Milestones eNews
Welcome to the Milestones e-news section of the pcaCares.org website. All of the articles found in this section were originally featured in our weekly Milestones email newsletter. To suscribe to the newsletter, click here. To see this week’s newsletter, click here

Elder Care


Click on the headline to read the full article.

12.23.14

 Caregiving edition

08.13.13

 City of immigrants

07.30.13

 Pets make their day

05.03.11

 Walkability matters

02.23.10

 Care for caregivers

09.08.09

 Heat can be deadly

 

Bullying occurs in senior years, too


By Marcia Z. Siegal



Bullying, unfortunately, is ageless. Some seniors bully others wherever they meet: in long-term care facilities, in senior community centers, and in senior housing, says Lynda Pickett, ombudsman program manager at Philadelphia Corporation for Aging (PCA).
 
According to the U.S. National Library of Medicine of the National Institutes of Health, “bullying is when a person or group repeatedly tries to harm someone who is weaker or who they think is weaker.”

Usually there is a real or perceived imbalance of power, in which the perpetrator has more “power,” physically, socially or emotionally.

The most recent national report by the National Long Term Care Ombudsman Resource Center found that, in 2013, there were 5,235 incidents of resident-to-resident conflict in nursing homes and a total of 1,589 incidents in personal care homes/assisted living.

Experts believe senior-to-senior bullying occurrences are actually much higher; however, many victims are ashamed to report it.

Some typical bullying behaviors include:

- Verbal: Name calling, teasing, insults, threats or jokes targeting a specific individual
 
-  Physical: Hitting, pushing, punching, kicking or destroying an individual’s property
 
- Antisocial behaviors: Shunning/excluding; gossiping; spreading rumors; and using non-verbal body language, like mimicking or offensive gestures

"Whatever form it takes, bullying can be very demeaning,” says Pickett.

The Ombudsman Program, which she oversees, works to protect residents’ rights and quality of life in Philadelphia nursing homes, personal care homes, domiciliary care homes and adult day care facilities.

While bullies often target victims repeatedly, even one incident can have a profound impact.


Victims often experience shame, depression and/or fearfulness. Bullying can also worsen existing mental health conditions.

Some victims may try to cope by seeking relationships with supportive people and focusing on positive activities. However, others focus on avoiding situations where they may encounter such mistreatment. This can result in isolation. For instance, someone is rejected her when trying to sit at a communal table in the dining room may choose to eat alone instead. Staff and family should take notice if a senior in a congregate setting begins to self-isolate, Pickett says.

Bullies usually target those they perceive as vulnerable or different. They may hone in on someone who cries easily, or who is shy, introverted, anxious, or physically or mentally impaired. Some bullies target their victims based on race, religion, ethnicity, sexual orientation or other personal characteristics.

Many older bullies may have displayed such behavior since childhood.  “Just because they are in their 70s or 80s, it doesn’t mean they’ve changed their ways,” Pickett says. “They view it as a behavior they can get away with.”


Seniors may also use bullying to assert control at a time when they feel powerless; for instance, if they have given up independent living to move to a more regulated senior facility.

Some bullies may lack self-awareness about the effect of their words and actions. “What people may not realize is that bullying impacts the well-being of everyone in that environment, because it allows negativity to flourish,” says Pickett. By joining in, or standing by and doing nothing, those who witness that behavior help to contribute to it. 

“Everyone has the responsibility to speak up against it and to show zero tolerance for it. It’s also important that facilities educate staff and residents about bullying and have policies and procedures in place to prevent and deal with senior bullying, including channels for residents to report this type of mistreatment,” she says. 


Residents can also be proactive. One facility developed a peace council to promote its no-bullying policy. Often facilities have resident ambassadors to welcome newcomers and help smooth their acceptance and comfort in their new environment.

Protection and education about bullying is available

PCA contracts with two providers for the Philadelphia Long Term Care Ombudsman Program (PLTCOP): the Center for Advocacy for the Rights and Interest of the Elderly (CARIE), and Center in the Park. These agencies work with and train staff and volunteer ombudsmen who provide information, respond to complaints, and make quality assurance visits to residents in long-term care facilities.

Ombudsmen also will make presentations for staff, resident councils and family councils of long-term care facilities about bullying, residents’ rights and quality of life. Each agency covers a designated geographic area of the city. 

For South, West or North Philadelphia, contact Center CARIE at 2 Penn Center, 1500 JFK Blvd., Suite 1500; 215-545-5728; 1-800-356-3606 (toll-free); or www.carie.org.

For Northeast or Northwest Philadelphia, contact Center in the Park at 5818 Germantown Ave.; 215-844-1829 or www.centerinthepark.org.

PCA’s ombudsman program will also present senior bullying education programs at senior centers and senior housing. To schedule a presentation, contact Lynda Pickett 215- 765- 9000, ext. 3109 or e-mail lpickett@pcaphl.org.

Back to Top
 

Caregiver's many acts of love


By Marcia Z. Siegal
Elsie Shelton has spent years as a caregiver, first for her mother and now for her aunt. In the process, she’s learned a lot firsthand about Alzheimer’s disease.

Shelton, of West Philadelphia, was a long-distance and frequent on-site caregiver for mother, Marian Jones Jackson, during the last years of her mother’s life. Her mother had been a hospital nurse and, after she retired, operated a business buying and managing real estate in Maryland where she lived. She was known to be pleasant, easygoing and highly organized. “But in her last years, her personality changed,” Shelton says. 


Jackson, who had always been an excellent housekeeper, became a hoarder. Bills piled up. She neglected the properties she owned, and many fell into disrepair. She was often angry and suspicious, especially when her daughter tried to help her."  

I had handled her taxes for years,” says Shelton, who had taught business education and oversaw job placement for hundreds of business students in the Philadelphia School District prior to her retirement. “But she refused to let me prepare her taxes and said she wasn't turning her business over to anybody. When I came, she made remarks that I did not come for her sake but to spend time with the neighbors. It was difficult to be with her.”

Shelton did not understand those changes at the time. Jackson’s physician did not see them in his limited interactions with the older woman, and Jackson was never diagnosed with a specific problem.

It was only after Jackson passed away that Shelton realized what her mother – and she – had faced. With more free time available and aided by her church's Community Center Committee, Shelton volunteered to organize senior health and consumer education programs at the First Corinthian Baptist Church, where she is a member.

Some of those programs, led by experts from the Alzheimer’s Association-Delaware Valley Chapter and the University of Pennsylvania’s Penn Memory Center, focused on Alzheimer’s disease and highlighted changes in thinking, communication and personality that can occur. Listening to them, “it was as if a light bulb went off in my head,” says Shelton. “I said to myself, ‘that’s what happened to my mom.’”

This year, Shelton assumed caregiving duties once again when she took in her mother’s sister, Mary VanBuren, to live with her.  “There are many difficult situations with my auntie, but at least I know what’s going on this time,” she says, noting her aunt has been diagnosed with Alzheimer’s disease.

H
er aunt had arrived seriously underweight, unable to care for herself or even remember to eat. VanBuren’s finances were in disorder. “She was using her checkbook as a notebook to jot down anything and everything. I provide meals, snacks, see that she is bathed and dressed, and take care of her finances,” Shelton says.

Shelton’s grown daughter, Karen Shelton-Aston, recently moved back in with her mother to help with caregiving duties. One of the younger woman’s main responsibilities is to talk with VanBuren’s physicians about her medication and to oversee medication administration at home. “We’re a team,” Shelton says emphatically, “I couldn’t do it without Karen.”

With VanBuren’s Alzheimer’s far advanced, her caregivers must be constantly vigilant. “I can’t let her go into a room alone,” Shelton says. “My daughter or I have to follow her to see what’s going on. Sometimes she takes out everything from every drawer and rearranges it, and we have to put everything back. The most difficult part is not getting enough sleep because my auntie wakes up three or four times each night and starts to prepare to bathe and dress as if it is time to go. We have to convince her it's not daytime yet.”


Weekdays VanBuren goes to the Living Independently for Elders (LIFE) program in West Philadelphia, operated by the University of Pennsylvania School of Nursing. LIFE provides socialization, physical activities and mentally stimulating recreation at a level geared to participants' skills and ability. For her caregivers, the program offers much needed respite.

Years before becoming her aunt’s caregiver, Shelton helped to organize a caregiver support group at First Corinthian. Now, she hopes to participate in that group when she has the time.

I
nformation and support are crucial, she says. “My number one advice to a caregiver is get as much information as possible from agencies that work with people in this situation, so you can understand what’s going on,” she says. “Second, don’t be afraid to ask for help. If people ask, ‘can I do anything?,’ tell them what it is you need.” 

Caregiving has entailed enormous sacrifices, but it’s also rewarding. It’s been a family tradition passed down through generations, Shelton says. “My grandmother was a caregiver. She was always there with clean linen and food and to help out when anyone in the community was sick. My mother was the same. She was very caring, and she was also a nurse. Whenever someone in the family or neighborhood was sick, the word went out to call Marian.”

Shelton says her faith helps sustain her when caregiving seems overwhelming.  “God gives me the strength to do what I have to do. I also think God led me to create educational programs and give out information about Alzheimer’s disease in my church to prepare me for what I would have to do,” she says. Caregiving and helping others to understand Alzheimer's disease and deal with its challenges is now her mission. "God's plan has become my journey," she says.

For more information about Alzheimer's disease and support, Click Here>>

CAPTION: Caregiver Elsie Shelton (left) prepares to serve a meal to her aunt, Mary VanBuren. (Photo by Paola Nogueras)

Back to Top
 

Resources for caregivers


By Alicia M. Colombo
Last year, more than 34 million Americans provided unpaid care to an adult age 50-plus, according to “Caregiving in the U.S. 2015” by the National Alliance for Caregiving and AARP Public Policy Institute.
 
The services provided by caregivers account for the largest source of long-term care services in the U.S. and are valued at more than $450 billion per year.

More than half of caregivers for older adults are age 50-plus. Nearly 10% of caregivers are 75-plus. The stress of caregiving can lead them to neglect their own health, which is especially concerning for older caregivers with chronic health conditions.

In November, the observances of National Alzheimer’s Disease Awareness Month and National Family Caregivers Month are aimed at informing families about resources available, and encouraging them to talk to loved ones about future care. 

Assistance for caregivers
 
While caregivers tend to be family members, especially spouses or adult children, the role can fall on anyone. "Many times friends, neighbors and domestic partners are serving as caregivers,” said Maria Zyborowicz, service coordinator for the Caregiver Support Program at Philadelphia Corporation for Aging (PCA). 

“They are determined to keep their loved ones at home for as long as possible. Many caregivers consider facilities a last resort. They feel their loved ones can get the best care at home, surrounded by family," she said.

PCA’s Caregiver Support  Program links caregivers to education and services that facilitate self-care and skill-building and provide much-needed support.

"We see varying degrees of need. Some caregivers need only companion services for light housekeeping or transportation, while others require round-the-clock care for their loved ones,” said Zyborowicz.  "The program is unique because we are serving the caregiver, not just the older adult. By giving them resources and support services, they can better care for their loved ones.”

Assistance is available for families caring for both older adults who are eligible for nursing home care and those who are not.  Currently, more than 700 caregivers in Philadelphia ranging in age from their 30s to 90s are being served by the program. Some have been receiving services for 15 years or more, which speaks to the program’s success in helping to keep older adults in the community rather than in a long-term care facility.

Eligible caregivers may receive monthly reimbursement for $250 to $500 for related expenses. The most frequent expenditure is for respite care, which provides personal care or companion services for the older person while the caregiver is at work, medical appointments, taking a break or running errands. Ointments, incontinence supplies and other related items may also qualify for reimbursement. In addition, participants may receive up to $2,000 in housing modifications and assistive devices to assure that the caregiver can safely assist with their loved one’s care.

“Installing grab bars or railings, tub seats and stair lifts in an older person’s home are a necessity for most caregivers. The program also provides reimbursement for lift chairs to assist with safe transfer from a sitting position and emergency response systems to give the caregiver peace of mind,” said Zyborowicz. 

The unreimbursed expenses of caring for an older adult who requires 24-hour supervision due to severe health issues or advanced dementia can be $2,000 or more a month. While reimbursement will only cover a small portion of this expense, the emotional support and resources that are also provided are invaluable.
 
“We are helping with a lot of resources related to caregiving, so no matter what the problem is, we can connect them with materials, information or other community resources,” said Zyborowicz. Caregiver training and education is available to provide resources and referrals to other community services that are focused on improving and sustaining the well-being of the caregiver and caregiving relationship.

“We have a library of books and materials about dealing with stress and effective communication strategies,” she said. But she said sometimes what is most needed is emotional support.  “The task that they have is so overwhelming. Sometimes all they need is someone who will listen.”

To be eligible for Caregiver Support Program services, a caregiver must have primary responsibility for the care of a person with physical and/or cognitive impairments who lives in Philadelphia and is unable to perform essential self-care tasks. The care recipient must either be age 60-plus ; younger than 60 with chronic dementia; or aged 19-59 with disabilities and living with a relative caregiver who is age 55-plus.

The program also supports grandparents and other relatives who are raising children 18 or younger. The care recipient must also meet household income guidelines for financial support to be available, but other services are not dependent on income. For more information, call the PCA Helpline at 215-765-9040 or go to www.pcaCares.org.

Support for Alzheimer’s caregivers
 
The Alzheimer’s Association Delaware Valley Chapter offers regularly scheduled gatherings for caregivers, family and friends of individuals with Alzheimer’s disease or a related disorder. Caregiver support groups enable people to discuss best practices and offer supportive listening. Monthly support groups facilitated by trained volunteers are held at the following locations in Philadelphia: 

1st Tuesday at 2:30 p.m. – Abramson Center for Jewish Life, 12003 Bustleton Ave. 

1st & 3rd Tuesday at 6 p.m. – Ebenezer S.D.A. Church, 1437 Christian St.

3rd Tuesday at 5:30 p.m. – Center on the Hill, 8855 Germantown Ave.

4th Tuesday at 6:30 p.m. – St. Timothy’s Church, 5720 Ridge Ave., Parish Hall, 2nd Fl. (Adult children 50+; long-distance caregivers) 

Last Tuesday at 5:30 p.m. – Atria Senior Living Center City, 150 N. 20th St. (Free Parking in garage on Race & Woodstock Sts.)

2nd Wednesday at 7 p.m. – Enon Tabernacle Baptist Church, 230 W. Coulter St.

3rd Wednesday at 12:30 p.m. – Alzheimer’s Association Delaware Valley Chapter Headquarters, 399 Market St., Suite 102
 
3rd Wednesday at 6:30 p.m. – Ralston Penn Center, 3615 Chestnut St. (Young adult children of people with early onset Alzheimer’s)

1st Friday @ 10:30 a.m. – Lafayette Redeemer Library, 8580 Verree Rd. 

1st Friday at 12:30 p.m. – LIFE, 4508 Chestnut St.

1st Saturday at 1 p.m. – Vine Memorial Baptist Church, 5600 West Girard Ave. (African-American)

3rd Saturday at 1 p.m. – Methodist Hospital, 2301 S. Broad St., Conf. Room #1
 
4th Saturday at noon – First Corinthian Baptist Church, 5101 Pine St.
 
4th Sunday @ 1 p.m. – Pinn Memorial Baptist Church, 54th St. and Wynnefield Ave. (African-American)
 
For support and helpful information for Alzheimer’s caregivers, contact the Alzheimer’s Association Delaware Valley Chapter, 399 Market St., Suite 102; 24/7 Helpline: 1-800-272-3900; or  www.alz.org/delval.
Back to Top
 

Want to age in place? It takes a village


By Alicia M. Colombo
Janet Burnham loves the Washington Square neighborhood where she has lived happily for more than 30 years, and she plans on staying. At 71, Burnham is active and healthy, but knows she can't forestall the effects of aging forever. She can, however, plan for a day when she may need some help with everyday activities, such as shopping or getting to medical appointments.
 
Burnham was a member of the founding board for Penn’s Village, which got its start in 2008 and is now the largest of Philadelphia’s three villages with 270 current members. “The original vision was to create a community that connects people, so they can support and help each other,” she said.

The village concept is to create a framework that enables people to remain active and engaged in their community for as long as possible. All villages have a common structure, according to the Village to Village Network, a national resource for connecting, establishing and improving villages. They are membership-driven, grass-roots organizations that, through volunteers and sometimes paid staff, coordinate access to affordable services.

These range of services varies by village, but often includes transportation, health and wellness programs, home repairs, social and educational activities, and other day-to-day needs that enable individuals to remain connected to their community throughout the aging process. Members pay an annual fee to join and receive a variety of benefits.

The village movement is growing; there are currently 170 active villages worldwide and another 160 in development. Beyond the basic framework, the similarities of individual villages end. “If you’ve seen one village, you’ve only seen one village. Each one is different,” said Mary Flournoy, co-chair of East Falls Village, which has about 165 members. She added that villages are not restricted to cities. They are found in many suburban and rural areas, as well. 

Community connection

One key benefit is maintaining a meaningful connection to your community. “Isolation is a big issue for older adults. This is a way of making and keeping connections,” said Jane Eleey, executive director of Penn’s Village. “Members maintain stimulation by going out regularly and meeting others. For volunteers, the problem-solving and engagement in creative work and meaningful tasks helps keep their minds active after retirement.” 

Participation gives retirees and active adults, like Burnham, an opportunity to use their time and talents. “But it’s also an insurance policy. If I ever need some help to stay in my own home, I know that help’s going to be there,” said Burnham. 

Social and informational events are a mainstay of village offerings, since remaining active is essential to healthy aging. Members can partake in regular trips to museums, restaurant outings, and workshops or educational programs. There are weekly gatherings for coffee, and seminars about topics of interest to seniors, from how to continue gardening with arthritis to making end-of-life decisions. Penn’s Village also has a caregiver support group that’s facilitated by a retired social worker over the phone.

Most events are included with membership or charge a nominal cost to cover expenses of a speaker, instructor or meeting space. Since villages operate as community organizations and partner with neighborhood agencies, they are able to keep costs low.

Services in your home

Older adults don’t want to burden their children or family, and are often reluctant to ask for help. “Government is imperfect, to say the least. We are taking it upon ourselves to prepare for our future,” said Peter Javsicas, president of Northwest Village Network, which is the newest of Philadelphia’s villages with 67 members and growing. “Lots of us have trouble asking for help, but it’s easier to approach someone you know. In many cases, you will know the volunteer who is coming to drive you,“ he said.

There’s a range of ages and activity levels in villages. While villages attract many older adults, they also have an intergenerational makeup. Penn’s Village, for example, serves some younger adults with chronic diseases. “When we started out, membership was restricted to people age 50-plus. But we were approached by some younger residents who wanted to join. Even after we dropped the age requirement, our membership has remained predominantly older folks,” said Flournoy.

The most requested service for all of the villages is transportation, and the need can arise unexpectedly. “When I had shoulder surgery, I only had one operable arm. My wife injured her wrist at the same time, so neither of us was able to drive for two weeks. I only had to pick up the phone once. People even brought food, although we didn’t ask for it,” said Phil Hineline, the other co-chair of East Falls Village.

Technology assistance is a growing need among seniors. Whether you need help setting up a new printer, have a question about Facebook, or can’t figure out your TV remote, a tech volunteer will come to your rescue. “A member pointed out that the cost of one call to professional tech support pays for the village membership,” said Hineline.

Other services can include friendly visiting; minor home repairs or assistance, such as changing light bulbs; and assistance with grocery shopping and errands. Like some other villages, Penn's Village is piloting a new program, which includes accompanying members to medical appointments.

All services are provided by volunteers, who are thoroughly vetted by an interview process that includes background and reference checks. For drivers, valid insurance and vehicle registration, and a clean driving record is also required. 

For services beyond the scope of what volunteers can provide, such as home remodeling or appliance installation, village members have access to a list of recommended service providers in the area.

Northwest Village Network has a partnership with local retailers and professional services that provide a discount to members. “We try to be a hub of existing resources, so we don’t have to duplicate efforts. We have an ongoing relationship with community organizations and try to encourage our members to take advantage of existing programs, such as Ralston My Way, Weaver’s Way Food Co-op, Morris Arboretum, Center in the Park, Center on the Hill, UUH (Unitarian Universalist House ) Outreach and Mt. Airy Learning Tree,” said Javsicas.

Benefits of village membership are both tangible and intangible. Many village members report an increase in their circle of friends. “It’s a social network. I know at least 20 people who I didn’t before. People talk about having a sense of community, and what follows from that is a sense of security,” said Hineline. “On the flip side, there’s an opportunity to be helpful. One of the best contributors to well-being is opportunities to be helpful to others. The village solidified a community waiting to happen.”

For more information on villages in Philadelphia, Click Here>> 
 
CAPTION: Members of the Northwest Village Network enjoy a weekly coffee klatch at a local café, one of the village's many social activities. (Photo courtesy of Northwest Village Network).
Back to Top
 

Villages in Philadelphia


Help with aging in place
Philadelphia has three villages that were each developed to help elders age in place. Each Village is independently run; and therefore, sets its own membership requirements, fees and services. However, all require participants to be age 18 or older and to live in the specified geographic area, which makes it convenient for volunteers to provide services and allows members to feel close. For more information about villages in Philadelphia and elsewhere, contact the following:

East Falls Village
– Residents in East Falls (zip code 19129). Annual membership costs $125 for individuals and $175 for households, which includes unlimited services and events. Those who wish to support the village at a higher level can become a sustaining ($300) or supporting ($500) member. People who move out of the area can purchase an Emeritus membership to continue participating in events, but not receive services. Info: 267-444-4507, e-mail info@eastfallsvillage.org  or  www.eastfallsvillage.org.

Villages2.jpg 
Penn's Village – Residents of Central Philadelphia (river to river, Washington Ave. to South of Girard Ave.). Annual membership costs are the same for individuals or households. For $600 a year, “Villagers” can receive up to three services per week. “Neighbors” can participate in all activities and events for $200 without being eligible for services. Membership subsidies may be available. Info: 215-925-7333, e-mail info@pennsvillage.org or www.pennsvillage.org.

Northwest Village Network – Residents of Northwest Philadelphia, including Mt. Airy, Chestnut Hill, Germantown and Wyndmoor. Annual membership costs $125 for an individual or $175 for a household. Special consideration will be made for financial hardship. Membership includes services and members-only activities. Most activities are open to the public or allow members to bring guests. Info: 215 247-0457 or www.northwestvillagenetwork.org.
 
The Village to Village Network – Information and resources about villages worldwide. Info: 617-299-9638, e-mail vtv@vtvnetwork.org or www.vtvnetwork.org.

Learn more>> about Philadelphia's Villages.

PHOTO: In-home tech support with computers and other  electronic devices is available to village members. East Falls Village member Hank Harrison Helps Jeanne Maxwell with her tablet. (Photo by Susan Harrison)

Back to Top
 

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 www.pcaCares.org.
Back to Top
 

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 www.libertyresources.org.
Back to Top
 

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

Back to Top
 

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.
Back to Top
 

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.

Back to Top
 

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 www.alz.org/delval.

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

Back to Top
 

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.
Back to Top
 

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:

Hoarding

Inappropriate dress for weather conditions

Leaving burning stove unattended

Confusion

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, www.napsa-now.org and click on “Get informed.”
Back to Top
 

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.
Back to Top
 

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 www.congreso.net. To contact the VIDA program staff: 215-763-8870, ext. 1417; elliottt@congreso.net or crespoe@congreso.net.

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)

Back to Top
 

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 http://federalregister.gov/a/2014-28268 
  
 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 
http://www.regulations.gov. Follow the "Submit a comment" instructions. 
  
 2. By regular mail. You may mail written comments to the following address 
ONLY: 
 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. 
  
FOR FURTHER INFORMATION CONTACT: 
Ronisha Davis, (410) 786-6882. 
SUPPLEMENTARY INFORMATION: 
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: http://www.regulations.gov. 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- 
3951. 
  
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.) 

Back to Top
 

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.  

Eligibility
   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.
Back to Top
 

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.
Back to Top
 

Caregiving edition



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

candle-170.jpg
The next Milestones e-news will be published January 7, 2015. Philadelphia Corporation for Aging wishes you a happy and healthy New Year!

Back to Top
 

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 www.emotionalsurvivalguide.com.  
Back to Top
 

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.

CARES
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 sissenberg@lutheransettlement.org.

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 elaine.prowler@temple.edu or go to www.timeoutprogram.org.

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 eldercare@jefferson.edu, or go to www.jefferson.edu/elder_care.

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 www.pcaCares.org; or www.portal.state.pa.us (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     
Website: www.LIFEUPENN.org
Areas served: zip codes 19103, 04, 21, 30, 31, 39, 42, 43, 51, 53 

Mercy LIFE Program
Phone: 215-339-4747 
Website: www.mercylife.org
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     
Website: www.newcourtlandlife.org
Areas served: zip codes 19100-11, 14-16, 18-20, 24, 26-29, 32, 35, 36,  38, 41, 44, 49, 50, 52, 54

Back to Top
 

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 www.readynotifypa.org. 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, www.phila.gov/ready, 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. www.phila.gov/311

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

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 www.redcross.org. 
Back to Top
 

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.
Back to Top
 

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.

CAREGIVERS
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.


GRIEF
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. 

HEALTH
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.


SHARING WHAT’S ON YOUR MIND

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. 

VETERANS
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.


LADIES OR GENTS 
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.


CURRENT EVENTS

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.

                                                            
Back to Top
 

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 tmoore@pcaphl.org.
Back to Top
 

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. 
Back to Top
 

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
TeleCare

You can also apply, or refer someone for services, on PCA's website.
Back to Top
 

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 info@pennsvillage.org or Rhawnhurst NORC at 215-320-0351 or agilbert@jfgp.org.
Back to Top
 

Find help, resources, services for seniors


www.pcaCares.org
Philadelphia Corporation for Aging’s (PCA) website, pcaCares.org, 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.