

She saw nice nursing homes, but sought one to suit her father’s taste. “He’s not a silk-and-chandeliers man,” says Keitt, who began driving from Philadelphia to take her mother on errands. “He likes clean and comfortable.”      

Keitt’s designation as agent under Power of Attorney (POA) for her father, through the POA document he authorized years earlier, simplified matters. 

But doing the paperwork, checking out facilities and working a full-time job overwhelmed her. “I’d planned to work to age 65, but I retired at 62, nine months after Daddy’s fall,” says Keitt, whose career in banking had centered on credit cards and installment loans. 

After retiring, Keitt needed part-time work. She learned about job opportunities at My Way, a not-for-profit organization headquartered in Mt. Airy that handles housekeeping, personal care and more for Northwest Philadelphians ages 55 and older. “I do transportation,” says Keitt, who has two daughters and three grandchildren living in Florida. “I take people to the doctor’s office and other places. I needed part-time work that let me continue helping my mother.

“Is my father’s situation a challenge? Yes. Do I have regrets? No. He did his best for my brother and me, and now we’re returning the favor.”

Advice from a caregiver 

Keitt offers the following tips that she’s gained from her experience: 

- Prepare a Power of Attorney document while your parents can express their wishes clearly. “It let me obtain information that only my father would have received otherwise,” says Keitt

 - Accept help and encouragement. Friends can see you through when you feel you can’t go on.

- Do the best you can. Don’t push for perfection.

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Art helps those with early Alzheimer's

By Alicia M. Colombo
As a form of self-expression, art provides an outlet for creativity and emotion, and can have both therapeutic and cathartic benefits. For people with dementia, art can also be a bridge to social engagement, increase feelings of connectedness and enhance communication. 

“In the early stages of diagnosis, people face marginalization, and fear of judgment can lead to isolation,” said David Johnson, coordinator for The Rocket Education Community (REC) Center for Life Long Learning. A program of the Alzheimer’s Association Delaware Valley Chapter, the REC Center provides activities for people in the earliest stages of Alzheimer’s disease and related disorders. “We provide a safe and supportive environment to meet with their peers and to discuss what they’re going through. It’s not a support group, or therapy. It’s activity-based,” said Johnson. 

When the REC Center began as a pilot program in 2011, it was largely arts focused. “Through gathering input from participants, we’ve changed the program to have a more social focus. We now gear it towards what the participants like. A lot of the activities remain arts-based, because it’s a great way for everyone to get involved in the same activity. The need for this type of program has grown over the years as more diagnosed individuals are seeking early-stage services,” said Johnson. 

Participants engage in 10 weeks of stimulating cultural events, such as discounted trips to the cinema, theater, museums, performances and tours. Creative activities provide opportunities to explore new experiences and rekindle old hobbies or interests. Through volunteerism and advocacy initiatives, a sense of purpose is gained by contributing to Alzheimer's education. All of these activities allow people with early stage Alzheimer’s and related disorders to connect with others, remain engaged, increase communication, reduce stress and enhance coping skills.

Getting involved

Taking part in the REC Center requires comfort with sharing personal information. “It can be emotional at first. Many people feel socially isolated. The REC Center is a great opportunity for folks who are comfortable talking about their diagnosis and are seeking ways to get involved and engaged,” said Johnson. 

Mild cognitive impairment may be present in the beginning stages of dementia, but people are still high-functioning and remain fairly independent. “It’s an environment of peers. Having a care provider or companion would deter from the atmosphere of the group. Some folks still drive or are able to navigate public transportation,” Johnson said, who added that no medical assistance, medication administration or personal care is provided. 

People with early Alzheimer’s who may be interested in this program, or their caregivers, may call the Alzheimer’s Association. “We are against ‘information fatigue.’ Just mailing out materials can be overwhelming. We speak with the caregiver or person individually and discuss their situation to determine which programs may be right for them,” he said. 

Other early-stage Alzheimer’s programs include dual support groups for individuals with memory loss and their families; educational events featuring stories from people living with Alzheimer’s; and Peer-to-Peer anonymous telephone counseling. “Peer-to-Peer is a great first step for those who may just have received a diagnosis and are not yet comfortable enough to speak with a group about their situation. Unlike the people who answer our helpline who are trained professionals, these are volunteers with early-stage Alzheimer’s themselves, who truly understand what the person is going through,” said Johnson. People with Alzheimer’s can take advantage of any or all of these services. 

“The majority of Alzheimer’s Association services are focused on providing resources to professionals and caregivers. The REC Center is the first program that focuses on the person with Alzheimer’s and not just those who provide support or treatment,” he said.

Next steps

Individuals may participate in the REC Center as long as their condition remains in the early stages. “In times of transition, we have a conversation with the participant and family about other options,” said Johnson. A clinical team will work with transitioning REC Center participants to provide care consultation services for future planning; complementary support programs for caregivers; and referrals to additional resources, such as adult day centers or in-home care services. 

Later-stage art programs include Memories in the Making, an expressive watercolor program, and the Arts and Cultural Program. The latter is a partnership with ArtReach that provides $1 tickets for structured, artistic and cultural experiences to caregivers, family, friends and all people with Alzheimer’s.

About the REC Center

Sessions are 10 weeks long, and the next Philadelphia session begins on April 13. The group meets from 1 to 4 p.m. on Mondays and Wednesdays in Philadelphia, at the Alzheimer’s Association Delaware Valley Chapter Headquarters at 399 Market St., Suite 102; and on Tuesdays and Thursdays in Marlton, N.J. There are occasional outings to museums during nice weather. 

There is a fee of $60 per 10-week session, which includes access to all REC Center programming, event opportunities and other early-stage initiatives. For participants with financial difficulty, a sliding fee scale is utilized. 

For more information about joining the REC Center and other Alzheimer’s Association programs, call the Alzheimer’s Association 24/7 Helpline at 1-800-272-3900 or go to

CAPTION: Temple University student and volunteer biographer Emily SCott interviews REC Center participant Christopher Gadegbeku for The Spaces Between Your Fingers Project.  Photo by Alicia M. Colombo

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Putting a stop to elder abuse

By Marcia Z. Siegal
Elder abuse affects an estimated in one in 10 people age 60-plus, according to the National Adult Protective Services Association (NAPSA). It includes neglect/self-neglect; physical, emotional, and sexual abuse; and financial exploitation. Elders may be victims of more than one form at a time. For every case reported, many more go unreported, experts say. 

However, the issue is moving up on the national radar. On a federal level, the landmark Elder Justice Act, passed in 2010 as part of the Affordable Care Act, has resulted in increased resources and spurred new community collaborations and trainings to address all forms of elder abuse. Publicity about cases like those of Brooke Astor and Mickey Rooney have also helped to bring the issue to the public’s attention. 

In Philadelphia, reports of suspected elder abuse to the PCA Helpline have been rising steadily, according to Joseph Snyder, director of Philadelphia Corporation for Aging’s (PCA) Older Adults Protective Services (OAPS) and past-president of NAPSA. PCA’s Helpline received 2,600 elder abuse reports in fiscal year 2013; 3,000 the following year; and, halfway through the current fiscal year, had already received 1,700. Snyder predicts at least 3,400 reports will be made by year’s end. 

“It’s important to know the signs of elder abuse,” he says. “When in doubt, make the call.

Abusers are often family members

Self-neglect continues to be the most frequent issue reported, with financial exploitation second, according to Snyder. Older adults can be easy prey, especially because abuse often occurs at the hands of family members or trusted others. Victims may be afraid or embarrassed to speak out, or unwilling to report someone close to them. They may have cognitive impairments that make it difficult to care for themselves or to recognize and report abuse by others. In addition, Snyder says, recent studies suggest that brain changes related to aging may impact older adults’ judgment and decision-making, leaving them more gullible, especially in terms of financial exploitation. Dementia and isolation can also increase vulnerability. 

The Philadelphia Financial Exploitation Prevention Task Force, formed five years ago, has successfully collaborated on a number of investigations and prosecutions of elder financial abuse. The Task Force includes PCA; the Mayor’s Office and city law enforcement agencies; financial institutions; and legal and social service agencies serving the elderly. 
In Philadelphia, all forms of elder abuse, including financial exploitation can be reported 24/7 to PCA’s Older Adult Protective Services by calling the PCA Helpline at 215-765-9040. Anyone can report suspected abuse, and reports can be anonymous. Trained social service workers are available to provide intake, investigation, assessment, care planning and crisis resolution. The Pennsylvania Department of Aging also maintains a toll-free, 24/7 hotline for reporting elder abuse at 1-800-490-8505.
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Recognize & report elder abuse

Philadelphia Corporation for Aging offers these tips to help spot common signs of elder abuse:

Signs in the older adult:

Unexplained injuries: bruises, broken bones, burns, abrasions 

Poor hygiene, unusual weight loss or dehydration

Lack of needed glasses, hearing aids or other assistive devices

Over- or under-use of medication

Emotional state: anxious, timid, fearful or depressed

Caregiver signs:

Violence or excessive anger towards the older adult 

Conflicting stories about what is happening with the older person

Financial exploitation:

Abnormal bank account closings

Major withdrawals

Older adult visiting bank in the company of a stranger 

Sudden display of new wealth by the caregiver

An abrupt change in the person's will

New transfer of property

Older adult lacking basic needs despite adequate financial resources 
Signs of self-neglect:


Inappropriate dress for weather conditions

Leaving burning stove unattended


Lack of housekeeping

Failure to take needed medications
For more information on all forms of elder abuse, visit the National Adult Protective Services Association website, and click on “Get informed.”
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Diversity of city’s elders is growing

By Allen Glicksman

Philadelphia’s population encompasses a vibrant variety of ethnic and national backgrounds. Among the city’s elders, this diversity stems from three sources. First, the ethnic heritage of older persons born in the city, many of whose parents and grandparents were immigrants; second, those who migrated to the city from other locations in the United States; and finally, the foreign-born elderly.

Of the city’s 273,000 elders (age 60-plus), close to 112,000 are African-American; 37,000 of them migrated from the South to the city. About 16,000 have Latino origins. More than 40,000 older Philadelphians were born in another country. These foreign-born elders come from more than 40 different counties, from regions representing almost every area of the globe – Asia, Europe, the Americas and Africa. Their numbers have increased, from 11% of the city’s older adults in 2007 to 15% today.

The West Indies is the number one place of origin for foreign-born older Philadelphians, followed by the former USSR, China and Africa.

More than 40,000 older Philadelphians were born in another country. These foreign-born elders come from more than 40 different counties, from regions representing almost every area of the globe – Asia, Europe, the Americas and Africa. Their numbers have increased, from 11% of the city’s older adults in 2007 to 15% today.

Among Asian elders in the city, 99% were born outside the United States. More than 5,000 are from China; more than 2,000 from Vietnam; close to 2,000 from Cambodia; and close to 1,800 are from India.

White, American-born elders comprise 41% of the city’s senior population. Among them, four ethnic groups predominate: 20% report their heritage as being Irish; 18% Italian; 11% German; and 9% Polish. The remaining 42% is distributed among many different ethnicities. 

Significantly, almost half of foreign-born older adults came to the United States after age 40, with a quarter arriving after turning 55. For those who migrated in old age with children and grandchildren, the process of adjustment to a new land can both bind families closer together but can also place strains on relations between generations. 

Each of these groups brings its own customs and beliefs about caring for the elderly, attitudes toward formal service providers, and assumptions about the origins and treatment of various ailments in old age, especially dementia. Helping and supporting them in ways that are compatible with their cultures presents real challenges for the city and the social service organizations that serve them. 

The information provided above comes from analyses of information taken from the Integrated Public Use Microdata Series of the 2013 American Community Survey conducted by the Bureau of the Census. IPUMS-USA, University of Minnesota. 

Allen Glicksman, Ph.D., is director of research and evaluation for Philadelphia Corporation for Aging.
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VIDA program helps Latino seniors

by Marcia Z. Siegal

In Spanish, “vida” means life. At Congreso de Latinos Unidos, a human service agency focusing on Philadelphia’s Latino community, vida has an added meaning. Just ask Amada Mejía.

Mejía, 80, is one of scores of older adults to benefit so far from Congreso’s new Aging at Home – A Community Network program, referred to as “VIDA at Congreso” or simply, “VIDA.” Launched in spring 2014 through a three-year grant from the United Way of Greater Philadelphia and Southern New Jersey, VIDA serves Latino consumers 60-plus or those caring for an older adult, connecting them to benefits, social services and volunteer opportunities through a network of 40 collaborating agencies. “Whenever I have a problem I bring it here,” Mejía says smiling, as VIDA Director Teresa Elliott translates. “They help me with everything.”

A Colombian immigrant, Mejía is typical of many VIDA participants, who cannot read or write English and are often unable to access the help they need, according to Elizabeth Crespo, VIDA manager. “I am happy they feel comfortable coming here,” she says. 

Through VIDA, “we have the opportunity to spend time with clients and address their needs holistically,” says Crespo. For example, people might come in to apply for LIHEAP (the federal Low-Income Home Energy Assistance Program), “but I can talk to them about many things. I can help them apply for the rent/property tax rebate, food stamps, prescription and utility assistance programs, and more.”

This day, Mejía hands Crespo a statement she received from her Medicare-Medicaid HMO plan. “Nothing to worry about,” Crespo tells her. “They approved your expenses.” Mejía nods, relieved. Recently, Crespo and Elliott helped the older woman access private funds to fix her broken sidewalk. They also helped her deal with a bill for a kitchen tool she did not remember ordering, Mejía says.

One difficulty consumers face is having to get through automatic telephone prompts to get to the right person when there is a problem, VIDA staff says. With Mejía by her side, Elliott called the company to inquire about the bill, explained Mejía knew nothing about it and made sure the bill was cancelled.

Many times when a stranger calls on the telephone and talks to seniors like Mejía, “they don’t understand and just say ‘yes,’” Crespo says. Other times they are the targets of scammers, she says, adding “I tell them to just say no and if they receive a bill they don’t understand, to bring it to us. We keep a copy of everything in the consumer’s file – bills, correspondence, deeds, benefit applications, so that we have the information whenever we need it.”

“May God reward you,” Mejía says to Elliott and Crespo. “I don’t know if I deserve it, but you are very good to me.”

In years past, Mejía’s ex-husband, who is literate in English, helped her with benefit applications and financial matters. However, he is beginning to develop dementia and vision loss, she says. Since she acts as his caregiver, she also turns to VIDA on his behalf and for caregiving support.

Elliott and Crespo can meet with consumers at their homes and often make outreach visits there. They have visited Mejía’s ex-husband and helped to link him to a care-at-home program to provide him with meals, transportation and other needed services. They also helped him apply for benefit and entitlement programs. They often refer caregivers, like Mejía, to the Alzheimer’s Association Delaware Valley chapter, which offers support programs tailored to Latino individuals and families affected by this disease.

Through VIDA, Elliott and Crespo have intervened on behalf of Latino seniors facing homelessness. A  recent case included  an 80-year-old woman and her 60-year-old daughter who had been evicted from their apartment.

VIDA also addresses issues of deteriorating housing. “Housing repair is a huge issue in our community,” says Elliott. “There are houses with towels in the windows and mold everywhere.” A Latino senior who is a professional carpenter has volunteered to help with some of the repairs. As part of the project, he will train young men in the community in carpentry skills so they can help repair seniors’ homes and also learn a vocation.

VIDA also offers health and nutrition presentations; fitness activities, including a walking group; volunteer opportunities; gardening activities and classes in computers, English and more.

As has become routine for her, Mejía asks for VIDA brochures to take with her – 40 on this particular day – to hand out to Latino seniors she meets in the course of her daily activities. “I tell people ‘Go to Congreso. You can get a lot of help from this program,’” she says.

Congreso offers an array of health, education, employment, social service and volunteer programs in addition to its VIDA program. For more information: Congreso de Latinos Unidos, 216 W. Somerset St.; 215-763-8870; to To contact the VIDA program staff: 215-763-8870, ext. 1417; or

Caption: VIDA Director Teresa Elliott (center) and VIDA volunteers Carmen Laureano (left) and Amada Mejía unpack items to stock the food pantry for distribution to Congreso clients. (Photo by Paola Nogueras)

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CMS proposes rule on rights of same-sex couples

Comments due by Feb. 10 two-women-hug.jpg
The Centers for Medicare and Medicaid Services (CMS) has issued guidance and proposed regulatory revisions that provide equal treatment to all spouses, regardless of sex, of a valid marriage, even if the state where the individual lives or receives services does not recognize same sex marriage. Comments on the proposed rule are due February 10, 2015.   

Through the proposed rule, CMS seeks to ensure that definitions and rights provisions in the Nursing Home Reform regulations that currently defer to State law instead provide equal rights for same-sex spouses in legally-valid marriages in facilities participating in Medicare and/or Medicaid.

To that end, the proposed rule recommends a change to section 483.10 Resident’s rights and 483.128 PASARR evaluation criteria by adding language that “the same-sex spouse of a resident must be afforded treatment equal to that afforded an opposite-sex spouse if the marriage was valid in the jurisdiction in which it was celebrated.”

In addition to LTC Facilities, the proposed rules and guidance also apply to Ambulatory Surgical Centers, Hospice Care, Hospitals, and Community Health Centers.
For terms such as: spouse, marriage, family, and relative, and words often associated with the spousal relationship, like representative, support person, surrogate, and next-of-kin, CMS intends that these terms include spouses from all lawful marriages.

This includes same-sex marriages, regardless of where the couple resides or where the services are provided to the individual. 
Both the proposed rules and revised language for the State Operations Manual, Appendix PP – Guidance to Surveyors for Long-Term Care Facilities were issued December 12, 2014. An advanced copy of the revisions to Appendix PP was issued in a Letter from CMS to State Survey Agency Directors (S&C: 15-13-ALL) and is effective immediately. 
This document is available online at 
 You may submit comments in one of four ways (please choose only one of the 
ways listed): 
1. Electronically. You may submit electronic comments on this regulation to Follow the "Submit a comment" instructions. 
 2. By regular mail. You may mail written comments to the following address 
 Centers for Medicare & Medicaid Services, 
Department of Health and Human Services, 
Attention: CMS-3302-P, 
P.O. Box 8013, 
Baltimore, MD 21244-8013. 
Please allow sufficient time for mailed comments to be received before the close 
of the comment period. 
3. By express or overnight mail. You may send written comments to the 
following address ONLY: 
 Centers for Medicare & Medicaid Services, 
 Department of Health and Human Services, 
 Attention: CMS-3302-P, 
 Mail Stop C4-26-05, 
 7500 Security Boulevard, 
Baltimore, MD 21244-1850. 
Ronisha Davis, (410) 786-6882. 
Inspection of Public Comments: All comments received before the close of the comment 
period are available for viewing by the public, including any personally identifiable or 
confidential business information that is included in a comment. We post all comments 
received before the close of the comment period on the following Web site as soon as 
possible after they have been received: Follow the search 
instructions on that Web site to view public comments. 
Comments received timely will also be available for public inspection as they are 
received, generally beginning approximately 3 weeks after publication of a document, at 
the headquarters of the Centers for Medicare & Medicaid Services, 7500 Security 
Boulevard, Baltimore, Maryland 21244, Monday through Friday of each week from 8:30 
a.m. to 4 p.m. To schedule an appointment to view public comments, phone 1-800-743- 
The information in this article was provided by Lori Walsh, manager of the Philadelphia Long Term Care Ombudsman Program and the CARIE Line -- 215-545-5728 -- at the Center for Advocacy for the Rights and Interests of the Elderly (C.A.R.I.E.) 

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Caring for a loved one, feeling stressed?

PCA's Family Caregiver Support Program is here to help: Call the PCA Helpline, 215-765-9040
Philadelphia Corporation for Aging’s (PCA) Family Caregiver Support Program (FCSP) provides qualified caregivers with:

·         Care management
·         Benefits counseling
·         Education and training
·         Home modifications
·         Assistive devices
·         Reimbursement benefits. 

“Our goal is to reduce caregiver stress and provide support to maintain the caregiver-care recipient relationship,” said Cheryl Clark, FCSP director at PCA.

Caregivers may receive $200 a month in reimbursement for caregiving services and supplies, and may also receive up to lifetime maximum of $2,000 in housing modifications or assistive devices, such as stair glides and tub grab bars, to make caring for the loved one at home easier.

The monthly reimbursement funds are most commonly used for “respite” care, where an in-home care aide comes in for a few hours to give the caregiver a needed break, and for personal or medical supplies. 

The caregiver may select a respite worker from personal contacts or a home care agency, but the worker cannot be the caregiver or a relative of the care recipient. The monthly reimbursement benefit may be increased based on the caregiver’s needs.  

   To be eligible for the state program, the caregiver must reside with the care recipient, provide daily hands-on care and have primary responsibility for the physical and emotional well-being of the care recipient. 

The care recipient must be age 60-plus, or 18-plus with a diagnosis of dementia or a severe disability, and require assistance with at least one activity of daily living (ADL). Information and benefits counseling is available to eligible caregivers, regardless of income. 

A sliding scale is used to determine reimbursement benefits based on household income. PCA also supports other caregiving programs, such as those assisting grandparents who are raising their grandchildren. 

FCSP currently has no waiting list, so applications and referrals are encouraged.

Call the PCA Helpline at 215-765-9040.
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Caregiver gets much-needed support

By Alicia M. Colombo
Sergey Denisenko works with the precision and dedication of a skilled health care worker, giving his 66-year-old mother insulin shots to control her diabetes. He has no formal medical training, but has learned the skills he needs to cope with the demands of her multiple chronic conditions, including diabetes, blood circulation problems and asthma.

Although Klavdiya Denisenko requires daily care and monitoring to manage her health, thanks to her son’s dedication she is able to live independently in her own home, in Philadelphia’s Rhawnhurst section.

As an only child, he has shouldered the responsibility for her care alone since 2008. “I have no siblings. There is no one else in the family to help my mother. She only has an older sister left, who needs help herself,” he says.

He makes the half-hour drive from his home in Warminster to his mother’s house first thing every morning. “She can take pills when I leave them for her and do other things for herself, but it takes longer. You have to be very patient and understanding. She did not choose to be in this situation,” he says.

Help for the caregiver
Caring for his mother has put a strain on Denisenko, both financially and emotionally. A friend suggested he call Philadelphia Corporation for Aging (PCA) to seek help, and as a result, he connected with PCA’s Family Caregiver Support Program (FCSP).

“Sergey (Denisenko) is the most dedicated and loving caregiver you’ll ever meet,” says Isabella Berrman, a service coordinator at PCA.

Through FCSP, he receives caregiver education, benefits information, assistance in accessing services and reimbursement for some of his out-of-pocket caregiving expenses.

Denisenko utilizes the reimbursement from PCA to hire a family friend to come in for a few hours during the day, so he can run errands or just have some time to himself. He says his mother is comforted by the structure of her daily routine and enjoys spending time with her friend.

“Mom communicates well with her, not just because they both speak Russian. They have a connection. It’s a relief that it doesn’t all fall on me,” he says. 

Seeing a friendly face, and having someone who understands his struggle is as important to him as receiving financial support. “Sometimes with professional home care workers you feel they are doing the bare minimum or they may have an attitude. My PCA service coordinator, Isabella, is really great. You can feel that certain people care. It’s a special human element,” says Denisenko.

He also receives private counseling through the CARES program, which is a service providing caregiver support and strategies, that helps to put his mom’s situation into prospective.

“It’s showed me that yelling doesn’t help and that approaching a situation differently can make a difference. As time progresses, we only get sicker. No one gets younger. It’s great that this program exists to help older people stay at home. It’s help that I otherwise wouldn’t be able to get,” he says.
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Caregiving edition

This special issue is dedicated to the many loving and generous caregivers, wishing you joy and peace, this holiday season.

The next Milestones e-news will be published January 7, 2015. Philadelphia Corporation for Aging wishes you a happy and healthy New Year!

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Build a family caregiving team

By Marcia Z. Siegal
“Nothing reveals the fault lines in sibling relationships like the seismic shift caused by an aging parent’s sudden decline,” wrote psychologist Barry Jacobs in his article “Doing What’s Best for Mom and Dad,” (Psychology Network Magazine, Sept./Oct. 2010).

While one or more siblings may live close to the person in need of care, others may live far away. Caregiving expenses can become an issue. Old sibling conflicts may flare up again.

To build a successful family caregiving team, siblings need to share a common view of their parent’s medical and functional situation, learn to collaborate, and let go of the past, he advises.

Jacobs is director of behavioral science for the Crozer-Keystone Family Medicine Residency Program in Springfield, Pa. and author of “The Emotional Survival Guide for Caregivers – Looking After Yourself and Your Family While Helping an Aging Parent” (The Guilford Press, 2006).

“Ninety percent of the time, one person is responsible for caregiving, often the youngest daughter,” he says, noting that shouldering such responsibility alone can be immensely stressful.

“Caregivers tend to be very focused on the needs of the person they are caring for and consequently neglect their own medical and social needs. This makes them more likely to burn out over time if their needs are not replenished. Ideally, family members should have roles that complement one another,” he advises. 

In “Doing What’s Best for Mom and Dad,” Jacobs described a family of five siblings who consulted him to mediate issues they were having over their aging mother’s care.  Diane, the youngest, had been providing daily care to their severely arthritic mother while her siblings “cheered from a distance.”

As her mother’s health declined, Diane felt she couldn’t continue to provide the increasing level of care her mother needed, so she urged the older woman to sell her house and move into an assisted living facility. Her four siblings objected angrily. They met with their mother and convinced her that remaining in her home was in her best interests. 

Develop a common vision

Jacobs says the first, most important and usually most difficult step for siblings is to develop a similar view about their parent’s physical and mental health status and care needs. Conferring together with their parent’s doctor or having a mediator do so on their behalf can help to clarify the situation, because frequently siblings disagree about what’s going on.

In the case described above, Jacobs met with the five siblings after consulting with their mother’s physician and conveyed the physician’s view of their mother’s medical and functional issues. As a result of that meeting, all of the siblings were able to agree that their mother needed more hands-on care but did not yet require institutional care. 

Communicate, collaborate

Beyond developing a common vision, siblings need to share information and keep each other updated to operate effectively as a caregiving team, Jacobs says. One effective tool, he suggests, is to create an e-mail group to communicate regularly about a parent’s medical status, logistical requirements, insurance and other pertinent information.  Then meet periodically in person or via conference call to discuss what’s needed and divide responsibilities. 

While one sibling may still be the primary caregiver, “there is a long list of chores and ways other siblings can contribute,” he says. For example, this can include shopping and/or driving to medical appointments, handling finances, providing respite to the caregivers or helping with expenses. “Ideally, siblings should meet and review the caregiving plan at least every three months because the situation is never static,” he says.  

Let go of the past

Differing perceptions, sibling grudges and rivalries, and other past family experiences can sabotage the caregiving team, but the need to come together for a parent’s sake can help siblings surmount these obstacles. While they may still view things through the lens of the past, helping a parent in declining health usually brings out unforeseen capabilities in family members, says Jacobs.

Through meetings, sharing information and collaborating on a parent’s behalf, siblings can increase mutual trust, learn to negotiate and better appreciate one another. Building a caregiving team not only benefits the aging parent, it can help families to become stronger, he says. 

For information on “The Emotional Survival Guide for Caregivers,” visit  
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Resources, respite for caregivers

By Alicia M. Colombo
The daily stress of caregiving can be overwhelming. Even if you take on the role of caregiver happily and voluntarily, you may find that the responsibilities put a strain on your emotions, finances, social life and physical health.

Caregivers provide an invaluable service to their older or disabled loved ones, assisting with daily activities and medical care to help them remain at home. If you are caring for a spouse/partner, family member, friend or neighbor, you are not alone. According to the Family Caregiver Alliance, 43.5 million adults in America provide care for someone age 50-plus.

There is help for caregivers in Philadelphia. If you are caring for an older adult and need help, the following resources may be helpful. The person you are caring for need not live with or be related to you, to utilize these services.

Caregivers Reducing Stress (CARES) is a free program from Lutheran Settlement House designed to ease the emotional burden of caregiving, through individual or family counseling, support groups, and connection to resources.

“The goal of CARES is to reduce the stress of people informally caring for low-income older adults. By improving the well-being of caregivers, the program also enables older adults to age in place,” said Sarina Issenberg, LSW, CARES program manager. CARES is based on a long-term study of spouse caregivers for people with dementia, conducted by New York University, which found that personalized counseling reduced stress and depression among caregivers, and delayed nursing home entry for care recipients.

To be eligible, the care recipient must be age 55-plus and living independently in Philadelphia with a household income of no more than $17,505 (individual) or $23,595 (two people). The caregiver must be age 18-plus and provide unpaid assistance with an activity of daily living (ADL), such as dressing, bathing, eating, transferring or toileting.
“A caregiver assessment is administered to identify stressors, then an individualized action plan is created," Issenberg said. "This can include working on relaxation, developing communication techniques with family members, mobilizing social support networks, dealing with feelings of guilt and frustration, and accessing resources. It’s not psycho-therapy, or long-term counseling, but rather a collaborative effort to help the caregiver healthily adapt.”

Six counseling sessions are provided for the caregiver alone or in conjunction with family members and/or the care recipient. In addition, CARES also hosts support groups for caregivers of older adults that are free and open to the public. These take place at Northeast Regional Library, Cottman & Bustleton Aves., on the first Thursday of the month at 10:30 to noon; and at West Philadelphia Senior Community Center, 41st & Poplar Sts., on Wednesdays (except last in month) at 10:30 to 11:30 a.m. Alternate sites and times can be arranged by request. 

Even if your income is above the guideline, Issenberg said she can connect you with resources. “I encourage all informal caregivers of older adults to call us for assistance. We keep an active, updated list of referral programs and caregiver resources,” she said. For information about CARES, call 215-426-8610, ext. 1207 or e-mail

Family Caregiver Support Program
 Philadelphia Corporation for Aging’s (PCA) Family Caregiver Support Program (FCSP) provides caregivers who qualify with financial support, as well as education, training and resources. Caregivers may receive $200 to $500 a month in reimbursement for caregiving services and supplies, and may also receive up to $2,000 in housing modifications or assistive devices, such as stair glides and tub grab bars, to make caring for the loved one at home easier. The monthly reimbursement funds are most commonly used for “respite” care, where an in-home care aide comes in for a few hours to give the caregiver a needed break, and for personal or medical supplies. The caregiver may select a respite worker from personal contacts or a home care agency, but the worker cannot be the caregiver or a relative of the care recipient.

“Our goal is to reduce caregiver stress and provide support to maintain the caregiver-care recipient relationship,” said Cheryl Clark, FCSP director at PCA. 

To be eligible, the caregiver must provide hands-on care and have primary responsibility for the physical and emotional well-being of the care recipient. The care recipient must be age 60-plus, or 19-plus with a diagnosis of dementia or a severe disability, and require assistance with an ADL. Information and benefits counseling is available to eligible caregivers, regardless of income. To receive reimbursement for services or supplies, the household income limit for FCSP is $44,347 for one person or $59,775 for two people.  

“In a perfect world, older adults would be cared for by their children or closest relative. But children might live far away, or they might not be willing or able to provide care full-time,” said Clark, who added that caregivers do not have to be a relative as the program’s name suggests. Friends, neighbors or church members can be, and often are, caregivers. 

FCSP currently has no waiting list, so applications and referrals are encouraged. For more information about FCSP and other caregiving programs, such as those assisting grandparents who are raising their grandchildren, call the PCA Helpline at 215-765-9040.

Temple Time Out
Caregivers for an elder with cognitive and/or physical challenges can benefit from Time Out, a program of Temple University’s Intergenerational Center. College students are trained to be respite care providers and act as companions for these older adults, providing socialization and stimulation; assistance with light meal preparation, laundry or changing bed linens; accompaniment on public transit for grocery shopping and other errands; and medical escorts. The program does not assist with personal care, medication administration or therapies. 

“We are able to visit people who live in Philadelphia or the nearby suburbs. Our main goal is to provide the caregiver some ‘time out’ – a chance to take a deep breath,” said Mady Prowler, MSW, program manager of the Time Out Respite Program.

Time Out is unique because it serves multiple purposes – reducing isolation and promoting independence for the elder; lightening the caregiver’s load; and providing real-life experience for students interested in the helping professions, particularly those thinking about working with older adults.

“Ageism still exists, and we’re trying to change young people’s perceptions of an older person and what they can do,” said Prowler. “Students cater to the specific needs and tastes of the care recipient. They discuss shared interests, build a strong bond, and learn to respect the person they’re caring for. For elders who don’t have grandchildren to spend time with or children who live far away, it’s a very special gift.”
           Student respite workers receive rigorous pre-service training and ongoing support related to aging and the needs of caregivers. Students are carefully screened through references and a criminal background check. “Time Out is very well-established with a 28-year history in Philadelphia. It’s a reputable, respected and needed program. We work with the students throughout their respite home care experience to help them develop the best approach for their particular individual or family,” said Prowler

The cost to receive services through Time Out is $8 an hour, plus a $25 annual registration fee. A limited number of no-cost student respite workers may be available through their college’s work study program.

For information or to apply, call 215-204-6540, e-mail or go to

Jefferson Elder Care
           Caring for an older adult with dementia poses special challenges and stressors. According to the Alzheimer’s Association, nearly 15 million adults in the United States are caring for someone with dementia. Through Jefferson Elder Care, caregivers of someone with memory loss, Alzheimer’s disease or a condition that causes dementia, such as Parkinson’s disease, can receive occupational therapy (OT). 
Unlike the other programs mentioned, the caregiver can be paid or informal.

“It’s so important for the person with dementia to have an educated caregiver. Caregivers are often not provided with training and education to meet needs of a person with dementia,” said Catherine Verrier Piersol, PhD, OTR/L, clinical director of Jefferson Elder Care. “We’ll work with any caregiver in the home. Sometimes, we’re helping the family caregiver by empowering them to teach skills to paid workers.”
When a person with dementia has trouble starting activities, such as getting dressed or taking a shower, occupational therapists teach caregivers to simplify what they say or use different types of cues to enhance participation. “We help the caregiver to ensure safety during daily activities and promote the person’s maximum level of capacity. This in-home OT service is meant to help give caregivers the skills to do their job better; caregivers are typically involved in the sessions, so it is not considered a respite program,” said Piersol.  
This home-based clinical service is available to everyone with Medicare Part B, which covers outpatient services. Under standard Medicare Part B, there is a 20% co-pay for OT services, but most patients have a supplement that covers that. “The beauty of the program is that Medicare Part B provides reimbursement to enhance the skills of caregivers. It’s been our experience that most people are not taking advantage of this OT benefit. Each Medicare beneficiary can receive $1,920 of OT services per calendar year,” said Piersol.
Through a grant from The PEW Fund, Jefferson Elder Care is able to serve low-income elders and their caregivers who do not have Medicare Part B. To be eligible for no-cost services, the elder must meet Medicaid income guidelines of $2,400 a month for a single person or $3,400 a month for a married couple. 
For more information, call 215-503-6791, e-mail, or go to

Older adult daily living services
For elders who need extended supervision or assistance while a caregiver is out during the day, adult day centers may be a viable option. Adult day centers are non-residential facilities that provide a safe environment for elders who cannot remain at home alone. Licensed by the Pennsylvania Department of Aging (PDA), these facilities provide a planned program of activities that promotes well-being and social interaction.

Adult day centers typically provide personal care, recreational activities, counseling and social services, medical support and monitoring, and transportation to/from the center. Some facilities may also offer dementia care and specialized health care services. 
 Adult day services can be provided in half- or full-day time increments, which  offers caregivers flexibility.  
“Adult day centers provide a dual benefit. The caregiver receives an extended break, while the care recipient receives stimulation and socialization through activities with others. It can be especially beneficially for people with dementia, by providing a structured routine,” said PCA’s Clark.

At an average cost of $75 a day, enhanced adult day centers licensed by PDA are a good alternative for extended daily care assistance. However, they are more expensive than an in-home care aide. Medicare and standard health care insurance do not cover adult day services, but some programs, such as Aging Waiver or Options, Veterans Administration or long-term care insurance may assist with the cost.  For a list of adult day services in Philadelphia, call the PCA Helpline at 215-765-9040 or visit; or (type “Philadelphia Adult Day” in the search box).

Living Independently for Elders (LIFE) Programs
The LIFE program offers participants a comprehensive array of medical services, adult day services, meals, transportation and personal care, all provided and coordinated from a single location. The program is known in Pennsylvania as “LIFE” and nationally as the Program of All-Inclusive Care for the Elderly (PACE). It is designed to enable the elderly to live as independently as possible, in the community. 

To be eligible, an individual must be 55 years of age or older and eligible for Medicare and/or Medicaid; require nursing facility level of care services; and live in one of the LIFE programs' service delivery areas. Participants must meet the financial requirements as determined by the Department of Public Welfare, or be able to privately pay.

There are currently three LIFE Programs in Philadelphia, which serve designated geographic areas. Following are the centers and service areas:

University of Pennsylvania School of Nursing LIFE Program
Phone: 215-573-6691     
Areas served: zip codes 19103, 04, 21, 30, 31, 39, 42, 43, 51, 53 

Mercy LIFE Program
Phone: 215-339-4747 
Areas served: zip codes 19106, 07, 22, 23, 25, 33, 34, 37, 40, 45-48; and Delaware County 

NewCourtland LIFE Program
Phone: 267-335-1500     
Areas served: zip codes 19100-11, 14-16, 18-20, 24, 26-29, 32, 35, 36,  38, 41, 44, 49, 50, 52, 54

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Stay informed during an outage

One of the most important pieces of equipment you can have is a battery-operated radio so you can stay informed.

Leading up to a storm, the Office of Emergency Management monitors forecasts carefully, and strives to determine in advance what emergency measures may be needed, and to keep the public informed. “Heading up to a storm, we generally do a press conference with the Mayor,” said Edward Vassallo, public information program manager for the Office of Emergency Management (OEM). Media outlets are updated frequently on conditions and resources, so tuning in to TV or radio news is helpful. 

Vassallo also recommended signing up for emergency alerts through These can be sent to an email account or to your cell phone. If you do not have either of these, you can call the city’s information line at 3-1-1.
Key resources: 

Philadelphia Office of Emergency Management (OEM): The website,, is updated 24/7 during an incident. OEM also posts emergency information on TV Channel 64, the City’s Government Access television channel. OEM posts frequent updates on Twitter, Facebook, Google Plus, LinkedIn, YouTube and Blogger.

City of Philadelphia information call center: 3-1-1 – or, for those with Voice over Internet Protocol (VoIP) and for calls from outside of Philadelphia: 215-686-8686.

PECO: 800-841-4141 to report power outages or fallen power lines. More information, and updates on outages:

Red Cross: 1-866-GET-INFO is a central number where you can register, so family from outside the area can get information about you. You can also register online at 
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Some war vets may qualify for free care at home

Source: U.S. Department of Veterans Affairs The Veterans' Administration "Aid and Attendance" program provides financial assistance with personal care for low-income veterans who meet specific requirements for military service, or their surviving spouse. You must already qualify for the Veterans Pension to receive this additional aid. 

An Aid & Attendance (A&A) increased monthly pension amount may be added to the monthly pension amount if you meet one of the following conditions:
  • You require the aid of another person in order to perform personal functions required in everyday living, such as bathing, feeding, dressing, attending to the wants of nature, adjusting prosthetic devices, or protecting yourself from the hazards of your daily environment
  • You are bedridden, in that your disability or disabilities requires that you remain in bed apart from any prescribed course of convalescence or treatment
  • You are a patient in a nursing home due to mental or physical incapacity
  • Your eyesight is limited to a corrected 5/200 visual acuity or less in both eyes; or concentric contraction of the visual field to 5 degrees or less
There is also a separate benefit if you are housebound. This increased monthly pension amount may be added to your monthly pension amount when you are substantially confined to your immediate premises because of permanent disability. 

You cannot receive both Aid & Attendance and Housebound benefits.

Apply for Veterans Pension
To apply for Veterans Pension, download and complete VA Form 21-527EZ, “Application for Pension”. You can mail your application to your local regional benefit office. You can locate your local regional benefit office using the VA Facility Locator. You may also visit your local regional benefit office and turn in your application for processing.

How to Apply for Aid or Attendance or Housebound benefits
Write to the VA regional office where you filed a claim for pension benefits. If the regional office of jurisdiction is not known, you may file the request with any VA regional office.

You should include copies of any evidence, preferably a report from an attending physician validating the need for Aid and Attendance or Housebound type care.

The report should be in sufficient detail to determine whether there is disease or injury producing physical or mental impairment, loss of coordination, or conditions affecting the ability to dress and undress, to feed oneself, to attend to sanitary needs, and to keep oneself ordinarily clean and presentable.

Whether the claim is for Aid and Attendance or Housebound, the report should indicate how well the applicant gets around, where the applicant goes, and what he or she is able to do during a typical day. In addition, it is necessary to determine whether the claimant is confined to the home or immediate premises. 
For more details, click here.
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Support groups offer safe haven

By Alicia M. Colombo Senior centers are a valuable resource for the support and connections that are so essential to maintaining emotional health as people age.

In addition to social and recreational activities, centers have staff counselors who can provide one-on-one help and resources. Regularly scheduled support groups provide a safe, confidential and nurturing environment. These groups may be led by licensed social workers, trained counselors or therapists, or senior volunteers.
          Here is a sampling of the support groups, grouped by topic, currently meeting at senior community centers in Philadelphia.

Boomers R Heroes:
Caregivers meet to download stress, voice needs and fears, and learn to take care of themselves. North Broad Senior Center, twice a month (Sept. 9 & 23), 11:30 a.m. to 12:30 p.m.
Caregivers Support Group: I nformation, support & sharing of personal experiences. West Philadelphia Senior Community Center, most Wednesdays (Sept. 3, 10 & 17), 10:30 to 11:30 a.m.

Bereavement Support Group:
Southwest Senior Center, monthly, date varies, next session: Sept. 24, 11 a.m.
Loss & Support Group: Klein JCC, Wednesdays, 12:40 to 1:40 p.m.
Newly Bereaved:
Klein JCC, Thursdays, 12:30 to 2 p.m.
Post Bereavement
(continued support in later months and years of grief): Klein JCC, Thursdays, 10:40 to 11:40 a.m.
Widows & Widowers Support Group:
Northeast Older Adult Center, Fridays, 10 a.m. 

Brain Health & Memory Retention:
 Exercises & activities for the mind.

West Philadelphia Senior Community Center, Mondays, 1 p.m.
Center in the Park, Wednesdays, 10 to 11:30 a.m.

Let’s Talk  (cancer survivors & relatives celebrate life): Mann Older Adult Center, 2nd Thursday of month, 10:30 a.m.

The Women of Faith & Hope   (breast cancer support group): Center in the Park, 3rd Monday of month, 1 to 2:30 p.m.

Kicking Cancer to the Curb  (cancer survivors): Marconi Older Adult Program, 3rd Wednesday of month (Sept. 17), 10 a.m.

The Doctor’s in the House  (discuss health concerns): Center in the Park, 1st Monday of month, 10 to 11:30 a.m.


Center Counselor Support Group:  Norris Square Senior Citizen Center, 2nd & 4th Thursdays of month, 10 a.m. to 12 p.m.

COMHAR Support Group  (Community Organization for Mental Health and Rehabilitation): Depression screenings, resources and referrals. Norris Square Senior Citizen Center, Wednesdays, 10 a.m. to 12 p.m.

LGBT Age 50+ Rap Session:  Outlet for LGBT older adults to discuss feelings and experiences. William Way LGBT Community Center, 1315 Spruce St., 215-732-2220, Thursdays, 1 to 2 p.m. 
The Next Chapter – Sharing Our Joys, Sorrows & Everything in Between: Volunteer-led peer discussion groups on life, love, loss and change. Sponsored by the Center at Journey’s Way.

·         St. Anne’s Senior Citizen Center, Tuesdays (starting Sept. 9), 10:45 to 11 a.m.

·         West Philadelphia Senior Community Center, Tuesdays, 12:30 to 1:30 p.m.

·         The Center at Journey’s Way, Tuesdays (Sept. 9 through Nov. 25), 1 to 2 p.m.

·         Center in the Park, Tuesdays, 1 to 2:30 p.m.

·         Juniata Park Older Adult Center, Wednesdays, 12:30 p.m.

·         Northeast Older Adult Center, Thursdays at 10:30 a.m.
Peer Support Counseling:   Juniata Park Older Adult Center, Tuesdays, 10 a.m.

Reminiscence Group:  Share memories of growing up, your family, happy times and more. South Philadelphia Older Adult Center, Thursdays, 9:30 a.m. 
Sharing and Caring: 
Discuss your concerns over coffee, give advice and share resources. West Philadelphia Senior Community Center, Wednesday, 9:15 a.m. 
Silver Foxes (social and discussion for LGBT elders): William Way LGBT Community Center, 1315 Spruce St. 215-732-2220, 4th Sunday of month, 2 to 4 p.m. 
Spiritual Journeys

·         Inspirational Hour  (share blessings, request prayers, encourage others): West Oak Lane Senior Center, Thursdays, 11 a.m.

·         Non-Denominational Inspirational Group  :Northeast Older Adult Center, Fridays, 9 a.m.

·         Pastor-led group reads and discuss passages: Peter Bressi Northeast Senior Center, two Mondays a month (Sept. 8 & 22). New group, call for details.       

TLC (Talking Listening & Caring) Groups:

·         Philadelphia Senior Center – Main Branch, Thursdays, 10 a.m.

·         South Philadelphia Older Adult Center, Fridays, 10:30 a.m.

·         St. Anne’s Senior Citizen Center, monthly (Sept. 24), 11 a.m. to 12 p.m.

Transition to Aging Group:  Adults, ages 50 to 100-plus, discuss  the challenges, surprises, and rewards of growing older.  West Philadelphia Senior Community Center, Tuesdays, 10:30 a.m. 

M  ale and female veterans from all branches of the military meet to talk and learn about resources.

·         Haddington Multi-Services for Older Adults, monthly (Sept. 3), 10 a.m. to 12 p.m.

·         West Philadelphia Senior Community Center, 3rd Wednesday of month, 10:30 to 11:30 a.m.

·         North Broad Senior Center, last Wednesday of month, 1 to 2: 30 p.m.

Man to Man Wellness Sessions:
Haddington Multi-Services for Older Adults, Thursdays, 10 to 11 a.m.

Men’s Bull Session:  Men discuss sports, news, the economy & more. Marconi Older Adult Program, Tuesdays, 10:30 a.m. 
Phenomenal Women Group: Share life stories & record your experiences for future generations. Philadelphia Senior Center – Tioga Branch, Thursdays, twice a month (Sept. 4 & 18), 10 a.m. 
Supportive Older Women’s Network (SOWN) Groups:

·         Northeast Older Adult Center, Mondays, 9:30 a.m.

·         Klein JCC, Wednesdays, 10:40 to 11:40 a.m.

·         South Philadelphia Older Adult Center, Thursdays, 10:30 a.m.

·         Southwest Senior Center, Thursdays, 1 to 2 p.m.

Women’s Support Group:  Lutheran Settlement House, Mondays, 9 to 10 a.m.


Having Our Say:  Discuss news and Black history. Martin Luther King Older Adult Center, Tuesdays, 1:30 to 3 p.m.

Current Events  Discuss what’s happening in the world and how you feel about it. West Philadelphia Senior Community Center, Fridays, 9:15 a.m. 
Lifestyles: Reinvent yourself. Learn positive, inexpensive ways to redesign your home, clothing style, make-up, jewelry and more. Spring Garden Center, Thursdays, 10:30 a.m.
          Unless indicated otherwise, the above activities are free. All older adults, age 60-plus, are welcome at any senior center in Philadelphia. Some centers also welcome adults between the ages of 50 and 60. Contact your local senior center directly for more information.   Click here for a list  of senior centers. You may also contact the PCA Helpline at 215-765-9040.

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Companions help brighten lives

By Marcia Z. Siegal Evelyn Riley and Ernestine White, both 74, have developed quite a rapport in the two years they have known each other. Riley is homebound as a result of multiple chronic health conditions. White is her Senior Companion, who visits 20 hours each week, socializing with her and assisting with small tasks. Both say they might be sitting home alone, were it not for the other.

Riley is a participant in the In-Home Support Program (IHSP) intended to assist her in remaining safely at home.

“I’ve got a bad heart, high blood pressure, arthritis, slight dementia, and I’m bipolar,” Riley says. White helps her with light meal preparation, running errands, and accompanies her on outings and tomedical appointments. Most importantly, White’s companionship reduces the isolation Riley might otherwise experience “being homebound with no one to talk to,” as Riley puts it.

“Ernestine goes with me for shopping and to pay bills because I can’t walk by myself. Sometimes we go out on the plaza nearby and just sit and talk,” Riley explains “She’s an all-around help.

The Senior Companion Program (SCP) is one of three service programs for older adults sponsored by the federal Corporation for National and Community Service. Philadelphia Corporation for Aging (PCA) oversees the program in Philadelphia, working with 20 nonprofit organizations, including the five senior centers administering IHSP, to identify homebound elderly who could benefit by having a companion. Riley and White were matched through the IHSP for North Central Philadelphia administered by North City Congress at the North Broad Street Senior Center. 

In addition to IHSP consumers, Senior Companions work with homebound older adults identified by senior apartment buildings and by other social service organizations, according to Kimberley Johnson, PCA manager for the program.

There are currently 73 Senior Companions in Philadelphia, ranging in ages from 55 to 88, and “we are always looking for more people to serve,” she says. Senior Companions must be age 55-plus and meet income eligibility requirements and commit to 20 hours of service a week. In turn, they receive a tax-free stipend; travel and meal reimbursements; accident and liability insurance; mileage reimbursement while serving; paid holiday, sick leave and vacation time; paid pre-service training; and ongoing monthly training. 

White says she is grateful for the opportunity to serve this way. “It keeps me from sitting at home. I like being busy, and I like being useful,” says the retired administrative assistant. “Evelyn and I have a very good relationship. When she’s having a difficult day, we sit and talk it over. There’s always a way to talk things out. She lets things worry her. I tell her to try not to let things worry her. I’ll suggest we go for a walk if the weather is nice to take hermind off her worries, and I try to get her to smile and laugh.

Courtney White, IHSP supervisor at Center in the Park in Northwest Philadelphia, says Senior Companions are invaluable. “They’ve told us about extermination issues,about homes that need repair, about consumers who need a fan or air conditioner to deal with the summer heat, and other problems. Recently a Senior Companion shared with us that it did not seem safe for her consumer to live alone, that she was not doing well. We investigated further and eventually helped that person to move in with family. Senior Companions are our eyes and ears in the consumer’s home when staff or family members cannot be there.”

For information about having a Senior Companion assigned to you, call the PCA Helpline at 215-765-9040. For information about the Senior Companion Program, call 215-765-9000, ext. 5126 or e-mail
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Help when it's needed

The In-Home Support Program (IHSP), administered through five senior centers in different areas of the city, provides early intervention and preventive services to assist eligible older adults, age 60-plus, on their way back to independence. Services, such as personal care, may be provided for four weeks for individuals who are in a period of recovery from a medical condition, or other circumstances for which assistance is needed.

If home support services, such as housekeeping or shopping are needed, help is available for a short-term period of six months. Other services, such as a Senior Companion, home-delivered meals and transportation, may be offered for a longer period of time. Seniors can also receive counseling about benefits and discounts. For information about the IHSP program, call the PCA Helpline at 215-765-9040. 

The following organizations currently administer the IHSP program: 
Catholic Health Care Services, St. Charles Senior Community Center (South Philadelphia): 215-732-1140 
Center in the Park (Northwest Philadelphia): 215-848-7722 
Klein JCC (Northeast Philadelphia): 215-698-7300 
Lutheran Children & Family Service, West Philadelphia Senior Community Center (West Philadelphia): 215-399-4980 
North City Congress, North Broad Street Senior Center (North Central Philadelphia): 215-978-1360

Photo of Senior Companion Don "Rick" Graddick and Dorothy Moore  by Raymond W. Holman, Jr. 
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PCA services help seniors stay in their homes

As people age, tasks which once were easy become more difficult -- cooking, cleaning, even caring for oneself can be a challenge. But with the proper support, many people can, and most would prefer, to stay in their homes. A broad range of services and resources is available to help make this possible. 

Home-based care enables the person to maintain independence; to remain in a familiar setting; and to maintain optimum control over his or her own well-being. 

The process begins with a phone call to the PCA Helpline at 215-765-9040. Following a telephone interview, an assessment worker may be scheduled to visit the home. A determination of eligibility will be made, based on your care needs and financial resources.

Getting the Care You Need
There are two options for service through PCA; Aging Home and Community-Based  Waiver Services; and Options.

Eligibility for services is based both on the individual’s need for care, and on ability to pay for services. There are formulas that take into consideration income, assets and expenses, to determine on a case-by-case basis whether a person is eligible to receive services at no cost; on a sliding scale; or on a personal pay basis.

To begin the process of determining eligibility, contact the PCA Helpline at 215-765-9040.

Following is a list of services that may be available to you:

Adult Daily Living Services
Community Transition Services
Companion Services
Counseling Services
Environmental Modifications
Financial Management Services
Home-Delivered Meals
Home Health Services
Non-Medical Transportation Services
Participant-Directed Goods and Services
Participant-Directed Community Supports
Personal Assistance Services
Personal Care Services
Personal Emergency Response System
Respite Services
Specialized Medical Equipment and Supplies

You can also apply, or refer someone for services, on PCA's website.
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Neighborhoods help seniors age in place

By Rita Charleston
Be it ever so humble, for many of us there’s no place like home – except when we reach our senior years and almost everything seems too much for us to handle. In some parts of Philadelphia, organizations have formed to provide the kind of help people need to “age in place,” an increasingly popular concept. Both Penn’s Village and the Rhawnhurst Naturally Occurring Retirement Community (NORC) operate largely on the basis of volunteer labor, but organizational models and funding differ.

Penn’s Village relies on volunteers to help elders who live in Center City from the Schuylkill to the Delaware Rivers, from Washington Avenue to Spring Garden Street. The organization provides all sorts of services so seniors can lead vibrant, active and healthy lives while staying in their own homes and in the neigborhoods they love.

It takes a “Village”
According to Jane Eleey, executive director of Penn’s Village, the “village” strategy for aging in place began in Boston’s Beacon Hill neighborhood in 2001. Today there are more than 145 villages in the U.S., plus in Canada, Australia and The Netherlands. Penn’s Village was established in 2008.  

“Our goal is to create a supportive community where people can stay in their own homes as they age, with the confidence that they are safe and connected to familiar surroundings, friends and services,” says Eleey. Penn’s Village provides its services thanks to more than 60 volunteers. Eleey, 68, works part time, and is the only person on salary. One phone call or e-mail message brings village members a wide range of volunteer services, including transportation, companionship, home organization, yard work, and light home repairs.

“If we can’t provide a particular service, we can usually offer members information on someone who can,” Eleey says. “Additionally, we offer any number of educational, social and cultural events twice a month and our 250 members can attend as many as they like.”

The cost for a “Villager” membership is $600 a year per household, which amounts to $50 a month; some limited subsidies are available to help people who cannot afford the cost. A tax-deductible “social membership” is $200 a year and entitles the person to attend events and obtain referrals to recommended service providers. “We need to grow our membership and are working hard toward that goal,” Eleey says. “Some people think they only need to join us when they need services, but by then it might be too late. Others support the organization before they need help themselves to insure that Penn’s Village is a strong organization at the point when they need services.” 

“Helping people stay in the community and in their own home is a very concrete concept. I like exciting, innovative projects, and I think this is surely one of them. We do things that nobody else can do,” says Eleey, who is a professional social worker.

NORC supports independence 
Abby Gilbert, program manager of Rhawnhurst Naturally Occurring Retirement Community (NORC), agrees. “ Supporting seniors 60-plus in their ability to stay in their homes and live independently, is our number one priority,” Gilbert says. Rhawnhurst NORC operates in Northeast Philadelphia in zip codes 19152, 19111 and 19149, and is a joint effort of the Jewish Federation of Greater Philadelphia and Catholic Social Services. 

Founded in 2005, the NORC serves some 750 seniors in this tightly-knit community. Gilbert, who joined the organization in 2011, is a full-time staff member; there are also a full-time outreach coordinator, two part-time transportation coordinators and a dedicated staff of volunteers. 

“Some of the services we provide include transportation to grocery shopping and medical appointments within a seven-mile radius; home maintenance support; socialization and support groups; and a monthly newsletter of events information benefiting senior adults in the community. 

“We have also added three more zip codes: 19114, 19115 and 19116, in providing rides for essential errands. We can either provide them with a ride or refer them to other transportation opportunities available to them. For more information about the program, seniors can call 844-511-RIDE.” 

According to Gilbert, former director of the Klein JCC, Rhawnhurst NORC is committed to not duplicating services that are available elsewhere. “So we partner with other organizations that already provide things our seniors need, and we serve as a conduit between what they need and the provider who can best supply that need.” 

In her early 50s and still too young to be considered a senior herself, Gilbert nonetheless understands the importance of what she does. “Knowing that at the end of the day the work we provide makes our seniors feel safer and more comfortable in their own homes, and that we are only a phone call away, is reward enough for me.”  

For more information, contactPenn’s Village at 215-925-7333 or or Rhawnhurst NORC at 215-320-0351 or
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Find help, resources, services for seniors
Philadelphia Corporation for Aging’s (PCA) website,, offers a data base of more than 1,300 organizations searchable by keyword, type of service or organization name.

These include senior community centers, affordable housing, food banks,personal care serviceshome-delivered meals, employment assistance, legal services and benefit counseling, among others.

You can apply for in-home care services online, or find instructions for making application by phone or in person. There is also information about a wide range of resources and opportunities for seniors and caregivers; and listings of programs and events taking place in Philadelphia.

One section of Search is dedicated to a Calendar of general interest, senior-specific, and professional events.

Another section will help you find Senior Centers. Here you can search by name or geographic area of the city; or get a list of all centers by clicking “Search” at the bottom of the page.

In Search for Services, you can search by major category or a specific service type. 

Keyword Search is another way to find information on the website. Type what you are looking for into the Keyword Search bar at the right  side of the top navigation bar on every page.

Need more help navigating the website? Click here for a quick "how-to" guide that explains searching, printing search results, and how to get the most out of using this website.

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Advocacy alert: Support Governor Corbett's Budget

Contact your legislators Governor Tom Corbett has included in his proposed budget an increase in Pennsylvania Lottery funds for providing home and community-based services (HCBS) to senior citizens, enabling them to remain safely in their homes.

This is critical funding that will allow Philadelphia Corporation for Aging to continue to meet the needs of seniors currently receiving services – services that we know delay the need for more costly nursing home services. 

Philadelphia Corporation for Aging, along with AARP and the Pennsylvania Association of Area Agencies on Aging, is urging state legislators to support the Governor’s proposal. Statewide, the Governor’s proposal will appropriate:
• $12.9 million in Lottery Funds to annualize prior year’s expansion of HCBS
• $4.19 million to continue current programs
• $1.1 million  to provide HCBS to additional 500 seniors
• $2 million in Lottery Funds for grants to Senior Centers.

While the General Fund is experiencing significant revenue shortfalls, the Lottery Fund remains financially solid, and therefore we hope the budget that is enacted includes the Lottery funding necessary to meet the needs of seniors.

Call your legislators
AARP has activated a toll-free advocacy phone line to enable Pennsylvania residents to urge their lawmakers to support an increase for Home and Community Based Services in the state budget.

This hotline will connect individuals with their state legislators, enabling them to advocate for Governor Corbett’s budget proposal of a $21 million increase for Pennsylvania Lottery-funded programs that help seniors age with dignity and independence in their own homes and communities. Callers will be asked to enter their zip code, and then will be connected with their state legislator’s office.
 Call the AARP Advocacy Hotline Number: 1-800-295-5855

Last June, the legislature passed a budget that included an additional $20 million appropriated from the Pennsylvania Lottery to the PennCare block grant to address waiting lists in the Options program.  The budget also included $5 million going to AAAs to address local needs.
With that funding, we have been able to:
Provide home and community-based services (HCBS) to more than 450 new consumers through the Options program. Close to 2,000 seniors are now able to remain safely in their homes thanks to the Options program.
Eliminate the waiting list for HCBS through the Options program  
Grant most PCA Providers a 1% increase, the first increase in seven years. 
This year the Governor is again requesting additional lottery funds for the PennCare block grant, with the majority of that funding going to support the annualized costs associated with meeting the needs of those removed from waiting lists.

AARP has activated a toll-free advocacy phone line to enable Pennsylvania residents to urge their lawmakers to support an increase for Home and Community Based Services in the state budget.

Call the AARP Advocacy Hotline Number: 1-800-295-5855

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Choosing a personal response system

By Marcia Z. Siegal Receiving prompt assistance in a medical emergency can help limit damage from a fall or stroke, for instance, and might even save your life. Personal Emergency Response Systems (PERS) are one tool that can increase safety for people who live alone or who have medical conditions that put them at risk.

These systems consist of a button radio transmitter, typically worn on a bracelet or pendant; a console that receives your alarm transmission and connects you to a monitoring center; and a monitoring center that responds to the alarm. PERS enable you to summon help in a medical emergency at the push of a button.

 Professionals in the center can communicate with you about the emergency; contact the ambulance or fire department; and notify your emergency contacts. Systems range from basic to complex; your needs, budget and service preferences will determine which you select. Some of the latter offer a range of services, including fall detection; GPS trackers; medication, treatment and appointment reminders; and smoke, fire and carbon monoxide detection. In shopping for a personal response system, research the company’s track record. Here are some considerations to help guide you in determining which system is right for you.

Services offered
Is the monitoring center open 24/7? What is the average response time? What is the notification procedure. and who gets alerted when an alarm is received? What kind of training does the staff receive? Does the company operate its own monitoring center or outsource this service? If you are interested in add-ons, such as fall detection, you’ll want a provider that offers those services. Many providers will cover an additional person in the household, such as a spouse, often for the cost of an extra help button device.

Making the connection 
Most PERS consoles connect over a landline telephone, but a number of companies also offer the option of connecting through the internet and mobile devices. Check on the PERS back-up system. The battery life of the button transmitter can vary and can be up to several years. Most companies monitor battery strength and many replace batteries for free. How long could the system operate in the event of a power outage in your home or area? You’ll also want to know about the power range: how far you can you be from the console and still communicate with the monitoring center. Does the company test the equipment regularly to find out if it is working? Check on the company’s policy for repair and replacements. Make sure that the help button device is waterproof, so you can wear it when bathing or showering.

Initial costs and installation fees and ongoing costs can vary widely. Some companies offer a subscriber price guarantee; others may increase fees over time. Find out about the cancellation policy. Some systems are available on a month-to-month basis, but others require longer term contracts and may have steep cancellation fees.

Company history
Check on how long the company has been in business, and whether the equipment and call center technology meet industry standards. Underwriters Laboratory (UL) certification for safety and reliability is widely respected for this industry. For information, call 1-877-854-3577 or go to Click on online certification directory at the bottom of the homepage, then key in the UL label information on your PERS equipment to check if the certification is current.

You can also check on the company’s Better Business Bureau rating at 215-893-9235 or Click on “Check out a business or charity” and put the company’s name in the search function to see how the company is rated. You can also e-mail for information or to submit complaints.

Beware of scams 
The Federal Trade Commission (FTC) advises consumers to beware of unsolicited calls, letters or bogus invoices claiming that a relative or friend has signed you up for a prepaid personal response system and that you owe activation and other fees. For consumer protection advice, to submit complaints and/or report scams, call 1-877-FTC-HELP or go to

Philadelphia Corporation for Aging’s Older Adult Protective Services Department  takes reports of senior scams and other forms of elder abuse at 215-765-9040 (open 24/7 for elder abuse).

Making a commitment

Get price quotes and terms of service in writing, and make sure to read the fine print. You may want to have someone else you trust read it over as well. But remember: a personal response system can only be helpful if it is used. Once you get it, keep the help button device on you.
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Combating elder abuse daily

By Marcia Z. Siegal

World Elder Abuse Awareness Day on June 15 is designed to call attention to the millions of older adults who suffer abuse and exploitation.

But Valerie King and Kristen Klem are focused on the problem of elder abuse every day. They are investigators with Philadelphia Corporation for Aging’s (PCA) Older Adult Protective Services (OAPS) Department, which investigated 2,475 reports of suspected elder abuse last year.

Elder abuse includes physical, emotional, and sexual abuse; financial exploitation; and neglect or abandonment. In the U.S., one in 10 older adults experience at least one form of abuse each year according to the American Society on Aging (ASA). For every case reported, nearly 24 cases go unreported, according to the ASA.

Neglect and self-neglect are the most common forms of elder abuse, according to PCA and national statistics. King recalls one case when OAPS was called in by the neighbor of a highly educated retired professional whose house had become unsanitary and was deteriorating. The man had been accustomed to being independent his whole life and had a hard time realizing he needed help, King says.

“He was anxious and overwhelmed and was lucky to have concerned neighbors who looked in on him," she says. 
"He became open to getting the services he needed to make the house safer and cleaner.”

While certain professionals are mandated to report elder abuse, anyone can report suspected elder abuse and neglect as this man’s neighbor did, and reporters can be anonymous.

Trained to look for all signs of elder abuse, OAPS investigators may find that an elder is experiencing more than one form of abuse. “Neglect and exploitation often go hand in hand, for instance,” Klem says.

An individual may be an easy target for exploitation due to dementia or other cognitive impairment, she says. “Someone might offer to help the person pay bills or shop, then take the person’s ATM card and help himself; or get power of attorney and take over the person’s assets,” she says. “If I see bills piling up or shut-off notices, or if the person is malnourished, even though he or she has an adequate income, I’ll call in our financial exploitation specialist to investigate whether financial abuse is occurring.

>While neglect is the most common form of elder abuse, financial exploitation is the most often reported, according to the ASA. In the U.S., the direct costs associated with elder financial exploitation were estimated to be $2.9 billion in 2011, a 12% increase from 2008, the organization reports.

The trusting nature of many older persons, combined with the fact that many own their homes and have accumulated savings and other assets, make them an attractive target for financial abuse, says Joseph Snyder, OAPS director and former president of the National Adult Protective Services Association. In addition, he points out, research suggests that other age-related changes in the brain may contribute to poor financial decision-making, including susceptibility to scams.

Financial exploitation is the fastest rising form of elder abuse and has been termed the “crime of the 21st century,” given the rapidly expanding demographic of older adults. 

OAPS Financial Exploitation Specialist Carlotta Bulls has seen older adults stripped of assets they worked all their lives to accumulate; even losing their homes and being forced to go into a nursing home. Family members are frequently involved. Even if the elder is aware of the abuse, he or she may be too embarrassed or reluctant to seek help.

“If an older person is used to taking out a certain amount from the bank each week and the account suddenly reflects, large and/or frequent withdrawals, that can be a red flag,” Bulls says. Scams targeting seniors are also rampant and can range from charity and sweepstakes fraud, telemarketing scams, home repair fraud, and more, according to Bulls. “As the saying goes: ‘If it sounds too good to be true, it probably is,’” she notes.

Philadelphia is on the forefront of addressing the issue, Snyder says. The Philadelphia Financial Exploitation Prevention Taskforce formed four years ago to strengthen collaboration between the Mayor’s office; law enforcement and legal assistance agencies; social services organizations, like PCA; and financial institutions. The Taskforce aims to prevent, detect, investigate, recover assets and prosecute financial elder abuse. Its collaborations have resulted in a number of referrals to law enforcement and arrests, Snyder says.

The Taskforce also provides training to help banks, investment firms, law enforcement, social workers and community agencies recognize the signs of elder abuse, and works to educate the broader community.

To report elder abuse 24/7, call: PCA Helpline 215-765-9040; toll-free outside Philadelphia: 1-888-482-9060; or the Pennsylvania Elder Abuse Hotline: 1-800-490-8505.

To request training about detecting and preventing financial exploitation or other forms of elder abuse for your organization, call 215-765-9000, ext. 4457 or 4403 or e-mail or
PCA’s Stop Senior Scams website,, offers tips to detect, prevent and report senior scams. A brochure is available by calling the PCA Helpline, 215-765-9040.
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Signs of elder abuse

There are many indicators of abuse, neglect and self-neglect, which can be observed in both the behavior and condition of the older adult and the caregiver. Here are some of the common signs according to Philadelphia Corporation for Aging’s Older Adult Protective Services Department:

Signs in the older adult
• Bruises, broken bones, burns, abrasions or other unexplained injuries
• Poor hygiene, unusual weight loss or dehydration
• Lack of needed glasses, hearing aids or other assistive devices
• Over- or under-use of medication
• Emotional state: anxious, timid, fearful or depressed
Caregiver signs
• Violence or excessive anger towards the older adult
• Conflicting stories about what is happening with the older person.

Financial exploitation
• Abnormal bank account closings
• Withdrawals of large amounts
• Older adult visiting bank in the company of a stranger
• Sudden display of new wealth by the caregiver
• An abrupt change in the person's will
• New transfer of property
• Older adult lacking basic needs, despite adequate financial resources
Signs of self-neglect
• Hoarding
• Inappropriate dress for weather conditions
• Leaving stove unattended
• Confusion
• Lack of housekeeping
• Failure to take needed medications

  For more information, visit the U.S. Administration on Aging’s National Center on Elder Abuse website at
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Making the arts accessible

By Rita Charleston
Marion Young is passionate about bringing the transformative power of the arts to those whose physical and mental limitations may present challenges.

“We know that art improves life, even if it’s simply the joyful experience of going to the theater or a museum,” Young says. “From studies done, we also know a lot about how exercising the creative muscle in your brain, especially with the disabled, can improve physical or mental skills.”As executive director of Art-Reach, Young practices what she preaches.

For the past 27 years, the organization has helped to provide accessibility to live theater, movie theaters and museums through the use of headphones or other devices for the hearing impaired, interpretation for the seeing impaired, and wheelchair access for all who need it. 

According to Young, Art-Reach was founded in 1986 by Joyce Burd, who had been working with the disabled community in Boston. When she moved to Philadelphia, she recognized a niche here that needed to be filled. 

“She noticed that theaters and other venues had a lot of empty seats on their hands, and a lot of people in the community who were unable to take advantage of any of those seats because they had various disabilities. So she looked for a way to meld the two things together so that everyone could benefit.”

“Often we see seniors who have experienced some sort of brain trauma, mental or cognitive changes, or who are wheelchair bound. They are often immobile and feeling very isolated. So bringing them to a venue and watching them come back to life and smile is remarkable,” says Young.

Art-Reach also sponsors a program called Independence Starts Here (ISH), a program that specifically targets those with hearing or vision loss so that they can fully participate in arts and cultural experiences.

Another part of the Art-Reach program connects cultural institutions with organizations that serve individuals with disabilities, such as residential homes, schools, churches, nursing homes and more. The cultural institutions provide them with deeply discounted or free tickets, or on-site programs. These cultural partners include theaters, dance companies, museums, gardens and historic sites, among others.

“Each year we serve about 17,000 people who normally would not have had a chance to enjoy the arts. That adds up to more than 250,000 since we began,” says Young. It’s gratifying , she says, to see “how important it can be to individuals to enjoy the kinds of things that have not been part of their lives for many years. We get such wonderful feedback from those we have helped bring joy back into their lives, that it makes me feel wonderful just to be a part of it all.”

For information, visit or call 215-568-2115.
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PCA releases State of the Agency Report

Forty years ago this spring, Philadelphia Corporation for Aging (PCA) first began providing and coordinating congregate meals for older Philadelphians through a network of 13 nutrition sites located in neighborhoods throughout the city.

Today that program has grown to 23 full-service senior community centers and 10 satellite meal sites which last year served 495,964 congregate meals. PCA's State of the Agency Report for fiscal year 2013 details this, and the many other programs and services aimed at improving the lives of older Philadelphians.

Among them: 1.5 million meals were delivered to frail homebound seniors; 495,964 meals were served at senior centers; and 21,397 older adults received in-home services to help them remain in their homes.

These programs and services are crucial in a city where 43% of seniors are unable to afford one of life’s basic necessities, and 28,000 report skipping meals due to lack of money.

Click here to read PCA’s State of the Agency Report for Fiscal Year 2013.
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Make PCA's website work for you

Please help us improve our site
Click here to take a survey.

 Seven years ago, Philadelphia Corporation for Aging (PCA) created the website,, to serve as a resource for seniors, caregivers and professionals in the aging network. You can:
  • Search for senior centers and see a map showing where they are in the city
  • Get a list of affordable housing facilities, with phone numbers, addresses and emails
  • Find out about free or low-cost home repairs through PCA
  • Find resources for caregivers
  • Find job postings and professional conferences

The site includes a directory of more than 1,300 organizations that provide services, resources and information about aging. 

We would very much appreciate your input on the site, and on improvements that could be made. This survey has just 13 questions and will take just a few minutes to complete. Click here to take the survey.

For more information about, and a video about using it, click on "read more" below.
The website organizes information into subject areas: 
  • Senior services
  • Senior lifestyle
  • Caregiving
  • Professionals; 
  • News and information
The listings of organizations are in the directory of resources, which is accessed through "Search" on the home page.  There are dedicated landing pages from which to search for senior centers; organizations; services; and calendar events. Within services, users can search by broad categories, such as In-Home Care; Housing; or Emergency. They can also search a list of specific services, such as personal care; housekeeping; assisted living; or utilities.

David Besnette, owner of  the website, has created a video that shows how to search to find services for seniors. While he focuses on assisted living, the information is valid for whatever sort of search you wish to do. He also includes information about the resources available on the Pennsylvania Department of Public Welfare's website.

Please help us make a useful tool for you and others in the community by completing this survey. Thank you!

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This gift for Mom is more important than flowers


Each May, we take time to honor our mothers. We reflect on the valuable lessons we have learned from Mom, the selfless things she has done and her many contributions to our life.

This May, when you get together with mom or call her on the phone, take some extra time and figure out how she is really doing. Here are five questions to consider that might be helpful for Mom and the rest of the family to ensure she stays healthy and safe.

1. Are there major changes? Take note of physical and psychological changes that may be happening.
Check the 10 Warning Signs that indicate your mother might need some additional assistance.

2. What about end-of-life planning? Are you familiar with your mom’s end-of-life wishes? This might be a tough conversation to initiate, but will be valuable for all involved. Click here for tips on starting the conversation.

3. Does she know how to avoid scam artists? Anyone can be the victim of fraud or a scam, but older adults tend to be targeted more. Make sure mom is educated about avoiding scams and fraud.Useful tips to Protect Your Pocketbook.

4. Is home livable? Mom might be living in the same home you grew up in or a different place altogether.
Regardless, as she ages, there may be certain hazards in a home that increase the likelihood of a
fall. Learn about ways to Prevent Falls in the Home.

5. How do we keep in touch? Visits and phone conversations are great, but they are not always possible.

Make sure Mom can keep in contact. Has she tried emailing, texting and using Facebook? What about
Skype or Instant Messages? Make sure mom is comfortable Staying Connected many different ways.

These, and the resources below are provided by the U.S. Administration for Community Living:

Eldercare Locator Brochure
This brochure provides general information about the Eldercare Locator and community-based services. en Español  

Employment Options: Tips for Older Job Seekers
This brochure has tips for older adults who are looking to enter or re-enter the workforce, with suggestions for identifying job skills, finding job leads, filling out an application and preparing for an interview. 

Hospital to Home: Plan for a Smooth Transition
The guide provides planning tips for pre-hospital check-in as well as post-checkout from the hospital.

Housing Options for Older Adults: A Guide for Making Housing Decisions
This booklet provides an overview of the types of housing available to older adults, and highlights some personal and legal issues to consider in making housing decisions. 

Let’s Talk
This guide provides tips for starting the conversation about health, legal, financial and end-of-life issues with a loved one. 

Medicines and You: A Guide for Older Adults As You Age
It is important to know about your medicines to avoid possible problems. This brochure provides tips on taking medicines safely.

Pick Up The Pace
This consumer guide is designed to educate boomers about financial and retirement planning choices and to help them secure their financial outlook for the future. 

Prescription Drug Options for Older Adults: Managing Your Medicines
This brochure describes helpful ways of managing medicines and getting the best value for your medicines. The brochure lists key questions to ask health care professionals and suggests options to help pay for medicines, and ways of overcoming some medicine hurdles. 

Preventing Falls at Home
This brochure describes safety checks older adults can do in and around the house to reduce their risk of falling and help enhance their independent living. 

Protect Your Pocketbook: Tips to Avoid Financial Exploitation
This brochure provides information and resources on avoiding financial exploitation and offers tips on how to stay safe. 

Staying Connected: Technology Options for Older Adults 
This brochure features information for older adults who are interested in learning about new technology tools they can utilize to communicate with family and friends-especially younger generations. It includes tips on text messaging, setting up a Facebook page and emailing.

Staying "IN TOUCH" in Crisis Situations
This brochure outlines how families can stay in touch with older loved ones and be prepared when a crisis situation occurs. It includes a tear-off sheet for personal planning. 

Transportation Options for Older Americans: Choices for Mobility Independence
The brochure describes various types of transportation services for older adults and lists key questions to ask transportation provider to determine the best option to meet individual needs.

Winter Warmth and Safety: Home Energy Tips for Older Adults
The brochure offers some economical ways to stay warm and safe at home. 

If you find that mom might need a little assistance, you are interested in learning more or would like a free copy of one of these brochures, call the Eldercare Locator at 800.677.1116 or visit to get connected with trusted local aging resources in your community.

Source: U.S. Administration for Community Living, Department of Health and Human Services
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Combating isolation, hunger, despair for four decades

By Linda L. Riley
Meet Helene, who is caring for her elderly mother; Emphers, who doesn't want to be a burden to her children; Walter, who needs help to stay in his own home since losing his eyesight. Philadelphia Corporation for Aging (PCA) has been helping thousands of older Philadelphians like them combat hunger, isolation and despair since 1973.

This week, PCA relleased a new, four and a half minute video, "PCA Cares for Seniors," where they, and others who receive PCA services, share their stories.

"The video really goes to the heart of what PCA does," says PCA President and CEO Holly Lange. "Whether it's  doing yoga at a senior center, or using CCT Connect to get to the doctor, or getting help caring for a loved one so she needn't go into a nursing home - all of our services are aimed at improving the lives of older Philadelphians."

The video is posted on PCA’s new YouTube channel, along with another, titled “Senior Centers: the original social network.” “We had some fun with that one,” Lange said. “We played on the themes of “chat room” and “instant message” and “friend requests” to show off the ways senior centers bring people together.”

Centers are crucial in helping combat isolation, Lange said. she said. “We know that in Philadelphia, more than 36% of those age 65 and older live alone. New neighbors may not be familiar, and family members may live far away. Being able to go to a senior center and meet people, have a good lunch, take an art or exercise class and learn about topics of interest to them provides a lifeline. They become part of a community, and remain active and engaged.”

“Isolation is a risk factor for many negative outcomes,” Lange said. “As seniors become more frail, and have mobility problems, they may not feel comfortable going to the supermarket. Nutrition suffers, and their health deteriorates further.”

For frail or homebound seniors, there are services and programs to help overcome isolation, providing transportation, companionship, in-home care, and home-delivered meals.

For more information about PCA’s services for seniors and caregivers, visit the website at or call the PCA Helpline at 215-765-9040.

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Open House: LGBT-friendly apartments

Low-income senior housing
An Open House will be held on Saturday, March 15 from 11 a.m. to 3 p.m. at the new John C. Anderson Apartments at 249 S 13th St. in Philadelphia. 

Seniors, age 62 or older, who meet income restrictions are welcome to apply for residence in this LGBT-friendly complex. The income limits are $33,300 a year for one person and $38,040 for two people.
Rent is based on income and ranges from $638 to $786 a month.  There are nine one-bedroom apartment homes available for immediate occupancy. For more information, call 855-657-0325, e-mail or go to Back to Top

City's many transportation alternatives

By Alicia M. Colombo Often the difference between an active, healthy lifestyle and being isolated from the community is access to transportation. According to the American Public Transportation Association, older non-drivers make 15% fewer trips to the doctor; 59% fewer shopping trips and visits to restaurants; and 65% fewer trips for social, family, and religious activities.

“Transportation services provide an important link in helping older Philadelphians maintain their independence and stay actively engaged in their communities,” said Bruce Bornmann, transportation manager at Philadelphia Corporation for Aging. “A variety of transportation programs available in Philadelphia help decrease the risks of driving, provide social interaction, and diminish the attributes of otherwise being homebound.”       

Free or discount rides for seniors 

In Philadelphia, adults who are age 65 or older may ride SEPTA buses, elevated trains, trolleys, and subways on its fixed-route service free of charge.

To travel outside of the city, there is a $1 reduced rate to ride Regional Rail within the Commonwealth of Pennsylvania. A pack of 10 Regional Rail tickets can be purchased for a 15% discount ($8.50) from the SEPTA website or any ticket office. Anyone can purchase these tickets on behalf of seniors, since they are validated at the time of travel.

To ride SEPTA for free or a reduced fare, seniors must show one of the following forms of ID: Railroad Retirement Annuity Card, Medicare Card (issued by the Social Security Administration), or PA Senior Citizen Transit ID Card. For information, call 215-580-7800 or go to

Seniors or adults with disabilities who would like to become more familiar with SEPTA’s fixed route service may utilize the Accessible Travel Center at Suburban Station, 16th St. & JFK Blvd. Information about accessible service options is available at the center.
There is also a full-size vehicle that allows riders to practice boarding and navigating mass transit in a stress-free environment.

Service animals, wheelchairs, and personal trainers or instructors are welcome at the center and on SEPTA vehicles. The center is open by appointment on weekdays during regular business hours.  For more information about accessible travel on SEPTA, go to

Philadelphia’s purple PHLASH trolleys provide quick, easy and inexpensive travel to key historic attractions and cultural institutions. The route hits more than 19 key locations in Center City, including Sister Cities Park, The Barnes Foundation, Philadelphia Zoo, Penn’s Landing, African American Museum, Liberty Bell, PA Convention Center, U.S. Mint, and Shofosu Japanese House & Garden.

The PHLASH runs every 15 minutes from 10 a.m. to 6 p.m., daily from Memorial Day through Labor Day, and Friday through Sunday in May, September and October. Seniors and children up to age 4 ride free. For information: 215-389-8687 or

Accessible transit
SEPTA Customized Community Transportation (CCT) Connect administers two ride-sharing programs. They are the federally mandated ADA service and Shared Ride Program, which is funded by the Pennsylvania Lottery. In accordance with the Americans with Disabilities Act (ADA), SEPTA CCT Connect provides comparable service for people with disabilities who are functionally unable to use regular accessible fixed-route bus service for their transportation needs. Eligible individuals can travel whenever and wherever buses operate in SEPTA's five-county service region. 

For older adults 65 and older, who are unable to use SEPTA’s fixed route system, SEPTA CCT Connect’s Shared Ride Program provides door-to-door transportation by advance reservation to registered Philadelphia seniors. Riders pay 15% of the ride cost and share a vehicle with other passengers; for programs funded by Philadelphia Corporation for Aging (PCA), the 15% rider’s share of the cost of the ride is paid through that program, while the Pennsylvania Lottery pays the remaining 85%.  Shared Ride can take seniors to adult day services; senior community centers; medical appointments; and errands, such as shopping and banking. It is fully handicapped accessible. For more information or to register for SEPTA’s CCT Connect, call at 215-580-7145

For some riders who need additional assistance to utilize Shared Ride, the Attendant Transportation Service (ATS) is also available. Facilitated directly by PCA, this service provides door-through-door and upper floor assistance to eligible older adults with physical and/or mental handicaps who would not otherwise have access to transportation. Shared Ride registration and a separate ATS certification are required.  For more information about ATS or other transportation options for seniors in Philadelphia, contact the PCA Helpline at 215-765-9040.

Volunteer rides

Silver Wheels can take older adults to non-emergency medical appointments, shopping, banks, pharmacies, social activities, and to visit friends or loved ones. “Silver Wheels is designed to ensure that older adults can continue to maintain their meaningful and vital community connections, regardless of their ability to drive to their destinations,” said Sara Popkin, co-director of adult and senior services at JFCS.

Riders must be able to make appointments for themselves and walk/transfer to vehicles without the driver's assistance. Walkers or canes are permitted, but the vehicles are not wheelchair accessible. A yearly assessment fee, which is calculated based on ability to pay, is required to register for Silver Wheels. There is also a $4 per-trip fee for a one-way ride of up to 30 miles, and one companion may ride along at no additional cost. For information on becoming a Silver Wheels rider or driver, or to schedule an appointment, call 1-866-532-7669 or e-mail
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Ombudsman's role is protection

By Marcia Z. Siegal While a nursing home is commonly regarded as institutional living, for the people who reside there, it is their home. The same holds true for residents in other long-term care facilities, says Lynda Pickett, manager for PCA’s Long-Term Care Ombudsman Program.

“I stress over and over that this is where you live. You are paying for your care.  You deserve to have a voice in the quality of care and services you receive,” she says. In fact, federal and state regulations mandate long-term care residents’ rights to both quality of care and quality of life. 

The Ombudsman program utilizes both staff and volunteers to advocate for, and help to protect those rights.

“Everyone in long-term care needs an advocate,” says Pickett, noting that 443 complaints about Philadelphia long-term care facilities were reported to ombudsmen last year. “The role of the ombudsman is to hold systems accountable, to ensure that residents’ rights are protected,” she emphasizes.

 The ombudsman may address such issues as:
• Residents’ finances: Access to personal funds, Medicare and Medicaid benefits, charges, and billing
• Quality of life: Concerns about food, the physical environment, and social activities
• Professional care: Issues concerning medications, nursing care, physician and rehabilitative services, and the use of restraints
• Residents’ rights: Practices and policies that maintain the resident’s dignity; as well as policies regarding admission, transfer and discharge

“Many of the issues we address center on poor communication,” says Lori Walsh, ombudsman manager for CARIE, which provides services for long-term care residents in North, South and West Philadelphia.

"The nursing home, for instance, can be a confusing place especially for someone who has just moved in. It's busy and fast paced. People often don't know who they should (or can) complain to. It's always better to address a problem as soon as it has started, instead of waiting until it has escalated out of control. Residents and families can always call the ombudsman. Calls are always confidential and callers can be anonymous.”

Another growing concern pertains to discharge rights, she reports. “It's important for nursing home residents (and their families) to know that they have a lot of protection when it comes to discharge from a nursing home. If residents are in a nursing home for rehabilitation and they are told that their Medicare days are up and are feeling pressured by the nursing home to move out, they should contact the ombudsman. The ombudsman can educate callers about their discharge rights and advocate for nursing home residents when these types of issues come up.”

 A growing movement is underway to train long-term care residents as volunteer ombudsmen within their facilities. Pioneered nationally in 2002 by the Pennsylvania Department of Aging, the Pennsylvania Empowered Expert Residents (PEER) program trains long-term care residents to work with facility staff to enhance the quality of care and quality of life for all residents and to educate them about their rights. Advocating and championing resolutions in-house, they are well-positioned since fellow residents are more likely to share their concerns with someone they know. In Philadelphia there are now eight facilities and 71 PEER volunteers participating in the program. 

The ombudsman program itself also relies on trained volunteers. “We are always in need of more community volunteers to expand our capacity to reach out and help,” Pickett says.

To learn more about residents’ rights in long-term care facilities or about the ombudsman program, including volunteer and PEER ombudsman opportunities, contact the following organizations:

In Northeast and Northwest Philadelphia:
 Center in the Park
 5818 Germantown Ave.

In South, West or North Philadelphia:

Center for Advocacy for the Rights and Interests of the Elderly (CARIE)
 100 S. Broad St.
 Main number: 215-545-5728; Toll-free number: 1-800-356-3606
 Information is also available through the Office of the State Long-Term Care Ombudsman at 717-783-8975 or Click on “Advocacy (ombudsman).”
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Generations keep tradition going

By Marcia Z. Siegal
“Mom-Mom has lived with me almost all of my life,” says Karen Mangan. Growing up, Mangan’s household included her parents, Bob and Kathleen Snyder; brother Bob; and her maternal grandmother, “Mom-Mom.”

 “Mom-Mom” Helen Frain, now 94, continued to live with her daughter, Kathleen, after the children had grown up and their father, Bob Snyder, Sr. died. When Kathleen Snyder developed lung cancer, Frain helped care for her until she died, four years ago. She was quickly welcomed into her granddaughter’s Northeast Philadelphia home.

“Mom-Mom always told me that when she got old she didn’t want to go to a nursing home,” says Mangan, 43, who shared a bedroom with her growing up.  “It never occurred to us that she should.”

 Frain contends with serious hearing loss and with macular degeneration that impairs her vision and limits some of her activities. She has experienced several falls in recent years. “I don’t want to be alone. I feel safe being here,” she says of her current home.

“I help when I can.” She is a central figure in the household, where she joins in meals, helps with some of the everyday tasks, regales her great-grandsons with stories of her younger years, and can be with the boys when her granddaughter needs to run errands.

  She is quick, from force of habit, to straighten up and put things away so the house stays neat. “Sometimes, I like a bit of messiness,” Mangan jokes. “I know where things are.”

 Mangan, a stay-at-home mom for sons Paul (“Paulie”), and Shaun, ages 12 and 9, emphasizes that being her grandmother’s full-time caregiver is not something she could manage alone. Her husband, Paul, has been strongly supportive from the outset.

 "My mother was in a wheelchair when I was growing up, so I know firsthand what it’s like to live with someone with a disability,” says Paul Mangan, 49, a self-employed masonry contractor. “I used to help with the cleaning and the cooking and would assist her in moving from her wheelchair to the car, if she had to go somewhere.” These days, he drives Frain to doctors’ appointments and on banking errands when he is available, and helps Frain with her bills.

 Philadelphia Corporation for Aging’s (PCA) Family Caregiver Support Program (FCSP) also provides assistance.  Funded through the federal government and Pennsylvania Department of Aging, FCSP aids eligible caregivers of adults 60+ when care recipients are unable to perform some of the tasks of daily living.

Mangan’s PCA care manager helped her develop a care plan, advises her about community and government resources, and keeps in touch regularly by phone and through periodic home visits. Mangan also receives financial assistance through FCSP, which she uses to help pay for some of her grandmother’s medical supplies which are not covered by Medicare or Medicaid, and for several hours of housecleaning help each week.

 Frain's daily presence is not just a responsibility, “it’s a comfort,” Mangan points out.  “I have a small family,” she says. “My father and mother are deceased, and my brother lives in Pittsburgh. In some ways, Mom-Mom is all I have left. It’s great having her here.”

For her part, Frain says she enjoys being a part of the busy household and seeing yet another generation of the family grow up.  Her great-grandchildren return her affection, and both say they are lucky to have her in their lives. 

“She makes me happy when I am sad,” says Paulie.

“She always cares about my feelings,” says Shaun.
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Time to make a move?

By Alicia M. Colombo Most older adults want to be as independent as possible as they age, but the time may come when you are no longer able to be completely self-sufficient. There are many living options designed to support independent living, including in-home care and senior-friendly housing.

For seniors who need more care, other alternatives include personal care homes and 24-hour skilled nursing facilities. Each option varies based on physical needs; amenities or services desired; and finances. The first step is to decide what level of help you need.

“If people are having difficulty with their personal care, such as bathing, dressing or grooming; or mobility, it’s time to think about getting help,” said Ann Danish, director of care management at Philadelphia Corporation for Aging (PCA)

Family members may start to notice changes in an older person’s grooming or hygiene. A lack of food in the kitchen or too many pills left in the bottles of regular medications may signal that the person is neglecting self-care.

Care at home
PCA can conduct a free in-home assessment to determine a person’s eligibility for in-home care services through the Medical Assistance Aging Waiver Program, which is funded by Medicaid; or the Options Program, which is cost-shared by the consumer on a sliding-fee scale based on income. The individual may also be assessed for the Family Caregiver Support Program, Domiciliary Care, or LIFE program. Home modifications may also be available to make an older person’s home more safe and secure. “Sometimes, what prompts an older person to request an assessment from PCA is difficulty with their personal care; shopping; meal preparation or housekeeping; or self-care for a health issue,” said Danish. The assessment looks at the person’s health status, functional abilities, finances, ability to handle daily activities, and support system. “Most older people want to stay at home. They are contributing members of their community. They’re comfortable in their homes, and often enjoy socialization and close relationships with friends and neighbors,” said Danish.

Receiving home-delivered meals, going to an adult day or senior center, or getting help with personal care for a couple of hours can often be enough to enable an older person to remain safely at home. “Home care is generally less costly than care received in a facility, but what’s more important is how a person wants to live,” said Danish.

Independent living
Seniors who are still independent, but do not wish to continue to live in their existing home may consider senior housing. There are several senior housing complexes in Philadelphia that offer the convenience of maintenance-free living in a single level layout with one or two bedrooms. The costs and amenities vary greatly, depending on the type of housing.

There are some affordable senior housing complexes that offer rent control, linkage to social services, and easy access to transportation. “Affordable housing communities are independent living situations that allow residents to mingle with other seniors,” said Judee Bavaria, president and CEO of Presby’s Inspired Life. “While the complexes don’t provide care services, each building has a Housing Service Coordinator who works with residents to assist them to utilize existing community services, like PCA, meals on wheels and veterans’ benefits. There’s so much available through the community that seniors don’t realize. When they learn about it, they often become overwhelmed. The coordinators are really talented at linking seniors to services and helping them maneuver the various application processes,” said Bavaria. Some senior housing complexes may provide limited programming, such as intergenerational activities, trips and onsite computer/internet access.

Rent for certain affordable housing complexes run by the U.S. Department of Housing & Urban Development (HUD), commonly known as Section 8, is 30% of a person’s adjusted gross income. The income limit is $27,750, which excludes expenses for medical and child care; and utilities are included in the monthly rent. Another HUD program, the Low-Income Housing Tax Credit program, allows residents to pay 20 to 60% of their median income for rent. The income limit is $33,300 with a maximum rent of $900, which also includes utilities.

For adults who have significant financial resources and would like more amenities, a Continuing Care Retirement Community (CCRC) might be a more desirable option. “Within 50 miles of Philadelphia, there are more CCRCs than anywhere else in the country,” Bavaria said. “People typically come in as independent, then adjust their level of care as their needs change. If the need is minimal, home care might be a great option. Independent communities provide onsite security, socialization, and an on-call button for emergencies.”

Independent living in a CCRC is the first tier of a step-up living option. They offer single level units and a host of onsite amenities, including meal plan options, social services, housekeeping and security. Many include fitness centers, swimming pools, and regular entertainment. The entrance fee for a CCRC ranges from $60,000 to $500,000, in addition to monthly fees of $2,000 to $6,000. Fees are dependent on a variety of factors, including the health of the occupants; type of housing selected; rental or purchase; number of residents; and the type of service contract. To enter a CCRC, residents must quality physically and financially. “If you are a threat to yourself or others because of dementia, independent living of any kind is not an option,” said Bavaria.

Residents of CCRCs may purchase a life care contract that locks in their current monthly fee and would offer personal or skilled nursing care services at the same rate, if needed at a later time. Individuals may opt to purchase private long-term care insurance instead or privately pay for services as needed.

Personal care home
“Personal care is a step above independent living for people who may need help with activities of daily living, such as bathing or dressing,” said Bavaria. Personal Care Homes are residences that provide shelter, meals, supervision and assistance with personal care tasks for seniors or people with physical, behavioral health, or cognitive disabilities who are unable to care for themselves, but do not need nursing home or medical care. A personal care home is often the second level of care in a CCRC, but independent personal care facilities are also available. Monthly fees at Presby’s personal care homes start at $4,000, and Bavaria said they offer residents a private unit with all meals, some personal care services, and memory support for individuals with mild dementia.

While some personal care housing options have entrance fees similar to CCRCs, others do not, and the services available may vary. “Personal care homes used to be considered the same as an assisted living facility in Pennsylvania. Now assisted living is licensed and is a higher level of care,” said Bavaria.

Assisted Living
In Pennsylvania, an assisted living facility provides onsite food, shelter, personal care and supervision. Assistance may be provided with eating, transferring, using the bathroom, personal hygiene, managing health care, and self-administering medication. Residents of an assisted living facility cannot require continuous nursing care. Weekly activities can include motor skills exercises; self-care activities; social activities; crafts; sensory and memory enhancement activities; and outdoor activities. The cost for assisted living in Pennsylvania ranges from $1,600 to $4,500 per month. Medicaid funding is not available, although a state supplement to Supplemental Security Income is available.

Skilled nursing facility

When a person becomes a safety risk and the individual’s well-being is compromised in a community setting, placement in a skilled nursing facility, commonly referred to as a nursing home, becomes necessary. “Extensive medical needs, such as use of a feeding tube, skin breakdown, or late stage dementia are conditions that may require 24-hour care,” said Danish. The cost of nursing home care can be $250 a day or more. When medically necessary, this cost may be paid for through Medicare on a short-term basis or medical assistance. Long-term care insurance and private pay options are also available.
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Help making the best choice

By Alicia M. Colombo
When considering the living option that’s right for you, think about the level of care that’s likely to be needed in the near future. As with PCA’s assessment for in-home care services, most facilities will conduct a thorough evaluation of your mental, financial and physical status to determine eligibility.

If you need help with one or two activities of daily living, such as dressing or bathing, in-home care in an independent living setting may be appropriate. If more extensive care is needed, a personal care home or assisted living facility may be a better fit. Skilled nursing facilities are for people who need the daily attention of a nurse, and/or have complex medical or behavioral issues.

Here are some resources to help you find living options:

A Place for Mom features a directory of 19,000 senior-care properties and facilities, including adult day care, Alzheimer’s memory care, assisted living, independent living, short stay respite care, nursing homes and 55+ communities: 1-866-344-8005 offers a directory of more than 36,000 assisted living facilities in the county and other resources, including a blog with related news articles and a Q&A forum: 1-866-333-6002

Friends Life Care serves eastern Pennsylvania and Delaware as a CCRC “without walls,” providing professional care management, home care and personal care services: 215-628-8964.

Philadelphia Corporation for Aging provides referrals to hundreds of local services and programs, as well as free in-home assessments (for Philadelphia residents) for long-term care services: 215-765-9040.

Questions to ask:
*Can my loved one's needs be met? Be explicit about what the person requires.
*What is the basic monthly cost and what does it include? What are the added costs if extra help is needed?
*Is there an entrance fee? If so, is it refundable?
*What activities are provided?
*Are religious services held at the facility, or are residents taken to services off-site?
*What is the ratio of caregivers to residents?
*What conditions would cause a resident to need to move to another level of care?
*Does a doctor make regular visits to the residence?
*Ask residents if they like living there, and ask any of their friends or family who might be visiting what they think about the facility.
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Modifications can make home livable

By Alicia M. Colombo
Many homes in Philadelphia were not built with aging in mind. As you grow older, climbing steps or getting around your home may become difficult. Changes or modifications to the home environment to accommodate a person’s physical needs can make completing daily activities easier and safer for older adults.

“A modification can be as simple as a stairway handrail or as complex as a motorized exterior wheelchair lift,” said Ellena Jonas, housing director at Philadelphia Corporation for Aging (PCA). “The goals are to allow the older person to be as independent as possible within the home; to access the community more freely and easily; and to prevent nursing home placement.”

PCA’s Senior Housing Assistance Repair Program (SHARP) provides minor repairs and modifications to homes of Philadelphia homeowners who are age 60 or older. The property must be structurally sound and have functioning utilities.

Repairs can include installing or repairing faucets, receptacles, doors and basement steps. Most homes also receive essential safety features, such as railings and smoke/carbon monoxide alarms. “Minor repairs can prevent a major problem. A small leak in the kitchen can eventually seep into the floor below and cause a big problem or an electrical short can start a house fire,” said Jonas.

Some of the modifications performed by SHARP include installing intercom systems, interior and exterior stairway railings, tub/shower grab bars, and adapted fixtures.
“People are unaware of how simple changes to their home can make such a big difference in their lives,” said Jonas. “A simple exterior wrought iron rail, which costs about $350, can provide a person with access to the outside world. An older woman once told me that she can now proudly walk up her front steps without needing to crawl. The neighborhood children made fun of her, whenever she returned to her home and had to crawl up the steps to the house.”

Small changes, like the exterior rail described above, provide multi-tiered benefits of increased independence, mobility, health and safety. Intercom systems can be installed with a door release to allow an older adult with mobility issues to communicate with visitors at the front door and to “buzz in” the meals on wheels delivery person, health care aid or friends, for example. “Many older adults in Philadelphia leave their doors unlocked, because they can’t get to the front door. An intercom provides safety and security. It can also decrease isolation, since the senior won’t miss visits from family or neighbors,” said Jonas.

Recipients of PCA’s long-term care (LTC) services can sometimes receive more extensive modifications, including electric stair glides. 

“I’m pleased to see so many exterior wheelchair lifts and stairglides being installed for our Waiver consumers,” Jonas said. “It allows wheelchair users to independently leave their homes to go to medical appointments, day care centers and other community programs.” Durable medical equipment, such as tub chairs and raised toilet seats, which are recommended by an occupational therapist (OT), may also be provided.

Choosing modifications
To determine whether an individual could benefit from home modifications, the SHARP program first has an OT evaluate the home. “The OT looks at the whole picture – not just the house – to evaluate an individual’s specific needs with regards to a disability,” said Jonas. For example, the height of a front door peep sight; an accessible kitchen counter; tub grab bar; or hand-held shower will be different for each person.  “The Americans with Disabilities Act guidelines aren’t a universal fit for all people with disabilities. The OT interviews the consumer about his or her lifestyle and personal habits to design modifications that are a good fit,” said Jonas. The OT completes a full-scale evaluation of the home, makes recommendations, and prioritizes them based on helpfulness and independence for the senior. The goal is to attempt to create a barrier-free environment.

Assistance with modifications available
Low-income older adult homeowners may re