LifeTimes

LifeTimes: Jingle Bell Run: December 11th at 8:30am

2010-11-05T16:47:00.000-07:00

Register by using this URL in your browser below:

http://bellinghamjbrw.kintera.org/faf/home/default.asp?ievent=429039&lis=0&kntae429039=9AE651B5A4864C8FBFA4D780435C9824

Jingle Bell Run: December 11th at 8:30am

2010-11-04T13:43:00.000-07:00

23rd Annual Jingle Bell Run
Saturday
December 11, 2010
Start: 8:30 am
Bellingham High School
In the spirit of Zero Waste bring your own water bottle!

REGISTER Here by clicking the link, signing up and following the prompts:

http://bellinghamjbrw.kintera.org/faf/home/default.asp?ievent=429039&lis=0&kntae429039=9AE651B5A4864C8FBFA4D780435C9824

Or Register in-store: November 1 – December 1 at:

Bellingham Athletic Club:
Downtown/1616 Cornwall OR Meridian/4191 Meridian 1209

Fairhaven Runners: 12th Street St.

Arthritis Foundation @ Joseph Hospital S. Campus: Bellingham 809 E. Chestnut.

Cost:
25$ per Walker, 35$ for walker and one dog

OR
REGISTER ON LINE at www.bellinghamjbrw.kintera.org

Last Chance Registration (Day of the Event at 7am)
4-Mile Run: (No Dogs)
2-Mile Walk: Dogs Welcome, Need to Register

For More Information? Call 360-733-2866

The Building Blocks of Wellness - Free Public Education at St. Francis of Bellingham, Sept 28th @ 7pm

2010-09-09T15:12:00.000-07:00

The Arthritis Foundation, North Puget Sound Branch & St. Francis of Bellingham Present:

Self Care -
The Building Blocks of Wellness

(a free public education program)

Tuesday, September 28, 2010
from 7:00 -- 8:30 pm
at St. Francis of Bellingham, 3121 Squalicum Pkwy, Bellingham WA 98225

Speaker: Susan Churchill, PT, DRS

Registration Required - call 360-733-2866 or email at bosen@arthritis.org

Heroes' Day 2010

2010-08-31T15:32:00.001-07:00

Its our 8th Annual St. Francis Heroes' Day!
Friday, September 10th

At St. Francis - 3121 Squalicum Pkwy
Parking lot & Backyard / Patio

11am Vehicle Tours

11:30 Hero Sandwiches (ends at 1pm)

RSVP with Sally at 360-752-6358

St Francis 25th Year Celebration & Car Show

2010-08-06T12:50:00.000-07:00

Come and Join us! August 15, 2010.

How much physical activity do older adults need?

2010-06-17T12:28:00.000-07:00

From the Center for Disease Control and Prevention website:
As an older adult, regular physical activity is one of the most important things you can do for your health. It can prevent many of the health problems that seem to come with age. It also helps your muscles grow stronger so you can keep doing your day-to-day activities without becoming dependent on others.

Not doing any physical activity can be bad for you, no matter your age or health condition. Keep in mind, some physical activity is better than none at all. Your health benefits will also increase with the more physical activity that you do.

If you're 65 years of age or older, are generally fit, and have no limiting health conditions you can follow the guidelines listed below.
Older adults need at least:

2 hours and 30 minutes (150 minutes) of moderate-intensity aerobic activity (i.e., brisk walking) every week and
muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms).

OR

1 hour and 15 minutes (75 minutes) of vigorous-intensity aerobic activity (i.e., jogging or running) every week and
muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms).

OR

An equivalent mix of moderate- and vigorous-intensity aerobic activity and
muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms).

10 minutes at a time is fine
We know 150 minutes each week sounds like a lot of time, but it's not. That's 2 hours and 30 minutes, about the same amount of time you might spend watching a movie. The good news is that you can spread your activity out during the week, so you don't have to do it all at once. You can even break it up into smaller chunks of time during the day. It's about what works best for you, as long as you're doing physical activity at a moderate or vigorous effort for at least 10 minutes at a time.

More time equals more health benefits
If you go beyond 300 minutes a week of moderate-intensity activity, or 150 minutes a week of vigorous-intensity activity, you'll gain even more health benefits.

Aerobic activity – what counts?
Aerobic activity or "cardio" gets you breathing harder and your heart beating faster. From pushing a lawn mower, to taking a dance class, to biking to the store – all types of activities count. As long as you're doing them at a moderate or vigorous intensity for at least 10 minutes at a time. Even something as simple as walking is a great way to get the aerobic activity you need, as long as it's at a moderately intense pace.

Intensity is how hard your body is working during aerobic activity.

How do you know if you're doing moderate or vigorous aerobic activity?
On a 10-point scale, where sitting is 0 and working as hard as you can is 10, moderate-intensity aerobic activity is a 5 or 6. It will make you breathe harder and your heart beat faster. You'll also notice that you'll be able to talk, but not sing the words to your favorite song.

Vigorous-intensity activity is a 7 or 8 on this scale. Your heart rate will increase quite a bit and you'll be breathing hard enough so that you won't be able to say more than a few words without stopping to catch your breath.

You can do moderate- or vigorous-intensity aerobic activity, or a mix of the two each week. Intensity is how hard your body is working during aerobic activity. A rule of thumb is that 1 minute of vigorous-intensity activity is about the same as 2 minutes of moderate-intensity activity.

Everyone's fitness level is different. This means that walking may feel like a moderately intense activity to you, but for others, it may feel vigorous. It all depends on you – the shape you're in, what you feel comfortable doing, and your health condition. What's important is that you do physical activities that are right for you and your abilities.

Besides aerobic activity, you need to do things to make your muscles stronger at least 2 days a week. These types of activities will help keep you from losing muscle as you get older.

To gain health benefits, muscle-strengthening activities need to be done to the point where it's hard for you to do another repetition without help. A repetition is one complete movement of an activity, like lifting a weight or doing one sit-up. Try to do 8—12 repetitions per activity that count as 1 set. Try to do at least 1 set of muscle-strengthening activities, but to gain even more benefits, do 2 or 3 sets.

There are many ways you can strengthen your muscles, whether it's at home or the gym. The activities you choose should work all the major muscle groups of your body (legs, hips, back, chest, abdomen, shoulders, and arms). You may want to try:

•Lifting weights
•Working with resistance bands
•Doing exercises that use your body weight for resistance (push ups, sit ups)
•Heavy gardening (digging, shoveling)
•Yoga

Narrative Comments Since 12/28/2009

2010-01-15T12:52:00.000-08:00

"I was treated with respect and consideration during my stay. The food was also very good." -Anonymous

"Your place is clean and well laid out. The combination of adult care and child care was refreshing." -Anonymous

"The attitude of all the staff was so friendly and positive. Medical care - very good." -Anonymous

"My stay with you was much longer than anticipated and one might expect a person to become anxious and or depressed. But for me- you all became family and St. Francis was not just a place to stay, but became my home. In fact, upon return from a Dr.'s appt i said to my friend who had accompanied me, 'I can hardly wait to get home' and that home was St. Francis. Leaving all of you was bittersweet because i was leaving security and real friends. Thank you for your care, you were wonderful." D.

Alzheimer's Disease

2009-12-06T13:04:00.000-08:00

What is Alzheimer’s Disease?

Alzheimer’s disease is the most common form of dementia among older adults. Alzheimer’s disease involves parts of the brain that control thought, memory, and language and can seriously affect a person’s ability to carry out daily activities. Although scientists are learning more every day, right now, they still do not know what causes Alzheimer’s disease.

Who has Alzheimer’s Disease?

As many as 5 million Americans suffer from Alzheimer’s disease. While younger people may get Alzheimer’s disease, it is much less common. The disease usually begins after age 60, and risk goes up with age. About 5 percent of men and women ages 65 to 74 have Alzheimer’s disease, and nearly half of those age 85 and older may have the disease. It is important to note, however, that Alzheimer’s disease is not a normal part of aging.

What causes Alzheimer’s Disease?

Scientists do not yet fully understand what causes Alzheimer’s disease. There probably is not one single cause, but several factors that affect each person differently. Age is the most important known risk factor for Alzheimer’s disease. The number of people with the disease doubles every 5 years beyond age 65.

Family history is another risk factor. Researchers believe that genetics may play a role in developing Alzheimer’s disease.

Scientists still need to learn a lot more about what causes Alzheimer’s disease. In addition to genetics, they are studying education, diet, and environment to learn what role they might play in developing this disease.. Scientists are finding more and more evidence that some of the risk factors for heart disease and stroke, such as high blood pressure, high cholesterol, and low levels of the vitamin folate may also increase the risk of Alzheimer’s disease. Evidence for physical mental and social activities as protective factors against Alzheimer’s disease is also growing.

What is the burden of Alzheimer’s disease in the United States?

Alzheimer’s disease is one of the top ten leading causes of death in the United States. Alzheimer’s disease has recently surpassed diabetes as the 6th leading cause of death among American adults. Notably, mortality rates for Alzheimer’s disease are on the rise, unlike heart disease and cancer death rates which are continuing to decline.

An estimated 5 million Americans have Alzheimer’s disease. This number has doubled since 1980, and is expected to be as high as 13.4 million by 2050.

In 2005, total Medicare spending for individuals with Alzheimer’s disease was estimated at $91 billion.

Individuals with Alzheimer’s disease make up less than 13 percent of the Medicare population, yet they account for 34 percent of Medicare spending.*

*Reference: Urban Institute, unpublished tabulations from the 2000 Medicare Current Beneficiary Survey and Medicare Claims, 2005; published by the Alzheimer’s Association, Alzheimer’s Disease Facts and Figures, 2007.

Avoiding the Complications of Diabetes

2009-11-29T10:00:00.000-08:00

2.2 million older Americans—almost one-fourth of us over age 60—are living with diabetes.

Diabetes develops when the pancreas can not manufacture enough insulin, or because the cells in the muscles, liver, and fat do not use insulin properly, or both. As a result, the amount of glucose in the blood increases while the cells are starved of energy.

The complications from the disease can be severe. They include serious problems such as heart disease, eye and kidney damage, high blood pressure, and nerve damage that could result in amputation.

While this is a very sobering list of complications, patients themselves have the power to reduce the potential for complications, and to successfully manage the disease. Self-care practices such as healthy eating, being active and monitoring blood glucose levels make a huge difference.

So, let's review some diabetes complications, along with some positive actions that can help patients and loved ones minimize damage and improve outcome:

Nerve Damage

Nerve damage called diabetic neuropathy can appear as numbness, tingling, pain, perspiration problems and bladder problems. It is caused by high blood sugar. You can help control your blood sugar through eating the diet your healthcare provider suggests, as well as with exercise, taking medications correctly and frequent blood glucose level testing.

Increased Risk of Infection

For people with diabetes, high levels of blood sugar foster the growth of bacterial and fungal infections, especially common in the skin and urinary tract. You can decrease the risk of infection by keeping skin clean and dry, bathing regularly, drinking plenty of water, and reporting to the doctor if a cut doesn't heal quickly.

Impaired Vision

While many people develop glaucoma and cataracts, people with diabetes develop them more often and at an earlier age. Over time, high blood sugar can injure the blood vessels of the eye, including the retina, lens and optic nerve. Regular eye examinations should be part of your diabetes management program, because early intervention for eye problems will help prevent more serious problems later. Remember—damage to the eyesight may not be apparent at first, so have an annual exam even if your vision isn’t bothering you.

Foot Problems

While anyone can have foot problems, people with diabetes are especially prone to corns, blisters, calluses, dry, cracked skin. Serious infection is much more common because the nerve damage described above can reduce feeling in the feet. It is important to pay attention to your feet, inspecting them regularly so problems won't worsen. Keep feet clean and dry, and talk to your healthcare provider about the best type of shoes and socks to select.

Heart or Kidney Disease

Diabetes also makes it more likely that a person will suffer from cardiac or renal disease. A healthy lifestyle and commitment to managing those conditions is very important. This includes getting the right amount and type of exercise, complying with medication instructions, quitting smoking if you do, and regular monitoring of blood sugar.

For More Information

Visit the National Council on Aging (NCOA) website to learn about the Connect the Dots program, which helps seniors learn about the link between diabetes and high blood pressure. Included is a handy take-along checklist to detemine a patient's risk for these two conditions.

In time for American Diabetes Month, the CDC offers updated information on diabetes prevention, detection and management.
The American Diabetes Association sponsors American Diabetes Month. Their website is a great source of consumer information for people with diabetes and their families. Learn more about American Diabetes Month 2009 and the Association's new Stop Diabetes campaign.

The National Diabetes Information Clearinghouse from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDKD) offers extensive information on preventing and treating diabetes.

By Joyce Remy, Editor, and Dennis Kenny, Co-Author, Aging in Stride–Plan Ahead, Stay Connected, Keep Moving. Copyright, 2009.

Planning for the End of Life

2009-11-14T14:16:00.000-08:00

Public health strategies, coupled with medical advances, have resulted in a 30-year increase in life expectancy since the dawn of the 20th century. People are living longer and expectations about their health and quality of life are increasing. These expectations extend to wanting to ensure that the last months and years of life are lived as fully as possible, as pain-free as possible, and with dignity.

Traditionally, much of the nation’s public health network focus is about infants and children—ensuring that babies are born into the world as healthy as possible and that children thrive and are protected from injury and communicable diseases. In more recent decades, additional strides have been made in ensuring that our nation’s adults practice healthy behaviors and take advantage of preventive measures that reduce their risk of chronic disease, injury, and infectious diseases such as influenza and pneumonia.

Now, as more and more baby boomers reach their older years, opportunities exist through the nation’s public health network to focus on more about the end of life and help ensure that Americans have the resources needed to make informed choices and decisions about how their final months and days are spent.

Recognizing how important it is to be prepared for the end of life, CDC defined better opportunities, public health roles, and responsibilities in 2002.

As a first step, CDC’s Healthy Aging Program, in collaboration with CDC’s Division of Cancer Prevention and Control and the National Association of Chronic Disease Directors (NACDD), worked with more than 200 key public health stakeholders to identify short-, medium-, and long-term public health priorities related to the end of life.

Of the priorities identified, five were deemed most critical and ready for action. These include the following:

Identify point of contact for end-of-life issues in state health departments.
Collect, analyze, and share data related to the end of life.
Incorporate end-of-life principles in state comprehensive cancer control plans.
Educate the public about hospice and palliative care.
Educate the public about the importance of advance directives and health care proxies.
Of these top priorities, CDC chose public education, data collection, and data analysis, to pursue initially.

Planning End-of-Life
Family members are often asked to make decisions on behalf of a loved one who is seriously ill without having a complete understanding of his or her preferences. To avoid this situation, older adults should discuss their end-of-life wishes with family members and health care providers well before the onset of a serious illness, and they should designate a surrogate decision maker for health care.

Having these conversations is the best way to protect one’s independence in a myriad of unpredictable situations. Many people find it difficult to begin a discussion about end-of-life issues, however. Fortunately, several resources are available to help foster meaningful conversations and practical planning for end-of-life care.

Understanding Palliative Care and Hospice Care
For the past several decades, the health care system has provided a number of options to ease the dying experience. Medical treatment has expanded to include palliative care and hospice care. The goal of palliative care is to achieve an optimal quality of life for patients by using a holistic approach that focuses on the alleviating of pain, symptoms, and other unique needs of the patient at any time during their experience with a serious or life-threatening illness. A combination of social support, emotional support, and attention to spiritual aspects of care and respect for the patient’s culture, beliefs, and values are essential components of this approach. Although the level of palliative care intensifies at the end of life, the focus on the relief of suffering and improving quality of life is important throughout the course of the illness, and aspects of palliative care can be provided along with life prolonging treatment during earlier phases of a patient’s illness.

Hospice care is an organized program for delivering palliative care that involves an interdisciplinary team of specially trained health professionals and volunteers. Hospice care is delivered to dying patients in inpatient units, nursing homes, or, most often, in their own homes. In addition to providing palliative care and personal support to individuals at the end of their lives, hospice provides support to the family while their loved one is dying as well as during the bereavement period. In 1982, Medicare began reimbursing for hospice services. To qualify for the Medicare hospice benefit, terminally-ill patients must have a terminal diagnosis, a life-expectancy of 6 months or less, and is willing to forgo further treatments. Patients who live longer than 6 months can be “recertified” if their situation still meets the criteria for the hospice benefit.

End-of-Life Resources
Advance Care Planning

Center for Practical Bioethics Caring Conversations
Caring Connections
Aging With Dignity-Five Wishes
Respecting Choices

Hospice and Palliative Care

National Hospice and Palliative Care Organization
National Association of Home Care and Hospice

Guardianship/Surrogacy Issues and Protection

American Bar Association Commission on Law Aging

Seasonal Affective Disorder

2009-11-07T11:01:00.000-08:00

By Matthew Solan, Natural Solutions

For 12 years Helena Davis’ life resembled a light switch. When daylight-saving time arrived in spring, it flipped on–she felt energetic, focused, and active. In winter, however, it switched off. She struggled to do the simplest household chores. Her weight ballooned. She could go to work and function at some level, she says, but it was obvious that something was wrong. “All winter I felt like a slug moving around in peanut butter,” says Davis, now 64.

She finally realized that her mood change coincided with her move to upstate New York, an area with few sunny days. A visit to her doctor filled in the diagnosis: Davis was one of 10 million to 25 million Americans, 75 percent of whom are women, who suffer from a subtype of depression called seasonal affective disorder (SAD).

You’ve no doubt heard of SAD. Also called “winter blues,” it often gets mistaken for clinical depression as the two share many symptoms–sadness, anxiety, lethargy, lack of sleep, diminished sex drive, and increased appetite. The difference lies in their duration and severity, according to Norman Rosenthal, MD, author of Winter Blues: Everything You Need to Know to Beat Seasonal Affective Disorder (The Guilford Press, 2006). SAD typically strikes around September or October and then fades away in March and April. (Depression on the other hand can occur year-round.) Merely troublesome and potentially disruptive at first, SAD can be controlled if you take appropriate action, but “left unchecked, the changes in mood and behavior can become so powerful they can create significant problems in your life and may manifest into year-round major depression if not addressed,” says Rosenthal.

Light therapy
The primary cause of SAD is light deprivation, so light therapy ranks as the first line of defense. Light boxes contain white fluorescent bulbs behind a plastic UV filter, and regular use can reset your body clock and increase serotonin. Effective light boxes generate 10,000 lux (a measurement of intensity); to put that therapeutic amount in perspective, traditional lighting produces 300 to 500 lux, and the sun produces more than 100,000 lux on a bright summer day.
Rosenthal recommends using light therapy for about 20 minutes a day at first, ideally in the morning. How early depends on the individual’s body clock, says Michael Terman, PhD, who heads the Center for Light Treatment and Biological Rhythms at Columbia Presbyterian Medical Center in New York.

If you suffer from SAD, try placing a light box 1 to 3 feet away while you eat, read, go through your mail, or meditate. If your symptoms remain unchanged, increase your treatment to 45 minutes a day, says Rosenthal. Reevaluate your symptoms on a weekly basis and make adjustments. “You should feel the effects within two to four days,” says Rosenthal. “Almost everyone should feel the benefits within two weeks.” (Find light boxes at lightforhealth.com or litebook.com.) Brighten up your living and work space with full-spectrum light bulbs that closely match natural daylight.

Diet and exercise
Dietary changes also can ease SAD symptoms, says Chris Krumm, ND, LAc, of the Bastyr Center for Natural Health, near Seattle. For breakfast, Krumm advocates a high-protein meal to boost intake of tyrosine. “Consuming this amino acid in the morning helps boost your energy throughout the day,” he says. For dinner, Krumm suggests less protein and more carbohydrates like whole grains to help the brain synthesize serotonin. “In addition to improving your mood, increased serotonin may help people sleep better,” he says.

You may want to add more fish to your diet, too, especially cold water types like mackerel and salmon that are rich in omega-3 fatty acids. People with depression often have low levels of omega 3s. A 2001 study found a correlation between increased fish consumption and decreased incidence of SAD in Iceland.

Davis has found that staying active in winter helps her feel less lethargic. She’s chosen a treadmill inside a brightly lit gym, but don’t be afraid to head outside. On bright afternoons, go for a long walk or run. Got more time? Climb on a bike or break out the skis. “You’ll get your required light exposure and also some exercise, which can help alleviate stress that may contribute to SAD-related depression,” says Rosenthal. Research in BMC Psychiatry found the combination of bright light exposure and aerobics reduced many depressive symptoms, especially those related to insomnia and other sleep problems.

Sweet dreams
Some people, like Davis, are prescribed antidepressants to ease their symptoms at first. Herbal alternatives exist, however, most notably St. John’s wort. Research from the University of Vienna, Austria found that taking 900 mg of hypericum (an extract of St. John’s wort) daily for four weeks was as effective as light therapy in treating SAD patients. And valerian root can help with insomnia caused by depression. A review of studies found that 300 to 600 mg taken 30 minutes to two hours before bedtime effectively eased sleeplessness.

Since SAD can alter normal melatonin production, which can also affect your sleep cycle, you may benefit from taking supplements. Melatonin levels increase before bedtime, peak during the night, and gradually decrease as morning approaches. Taking 2 mg of melatonin one to two hours before bedtime improved the sleep quality and resultant vitality of SAD patients, according to a 2003 study in the journal European Neuropsychopharmacology. (Caution: Children and teens should only take melatonin under a doctor’s supervision. Some experts believe extra melatonin could delay normal development during puberty.)

Short days and long nights can also disrupt your normal sleep routine since your body isn’t used to going to bed when the sun sets around dinnertime or waking up when it’s still dark. A dawn simulator can help maintain your normal spring/summer sleep cycle. The device gradually fills your bedroom with light, simulating a natural sunrise, to gently tell your body it’s time to wake up–even if it’s still dark outside. A 2005 study from the Center for Health Studies in Seattle found that dawn simulators along with light therapy helped reduce symptom severity in SAD patients.

Regular acupuncture treatments can also help control SAD. Stimulating the yintang point, between the eyebrows, relieves many of the symptoms, says acupuncturist Skya Abbate, DOM, executive director of the Southwest Acupuncture College in Santa Fe, New Mexico. “Needling yintang stimulates the pineal gland, which helps produce more melatonin and decreases lethargy and depression,” says Abbate.

No one can control the seasons, but you can stop them from controlling you. Davis has held her SAD in check for four years now. It takes effort, but her combination of exercise and light therapy has kept her light switch permanently in the “on” position. “I’m still not a winter person,” she says. “But now I can enjoy the parts of winter I used to, like the beauty of snow and the joy of holidays. I now have the confidence that I can function in a more normal way.”

Do You Have SAD?
You may, if your depression begins every September or October and ends each spring in March or April, and if your depressive episodes occur at least two years in a row. If you suspect SAD, it’s a good idea to first rule out hypothyroidism, anemia, hypoglycemia, and chronic viral illnesses, since these conditions may mimic SAD.

Core SAD symptoms:
Increased sleep (70 to 90 percent of SAD patients)
Increased appetite (70 to 90 percent)
Significant weight gain (70 to 90 percent)
Carbohydrate cravings (80 to 90 percent)
Other symptoms:
Fatigue/inability to carry out normal routine
Feelings of misery, guilt, low self-esteem, despair, apathy
Irritability
Avoidance of social contacts
Increased susceptibility to stress
Decreased interest in physical contact and sex.

AHCA CALLS UPON ALL MEMBERS TO RENEW GRASSROOTS ADVOCACY!

2009-10-27T11:56:00.000-07:00

Dear AHCA/NCAL Advocate:

Both the House and Senate have completed committee work on their health care reform proposals and are now preparing for passage in their respective chambers. Today, we are calling upon all AHCA/NCAL members to contact their legislators and tell them how these proposed Medicare cuts will impact skilled nursing facilities.

Updated letters are now ready for your use on our website. Even if you've already sent a letter, we need you, your staff, family members, and residents to renew your grassroots advocacy TODAY.

SNFs face serious cuts as part of health care reform and when combined with the $12 billon cut already imposed by CMS' SNF PPS final rule, our ability to provide quality care is undermined by the projected loss of as many as 50,000 jobs in 2010.

Throughout the remainder of the health care reform debate, we will all need to send a continuous stream of letters to Capitol Hill if we are to preserve the resources necessary to provide quality care and meet the needs of our patients and residents. We expect the debate on health care reform to continue until the end of the year and in large part, our success depends upon YOU!

Write to your Member of Congress today!

Thank you for your continued efforts in our "Save Our Seniors" campaign.

CHRISTMAS GIFT BOXES

2009-10-18T10:38:00.000-07:00

Each year at during the Christmas holiday season, St. Francis donates gift boxes to those who are in need. We fill these boxes with presents and the food items to fix a traditional holiday meal.

We are asking our friends and families to help up us with this wonderful opportunity to spread love and good cheer to our fellows.

Below is a list of needed food items for those who want to contribute to this endeavor.

You may bring in donated items and leave them in the holiday collection boxes by the front desk. Collection boxes will be set out on November 10th.

Pease do not contribute bulk food items, fresh foods or food items that have expired use dates- we are unable to use these items.

Items needed for a Holiday Meal,

Turkey Stuffing Mix
Turkey Gravy Mix
Instant Mashed Potato Mix
Cranberry Sauce- Canned
Pie Crust Mix-Dry
Canned Pumpkin or Cherry Pie Filling
Canned Peaches or Pears
Canned Yams or sweet potato
Martinellis Sparkling Cider
Black Olives- Canned

Thank you for you generous participation in helping to spread the joy of giving during this holiday season.

Santa's Chimney

2009-10-07T12:53:00.000-07:00

Happy Holidays everyone!

As we get into this busy time of year, it’s important to think of those who are struggling to make ends meet. It is a Holiday Tradition here at St. Francis to reach out to our community by providing boxes of food and gifts for families in need.

On the back of this letter is a simple form I would like you to complete if you know of a family which needs help to make the holidays happier. There is space for listing two families, but please feel free to copy the form or pick up another one at the front desk if you know of more than two families that need help. We are taking the information provided regarding families in need and creating a “Santa’s Chimney” at the front hallway. We will create a paper stocking for each child (names will be kept confidential) using the information you provide on the form. Then, we hope that people will choose a stocking to “adopt” and buy gifts for the child on that stocking.

Please have these forms completed and turned in to Tonja Myers or Mary Jenkins by November 20th. (Sooner is better!)

If you adopt a stocking, please have gifts purchased and turned in to Tonja Myers or Mary Jenkins by December 4th. Please keep gifts unwrapped, but labeled with the child’s age, gender, and family number (it’s on the stocking).

THEN we can all gather in the Dining Room on December 11th at 2:30 p.m. to celebrate the Season by wrapping gifts and assembling boxes of food and gifts for the families. Thank you for your help and input.

Sincerely,

Tonja A. Myers

Santa’s Chimney

Family Name/Contact:____________________________________________________
Family members: (List gender, age and clothing sizes for each child; include any special needs or requests for each person.) Tell us how many adults (over 18) so we can include them in the total family size. Number of Adults: Men:_____ Women: ______
Children Information:
Gender Age Clothing Sizes Special Needs/Requests (Use the back if needed)
______ ____ _____________ ____________________________________________ ______ ____ _____________ ____________________________________________
______ ____ _____________ ____________________________________________
______ ____ _____________ ____________________________________________
______ ____ _____________ ____________________________________________
______ ____ _____________ ____________________________________________
______ ____ _____________ ____________________________________________
______ ____ _____________ ____________________________________________

Please tell me why this family needs help this year: ______________________________
________________________________________________________________________
Will this family receive Holiday assistance from any other agency? Please list agencies if known:__________________________________________________________________
________________________________________________________________________
Your name and phone number, in case we have questions:________________________
________________________________________________________________________

--------------------------------------------------------------------------------------------------------------------------------

Family Name/Contact:____________________________________________________
Family members: (List gender, age and clothing sizes for each child; include any special needs or requests for each person.) Tell us how many adults (over 18) so we can include them in the total family size. Number of Adults: Men:_____ Women: ______
Children Information:
Gender Age Clothing Sizes Special Needs/Requests (Use the back if needed)
______ ____ _____________ ____________________________________________ ______ ____ _____________ ____________________________________________
______ ____ _____________ ____________________________________________
______ ____ _____________ ____________________________________________
______ ____ _____________ ____________________________________________
______ ____ _____________ ____________________________________________
______ ____ _____________ ____________________________________________
______ ____ _____________ ____________________________________________

Please tell me why this family needs help this year: ______________________________
________________________________________________________________________
Will this family receive Holiday assistance from any other agency? Please list agencies if known:__________________________________________________________________
________________________________________________________________________
Your name and phone number, in case we have questions:________________________
________________________________________________________________________

Is it time to give up the car?

2009-10-04T10:49:00.000-07:00

Giving up driving, for all or part of the time, doesn't have to equal a loss of mobility. Transportation alternatives are available in your community and they may save you money.

As we saw in the previous article, the normal physical changes of aging can make driving unwise beyond a certain point. Hearing loss, vision problems, decreased reaction time, memory loss, and lessened manual dexterity are all limitations that tend to increase as a person ages. There may come a point when any one of these conditions or a combination of several make it difficult and risky to keep driving.

Some older drivers become increasingly nervous about their driving ability, and consequently become less mobile in the community. Some keep driving until an incident occurs—a scare, a minor accident, or worse—and then quit driving abruptly, without having made plans for what they will do without the car. And others are in denial, refusing to face up to limitations until family members or the department of licensing step in.

It doesn't have to be that way. When you first begin to have concerns about your driving, that is the time to begin planning your post-driving strategy. Think of this as just another challenge to be addressed, and then use your best problem-solving skills to keep yourself active and mobile.

Giving Up Driving Doesn't Mean Giving Up Mobility

The first thing to do when considering becoming a non-driver is to add up what owning and maintaining a car costs you. Car payments, insurance, repairs, gasoline, parking fees all these should go into your calculation. For most people, the total is considerable. Think of those dollars as money available to you for alternative transportation.

Knowing you have this "transportation allowance" available to you, begin to calculate your alternatives:

Do you live on or near a bus or rapid transit route? Where are the places you can conveniently travel using public transportation? If you've never explored your local bus, subway or light rail, take a field trip! Just hop on and take a ride some day, making sure you know how to return to the same spot. Look for grocery stores, dry cleaners, other shopping possibilities along the route.

Do you have family or friends who might enjoy giving you a ride to church, to your doctor's office, to the barber or beauty shop, on a weekly shopping trip?
Is there special transportation for seniors in your area? Where will they take you? How convenient is it? How much lead time is needed to use this service?
How much do cab rides cost to your usual destinations? Will a cab company take "standing assignments" on a daily, weekly, or monthly basis? Once you have figured out how the first three modes of transportation will work for you, use taxis cabs to fill in the blanks.

Don't forget walking! We get in the habit of driving, even though some local destinations are close enough to provide a little extra exercise.

With this kind of planning, many seniors lose their anxiety over giving up driving. It still may not be easy, but having a workable plan for getting where you want to go is a major step forward. When the time comes to put away the keys, be creative in your approach. You might try these suggestions:

Leave your car in the garage for a while and see how you get along not using it.
Set a trial period during which you will try out transportation options.
Give your car as a gift to a favorite charity or to a grandchild.
Sell the car and set the money aside to increase your transportation fund.
Take advantage of planning for being a non-driver if that time comes. Be proactive; don't wait for circumstances to make decisions for you. If you're honest with yourself, you will know when you need to begin making plans. Giving yourself an extra margin of safety is the right thing to do for other drivers on the road, and it can, above all, be a gift to yourself and your family!

What's the Role of Family?

Don't let the topic of driving safety become a "taboo" subject in your family. Seniors have the right to make their own decisions as long as they're able, including the decision to keep driving. But family members have the right—and the responsibility—to be concerned about the safety of their loved one and of strangers who might be hurt in an accident. There is obvious potential for conflict here, but you shouldn’t let it reach that point. Be willing to talk candidly about the issue, and be open to some risk-reducing compromises. Work together to create a plan that respects while it protects.

Learn More About Alternate Transportation Strategies

The National Center on Senior Transportation website offers information for older adults, caregivers and transportation providers to promote the greatest independence and mobility for seniors in the community.

For more senior driving safety resources, visit the Aging in Stride "Online Resource Center," and see "Safer Driving Courses and Information" under the "Staying Safe and Secure" heading.

By Joyce Remy, Editor, and Dennis Kenny, Co-Author, Aging in Stride–Plan Ahead, Stay Connected, Keep Moving. Copyright, 2009.

Driving Safety for Older Adults

2009-09-27T12:07:00.000-07:00

For most Americans, the automobile represents independence, control and mobility. We couldn't wait to get our first drivers license and be handed the keys to the family car when we were teenagers...and we'd like to keep driving as long as possible.

However, some of the normal changes of aging can make driving more challenging. Impediments to safe driving include hearing loss, vision problems, decreased reaction time, memory loss and lessened manual dexterity. In addition, the loss of depth perception and peripheral vision may narrow the margin of safety on crowded roads and highways.

Older adults should periodically assess their driving abilities, both to increase safety and to honestly judge whether they are still safe behind the wheel.

Making Changes for Safer Driving

Here are ten good ways to improve driving skills and extend safe driving capability:

Take a refresher driving course for seniors. Classes on defensive driving for older drivers focus on specific strategies for dealing with the impact of the aging process on driving. (See the resources at the end of this article for some useful information and class listings.)

When filling any prescriptions, ask your doctor or pharmacist if your medications have any potential side effects that could hinder your ability to drive.

Have regular eye examinations, and keep your glasses prescription current.

Make sure your car is in good working condition. Have it checked for mechanical problems and other defects. Watch for carpet and pedal wear that could cause the accelerator or brake to stick, or a foot to slip.

Keep windows, mirrors, windshields, and wiper blades clean, as well as headlights, taillights and turn signals.

Have your tires regularly checked for low air pressure and excessive tread wear.

Make adaptive modifications to the vehicle itself for enhanced driving safety. For example: improved side and rear-view mirrors; a back-up warning buzzer; steering wheel grips; and pedal adjustments.

If the car is large and difficult to maneuver, consider trading it for a smaller car, which might be easier to handle and park.

To avoid the most challenging driving situations, investigate route and time of day adjustments. If night vision has diminished, scheduled car trips during daylight hours. Busy highways and rush hour traffic can be avoided with some advance planning and allowance for additional travel time. Boarding buses at Park and Ride lots can eliminate driving in the most congested areas.

Make sure that insurance is adequate and kept current.

Checklist for a Safe Car Trip

Whether you're going to the market or on a vacation trip, here are some things to consider before you turn the key:

Plan your route before you leave, and then stick to that route.

If you're uncomfortable driving at high speeds, avoid the freeway. Just allow more travel time for your trip.

Try to steer clear of rush hour traffic and congested routes.

Buckle up! Everyone in your car should wear a seatbelt. (Remember: airbags are supplements to seatbelts, not substitutes.)

Make yourself visible by turning on headlights in poor weather, even during daylight hours.

Always use turn signals to indicate your intentions. And be sure your signals stop blinking after you've turned. An unintentional signal could result in an accident.

Look in your mirrors frequently, and always use a head-check to your "blind spot" when changing lanes.

Maintain a safe distance from the vehicle in front of you.

Avoid distractions by keeping radio volume low and conversations to a minimum. And of course, even if your state allows cell phone use while driving—don't!

If you are feeling uneasy about your driving or the driving of a senior loved one, read on to learn about transportation alternatives in "Is It Time to Give Up the Car?"

For More Information About Safe Driving

Perform a self-assessment with the "Checklist for Older Drivers."

The American Society on Aging's DriveWell program includes the DriveWell Toolkit for on older driver safety and mobility.

The AARP Driver Safety webpage offers information on safe driving for older adults, and tells where you can take AARP Driver Safety classes in your area.

Sponsored by AARP and AAA, CarFit is an educational program that offers older adults the opportunity to check how well their personal vehicles "fit" them.

By Joyce Remy, Editor, and Dennis Kenny, Co-Author, Aging in Stride–Plan Ahead, Stay Connected, Keep Moving. Copyright, 2009.

2009 H1N1 Flu Q & A

2009-09-19T10:43:00.000-07:00

What is 2009 H1N1 (swine flu)?
2009 H1N1 (referred to as “swine flu” early on) is a new influenza virus causing illness in people. This new virus was first detected in people in the United States in April 2009. This virus is spreading from person-to-person worldwide, probably in much the same way that regular seasonal influenza viruses spread. On June 11, 2009, the World Health Organization (WHO) signaled that a pandemic of 2009 H1N1 flu was underway.

Why is 2009 H1N1 virus sometimes called “swine flu”?
This virus was originally referred to as “swine flu” because laboratory testing showed that many of the genes in this new virus were very similar to influenza viruses that normally occur in pigs (swine) in North America. But further study has shown that this new virus is very different from what normally circulates in North American pigs. It has two genes from flu viruses that normally circulate in pigs in Europe and Asia and bird (avian) genes and human genes. Scientists call this a "quadruple reassortant" virus.

Are there human infections with 2009 H1N1 virus in the U.S.?
Yes. Human infections with the new H1N1 virus are ongoing in the United States. Most people who have become ill with this new virus have recovered without requiring medical treatment.
CDC routinely works with states to collect, compile and analyze information about influenza, and has done the same for the new H1N1 virus since the beginning of the outbreak. This information is presented in a weekly report, called FluView.

Is 2009 H1N1 virus contagious?
CDC has determined that 2009 H1N1 virus is contagious and is spreading from human to human.

How does 2009 H1N1 virus spread?
Spread of 2009 H1N1 virus is thought to occur in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing by people with influenza. Sometimes people may become infected by touching something – such as a surface or object – with flu viruses on it and then touching their mouth or nose.

What are the signs and symptoms of this virus in people?
The symptoms of 2009 H1N1 flu virus in people include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. A significant number of people who have been infected with this virus also have reported diarrhea and vomiting. Severe illnesses and death has occurred as a result of illness associated with this virus.

How severe is illness associated with 2009 H1N1 flu virus?
Illness with the new H1N1 virus has ranged from mild to severe. While most people who have been sick have recovered without needing medical treatment, hospitalizations and deaths from infection with this virus have occurred.

In seasonal flu, certain people are at “high risk” of serious complications. This includes people 65 years and older, children younger than five years old, pregnant women, and people of any age with certain chronic medical conditions. About 70 percent of people who have been hospitalized with this 2009 H1N1 virus have had one or more medical conditions previously recognized as placing people at “high risk” of serious seasonal flu-related complications. This includes pregnancy, diabetes, heart disease, asthma and kidney disease.

One thing that appears to be different from seasonal influenza is that adults older than 64 years do not yet appear to be at increased risk of 2009 H1N1-related complications thus far. CDC laboratory studies have shown that no children and very few adults younger than 60 years old have existing antibody to 2009 H1N1 flu virus; however, about one-third of adults older than 60 may have antibodies against this virus. It is unknown how much, if any, protection may be afforded against 2009 H1N1 flu by any existing antibody.

How does 2009 H1N1 flu compare to seasonal flu in terms of its severity and infection rates?
With seasonal flu, we know that seasons vary in terms of timing, duration and severity. Seasonal influenza can cause mild to severe illness, and at times can lead to death. Each year, in the United States, on average 36,000 people die from flu-related complications and more than 200,000 people are hospitalized from flu-related causes. Of those hospitalized, 20,000 are children younger than 5 years old. Over 90% of deaths and about 60 percent of hospitalization occur in people older than 65.

When the 2009 H1N1 outbreak was first detected in mid-April 2009, CDC began working with states to collect, compile and analyze information regarding the 2009 H1N1 flu outbreak, including the numbers of confirmed and probable cases and the ages of these people. The information analyzed by CDC supports the conclusion that 2009 H1N1 flu has caused greater disease burden in people younger than 25 years of age than older people. At this time, there are few cases and few deaths reported in people older than 64 years old, which is unusual when compared with seasonal flu. However, pregnancy and other previously recognized high risk medical conditions from seasonal influenza appear to be associated with increased risk of complications from this 2009 H1N1. These underlying conditions include asthma, diabetes, suppressed immune systems, heart disease, kidney disease, neurocognitive and neuromuscular disorders and pregnancy.

How long can an infected person spread this virus to others?
People infected with seasonal and 2009 H1N1 flu shed virus and may be able to infect others from 1 day before getting sick to 5 to 7 days after. This can be longer in some people, especially children and people with weakened immune systems and in people infected with the new H1N1 virus.

What can I do to protect myself from getting sick?
There is no vaccine available right now to protect against 2009 H1N1 virus. However, a 2009 H1N1 vaccine is currently in production and may be ready for the public in the fall. As always, a vaccine will be available to protect against seasonal influenza
There are everyday actions that can help prevent the spread of germs that cause respiratory illnesses like influenza.

Take these everyday steps to protect your health:

Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub.*
Avoid touching your eyes, nose or mouth. Germs spread this way.
Try to avoid close contact with sick people.
If you are sick with flu-like illness, CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone without the use of a fever-reducing medicine.) Keep away from others as much as possible to keep from making others sick.
Other important actions that you can take are:

Follow public health advice regarding school closures, avoiding crowds and other social distancing measures.
Be prepared in case you get sick and need to stay home for a week or so; a supply of over-the-counter medicines, alcohol-based hand rubs,* tissues and other related items might could be useful and help avoid the need to make trips out in public while you are sick and contagious
What is the best way to keep from spreading the virus through coughing or sneezing?
If you are sick with flu-like illness, CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone without the use of a fever-reducing medicine.)
Keep away from others as much as possible. Cover your mouth and nose with a tissue when coughing or sneezing. Put your used tissue in the waste basket. Then, clean your hands, and do so every time you cough or sneeze.

If I have a family member at home who is sick with 2009 H1N1 flu, should I go to work?
Employees who are well but who have an ill family member at home with 2009 H1N1 flu can go to work as usual. These employees should monitor their health every day, and take everyday precautions including washing their hands often with soap and water, especially after they cough or sneeze. Alcohol-based hand cleaners are also effective.* If they become ill, they should notify their supervisor and stay home. Employees who have an underlying medical condition or who are pregnant should call their health care provider for advice, because they might need to receive influenza antiviral drugs to prevent illness. For more information please see General Business and Workplace Guidance for the Prevention of Novel Influenza A (H1N1) Flu in Workers.

What is the best technique for washing my hands to avoid getting the flu?
Washing your hands often will help protect you from germs. Wash with soap and water or clean with alcohol-based hand cleaner*. CDC recommends that when you wash your hands -- with soap and warm water -- that you wash for 15 to 20 seconds. When soap and water are not available, alcohol-based disposable hand wipes or gel sanitizers may be used. You can find them in most supermarkets and drugstores. If using gel, rub your hands until the gel is dry. The gel doesn't need water to work; the alcohol in it kills the germs on your hands.

What should I do if I get sick?
If you live in areas where people have been identified with 2009 H1N1 flu and become ill with influenza-like symptoms, including fever, body aches, runny or stuffy nose, sore throat, nausea, or vomiting or diarrhea, you should stay home and avoid contact with other people. CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone without the use of a fever-reducing medicine.) Stay away from others as much as possible to keep from making others sick.Staying at home means that you should not leave your home except to seek medical care. This means avoiding normal activities, including work, school, travel, shopping, social events, and public gatherings.

If you have severe illness or you are at high risk for flu complications, contact your health care provider or seek medical care. Your health care provider will determine whether flu testing or treatment is needed.

If you become ill and experience any of the following warning signs, seek emergency medical care.

In children, emergency warning signs that need urgent medical attention include:

Fast breathing or trouble breathing
Bluish or gray skin color
Not drinking enough fluids
Severe or persistent vomiting
Not waking up or not interacting
Being so irritable that the child does not want to be held
Flu-like symptoms improve but then return with fever and worse cough
In adults, emergency warning signs that need urgent medical attention include:

Difficulty breathing or shortness of breath
Pain or pressure in the chest or abdomen
Sudden dizziness
Confusion
Severe or persistent vomiting
Flu-like symptoms improve but then return with fever and worse cough
Are there medicines to treat 2009 H1N1 infection?
Yes. CDC recommends the use of oseltamivir or zanamivir for the treatment and/or prevention of infection with 2009 H1N1 flu virus. Antiviral drugs are prescription medicines (pills, liquid or an inhaled powder) that fight against the flu by keeping flu viruses from reproducing in your body. If you get sick, antiviral drugs can make your illness milder and make you feel better faster. They may also prevent serious flu complications. During the current pandemic, the priority use for influenza antiviral drugs is to treat severe influenza illness (for example hospitalized patients) and people who are sick who have a condition that places them at high risk for serious flu-related complications.

What is CDC’s recommendation regarding "swine flu parties"?
"Swine flu parties" are gatherings during which people have close contact with a person who has 2009 H1N1 flu in order to become infected with the virus. The intent of these parties is for a person to become infected with what for many people has been a mild disease, in the hope of having natural immunity 2009 H1N1 flu virus that might circulate later and cause more severe disease.

CDC does not recommend "swine flu parties" as a way to protect against 2009 H1N1 flu in the future. While the disease seen in the current 2009 H1N1 flu outbreak has been mild for many people, it has been severe and even fatal for others. There is no way to predict with certainty what the outcome will be for an individual or, equally important, for others to whom the intentionally infected person may spread the virus.

CDC recommends that people with 2009 H1N1 flu avoid contact with others as much as possible. If you are sick with flu-like illness, CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone without the use of a fever-reducing medicine.) Stay away from others as much as possible to keep from making others sick.

How long can influenza virus remain viable on objects (such as books and doorknobs)?
Studies have shown that influenza virus can survive on environmental surfaces and can infect a person for 2 to 8 hours after being deposited on the surface.

What kills influenza virus?
Influenza virus is destroyed by heat (167-212°F [75-100°C]). In addition, several chemical germicides, including chlorine, hydrogen peroxide, detergents (soap), iodophors (iodine-based antiseptics), and alcohols are effective against human influenza viruses if used in proper concentration for a sufficient length of time. For example, wipes or gels with alcohol in them can be used to clean hands. The gels should be rubbed into hands until they are dry.

*What if soap and water are not available and alcohol-based products are not allowed in my facility? Updated on Sept 14
If soap and water are not available and alcohol-based products are not allowed, other hand sanitizers that do not contain alcohol may be useful.

What surfaces are most likely to be sources of contamination?
Germs can be spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth. Droplets from a cough or sneeze of an infected person move through the air. Germs can be spread when a person touches respiratory droplets from another person on a surface like a desk, for example, and then touches their own eyes, mouth or nose before washing their hands.

How should waste disposal be handled to prevent the spread of influenza virus?
To prevent the spread of influenza virus, it is recommended that tissues and other disposable items used by an infected person be thrown in the trash. Additionally, persons should wash their hands with soap and water after touching used tissues and similar waste.

What household cleaning should be done to prevent the spread of influenza virus?
To prevent the spread of influenza virus it is important to keep surfaces (especially bedside tables, surfaces in the bathroom, kitchen counters and toys for children) clean by wiping them down with a household disinfectant according to directions on the product label.

How should linens, eating utensils and dishes of persons infected with influenza virus be handled?
Linens, eating utensils, and dishes belonging to those who are sick do not need to be cleaned separately, but importantly these items should not be shared without washing thoroughly first.
Linens (such as bed sheets and towels) should be washed by using household laundry soap and tumbled dry on a hot setting. Individuals should avoid "hugging" laundry prior to washing it to prevent contaminating themselves. Individuals should wash their hands with soap and water or alcohol-based hand rub immediately after handling dirty laundry.

Eating utensils should be washed either in a dishwasher or by hand with water and soap.

Can I get infected with 2009 H1N1 virus from eating or preparing pork?
No. 2009 H1N1 viruses are not spread by food. You cannot get infected with novel HIN1 virus from eating pork or pork products. Eating properly handled and cooked pork products is safe.

Is there a risk from drinking water?
Tap water that has been treated by conventional disinfection processes does not likely pose a risk for transmission of influenza viruses. Current drinking water treatment regulations provide a high degree of protection from viruses. No research has been completed on the susceptibility of 2009 H1N1 flu virus to conventional drinking water treatment processes. However, recent studies have demonstrated that free chlorine levels typically used in drinking water treatment are adequate to inactivate highly pathogenic H5N1 avian influenza. It is likely that other influenza viruses such as 2009 H1N1 would also be similarly inactivated by chlorination. To date, there have been no documented human cases of influenza caused by exposure to influenza-contaminated drinking water.

Can 2009 H1N1 flu virus be spread through water in swimming pools, spas, water parks, interactive fountains, and other treated recreational water venues?
Influenza viruses infect the human upper respiratory tract. There has never been a documented case of influenza virus infection associated with water exposure. Recreational water that has been treated at CDC recommended disinfectant levels does not likely pose a risk for transmission of influenza viruses. No research has been completed on the susceptibility of 2009 H1N1 influenza virus to chlorine and other disinfectants used in swimming pools, spas, water parks, interactive fountains, and other treated recreational venues. However, recent studies have demonstrated that free chlorine levels recommended by CDC (1–3 parts per million [ppm or mg/L] for pools and 2–5 ppm for spas) are adequate to disinfect avian influenza A (H5N1) virus. It is likely that other influenza viruses such as 2009 H1N1 virus would also be similarly disinfected by chlorine.

Can 2009 H1N1 influenza virus be spread at recreational water venues outside of the water?

Yes, recreational water venues are no different than any other group setting. The spread of this 2009 H1N1 flu is thought to be happening in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing of people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose.

Note: Much of the information in this document is based on studies and past experience with seasonal (human) influenza. CDC believes the information applies to 2009 H1N1 (swine) viruses as well, but studies on this virus are ongoing to learn more about its characteristics. This document will be updated as new information becomes available.

Preventing falls at home

2009-09-13T12:43:00.000-07:00

Each year, thousands of older Americans fall at home. Many of them are seriously injured, and some are disabled. In 2002, more than 12,800 people over age 65 died and 1.6 million were treated in emergency departments because of falls.

Falls are often due to hazards that are easy to overlook but easy to fix. This checklist will help you find and fix those hazards in your home.

The checklist asks about hazards found in each room of your home. For each hazard, the checklist tells you how to fix the problem. At the end of the checklist, you’ll find other tips for preventing falls.

FLOORS: Look at the floor in each room.

Q: When you walk through a room, do you have to walk around furniture?
Ask someone to move the furniture so your path is clear.

Q: Do you have throw rugs on the floor?
Remove the rugs or use double-sided tape or a non-slip backing so the rugs won’t slip.

Q: Are there papers, books, towels, shoes, magazines, boxes, blankets, or other objects on the floor?
Pick up things that are on the floor. Always keep objects off the floor.

Q: Do you have to walk over or around wires or cords (like lamp, telephone, or extension cords)?
Coil or tape cords and wires next to the wall so you can’t trip over them. If needed, have an electrician put in another outlet.

STAIRS AND STEPS: Look at the stairs you use both inside and outside your home.

Q: Are there papers, shoes, books, or other objects on the stairs?
Pick up things on the stairs. Always keep objects off stairs.

Q: Are some steps broken or uneven?
Fix loose or uneven steps.

Q: Are you missing a light over the stairway?
Have an electrician put in an overhead light at the top and bottom of the stairs.

Q: Do you have only one light switch for your stairs (only at the top or at the bottom of the stairs)?
Have an electrician put in a light switch at the top and bottom of the stairs. You can get light switches that glow.

Q: Has the stairway light bulb burned out?
Have a friend or family member change the light bulb.

Q: Is the carpet on the steps loose or torn? Make sure the carpet is firmly attached to every step, or remove the carpet and attach non-slip rubber treads to the stairs.

Q: Are the handrails loose or broken? Is there a handrail on only one side of the stairs?
Fix loose handrails or put in new ones. Make sure handrails are on both sides of the stairs and are as long as the stairs.

KITCHEN: Look at your kitchen and eating area.

Q: Are the things you use often on high shelves?
Move items in your cabinets. Keep things you use often on the lower shelves (about waist level).

Q: Is your step stool unsteady?
If you must use a step stool, get one with a bar to hold on to. Never use a chair as a step stool.

BATHROOMS: Look at all your bathrooms.

Q: Is the tub or shower floor slippery?
Put a non–slip rubber mat or self–stick strips on the floor of the tub or shower.

Q: Do you need some support when you get in and out of the tub or up from the toilet?
Have a carpenter put grab bars inside the tub and next to the toilet.

BEDROOMS: Look at all your bedrooms.

Q: Is the light near the bed hard to reach?
Place a lamp close to the bed where it’s easy to reach.

Q: Is the path from your bed to the bathroom dark?
Put in a night–light so you can see where you're walking. Some night–lights go on by themselves after dark.

Other Things You Can Do to Prevent Falls

Exercise regularly. Exercise makes you stronger and improves your balance and coordination.

Have your doctor or pharmacist look at all the medicines you take, even over-the-counter medicines. Some medicines can make you sleepy or dizzy.

Have your vision checked at least once a year by an eye doctor. Poor vision can increase your risk of falling.

Get up slowly after you sit or lie down.

Wear shoes both inside and outside the house. Avoid going barefoot or wearing slippers.

Improve the lighting in your home. Put in brighter light bulbs. Florescent bulbs are bright and cost less to use.

It’s safest to have uniform lighting in a room. Add lighting to dark areas. Hang lightweight curtains or shades to reduce glare.

Paint a contrasting color on the top edge of all steps so you can see the stairs better. For example, use a light color paint on dark wood.

Other Safety Tips

Keep emergency numbers in large print near each phone.

Put a phone near the floor in case you fall and can’t get up.

Think about wearing an alarm device that will bring help in case you fall and can’t get up.

What You Can Do to Prevent Falls

2009-09-05T11:15:00.000-07:00

Many falls can be prevented. By making some changes, you can lower your chances of falling.:

Four things YOU can do to prevent falls

Begin a regular exercise program
Have your health care provider review your medicines
Have your vision checked
Make your home safer

1. Begin a regular exercise program
Exercise is one of the most important ways to lower your chances of falling. It makes you stronger and helps you feel better. Exercises that improve balance and coordination (like Tai Chi) are the most helpful. Lack of exercise leads to weakness and increases your chances of falling. Ask your doctor or health care provider about the best type of exercise program for you.

2. Have your health care provider review your medicines. Have your doctor or pharmacist review all the medicines you take, even over–the–counter medicines. As you get older, the way medicines work in your body can change. Some medicines, or combinations of medicines, can make you sleepy or dizzy and can cause you to fall.

3. Have your eyes checked by an eye doctor at least once a year. You may be wearing the wrong glasses or have a condition like glaucoma or cataracts that limits your vision. Poor vision can increase your chances of falling.

4. About half of all falls happen at home. To make your home safer:

Remove things you can trip over (like papers, books, clothes, and shoes) from stairs and places where you walk.
Remove small throw rugs or use double-sided tape to keep the rugs from slipping.
Keep items you use often in cabinets you can reach easily without using a step stool.
Have grab bars put in next to your toilet and in the tub or shower.
Use non-slip mats in the bathtub and on shower floors.
Improve the lighting in your home. As you get older, you need brighter lights to see well. Hang light-weight curtains or shades to reduce glare.
Have handrails and lights put in on all staircases.
Wear shoes both inside and outside the house. Avoid going barefoot or wearing slippers.

It is to laugh

2009-08-08T14:56:00.000-07:00

Perhaps because humor isn't seen as a "problem," little research has historically been done on the topic. Few people took the subject seriously, or paid much scholarly attention to this part of the human experience. But now, new studies are analyzing the workings of humor in the human brain—and demonstrating that the purpose humor serves is no laughing matter!

What is humor, and why do humans experience the phenomenon? Despite its seemingly lightweight nature, humor is actually a sophisticated tension-defusing mechanism, uniquely developed in human beings. Most people appreciate the sensation and seek it out. Perhaps for that reason, enjoying a good laugh is sometimes looked at as a meaningless, even frivolous, activity. But humor is actually a valuable tool of healthy aging, with a beneficial preventive effect on some of the most common health challenges of aging. These benefits fall in four important areas:

1.) Laughter Promotes Physical Wellness

Studies over the past decade show that using our sense of humor can have a positive impact on the perception of pain. It also benefits the immune system. And the benefits to heart health are especially well documented. A recent American College of Sports Medicine study describes the method by which laughter helps keep our blood vessels healthy. Earlier University of Maryland research showed that humor lowers blood pressure. And the American Physiological Society recently demonstrated that "mirthful laughter" improves cholesterol levels. It is believed that laughter works by relieving stress, which is implicated in so many negative impacts on our health.

Why is humor such an effective stress-buster? The process goes something like this: when we experience a stressful or frightening event, certain hormones flood our circulatory system, readying us for "fight or flight." These brain chemicals help us act quickly when we are in real danger—yet in our modern world, we are seldom in life-threatening danger, and over time the hormones do damage to the lining of blood vessels. But the perception of humor makes our brains release endorphins—natural "feel good" chemicals that, in a sense "dissolve" cortisol, epinephrine and other stress hormones. Built-up tension is released, fear and anger lessen, and the process of laughter relaxes the muscles by giving us a quick workout—a full body stretch, deep breathing, then relaxation.

For example: say you are sitting on the couch reading…and a large snake suddenly falls into your lap! Your heart rate immediately elevates, your blood pressure rises, all your muscles tense and your digestive system freezes. But then, you realize that the frightening reptile is actually made of rubber, and came your way when your five-year-old grandson missed the toy box. The laughter that follows—at ourselves and at the misunderstanding—quickly dissipates the fear chemicals, and you may actually end up more relaxed than when the episode began.

2.) Humor Supports Emotional Wellness

How many times have you asked someone: "Are you laughing or crying?" The confusion is no accident: physically and chemically, laughing and crying are closely related! Yet they are, in a sense, two sides of a coin. Scientists have long speculated about the function of humor in the complex makeup of human emotions. Most believe it developed because, with our species' highly developed sense of self-awareness, we need the perspective of humor to allow us to lower our wariness. Much humor is tied to a sense of relief—for example, in the case of the not-so-dangerous snake above. Humor is a great distraction and can "take us away" from our cares. It provides a long-lasting mood boost, and is sometimes "prescribed" to help treat depression and anxiety. A Texas A&M University study titled "Humor and Hope" that appeared in the International Journal of Humor Research showed that humor "can be a legitimate strategy for maintaining a general sense of well-being."

Humor is a powerful tool for seeing ourselves as part of the human race, and gaining the perspective that our individual personal challenges are part of "the human condition." And though psychologists caution against using humor as a mask to avoid facing grief or other difficult emotions, laughter can help us process painful events. Even hospice studies demonstrate much benefit in laughter. A study titled "Clinical Clowning: Humor in Hospice Care" showed that hospice patients often made humorous remarks to family and staff; the study instructed hospice workers in techniques of therapeutic humor for patients dealing with the end of life. Even at funerals and memorial services, a classic example of how sadness and laughter partner can be seen, when friends and loved ones are comforted by sharing affectionate stories of the person they have lost. On those occasions, tears of sadness and joy mingle in a soothing blend. Not only physically but also emotionally, humor heals.

3.) Humor Nurtures Social Connections

More and more research connects healthy aging to socialization—but in our later years, we can experience barriers to social engagement. (See "Rx Friendship: Add More Socialization to Your Healthy Aging Prescription" in the May 2009 issue of Aging in Stride E-News.) Fortunately, one of the major functions of humor is its capacity to bond us to other people. Anthropologists believe that humor is actually a sophisticated mechanism that developed so human beings, who traditionally lived in close quarters, could defuse tension within their close-knit band.

Humor helps when people are experiencing conflict. Could civilizations survive without it? Even in our modern day-to-day lives, laughter helps us take ourselves less seriously and serves as "social grease" to relieve tension between people.

Think of a typical exchange with a stranger: At an espresso stand, the barista inadvertently hits an extra zero on the cash register and charges you $35 for a cup of coffee. You might begin to scowl, until she quickly says, "Wow, that price really went up!" Her self-effacing joke lets you know she realizes her error. You might then make a joke yourself—something like "Until I have my morning coffee, I can't even add!" She then knows all is forgiven, and what began as kneejerk indignation on your part quickly changes into a brief connection with another person—you will probably be more likely to exchange pleasantries with her the next time you come in.

Humor also helped our early ancestors lessen hostility between strangers they encountered. Telling a good joke has long been known as a good "ice breaker," quickly tearing down the natural walls between people.

For example: You are sitting next to a stranger on a park bench, and a crow starts methodically pulling fast food bags out of a trash container, scattering the contents all over the walkway. You might smile, but keep your amusement to yourself. But what if the crow flies away just as a bicycle approaches, and upon witnessing the mess, the cyclist utters a disapproving "People make such a mess—they don't respect nature!" Chances are you and the stranger will share a laugh at the misperception.

4.) Humor Is Great Brain Exercise

Did you know that one of the first changes loved ones are apt to notice when a person has early Alzheimer's disease is a difference in the person's sense of humor? Brain imaging shows that several areas of the brain all work together in a complex way to produce the perception of humor. Many researchers believe that understanding its complex function helps lend insight into some fundamentals of human cognition.

Humor is a great tool for sustaining optimum intellectual function. We've already seen how it benefits physical, emotional and social well-being—which are three important building blocks of brain health. Beyond those benefits, humor also can give our brains a good workout. Despite its reputation as a low or even childish mode of thinking, humor can actually be a highly developed mental exercise, training us to approach ideas in different, inventive ways. Even the lowly pun requires the brain to shift perspective.

Much humor relies on the recognition of a shifting perception of a situation, and on a sophisticated understanding of context. For example, think about the mental leaps both people had to make in the seemingly simple episode above involving the messy crow. They had to hold onto their knowledge of crow's actions, simultaneously shift their perspective to understanding the cyclist's mistaken reasoning, perceive the reason behind his comment—and make the leap to enjoying the irony of the situation.

Don't Be Afraid to Laugh

Humor is an individual thing, of course—our personal sense of humor is as unique as any other part of our personality, and what sends one person into paroxysms of glee leaves another perplexed or rolling their eyes. And of course, not every situation is an appropriate setting for laughter. Part of what we think of as a "good sense of humor" is the sensitivity to the sensibilities of our audience.

But for most of us, adding more laughter to life can give a boost to healthy aging in many ways. With its combined utilization of mind, body and emotions, humor is indeed nothing to laugh at!

For More Information

The International Society for Humor Studies is an interdisciplinary scholarly and professional organization dedicated to the advancement of humor research. On their website you can find resources and information about the practical value of humor, including a good bibliography of books and publications.

Copyright 2009. Reprinted with permission from Aging in Stride eNews – subscribe free at www.AgingInStride.org

Be Prepared: Special Concerns for People with Disabilities

2009-07-25T14:34:00.000-07:00

According to the Red Cross, if you or a loved one has special medical needs, "You are in the best position to plan for your own safety, as you are best able to know your functional abilities and possible needs during and after an emergency or disaster situation." Here are some things to consider:

If you or a loved one live in a nursing home or other senior living community, find out what plans are in place for emergency situations.

Arrange for who will help if you or your loved one needs to evacuate, and have a back-up plan in case that person can't reach the home. Neighbors are often willing and eager to help those with special needs. But they can't help you without knowing who you are...and what they should do to assist you.

Persons with medical needs such as dialysis, oxygen, or infusion pump can be at grave risk if their medical regimes are interrupted, and should have access to a back-up power source, such as a generator or battery, in the home or nearby.

Know the location of your local emergency shelter that is equipped with emergency power generators, designated for people with special needs. If you are evacuated to a shelter, notify officials there right away about your disability and medical issues.

Persons who are hard of hearing, or who have Alzheimer's or other cognitive impairment may miss emergency siren and radio/TV warnings. Arrange for other methods of notification. (Keep in mind that your loved one may be hesitant to leave with a stranger, so explain your plan beforehand.)

If you normally use an electric wheelchair or scooter, be sure you have access to a manual model.

If you are unable to get out of a building on your own, let someone know where you are. Have a set of alternate emergency numbers with you, in case the 911 emergency number is overloaded.

Have a supply on hand of your prescription medicines and any other supplies you regularly use, such as oxygen tanks, catheters, hearing aid batteries, spare glasses, etc.

If you use home care or home health care services, make arrangements ahead of time for evacuation procedures. Discuss the provider's special provisions for emergencies, and go over your emergency plan.

If you or a loved one live in a nursing home, assisted living community or adult family home, learn about the evacuation and emergency policy. When selecting a facility, ask questions about their plan. Don't assume a plan is in place. Be sure the facility has your contact information.

While it is tempting to avoid "thinking about the unthinkable," taking the practical steps to preparedness can turn worry into action. You will be able to rest easier knowing that you have done everything you can to ensure the best outcome...no matter what emergency strikes.

For More Information

FEMA's Ready.gov website includes a section on preparedness for people with disabilities and other special needs, including an instructional video and information for Social Security recipients. FEMA also partners with the Red Cross to offer the free booklet Preparing for Disaster for People with Disabilities and Other Special Needs.

The Interagency Coordinating Council on Emergency Preparedness and Individuals with Disabilities now has a website, www.disabilitypreparedness.gov, offering more resources for special needs populations, family members and first responders.

Don't Forget Fido and Fluffy!

You might recall that during Hurricanes such as Katrina, Rita and Ike, many people were distraught to have to leave their pets behind. Indeed, many people refused to evacuate, rather than abandon their beloved animals. If you have pets, keep a supply of non-perishable food with your emergency supplies. And remember that if you evacuate to a shelter, normally only service animals are allowed to enter. FEMA now offers information for pet and service animal owners, including the Pets Preparedness Toolkit.

Copyright 2009. Reprinted with permission from Aging in Stride eNews – subscribe free at www.AgingInStride.org

Safe Gardening

2009-07-12T12:16:00.000-07:00

Suggestions from the Centers for Disease Control and Prevention (CDC) about staying safe while enjoying the benefits of gardening.

Whether you are a beginner or expert gardener heading out to your garden, vegetable plot, or grassy lawn, health and safety are important. Gardening can be a great way to get physical activity, beautify the community, and go green.

However, working in the garden can also expose you to potentially harmful elements, such as the sun, insects, lawn and garden equipment, and chemicals.

Here are some health and safety tips for gardeners to follow while enjoying the beauty and bounty gardening can bring:

Dress to protect. Prevent exposure to chemicals, insects, and the sun.

Put safety first. Limit distractions, use chemicals and equipment properly, and be aware of possible hazards to lower your risk for injury.

Watch out for heat-related illness. Even being out in short periods of time in high temperatures can cause serious health problems. Monitor your activities and time in the sun to lower your risk for heat-related illness.

Know your limits. Talk to your health care provider if you have concerns that may impair your ability to work in the garden safely.

Enjoy the benefits of physical activity. Gardening is an excellent way to get physical activity. Active people are less likely than inactive people to be obese or have high blood pressure, type 2 diabetes, osteoporosis, coronary artery disease, stroke, depression, colon cancer, and premature death.

Get vaccinated. Vaccinations can prevent many diseases and save lives. All adults should get a tetanus vaccination every 10 years.

Go green. Conserve water, reuse containers, recycle, and share your bounty.

For More Information

The CDC website offers more detailed information about garden safety.

Copyright 2009. Reprinted with permission from Aging in Stride eNews – subscribe free at www.AgingInStride.org

Age-Related Eye Problems Can Lead to Computer Vision Syndrome

2009-07-05T10:24:00.000-07:00

The American Optometric Association (AOA) recently advised that Americans who use computers daily at work or at home could suffer from computer vision syndrome.

This condition leaves them vulnerable to problems like dry eye, eyestrain, neck and/or backache, light sensitivity and fatigue. These symptoms can result from individual visual problems, poor work station configuration and improper work habits.

According to a recent AOA survey, 82 percent of Americans frequently work with a computer or a handheld device, such as a PDA, and 42 percent spend three or more hours a day in front of a computer or handheld device.

Pre-existing, uncorrected vision problems like farsightedness and astigmatism, inadequate eye focusing or eye coordination abilities, and age-related eye issues also contribute to computer vision syndrome.

"Working at a computer requires a great deal of eye movement and eye focusing," said Dr. Kent Daum, AOA optometrist and Vice President and Dean for Academic Affairs at the Illinois College of Optometry in Chicago. "The constant re-focusing effort stresses the eye muscle, leading to computer-related vision problems. It can have a great impact on individuals' comfort and productivity, whether they are at work, school or home."

According to the survey, Americans are feeling the pain of computer vision syndrome. Forty-one percent said they have experienced eye strain, and 45 percent cited neck or back pain after prolonged computer or handheld device use. Many of these symptoms are temporary and will improve after ceasing computer work. However, some individuals may continue to experience visual problems, such as such as blurred distance vision, even after computer work has stopped. If the causes of the problem are not addressed, the symptoms will recur, and perhaps worsen, with future computer use.

According to the AOA, Americans should follow these guidelines to prevent or reduce eye and vision problems associated with computer vision syndrome:

Have your vision checked regularly. Prior to age 61, adults should have a comprehensive eye exam every two years, or as recommended by an eye doctor, and annually after that age. Vision and eye health can change rapidly and frequently, particularly as one ages. Therefore, having one's vision examined on a regular, timely basis is important to maintaining overall health and for preventive reasons.

Limit the amount of time you continuously use the computer. Practicing the 20/20 rule (look away from the computer every 20 minutes for 20 seconds) will minimize the development of eye-focusing problems and eye irritation caused by infrequent blinking.

Check the height and arrangement of the computer. Optometrists suggest more comfortable computer viewing can be achieved when the eyes are looking downward. Optimally, the computer screen should be 15 to 20 degrees below eye level (about 4 or 5 inches) as measured from the center of the screen and 20 to 28 inches from the eyes.

Check for glare on the computer screen. Windows or other light sources should not be directly visible when sitting in front of the monitor. When this occurs, turn the desk or computer to prevent glare on the screen.

Reduce the amount of lighting in the room to match the computer screen. A smaller light can be substituted for a bright overhead light or a dimmer switch can be installed to give flexible control of room lighting. Turn three-way bulbs to the lowest setting.

Keep blinking. To minimize the chances of developing dry eye when using a computer, make an effort to blink frequently. Blinking keeps the front surface of the eye moist.

"Viewing a computer screen is different than reading a printed page," said Dr. Daum. "Often the letters on the computer screen are not as precise or sharply defined, the level of contrast of the letters to the background is reduced, and the presence of glare and reflections on the screen may make viewing difficult."

Computer vision syndrome can be diagnosed through a comprehensive eye examination. Your optometrist can determine if you have computer vision syndrome and advise you on treatment options. For additional information regarding computer vision syndrome, please visit the American Optometric Association website.

Copyright 2009. Reprinted with permission from Aging in Stride eNews – subscribe free at www.AgingInStride.org

The importance of exercise

2009-06-28T09:42:00.000-07:00

WHY WALK?
by Travis Tomulty, Director of Recreation

Walking is the single most functional way to produce body movement. Aside from simply maintaining self independence, consider the many benefits of aerobic exercise like walking:

• Walking loads the skeleton and helps build stronger bones.
• Walking can be done anywhere and the only equipment needed is a pair of walking shoes.
• Walking is one of the easiest and most commonly prescribed initial weight loss methods.
• Walking is often helpful for controlling excess body fat that can lead to more serious health problems.
• Walking is one commonly used method to help regulate blood sugar and insulin needs in diabetics. In many cases reducing either the amount or sometimes even the need for insulin altogether.
• Walking, when performed at moderate or greater intensities, has been proven to help delay the onset of mental diseases such as dementia and Alzheimer’s.
• Walking helps prevent frailty.
• Walking is a great way to socialize and exercise at the same time.

AEROBIC EXERCISE

While walking as a form of exercise may be the most common, the easiest, or even the cheapest method to get in good cardiovascular (“heart and lung”) fitness, any type of aerobic exercise will do. If you get bored with walking and want to stay in shape, consider these options:
• Gardening or Yard work;
• Housework;
• Stair Climbing;
• Bicycling;
• Swimming;
• Jump Rope;
• Elliptical and more.

The General Health benefits of aerobic exercise can not be overstated. Consider these additional health benefits when you need that extra motivation to go for a walk or do aerobic exercise:

• Helps prevent most forms of Cardiovascular Heart Disease.
• Decreases the risk of some cancers, including lung and gastrointestinal, among others.
• Lowers blood pressure and resting heart rate.
• Strengthens the heart and lungs. In many cases, walking (or biking) is even the first thing prescribed in an outpatient cardiac rehab program.
• Reduces stress and anxiety.
• Improves the immune system, keeping you from some sickness, and speeding your recovery from other sickness..
• Increases the metabolism to help control weight and blood sugar.
• Helps for fatigue during the day and insomnia at night.
• Strengthens mental and emotional health.
• Helps for cholesterol control, lowering the bad and bettering the ratio.
• It is a great way to socialize and meet people.
• Helps quit smoking.
• Helps prevent frailty and loss of self independence.
• Increases the overall quality of life.

Just Any Old Mosey (or casual walk)?

Remember that for any type of exercise (even housework) to be effective and to count, it must do these things:

• Raise your heart rate or HR. How much is enough?

As a general guideline, the training heart rate ranges for healthy adults depends on age and normal resting heart rate. See quick chart below:

Training Heart Rates (Min to Max)
If your Resting HR is 60 to 80 bpm
Aged 40: 132 160
Aged 60: 120 144
Aged 80: 108 128
bpm is beats per minute

• Be somewhat frequent. Target at least 30 minutes a day three to five days a week. Less is okay at first, but the more the better.

How To Keep With It

• Set a reasonable goal or identify an important reason to begin.
• Be gradual. Exercise will make you stronger and feel better, no need to over do it and risk getting burned out. If you’re feeling out of shape, try shorter bouts like 10 minutes at a time three times in a day, or two fifteen-minute sessions instead of one big one.
• Bring a friend or family member. Make it a social routine.
• Vary your route or do a different type of exercise.
• Make it convenient. Wear more exercise clothes around the house. Many new running or walking shoes are fashionable and well cushioned for a variety of other uses.
• Remember to warm up and cool down. This helps the body adjust easier to exercise. In some cases, warming up actually increases your performance. If you’re walking, start by stretching and a slower walk pace. If you’re cooling down, walk slower and stretch afterwards.
• Exercise can seem moderately uncomfortable but should not be painful. If you feel joint pain or are intolerant of weight bearing activities, try biking or swimming.
• See a physician if you’re feeling severe pain or dizziness, unexpected shortness of breath, extreme fatigue or sickness, chest pain or similar irritabilities, before continuing your exercise.
• Track your progress. Put a special check on the calendar; write it on a reminder pad or sticky note; or maybe put a star on a progress chart you made. The more noticeable the better.
• Resistance exercise has been shown to compliment aerobic exercise and is suitable for all ages. Resistance or Weight Training for strength alone, however, does not count as an aerobic exercise.
• If you feel like your exercise is still too intense, walk or aerobically exercise for a longer period as opposed to a more intense speed or effort.

# # #

Feedback

2009-06-21T09:20:00.000-07:00

Here's what residents are saying about St. Francis:

"Everyone has a smile and says, 'Hello, how are you today?' Quite focused on care of residents. Lovely surroundings outside and clean building inside."

"Was not looking forward to spending time in an extended care facility. However, it was the right thing to do and I received great care."

"I don't think I could have been treated so well anywhere else."

"Pleasant, kind and caring staff. Concerned about patients' care and well-being."

"It's like being surrounded by family and friends."

"Everyone cares and lots of smiles. They take time to listen and help as much as they can."

"Staff took the extra time and effort to address my questions or concerns I had."

"A very caring environment. Staff really tries to help you get better so you can return home, if possible."

"I could not find a more caring bunch of people."

"I don't know how the service could have been better."

"The nurses and staff were wonderful."

"Having experienced physical therapy before in many places, I must compliment staff on their attitude plus their excellent program for each patient."

"The nurses went above and beyond to give me the best care."

"Everyone is caring, friendly, smiling, positive, upbeat and efficient. They take the time to answer any questions you might have and will stop in to see you if you need anything, even if your call light isn't on."

"Physical therapy was fun and I do miss everyone."

"If I had wanted a vacation from my retired life, I wouldn't have asked for a better place to be."

"The PT and OT staff were an incredible team and their shared ideas helped to provide me with exceptional therapy."

Rx: Friendship

2009-06-13T09:49:00.000-07:00

Add More Socialization to Your Healthy Aging Prescription

We humans are "hardwired" to crave and rely on human contact. Unlike, for example, a turtle, which hatches from a buried egg and is on its own from that moment on, people depend on other people for survival.

Brain experts explain this "wiring": early human beings lived in small, interdependent groups. To survive and thrive, individuals needed to be finely attuned to their fellow tribesmen, so the part of our brain that controls communication is very large and developed. Just as humans have a built-in desire for food, water and sleep, we also have a deep need to connect with other people.

Deprived of engagement with others, human beings experience a condition that is damaging and distressing: loneliness. Loneliness can be a debilitating, distressing condition for humans. Consider that prisoners can be controlled with the threat of solitary confinement. And most people can identify with the movie Cast Away where Tom Hanks, marooned on a deserted island, creates a "companion" by drawing a face on a volleyball that has drifted ashore.

Over the last few decades, researchers have been fine-tuning a definitive "prescription" for healthy aging, defining the building blocks that combine to help us maintain the highest possible level of function and quality of life in our later years.

You have probably read a lot about the vital role of physical activity, about "brain care" and making lifestyle choices that support memory health, and about personal safety, including medication management and fall prevention.

But recently, increased attention is being focused on the importance of socializing and maintaining human relationships throughout life. Experts on aging have long suspected that socialization improves physical and emotional well-being, increases mental alertness and encourages a more active lifestyle. New research studies confirm these benefits and more, pinpointing the mechanisms behind the protective properties of human interaction that lessen the risk of Alzheimer's disease, promote heart health, improve symptoms of depression and minimize the effects of stress.

For many years, research focused on the "practical" view of socialization. As they grew older, people with more developed social connections could get a ride to the doctor, find someone to lend a hand with physical care, go out to dinner with companions, walk around the park with a social group. And this is indeed an important part of the picture. But we now know that this isn't the whole story of why social engagement is so important.

Science Says: 8 Good Reasons to Be Socially Engaged

Recent studies confirm that socialization can have a positive impact in these areas:

1. Immune System

A 2007 UCLA study demonstrated that loneliness decreases the efficiency of the human immune system. The study's author, Dr. Steven Cole, says, "The biological impact of social isolation reaches down into some of our most basic internal processes—the activity of our genes." Several other studies also confirm that people with strong social connections exhibit stronger immunity against disease.

2. Blood Pressure

University of Chicago researchers released a study in 2006 showing that loneliness is linked to high blood pressure. Stress seems to be a key element of this connection. Author John Cacioppo points out that lonely individuals are less likely to approach stressful situations with "active coping and attempting to problem solve," which leads to a hypertension-promoting passive reaction. For humans, discussing one's problems with someone else is an instant stress buster.

3. Brain Health and Memory

A 2009 study from the American Academy of Neurology examining stress and dementia confirms that people who are socially active may be less likely to develop cognitive impairment. And a 2008 Harvard School of Public Health study showed that an active social life slows memory loss. In another University of Chicago study, MRI scans confirmed the negative impact of loneliness on brain health. It is important to note that in these studies, the researchers were careful to rule out "reverse causation"—the possibility that study participants were less social because they had memory loss, and not the opposite.

4. Physical Activity

Physical activity is frequently called the number one ingredient for healthy aging…and numerous studies demonstrate that social connections lead to increased exercise. For people of any age, it can quickly grow boring to go for a walk alone day after day! And many gym members confirm that they would prefer waiting in line for the treadmill to work out in the company of a group of like minded people, rather than exercise at home. According to the International Council on Active Aging, for many seniors, one of the main predictors of maintaining one's fitness program over time is the good old "buddy system." So keep yourself motivated, and surround yourself with other people who will support your fitness goals.

5. Depression

Depression is one of the most common challenges of growing older. One of the most important and powerful ways to fight depression is to interact and engage with others. A 2009 report from the American Sociological Association examined the connection between depression and feelings of loneliness, finding that the two are intertwined. Untreated, depression can cause a senior to withdraw from social engagement…but spending more time with others can help "jump start" recovery.

6. Pain

Unfortunately, physical pain from conditions such as arthritis or osteoporosis also becomes more common as we grow older. Chronic pain can have a major negative impact on quality of life. A Harvard Medical School study describes the cycle: "Pain slows recovery from depression, depression makes pain harder to treat…depression leads to isolation and isolation leads to further depression." Maintaining social connection with others can be an important tool in decreasing the impact of pain. And people who are coping with chronic pain also report the positive effects of participating in support groups with others who are dealing with the same challenges.

7. Nutrition

Gerontologists have long known that social isolation is a big risk factor for malnutrition. A 2009 study of hospitalized seniors from the Universite de Montreal found "a clear correlation between food intake and social interaction." Seniors who live alone often say that it is "just too much trouble" to fix a nutritious meal for one, and they may skip meals or get in the habit of snacking on junk food. This can lead to a serious weight loss—or, in some cases, to obesity, when a lonely person turns to food for companionship.

8. Relationships

It may seem paradoxical, but socialization with a large number of people has been shown to have a positive impact on our primary relationships. A 2009 article in the AARP Bulletin points out that "even though Americans are closer to their spouses than ever before, that kind of intimacy can work against us if we allow ourselves to 'cocoon' within the relationship." Married couples who become too insular tend to expect their partner to meet all their emotional needs. In the same way, too much reliance on the parent/child bond can also be stressful for both, even when parents and children are the kind who describe each other as "best friends." Studies show that seniors who socialize not only with family members but also with their peers have better emotional, intellectual and physical health.

Meeting the Socialization Challenges in Our Later Years

Even though social engagement is just as—if not more—important for our well-being as we age, our social networks may diminish. We retire from work, our children grow up and move away, and we may face the loss of our spouse or partner. Changes in our health status can lead to decreased energy, communication or mobility challenges, and reduced transportation options. This potentially leads to one of the "downward spirals" we have previously examined in the Aging in Stride E-News: in this case, physical decline decreases opportunities for socialization, and the resulting loneliness and depression contribute to physical decline…which in turn makes it even more challenging to get out of the house and be with other people.

So, it is worth it to make the effort, make a plan, to add more socialization to your life! One of the gifts of being older is that you have more time to spend developing relationships and doing the things that bring you pleasure. Make a list of the activities you currently enjoy, as well as interests you've always wanted to pursue. Do you like to play cards, do needlework, or arrange flowers? Are you a birdwatcher or a fly fisherman or a bowler? Do you enjoy cooking, or art, or going to the theater? Have you always wanted to learn to ballroom dance, to quilt, to do woodworking, carpentry, or remodeling projects?

To help translate your interests into activities with other people, check into the opportunities offered by your local senior center, community colleges, parks and recreation department, church, synagogue or other faith community, and your friends, neighbors and acquaintances.

And as you think about creating a life that is full of meaningful interaction with other people, consider the possibility of becoming a volunteer. The need has never been greater in all communities, and volunteering is a great way to meet new friends. Many worthy organizations—schools, hospitals, museums, social service agencies—rely upon volunteers. Fortunately, many retirees are answering the call, serving their communities, sharing their gifts, and helping others. (See the March 2009 issue of the Aging in Stride E-News for many more ideas!)

Think also about where you would like to live for the rest of your life. Does your current living situation allow you to get "out and about" and have contact with others? Would a senior living community be a good choice as you plan for the future?

Yes, as we grow older, it takes a little more effort and more planning to stay fully engaged with life, but the rewards are great. Of course, this is an individual thing—some of us are born social butterflies and others need our "alone time" more than do others. But for most people, socialization is as important as physical activity—and when it comes to social skills, "use it or lose it" applies.

By Joyce Remy, Editor, and Dennis Kenny, Co-Author, Aging in Stride–Plan Ahead, Stay Connected, Keep Moving. Copyright 2009. Reprinted with permission from Aging in Stride eNews – subscribe free at www.AgingInStride.org

Long-term care 101

2009-06-07T10:29:00.000-07:00

A Consumer's Guide to Nursing Facilities
Assessing Your Needs

By planning ahead you can find the quality of care and quality of life that you desire in a nursing facility for yourself or your loved one.

Today's nursing facilities (often referred to as nursing homes, extended care services, or health care centers) serve the young and old alike, both those who expect to recover fully as well as those in need of extended long term care services. The goal of care in a nursing facility is to help individuals meet their daily physical, social, medical, and psychological needs and to return home whenever possible.

Whether you're thinking about a nursing facility for a relative, a friend, or yourself, this guide will help you make the best selection.

Services

Four basic types of services are offered by nursing facilities:

Medical Care
Residents in nursing facilities are under the care of physicians, who visit regularly and are responsible for the residents' overall plan of care. Physicians certify the need for nursing care and may serve as a resource for information about long term care facilities in the community. When individuals enter the facility, physicians write orders for necessary medication and play a role in the development of the residents' care plan, including restorative and rehabilitative procedures, special diets, and treatments. Every nursing facility has a medical director on staff who can address medical issues and other concerns with the patient, the patient’s attending physician or family.

Nursing and Rehabilitative Care
All nursing facilities require the professional skills of a registered or licensed practical nurse. Nursing services include assessment, treatments, injections, coordination of care, and medication administration. Rehabilitative services such as post-hospital stroke, heart, or orthopedic care are available in addition to related services such as respiratory therapy, physical therapy, occupational therapy, or speech therapy. Dental services, dietary consultation, laboratory, x-ray, and pharmaceutical services are also available.

Personal Care
Personal care is provided to residents who need help with various activities such as walking, getting in and out of bed, bathing, dressing, and eating. Certified nurse assistants provide many of these services.

Residential Care
Residential care services include general supervision, provided within a safe and secure environment, along with a variety of with a variety of programs to meet the social and spiritual needs of residents.

If you believe a long term care setting may be needed, it is best to begin planning well in advance. Try to involve the prospective resident in the planning process as much as you can. If the individual has questions regarding care that you are not able to answer, be sure to ask the facility's staff. Remember, experienced, professional caregivers understand both the concerns of the resident and those of the family and are eager to help make the transition as calm and positive as possible.

Finding A Nursing Facility
After you and your physician discuss the type of services needed, obtain the names of facilities in your area. Other resources for information about nursing facilities include:

Discharge planner (hospital);
Social workers;
Geriatric case manager;
State affiliate of the American Health Care Association*;
Local medical society;
State or local Office on Aging;
State long term care ombudsman program or health department;
The Medicare web site**;
Minister, priest, rabbi, or other spiritual advisers in your community;
Friends or neighbors who have had direct experiences with local nursing facilities;
Individual Facilities' Internet sites.

By telephoning the facilities on your list, you will be able to narrow the field to two or three offering the specific services and location you desire. Talk with administrative personnel and make an appointment to tour the facility. Try to visit each facility at several different times of the day; this will give you a better sense of the facility. Be sure to ask questions about what you are seeing, hearing, or feeling about the facility.

*A list of State Affiliates of the American Health Care Association is available on the Online at: http://www.ahca.org/who/pubstate.htm

**CMS (Centers for Medicare & Medicaid Services) is the federal agency that administers the Medicare and Medicaid programs. More information is available on the Internet at: http://www.cms.gov/

Services and Ambience
When you visit a nursing facility, you will see a variety of staff specialists. The numbers and specialties of staff reflect the specific needs of the facility's residents. Caregivers are available around the clock and licensed nurses with the help of certified nursing assistants provide 24-hour care.

Resident social activities are provided in all facilities. Ask what types of group activities are offered and how individual residents' needs and preferences are identified. Residents should have the opportunity to be involved in activities that provide mental, physical, and social stimulation. Some innovative examples include:

Using computers and e-mail to help residents keep in touch with their families and loved ones. Some facilities offer computer classes to residents to learn how to surf the Web and sharpen their skills.

Mentoring programs provide an opportunity for residents to interact with children from the local community. Art classes, music recitals and other activities also allow residents to interact with their fellow residents and the community in which the facility is located.

Take some time to talk with the residents. Ask them about their life in the facility. Also, try to plan a visit to the facility during mealtimes so you can observe food presentation and interaction in the dining room. Each facility has a registered dietitian who can talk to you about special dietary needs.

Other specialists who may be on staff or available on a consultant basis include physical therapists, speech pathologists, occupational therapists, psychiatric personnel, social workers, pharmacists, podiatrists, and dentists.

The overall management of the facility is the responsibility of the administrator. Other administrative personnel include medical records staff, personnel director, admissions director, and financial staff. Building maintenance, laundry, and housekeeping personnel are also on staff.

During your visit, talk to the caregivers; many of these talented professionals are registered or licensed practical nurses and certified nursing assistants who have devoted their careers to caring for the elderly and the disabled. People providing services to people is what long term care is all about.

Long-term care resources

2009-05-31T15:42:00.000-07:00

Resources for General Information and Assistance

Your state or local department on aging: Look for “aging” or “human services” in your local government blue pages of the phone book for the number. Specific resources to ask for include State Health Insurance Assistance Programs, and in many states Aging and Disability Resource Centers (ADRCs).

The Administration on Aging's national Eldercare Locator provides information including where to find specific services and supports in your community. Contact: 1-800- 677-1116, weekdays 9:00 a.m. to 8:00 p.m. (ET) or contact the Eldercare Locator website.

Women’s Health/Health and Human Services (HHS) provides a range of information from caregiving to end of life and advance directives.

Resources to Assist with Caregiving

Administration on Aging (AoA)/Elders and Caregivers
The Caregiver Resource Room is where families, caregivers, and professionals can find information about The National Family Caregiver Support Program, including: where you can turn for support and assistance, and finding services for caregivers. In addition, another AoA resource is the Elder Care Locator.

Family Caregiver Alliance
The Family Caregiver Alliance (FCA) operates the National Center on Caregiving (NCC). The FCA provides a central source of information and technical assistance on caregiving and long-term-care for policy makers, health and service providers, media, program developers, funders and families. Their website, www.caregiver.org, contains a wealth of resources for caregivers and providers, including fact sheets, research and policy studies.

Family Caregiving 101
This website, developed by the Family Caregiver Alliance and the National Alliance for Caregiving, provides information and resources for family caregivers.

NIA Booklet on Long Distance Caregivers - The National Institute on Aging (NIA) has released So Far Away: Twenty Questions for Long Distance Caregivers. This booklet focuses on some of the most important concerns caregivers have about providing long distance care. The booklet is free and may be ordered by calling 1-800-222-2225 or going to http://www.nia.nih.gov/HealthInformation.

National Alliance for Caregivng
The National Alliance for Caregiving (NAC) is a coalition of national organizations focusing on issues related to and in support of family caregivers. NAC conducts research, policy analysis, program development and public awareness about caregiving. Their website, www.caregiving.org, provides publications and information including a link to the Caregiving 101 website and surveys on the status of caregiving.

National Family Caregivers Association
The National Family Caregivers Association (NFCA) focuses on public awareness, and caregiver education and support, especially as it relates to helping family caregivers work effectively with healthcare providers. Resources on the site include ways to link and support family caregivers through the stories project and a caregiver bulletin board.

Resources for Healthy Aging

Centers for Disease Control and Prevention (CDC)
This government site provides a wide range of information and resources on health and prevention for all ages and groups. Each specific topic, for example aging, physical activity and exercise, and staying healthy, includes news on related reports, conferences, listservs, statistics, and additional resources. The “aging” topic includes a Healthy Aging for Older Adults web page.

Center for Healthy Aging
This National Council on Aging site provides information on a range of health issues and identifies state and local programs that provide health promotion and disease prevention for older adults. These programs include AoA funded Evidenced-Based Disease Prevention Programs.

Center for Nutrition Policy and Promotion
The US Department of Agriculture (USDA) Center for Nutrition Policy and Promotion (CNPP) works to improve the health and well-being of Americans by developing and promoting dietary guidance that links scientific research to the nutrition needs of consumers.

National Center for Complimentary and Alternative Medicine
The National Center for Complementary and Alternative Medicine (NCCAM) is the Federal Government's lead agency for scientific research on complementary and alternative medicine within the National Institutes of Health (NIH). The Center conducts research, trains researchers, and provides a clearinghouse for information on treatments and therapies.

National Institute on Health: Health Information and Exercise Guide
This government site provides an Exercise Guide and links to additional publications and resources on health and wellness. The Guide provides advice on nutrition, balanced diets, and explains the benefits of exercise and physical activity, including how to get started and how to check your progress.

Resources to Assist with Financial Planning

The Federal Citizen Information Center section on ‘Money’ provides a range of information, fact sheets and resources on money and planning issues including banking, financial security, insurance, and retirement planning.

The My Money.Gov website provides information and resources that include social security benefit information, retirement planning strategies, and guidelines and questions to ask about trusts, IRA and other financial options.

The National Association of Insurance Commissioners' (NAIC) provides shoppers guides for different types of insurance, including long-term care insurance to help individuals understand and compare policies - (NAIC) Shopper's Guide to Long-Term Care Insurance.

Your State Insurance Department will have information about long-term care insurance in your area. They also often offer a shoppers' guide to long-term care insurance. Contact: http://www.consumeraction.gov/insurance.shtml to find your State’s Insurance Department.

Women’s Institute for Secure Retirement (WISER). This website offers a variety of information and consumer publications to help women understand the complex issues in areas such as Social Security, pay equity, pensions, savings and investments, home-ownership, long-term care and disability insurance.

Resources to Assist with Housing Planning

AARP
www.aarp.org/money/revmort
This AARP site provides information on reverse mortgages including a quide to compare reverse mortgage products.

Administration on Aging (AoA)
http://www.eldercare.gov/Eldercare.NET/Public/Resources/Resources.aspx
This AoA site provides information and resources on housing including assistive technology, remodeling and housing with services.

A Guide to Making Housing Decisions: Housing Options for Older Adults
http://www.eldercare.gov/Eldercare.NET/Public/Resources/Resources.aspx
This booklet provides an overview of housing options – from home ownership to rental and housing with services – and the related benefits, challenges, and legal issues to consider.

Alliance for Technology
http://www.ataccess.org/default.html
This site provides a range of information and resources on assistive devices and technology including community resources and vendors.

Fair Housing Accessibility First
http://www.fairhousingfirst.org/information/design.html
This Housing and Urban Development (HUD) website provides a wide range of information on modifications and accessibility including issues related to individuals in rental housing.

National Association of Home Builders (NAHB)
www.nahb.org/directory.aspx?sectionD=686&directoryID=188
This site provides a web-based directory you can search to find remodelers or contractors who specialize in modifying homes to make them safer and more comfortable.

National Resource Center on Supportive Housing and Home Modification
http://www.usc.edu/dept/gero/nrcshhm/directory/il.htm
This site provides information and local and state resources related to housing modifications and financing for modifications.

Rebuilding Together
http://www.rebuildingtogether.org/
This national nonprofit volunteer organization focuses on the home repair and improvement needs of lower income homeowners and includes a search tool to identify local assistance.

U.S. Department of Housing and Urban Development (HUD)
http://www.hud.gov/groups/seniors.cfm
This government website provides information on housing including buying, owning, renting, home modifications, reverse mortgages, and legal issues.

Resources to Assist with Advance Care Planning

Agency for Healthcare Research and Quality (AHRQ) provides research on preferences for care at end of life that can help guide decision making for end of life care.

The American Bar Association provides a tool kit that offers information to help clarify decision-making before a health crisis occurs and resources for legal help in each state including legal services funded through the Older Americans Act: http://www.abanet.org/aging/resources/statemap.shtml. Specific contact for the Consumer’s Tool Kit for Health Care Advance Planning can be found at: http://www.abanet.org/aging/toolkit/home.html.

National Association of Attorneys General (NAAG) are charged with protecting constituents in matters affecting the public interest, including consumer protection of those who are dying. The NAAG End-of-Life Health Care Project includes information on a range of end of life issues.

National Hospice and Palliative Care Association’s Caring Connections website, supported by funding from Robert Wood Johnson Foundation, provides general information on Advance Directives and state specific forms that can be downloaded.

Own Your Future Planning Kit

Order or download the free Own Your Future Long-Term Care Planning Kit. It describes what is and what is not covered by public programs related to long-term care, as well as ways to plan ahead, address legal issues, assess services, and consider private financing options.

This kit is provided by the “Own Your Future” Long-Term Care Awareness Campaign, a joint Federal-State initiative to increase awareness about the importance of planning for future long-term care needs.

To air is human

2009-05-23T12:06:00.000-07:00

This week, I had the pleasure of participating in the first pledge drive for our local community radio station, KMRE. The low-power FM facility is part of the American Museum of Radio and Electricity, one of the organizations that makes Bellingham such a special place.

KMRE uses a format called "The Golden Age of Radio," with music from the 1920s to 1940s. The Resident Council at St. Francis voted some time ago to have that station playing in the dining room during meals. That indicated to me, as Marketing Director, that the station was targeting the audience we wanted to reach.

Last year, St. Francis began underwriting programming on KMRE. This not only benefits the radio station, it gets the St. Francis name out to the people of Bellingham. It has proved to be a fruitful partnership. The station's radio drama group, the Midnight Mystery Players, will be performing for residents at St. Francis and we are scheduling an outing for our residents to see the museum.

The successful partnership with KMRE defines the kind of win/win situation that St. Francis is building on. We also partner with a number of other organizations in the community and I urge you to view them on the Community Partners page of the Web site. I encourage you to listen to KMRE if you live in Bellingham. If not, you can listen on the Internet by going to www.amre.us. This wonderful community asset deserves your support and you can pledge by calling (360) 738-3886. You can also pledge on the Web site. Do it right now and help KMRE reach its fundraising goal.

Christopher Key

Public programs for long-term care

2009-05-10T10:38:00.000-07:00

There are a number of public programs that provide help paying for long-term care services. Each program has specific rules for what types of services it covers, how long one can receive services, eligibility for coverage, and, in some cases, cost sharing. For example, some programs, such as the Older Americans Act, focus on home- and community-based services, while the Medicare program only pays for some short-term nursing home stays or home health care. The following section provides information on some of the major public programs that may help pay for long-term care services.

Medicare

Medicare is a Federal program designed to cover health care for people age 65 and older, people under age 65 with certain disabilities, and people of all ages with end-stage renal disease (permanent kidney failure requiring dialysis or a kidney transplant.) It only covers medically necessary care and focuses on medical acute care (doctor visits and hospital stays) or short-term services for conditions expected to improve.

Generally, Medicare does not pay for most long-term care. Medicare does not pay for personal or custodial care (help with Activities of Daily Living), which is the greatest part of long-term care services. Medicare will help pay for a limited skilled nursing facility stay, hospice care or home health care if you meet certain conditions, which are described below.

Medicare will pay for care in a skilled nursing facility when:

you have had a recent prior hospital stay of at least three days,
you are admitted to a Medicare-certified nursing facility within 30 days of your prior hospital stay, and
you need skilled care such as skilled nursing services and/or physical or other types of therapy.
If all these conditions are met, Medicare pays a portion of your costs for up to 100 days. For the first 20 days, Medicare pays 100 percent of your skilled nursing facility costs. For days 21-100, you pay your own expenses up to $133.50/day (as of 2009) and Medicare pays the balance, if any. You pay 100 percent of costs for each day of a skilled nursing facility stay after day 100.

Medicare payments for home health care are limited to medically necessary part-time or intermittent skilled nursing care and home health aide services as well as physical therapy, occupational therapy and speech-language pathology that are ordered by your doctor and provided by a Medicare-certified home health agency. It also includes medical social services, medical supplies, and durable medical equipment (such as wheelchairs, hospital beds, oxygen, and walkers). Unlike nursing home services, there is no co-pay for home health, but for durable medical equipment you pay 20% of the Medicare approved amount. There is no limit on the duration of service as long as services continue to be medically necessary and your doctor requests or reorders these services at least every 60 days.

Hospice care is covered for people with a terminal illness, generally individuals who are not expected to live more than six months. Services include drugs for symptom control and pain relief, medical and support services from a Medicare-approved hospice provider, and other services not otherwise covered by Medicare (such as grief counseling). Hospice care is usually provided in your home (which may include a nursing home if that is where you live) or in a hospice care facility. Medicare does cover some short-term hospital and inpatient respite care to a hospice patient to allow the usual caregiver to rest.

Medicaid

Medicaid is a joint Federal and state government program that helps pay medical costs for some people with limited incomes and resources. People with Medicaid may get coverage for services such as nursing home and home health care, if they meet the eligibility requirements for Medicaid. Who is eligible and what services are covered vary from state to state. Most often, eligibility is based on your income and personal resources, but for coverage of long-term care services, you must also meet certain health or functional criteria to be eligible. The best source for that information is your State Medical Assistance office, whose phone number can be found at the Medicare Helpful Contacts search page. Your state Medicaid agency's website also has more information.

Sometimes you must spend down (or use up) your personal resources (assets) before you qualify for Medicaid. You may want to get more detailed information from your State Medical Assistance office or an attorney before spending down your resources.

A Brief History of Medicaid

The Medicaid program was enacted by Congress in 1965 in the same legislation that created the Medicare program. Medicaid is a state-administered program overseen at the Federal level by the Centers for Medicare & Medicaid Services (CMS). Specific program limits are set through a combination of Federal requirements and options, giving states flexibility in the design of their programs. As a result, standards and rules vary considerably from state to state.

Medicaid was originally designed to provide health care to poor families, children, the aged, and the disabled. Over time, the number of people served, as well as the cost of serving those people, has increased dramatically. A large part of that growth has been the number of people receiving long-term care services and the cost of providing those services.

The most common types of long-term care that Medicaid pays for are institutional care and home- and community-based service.

The following sections provide details about services Medicaid pays for, eligibility rules, rules about transfer of assets, how much you must contribute to the cost of your care, applying for Medicaid, and more.

Older Americans Act

The Older Americans Act is a Federal program designed to organize, coordinate, and provide home and community-based services to older adults and their families to help elders remain in the community as independently as possible.

The Older Americans Act provides funding, through state and local agencies known as the Aging Network, for a range of services that include nutrition programs in the community and for homebound elderly; programs for Native American elders; services for low-income minority elders; health promotion and disease prevention activities; in-home services for frail elders; services that protect the rights of older persons such as the long-term care ombudsman program; and services and supports for family caregivers. While there are no specific financial eligibility criteria for Older Americans Act services, they are generally targeted for low-income, frail seniors over age 60, and minority elders and seniors living in rural areas.

Local agencies, called Area Agencies on Aging (AAAs), in collaboration with State Agencies on Aging, plan and develop service and support programs based on the needs of elders and families in their respective areas. More information on Older Americans Act programs can be found on the Administration on Aging [offsite] website.

Veterans Affairs

The Department of Veterans Affairs (VA) may provide long-term care for service-related disabilities or for certain eligible veterans. In 1999, the Veterans Millennium Health Care and Benefits Act expanded VA health programs to include many that may be of use to aging veterans with long-term care needs. The Act requires the VA to provide long-term care to veterans who meet established disability criteria, or to those who need care because of service-connected disabilities.

This bill expands access to nursing home care and other extended care services to veterans who do not have service-related disabilities, but who are unable to pay for the expenses of necessary care. For those who qualify, the benefits can provide financial assistance for some long-term care costs. Co-pays may apply depending on the veteran's income level. Middle-class veterans who need long-term care for non-service-related conditions may find it difficult to access VA benefits for long-term care.

The VA also has a Housebound and Aid and Attendance Allowance Program that provides cash grants to eligible disabled veterans and surviving spouses in lieu of formally provided homemaker, personal care and other services needed for assistance in Activities of Daily Living and other help at home.

Visit the Department of Veterans Affairs to view available programs and services or download a Veterans Benefits fact sheet. You can call the VA at 1-800-827-1000 to obtain information about available services in your area.

The cost of long-term care

2009-05-03T13:35:00.000-07:00

An important part of planning for long-term care is deciding how to pay for services. This is because long-term care is very expensive, and contrary to what many people believe, their Medicare coverage will not pay for most of the long-term care services they need. While some people may qualify for Medicaid – the major payer of long-term care services, most people won't. There are other federal public programs, such as the Older Americans Act, or state funded programs, that pay some long-term care services, but like Medicaid they target those people with the most functional and financial need. Consequently, if you are one of the 70% of people over the age of 65 who will need long-term care services – there's a very good chance you will have to pay for some or all of your long-term care services out of your personal income and resources.

Paying for long-term care out of your personal income and resources can be challenging. Even if you have a modest need for assistance at home with personal care, say a visit from a home health aide 3 times a week, based on 2008 average costs, you would have to pay about $18,000 a year for those services.

To make the best decisions about how to pay for long-term care you need to understand what services cost, what public programs you are eligible for and what they cover, what private financing options are available, and which ones work best for you.

What Does Long-Term Care Cost?

LTC includes a broad range of health and support services that people need as they age or if they are disabled. The majority of these services are personal care, or assistance with activities of daily living that many families are able to provide all, or some of, free. But, as care and support needs increase, paid care is usually needed to supplement family provided services and supports, provide respite to family caregivers, or to pay for more extensive services in a facility, such as a nursing home or assisted living, when individuals can no longer be cared for in their homes.

There are variations in costs based on the type and amount of care you need, the provider you use, and where you live. Home health and home care services, provided in two-to-four-hour blocks of time referred to as “visits,” are generally more expensive in the evening, or on weekends or holidays. The costs of services in some community programs, such as adult day service programs, are often provided at a per-day rate, but vary based on overhead and programming costs. Many care facilities charge extra for services provided beyond the basic room-and-board charge, although some may have “all inclusive” fees.

The average costs in the United States (in 2008) are:

$187/day for a semi-private room in a nursing home
$209/day for a private room in a nursing home
$3,008/month for care in an Assisted Living Facility (for a one-bedroom unit)
$29/hour for a Home Health Aide
$18/hour for a Homemaker services
$59/day for care in an Adult Day Health Care Center

Who Pays for Long-Term Care?

If you have sufficient income and assets, you are likely to pay for your long-term care needs on your own, out of those private resources. If you meet functional eligibility criteria and have limited financial resources, or deplete them paying for care, Medicaid may pay for your care. If you require primarily skilled or recuperative care for a short time, Medicare may pay. The Older Americans Act is another Federal program that helps pay for long-term care services. Some people use a variety of payment sources as their care needs and financial circumstances change.

Long-Term Care Service
Medicare
Private Medigap Insurance
Medicaid
You Pay on Your Own*

Nursing Home Care
Medicare pays in full for days 0-20 if you are in a Skilled Nursing Facility following a recent hospital stay. If your need for skilled care continues, may pay for the difference between your co-payment of $133.50/day for days 21-100. After day 100 does not pay.
Private Medigap Insurance may cover the $133.50/day co-payment if your nursing home stay meets all other Medicare requirements.
Medicaid may pay for care in a Medicaid-certified nursing home if you meet functional and financial eligibility criteria.
If you need only personal or supervisory care in a nursing home and/or have not had a prior hospital stay, or if you choose a nursing home that does not participate in Medicaid or is not Medicare-certified.

Assisted Living Facility (and similar facility options)
Medicare does not pay
Private Medigap Insurance does not pay
Medicaid in some states, may pay care-related costs, but not room and board
You pay on your own except as noted under Medicaid if eligible.

Continuing Care Retirement Community
Medicare does not pay
Private Medigap Insurance does not pay
Medicaid does not pay
You pay on your own

Adult Day Services
Medicare - Not covered
Private Medigap Insurance - Not Covered
Medicaid - Varies by state, financial and functional eligibility required
You pay on your own [except as noted under Medicaid if eligible.]

Home Health Care
Medicare - Limited to reasonable, necessary part-time or intermittent skilled nursing care and home health aide services, and some therapies that are ordered by your doctor and provided by Medicare-certified home health agency. Does not pay for on-going personal care or custodial care needs only (help with activities of daily living).
Private Medigap Insurance - Not covered
Medicaid - Pay for, but states have option to limit some services, such as therapy
You pay on your own for personal or custodial care, except as noted under Medicaid, if you are eligible.

*See private finance options to learn more about a variety of private financing options to help you pay for your long-term care needs.

National Spending on Long-Term Care

The total amount spent on long-term care services in the United States (in 2005) was $206.6 billion. This does not include care provided by family or friends on an unpaid basis (often called “informal care.”) It only includes the costs of care from a paid provider.

While most information on “who pays for long-term care” presents these national figures, it is important to remember that each person's individual experience will differ. These figures combine the experiences of everyone receiving paid care, but there are significant variations from person to person.

On an aggregate basis, the biggest share, 49 percent, is paid for by Medicaid. On an individual basis, however, “who pays for long-term care” can look very different. This is because people with their own personal financial resources do not qualify for Medicaid unless they use up their resources first paying for care, so-called “spending down”. If you have reasonable income and assets, most likely you will be paying for care on your own.

Also, while Medicare overall pays for 20 percent of long-term care, it only pays under specific circumstances. If the type of care you need does not meet Medicare's rules, Medicare will not pay and you are likely to pay for your care on your own.

Learning more about the “rules” for when Medicare, Medicaid, other public programs or private insurance might pay for long-term care is an important part of understanding “who will pay” if and when you need care.

Long-term care resources

2009-04-26T11:15:00.000-07:00

Resources for General Information and Assistance

Your state or local department on aging: Look for “aging” or “human services” in your local government blue pages of the phone book for the number. Specific resources to ask for include State Health Insurance Assistance Programs, and in many states Aging and Disability Resource Centers (ADRCs).

The Administration on Aging's national Eldercare Locator provides information including where to find specific services and supports in your community. Contact: 1-800-677-1116, weekdays 9:00 a.m. to 8:00 p.m. (ET) or contact the Eldercare Locator website.

Women’s Health/Health and Human Services (HHS) provides a range of information from caregiving to end of life and advance directives.

Resources to Assist with Caregiving

Administration on Aging (AoA)/Elders and Caregivers
The Caregiver Resource Room is where families, caregivers, and professionals can find information about The National Family Caregiver Support Program, including: where you can turn for support and assistance, and finding services for caregivers. In addition, another AoA resource is the Elder Care Locator.

Family Caregiver Alliance
The Family Caregiver Alliance (FCA) operates the National Center on Caregiving (NCC). The FCA provides a central source of information and technical assistance on caregiving and long-term-care for policy makers, health and service providers, media, program developers, funders and families. Their website, www.caregiver.org, contains a wealth of resources for caregivers and providers, including fact sheets, research and policy studies.

Family Caregiving 101
This website, developed by the Family Caregiver Alliance and the National Alliance for Caregiving, provides information and resources for family caregivers.

NIA Booklet on Long Distance Caregivers - The National Institute on Aging (NIA) has released So Far Away: Twenty Questions for Long Distance Caregivers. This booklet focuses on some of the most important concerns caregivers have about providing long distance care. The booklet is free and may be ordered by calling 1-800-222-2225 or going to http://www.nia.nih.gov/HealthInformation.

National Alliance for Caregivng
The National Alliance for Caregiving (NAC) is a coalition of national organizations focusing on issues related to and in support of family caregivers. NAC conducts research, policy analysis, program development and public awareness about caregiving. Their website, www.caregiving.org, provides publications and information including a link to the Caregiving 101 website and surveys on the status of caregiving.

National Family Caregivers Association
The National Family Caregivers Association (NFCA) focuses on public awareness, and caregiver education and support, especially as it relates to helping family caregivers work effectively with healthcare providers. Resources on the site include ways to link and support family caregivers through the stories project and a caregiver bulletin board.

Resources for Healthy Aging

Centers for Disease Control and Prevention (CDC)
This government site provides a wide range of information and resources on health and prevention for all ages and groups. Each specific topic, for example aging, physical activity and exercise, and staying healthy, includes news on related reports, conferences, listservs, statistics, and additional resources. The “aging” topic includes a Healthy Aging for Older Adults web page.

Center for Healthy Aging
This National Council on Aging site provides information on a range of health issues and identifies state and local programs that provide health promotion and disease prevention for older adults. These programs include AoA funded Evidenced-Based Disease Prevention Programs.

Center for Nutrition Policy and Promotion
The US Department of Agriculture (USDA) Center for Nutrition Policy and Promotion (CNPP) works to improve the health and well-being of Americans by developing and promoting dietary guidance that links scientific research to the nutrition needs of consumers.

National Center for Complimentary and Alternative Medicine
The National Center for Complementary and Alternative Medicine (NCCAM) is the Federal Government's lead agency for scientific research on complementary and alternative medicine within the National Institutes of Health (NIH). The Center conducts research, trains researchers, and provides a clearinghouse for information on treatments and therapies.

National Institute on Health: Health Information and Exercise Guide
This government site provides an Exercise Guide and links to additional publications and resources on health and wellness. The Guide provides advice on nutrition, balanced diets, and explains the benefits of exercise and physical activity, including how to get started and how to check your progress.

Resources to Assist with Financial Planning

The Federal Citizen Information Center section on ‘Money’ provides a range of information, fact sheets and resources on money and planning issues including banking, financial security, insurance, and retirement planning.

The My Money.Gov website provides information and resources that include social security benefit information, retirement planning strategies, and guidelines and questions to ask about trusts, IRA and other financial options.

The National Association of Insurance Commissioners' (NAIC) provides shoppers guides for different types of insurance, including long-term care insurance to help individuals understand and compare policies - (NAIC) Shopper's Guide to Long-Term Care Insurance.

Your State Insurance Department will have information about long-term care insurance in your area. They also often offer a shoppers' guide to long-term care insurance. Contact: http://www.consumeraction.gov/insurance.shtml to find your State’s Insurance Department.

Women’s Institute for Secure Retirement (WISER). This website offers a variety of information and consumer publications to help women understand the complex issues in areas such as Social Security, pay equity, pensions, savings and investments, home-ownership, long-term care and disability insurance.

Resources to Assist with Housing Planning

AARP
www.aarp.org/money/revmort
This AARP site provides information on reverse mortgages including a quide to compare reverse mortgage products.

Administration on Aging (AoA)
http://www.aoa.gov/eldfam/Housing/Housing.aspx
This AoA site provides information and resources on housing including assistive technology, remodeling and housing with services.

A Guide to Making Housing Decisions: Housing Options for Older Adults
http://www.eldercare.gov/Eldercare/Public/resources/fact_sheets/pdfs/Housing%20Options%20booklet.doc
This booklet provides an overview of housing options – from home ownership to rental and housing with services – and the related benefits, challenges, and legal issues to consider.

Alliance for Technology
http://www.ataccess.org/default.html
This site provides a range of information and resources on assistive devices and technology including community resources and vendors.

Fair Housing Accessibility First
http://www.fairhousingfirst.org/information/design.html
This Housing and Urban Development (HUD) website provides a wide range of information on modifications and accessibility including issues related to individuals in rental housing.

National Association of Home Builders (NAHB)
www.nahb.org/directory.aspx?sectionD=686&directoryID=188
This site provides a web-based directory you can search to find remodelers or contractors who specialize in modifying homes to make them safer and more comfortable.

National Resource Center on Supportive Housing and Home Modification
http://www.usc.edu/dept/gero/nrcshhm/directory/il.htm
This site provides information and local and state resources related to housing modifications and financing for modifications.

Rebuilding Together
http://www.rebuildingtogether.org/
This national nonprofit volunteer organization focuses on the home repair and improvement needs of lower income homeowners and includes a search tool to identify local assistance.

U.S. Department of Housing and Urban Development (HUD)
http://www.hud.gov/groups/seniors.cfm
This government website provides information on housing including buying, owning, renting, home modifications, reverse mortgages, and legal issues.

Resources to Assist with Advance Care Planning

Agency for Healthcare Research and Quality (AHRQ) provides research on preferences for care at end of life that can help guide decision making for end of life care.

The American Bar Association provides a tool kit that offers information to help clarify decision-making before a health crisis occurs and resources for legal help in each state including legal services funded through the Older Americans Act: http://www.abanet.org/aging/resources/statemap.shtml. Specific contact for the Consumer’s Tool Kit for Health Care Advance Planning can be found at: http://www.abanet.org/aging/toolkit/home.html.

National Association of Attorneys General (NAAG) are charged with protecting constituents in matters affecting the public interest, including consumer protection of those who are dying. The NAAG End-of-Life Health Care Project includes information on a range of end of life issues.

National Hospice and Palliative Care Association’s Caring Connections website, supported by funding from Robert Wood Johnson Foundation, provides general information on Advance Directives and state specific forms that can be downloaded.

2009-04-14T16:01:00.001-07:00

April 14, 2009

Dear Families and Friends:

This morning I was interviewed on 790 KGMI Radio regarding the House and Senate budget proposals for 2009-2011. I appreciated the opportunity to share my concerns about the impact of proposed House and Senate nursing home budget cuts. As you are likely aware, each budget takes over $90 million from the care of nursing home Medicaid residents from throughout the state.

As a provider with over 21 years of operating experience, I take seriously my advocacy responsibilities on behalf of our residents and employees, and I was pleased to have the opportunity to share my concerns with the listeners of KGMI.

The Legislature is down to 12 days before they are scheduled to adjourn. Budget proposals are being negotiated now. This is a critical time for our legislators to hear from their constituents regarding the implications of these cuts. If you haven’t had a chance to do so, I would ask that you contact Senator Dale Brandland, Representative Kelli Linville and Representative Doug Ericksen and ask them to eliminate nursing home budget cuts. Just call the Legislative Hotline, 1-800-562-6000, and leave a message for each.

Your voice truly matters in this discussion.

We will continue to monitor budget negotiations and will keep you informed as the Legislature works to pass the 2009—2011 operating budget. If you’d like additional information, please check out www.helpwashingtonseniors.org.

If you have questions, or if we can provide additional information about how you can help us protect our residents, please don’t hesitate to call.

Sincerely,

Tonja A. Myers
Administrator

Planning for long-term care

2009-04-12T10:06:00.000-07:00

Planning for long-term care is a difficult task. It involves understanding and making decisions about services and options that are unfamiliar to many of us. These include services and supports, housing and financing options, and legal issues.

Personal Planning Steps

Assess Your Risk of Needing Long-Term Care Services

While you can never know for certain if you will need long-term care, assessing your risk factors can help you understand if you are at a higher or lower risk. Begin by talking with your doctor about whether you might be at increased risk based on your medical and family history or lifestyle choices. You will gain a better understanding of your risks, and your doctor may be able to help you decrease your risk.

Investigate Opportunities to Help Maintain Your Health and Independence

Many people fail to make the connection between healthy behaviors today and their impact on later life, but the science of aging indicates that chronic disease and disability are not always inevitable. Studies by the National Institute of Aging indicate that healthy eating, physical activity, mental stimulation, not smoking, active social engagement, moderate use of alcohol, maintaining a safe environment, social support, and regular health care are important in maintaining health and independence. Even if you haven’t been active in the past, it’s not too late to start.

Talk with Your Family about Caregiving

It is estimated that individuals turning 65 today could need up to 3 years of long-term care services, with almost 2 years of that care provided at home. Currently most care provided in the home is by an unpaid family member or other caregiver. You should talk to your family (spouse, adult children, siblings) or friends who would want to, or be able to, care for you if you became ill or disabled for a long time. Or, you might already be a caregiver for someone else. In either case, it is important for you and your family to understand how caregiving activities can affect you and your family, and what resources and supports are available.

Think about Where You Want to Receive Care

If you were to need care for an extended period of time, and were not able to stay at home, where would you want to receive care? If you need more information on long-term care services, review the list of services and providers in Understanding LTC. One way to find out what services are in your community is by contacting the Administration on Aging's Eldercare Locator.

Financial Planning Steps

Review Your Current Insurance Coverage

Do you know if your current health care insurance would pay if you needed to be in a nursing home or needed care at home for an extended illness? Unless you have purchased a specific long-term care insurance policy, your existing medical coverage, Medicare, Medicare supplement, or HMO will provide little if any coverage for long-term care. Review the policies you have with your insurance advisor or benefits counselor to learn what is covered and what is not.

Decide if You Can or Want to Pay for Long-Term Care Privately

If you don't have coverage for long-term care or prefer to pay out of your own resources, do you know if you would be able to cover all the costs from your retirement income and savings? Think about the financial resources you have and how you feel about using them to pay for long-term care. This could include various sources of income (for example, Social Security, pension, interest income, dividends from investments, payments from an IRA or 401 (k)), as well as cash, savings, stocks and bonds, and your home.

Investigate Future Insurance or Benefits You Expect or May Qualify for in Retirement

It is important to know and understand what your future benefits will cover, if you are not yet retired. If you only have Medicare, even with a Medicare supplemental plan, most of your long-term care services may not be covered. If you have limited resources, now or in the future, Medicaid may pay for your services. More information on Medicare, Medicaid and other public programs can be found in the Paying for Long-Term Care section of this website. You can also go to the Centers for Medicare and Medicaid Services [offsite] web site for more information on Medicare and Medicaid.

Find Out What Other Resources Can Help Cover Long-Term Care Expenses

Most people currently don't have coverage or do not have enough private funds to pay for all their long-term care needs, particularly if service needs are extensive or last a long time. There are an increasing number of private payment options available for this purpose. Two of the more common options are long-term care insurance and reverse mortgages. Review private financing options carefully to ensure that you understand all the details, eligibility requirements, and costs.

Housing Considerations and Planning Steps

Decisions about housing are often based on finances and personal choices such as neighborhood location or a retirement destination. But, there are numerous things to consider related to housing and potential long-term care needs as you age. The following sections summarize some of the major issues and considerations related to housing and long-term care planning.

Staying in Your Home or Moving to a New Independent Living Situation

If you are like most people and plan to stay in your own home for as long as possible, some important things to consider include the condition of your home, the accessibility of your home if you become less independent, the types of modifications you could make to your home, affordability of future maintenance and needed modifications, and the availability of services in the area.

If you decide to move, an important consideration is whether your new home has universal design features that can accommodate your needs if you become less independent. This could be a house all on one level, or an accessible condominium or apartment. A retirement community or senior housing complex that provides independent living units with support services such as transportation or house keeping are other options. Some issues to consider before making a decision to move include the value and equity you have in your home, whether this is a short term or long term move, the advantages of buying versus renting, and the related tax and legal issues.

Home Modifications

Home modifications can make your home safer and allow you to stay there longer. Modifications can range from lever style door and sink handles, grab bars in the bathroom, and improved lighting, to handrails, wider doorways for wheel chair access, stairway chair lifts, and adding a bathroom and/or bedroom on the first floor of a multi-story home to accommodate someone unable to climb stairs. You might also consider creating a separate apartment for a relative or renter in exchange for assistance when you need it. If you are not a home owner, you may have a right to some modifications, but you may need to negotiate with your landlord on types and costs.

Modifications can be costly, but those that meet universal design standards, such as wider doorways and walk-in, curbless showers, may add value to your home. If you have enough equity in your home, you can use it to help finance modifications, or other costs. There are also some state and local programs that provide low interest loans or grants for home modifications.

Assistive Devices

Assistive devices are tools, products or equipment that help you perform tasks and activities, as independently as possible, in your home and community. Some of the simplest are adapted kitchen and grooming tools that are easier to hold, or a “reacher” that grabs objects you can’t reach. Others may help you communicate, or move around. Mobility assistive devices include walkers, wheel chairs, and mopeds. Communication devices range from voice amplification and recognition tools to cueing and memory aids, and software such as word prediction programs.

In-home and Community Support Services

The availability of in-home and community supports can help you stay in your home longer. These include public transportation – or someone to drive you to do shopping or to go to appointments, help with housing and yard chores, or with personal care, even temporarily.

Moving to Housing with Services

At some point, you may decide to move into housing with services, often referred to as facility-based services. Many of these, for example assisted living and board and care homes, are group living settings that offer housing plus personal care and support services, but not the level of medical care provided in a nursing home. A Continuing Care Retirement Community (CCRC) is another type of housing with services that provides a range of housing options on one campus - independent units, assisted living, and nursing facilities. Generally, CCRCs have an initial entrance fee and require you to be independent when you first enter. Nursing Facilities are the most service intensive and include skilled nursing and therapies as needed. Planning considerations for any of these housing with services options include how much they cost, what you can afford, the range and quality of the services provided, what type of insurance or public programs reimburse these services, eligibility requirements, and how close you will be to family and friends.

Legal and Advance Care Planning Steps

What is Advance Care Planning?

Advance care planning is the process of discussing, determining and executing treatment directives - such as a Living Will, and appointing a health care proxy decision maker for care in the event that a person is not able to make medical decisions for him or herself. Advance Care planning can make a critical difference in your life, and the lives of the ones who care about you, either in emergency situations or when facing end-of-life care situations.

To be most effective, advance care planning needs to be a comprehensive, ongoing process that includes your family and friends, your proxy, and your providers. Planning should reflect your personal values and beliefs, and be adaptable if circumstances change.

Advance Care Planning Considerations:

Communication is the single most important first step in advance care planning. It is critical to consider what you want while you have time to think through the options clearly, and then to discuss your options and preferences with your family and others. While advance care planning may be difficult and emotionally charged, communicating your wishes ahead of time decreases the chance of future conflict and takes the burden off your family.

Several issues should be carefully considered for advance care planning.

Values and beliefs. Personal concerns, values, spiritual beliefs or views about what makes life worth living are important issues to consider when developing an advance care plan.

Preferences. Most people have ideas about the ways they wish to face death and/or disability, but may be uncomfortable discussing them. Sometimes sharing your own ideas, if you are helping someone, or reviewing the situations of other family or friends who have been in relevant situations can help.

Health care proxy: Decide who you will appoint as your health care proxy (surrogate or agent) decision-maker. Appointing a proxy is a very important decision. The person you choose as your proxy needs to be able to make decisions based on understanding and respecting your values and beliefs about care. Select someone who you believe will understand and be able to carry out your wishes even if they include denying life-sustaining treatments.

Help with Planning. Many different kinds of professionals can assist you in creating advance directives that help ensure that your wishes will be respected. Lawyers, social workers and members of the clergy are obvious examples. Some counselors and social workers – especially those who work for hospice services – are uniquely qualified to offer guidance at all stages of the advance care planning process.

What types of Planning Documents do I need?

Advance Directive – Living Will and Medical Powers of Attorney

Advance Directive is a general term used to describe two types of documents – living wills and medical powers of attorney. These planning documents allow you to convey the type of care you want if you cannot speak for yourself including the extent to which you want life-sustaining medical treatments, and who should make those decisions if you cannot. Advance directives are not only focused on what treatments you don’t want, they also should include all of the treatments you do want.

Living wills (sometimes called medical directives) are written instructions for care in the event that you are not able to make medical decisions for yourself. Currently, 47 states and the District of Columbia have laws authorizing living wills. State law, however, can vary on signing requirements and other aspects of a living will, so it is important to check on your state’s requirements when completing a living will.

Medical Power of Attorney (sometimes called a health care or durable power of attorney) is a document that appoints a particular person as a health care proxy or health care agent to make health care decisions for you if you are unable to do so yourself (not just during a terminal illness). A health care proxy is your substitute decision-maker. All 50 states and the District of Columbia have laws recognizing health care powers of attorney. Some specify the types of decisions that health care proxies can make.

Do Not Resuscitate (DNR) is a physician’s order that is written in a person’s medical record indicating that health care providers should not attempt life-saving measures such as cardiopulmonary resuscitation (CPR) in the event of a cardiac arrest (commonly known as a heart attack) or respiratory arrest. A request for a DNR can be included in your planning documents, or communicated directly to your physician. Also, most health care facilities have a Do Not Resuscitate order policy and forms that a hospital professional can help you with if you choose this option after being admitted to a hospital.

Steps to Insure that Your Advance Care Planning is Carried Out

Complete a living will and a medical power of attorney. If possible, you should consult with a lawyer or other professional regarding specific state laws or regulations related to these planning documents.

Insure that your family and other important people in your life understand what your wishes are, and what is included in these documents. It is particularly important to discuss your decisions with the individual who will be your health care proxy to be sure he/she is comfortable with that role, and can be available to carry out your wishes.

Keep your planning documents easily accessible and in multiple places. Consider carrying a wallet card with you. Give copies to family members, friends, your physician, and/or your lawyer if appropriate. It is critical that your health care proxy has a copy, or can access a copy quickly, if there is an unexpected emergency.

Review your plans periodically to be sure that you are still satisfied with your decisions, and your health proxy is still able and willing to be responsible for carrying out your plans.

The importance of planning

2009-04-05T10:28:00.000-07:00

Planning for long-term care is a difficult task. It involves understanding and making decisions about services and options that are unfamiliar to many of us. These include services and supports, housing and financing options, and legal issues.

Personal Planning Steps

Assess Your Risk of Needing Long-Term Care Services

While you can never know for certain if you will need long-term care, assessing your risk factors can help you understand if you are at a higher or lower risk. Begin by talking with your doctor about whether you might be at increased risk based on your medical and family history or lifestyle choices. You will gain a better understanding of your risks, and your doctor may be able to help you decrease your risk. You should also review other risk factors, such as gender, listed in the Understanding LTC section of this website.

Investigate Opportunities to Help Maintain Your Health and Independence

Many people fail to make the connection between healthy behaviors today and their impact on later life, but the science of aging indicates that chronic disease and disability are not always inevitable. Studies by the National Institute of Aging indicate that healthy eating, physical activity, mental stimulation, not smoking, active social engagement, moderate use of alcohol, maintaining a safe environment, social support, and regular health care are important in maintaining health and independence.

Even if you haven’t been active in the past, it’s not too late to start. You can begin by reviewing the information on healthy lifestyles and programs in the Resources section of this website.

Talk with Your Family about Caregiving

It is estimated that individuals turning 65 today could need up to 3 years of long-term care services, with almost 2 years of that care provided at home. Currently most care provided in the home is by an unpaid family member or other caregiver. You should talk to your family (spouse, adult children, siblings) or friends who would want to, or be able to, care for you if you became ill or disabled for a long time. Or, you might already be a caregiver for someone else. In either case, it is important for you and your family to understand how caregiving activities can affect you and your family, and what resources and supports are available.

Think about Where You Want to Receive Care

If you were to need care for an extended period of time, and were not able to stay at home, where would you want to receive care? If you need more information on long-term care services, review the list of services and providers in Understanding LTC. One way to find out what services are in your community is by contacting the Administration on Aging's Eldercare Locator.

Financial Planning Steps

Review Your Current Insurance Coverage

Do you know if your current health care insurance would pay if you needed to be in a nursing home or needed care at home for an extended illness? Unless you have purchased a specific long-term care insurance policy, your existing medical coverage, Medicare, Medicare supplement, or HMO will provide little if any coverage for long-term care. Review the policies you have with your insurance advisor or benefits counselor to learn what is covered and what is not.

Decide if You Can or Want to Pay for Long-Term Care Privately

If you don't have coverage for long-term care or prefer to pay out of your own resources, do you know if you would be able to cover all the costs from your retirement income and savings? Think about the financial resources you have and how you feel about using them to pay for long-term care. This could include various sources of income (for example, Social Security, pension, interest income, dividends from investments, payments from an IRA or 401 (k)), as well as cash, savings, stocks and bonds, and your home.

Investigate Future Insurance or Benefits You Expect or May Qualify for in Retirement

It is important to know and understand what your future benefits will cover, if you are not yet retired. If you only have Medicare, even with a Medicare supplemental plan, most of your long-term care services may not be covered. If you have limited resources, now or in the future, Medicaid may pay for your services.

Find Out What Other Resources Can Help Cover Long-Term Care Expenses

Most people currently don't have coverage or do not have enough private funds to pay for all their long-term care needs, particularly if service needs are extensive or last a long time. There are an increasing number of private payment options available for this purpose. Two of the more common options are long-term care insurance and reverse mortgages. Review private financing options carefully to ensure that you understand all the details, eligibility requirements, and costs. Read about the range of private long-term care financing options in the Paying for Long-Term Care section of this web site.

Housing Considerations and Planning Steps

Decisions about housing are often based on finances and personal choices such as neighborhood location or a retirement destination. But, there are numerous things to consider related to housing and potential long-term care needs as you age. The following sections summarize some of the major issues and considerations related to housing and long-term care planning. The "Housing Planning Resources" section of this site has more information and contacts related to each of these housing planning issues.

Staying in Your Home or Moving to a New Independent Living Situation

If you are like most people and plan to stay in your own home for as long as possible, some important things to consider include the condition of your home, the accessibility of your home if you become less independent, the types of modifications you could make to your home, affordability of future maintenance and needed modifications, and the availability of services in the area.

If you decide to move, an important consideration is whether your new home has universal design features that can accommodate your needs if you become less independent. This could be a house all on one level, or an accessible condominium or apartment. A retirement community or senior housing complex that provides independent living units with support services such as transportation or house keeping are other options. Some issues to consider before making a decision to move include the value and equity you have in your home, whether this is a short term or long term move, the advantages of buying versus renting, and the related tax and legal issues.

Home Modifications

Home modifications can make your home safer and allow you to stay there longer. Modifications can range from lever style door and sink handles, grab bars in the bathroom, and improved lighting, to handrails, wider doorways for wheel chair access, stairway chair lifts, and adding a bathroom and/or bedroom on the first floor of a multi-story home to accommodate someone unable to climb stairs. You might also consider creating a separate apartment for a relative or renter in exchange for assistance when you need it. If you are not a home owner, you may have a right to some modifications, but you may need to negotiate with your landlord on types and costs.

Modifications can be costly, but those that meet universal design standards, such as wider doorways and walk-in, curbless showers, may add value to your home. If you have enough equity in your home, you can use it to help finance modifications, or other costs. Ways to use home equity are described in the Paying for LTC: Reverse Mortgage section of this website. There are also some state and local programs that provide low interest loans or grants for home modifications.

Assistive Devices

Assistive devices are tools, products or equipment that help you perform tasks and activities, as independently as possible, in your home and community. Some of the simplest are adapted kitchen and grooming tools that are easier to hold, or a “reacher” that grabs objects you can’t reach. Others may help you communicate, or move around. Mobility assistive devices include walkers, wheel chairs, and mopeds. Communication devices range from voice amplification and recognition tools to cueing and memory aids, and software such as word prediction programs.

In-home and Community Support Services

The availability of in-home and community supports can help you stay in your home longer. These include public transportation – or someone to drive you to do shopping or to go to appointments, help with housing and yard chores, or with personal care, even temporarily. The “ Understanding Long-Term Care: Home and Community Based Services ” section of this website describes the types of services to look for in your community.

Moving to Housing with Services

At some point, you may decide to move into housing with services, often referred to as facility-based services. Many of these, for example assisted living and board and care homes, are group living settings that offer housing plus personal care and support services, but not the level of medical care provided in a nursing home. A Continuing Care Retirement Community (CCRC) is another type of housing with services that provides a range of housing options on one campus - independent units, assisted living, and nursing facilities. Generally, CCRCs have an initial entrance fee and require you to be independent when you first enter. Nursing Facilities are the most service intensive and include skilled nursing and therapies as needed.

Planning considerations for any of these housing with services options include how much they cost, what you can afford, the range and quality of the services provided, what type of insurance or public programs reimburse these services, eligibility requirements, and how close you will be to family and friends.

Legal and Advance Care Planning Steps

What is Advance Care Planning?

Advance care planning is the process of discussing, determining and executing treatment directives - such as a Living Will, and appointing a health care proxy decision maker for care in the event that a person is not able to make medical decisions for him or herself. Advance Care planning can make a critical difference in your life, and the lives of the ones who care about you, either in emergency situations or when facing end-of-life care situations.

To be most effective, advance care planning needs to be a comprehensive, ongoing process that includes your family and friends, your proxy, and your providers. Planning should reflect your personal values and beliefs, and be adaptable if circumstances change.

Advance Care Planning Considerations:

Communication is the single most important first step in advance care planning. It is critical to consider what you want while you have time to think through the options clearly, and then to discuss your options and preferences with your family and others. While advance care planning may be difficult and emotionally charged, communicating your wishes ahead of time decreases the chance of future conflict and takes the burden off your family.

Several issues should be carefully considered for advance care planning.

Values and beliefs. Personal concerns, values, spiritual beliefs or views about what makes life worth living are important issues to consider when developing an advance care plan.

Preferences. Most people have ideas about the ways they wish to face death and/or disability, but may be uncomfortable discussing them. Sometimes sharing your own ideas, if you are helping someone, or reviewing the situations of other family or friends who have been in relevant situations can help.

Health care proxy: Decide who you will appoint as your health care proxy (surrogate or agent) decision-maker. Appointing a proxy is a very important decision. The person you choose as your proxy needs to be able to make decisions based on understanding and respecting your values and beliefs about care. Select someone who you believe will understand and be able to carry out your wishes even if they include denying life-sustaining treatments.

Help with Planning. Many different kinds of professionals can assist you in creating advance directives that help ensure that your wishes will be respected. Lawyers, social workers and members of the clergy are obvious examples. Some counselors and social workers – especially those who work for hospice services – are uniquely qualified to offer guidance at all stages of the advance care planning process.

What types of Planning Documents do I need?

Advance Directive – Living Will and Medical Powers of Attorney

Advance Directive is a general term used to describe two types of documents – living wills and medical powers of attorney. These planning documents allow you to convey the type of care you want if you cannot speak for yourself including the extent to which you want life-sustaining medical treatments, and who should make those decisions if you cannot. Advance directives are not only focused on what treatments you don’t want, they also should include all of the treatments you do want.

Living wills (sometimes called medical directives) are written instructions for care in the event that you are not able to make medical decisions for yourself. Currently, 47 states and the District of Columbia have laws authorizing living wills. State law, however, can vary on signing requirements and other aspects of a living will, so it is important to check on your state’s requirements when completing a living will.

Medical Power of Attorney (sometimes called a health care or durable power of attorney) is a document that appoints a particular person as a health care proxy or health care agent to make health care decisions for you if you are unable to do so yourself (not just during a terminal illness). A health care proxy is your substitute decision-maker. All 50 states and the District of Columbia have laws recognizing health care powers of attorney. Some specify the types of decisions that health care proxies can make.

Do Not Resuscitate (DNR) is a physician’s order that is written in a person’s medical record indicating that health care providers should not attempt life-saving measures such as cardiopulmonary resuscitation (CPR) in the event of a cardiac arrest (commonly known as a heart attack) or respiratory arrest. A request for a DNR can be included in your planning documents, or communicated directly to your physician. Also, most health care facilities have a Do Not Resuscitate order policy and forms that a hospital professional can help you with if you choose this option after being admitted to a hospital.

Steps to Insure that Your Advance Care Planning is Carried Out

Complete a living will and a medical power of attorney. If possible, you should consult with a lawyer or other professional regarding specific state laws or regulations related to these planning documents.

Insure that your family and other important people in your life understand what your wishes are, and what is included in these documents. It is particularly important to discuss your decisions with the individual who will be your health care proxy to be sure he/she is comfortable with that role, and can be available to carry out your wishes.

Keep your planning documents easily accessible and in multiple places. Consider carrying a wallet card with you. Give copies to family members, friends, your physician, and/or your lawyer if appropriate. It is critical that your health care proxy has a copy, or can access a copy quickly, if there is an unexpected emergency.

Review your plans periodically to be sure that you are still satisfied with your decisions, and your health proxy is still able and willing to be responsible for carrying out your plans.

2009-03-29T10:22:00.000-07:00

The Importance of Planning

No one wants to think about a time when they might need long-term care. So planning ahead for this possibility often gets put off. Most people first learn about long-term care when they or a loved one need care. Then their options are often limited by lack of information, the immediate need for services, and insufficient resources to pay for preferred services. Planning ahead allows you to have more control over your future.

Why Plan Ahead for Long-Term Care?

Planning ahead for long-term care is important because there is a good chance you will need some long-term care services if you live beyond the age of 65. About 70 percent of people over age 65 require some services, and the likelihood of needing care increases as you age.

Planning ahead helps you understand what service options are available in your community, what special conditions may apply for receiving services, for example, age or other eligibility criteria, what services cost, and what payment options – public and private – apply. Having this information helps ensure you will have a range of options when you need long-term care, and makes it more likely that you will have more choice and control over where and how you receive services.

Planning ahead is important because the cost of long-term care services often exceeds what the average person can pay from income and other resources. By planning ahead, you may be able to save your assets and income for uses other than long-term care, including preserving the quality of life for your spouse or other loved ones. With planning, there is a greater likelihood of being able to leave an estate to your heirs, because you are less likely to use up your financial resources paying for care.

Planning ahead also means less emotional and financial stress on you and your family. It can provide a way to involve your family in decisions without depending on them to bear the entire burden alone.

Finally, for many people, one of the most important advantages of planning ahead is to ensure greater independence should you need care. Your choices for receiving care outside of a facility and being able to stay at home or receive services in the community for as long as possible are greater if you have planned ahead.

Why People Don't Plan Ahead

There are many reasons why people don't plan ahead for long-term care. These include the natural tendency to avoid thinking about becoming dependent on others for your care, misinformation about the risks of needing care, and lack of knowledge about the cost of care and payment options.

Most people don't like to think about getting older, developing a disability, becoming less independent, or needing help with personal care. Many people don't realize that their chance of needing long-term care by the time they turn 65 is as high as 70 percent.

People commonly misunderstand how expensive long-term care is, and how it is paid for. Consumer surveys have shown that many individuals don't realize that health insurance, Medicare, and/or disability coverage do not pay for most long-term care services. Medicaid pays for some long-term care services, but only if you qualify for the program because you have limited income and financial resources.

Some people find it too difficult to raise these subjects with their loved ones, making it difficult to explore and define their plans. Adult children often feel like they are patronizing their parents if they raise the subject or they are afraid of giving the impression that they might not want to provide care if it is needed. Parents often don't want to make adult children uncomfortable or to discuss details of their finances with them.

Finally, some people realize it is important to plan, but don't know how to go about it. The best way to begin is with small and easy steps. Even just talking with your loved ones is a great first-step!

Examples of People Who Planned

What exactly do we mean when we say “planning?” Below are some examples of how people might plan for long-term care before they need care. While these are fictional illustrations, they represent a variety of real-life situations.

You can also Listen to Some Real-Life Stories of people who planned ahead for their long-term care needs. Each person talks about a different planning option and the reasons for making that choice. Listening to their considerations and decisions can help you think through what might be best for you. If you are unable to listen to these stories it may be because your computer does not have the necessary components that allow the audio to work. You can get these stories when you order the Own Your Future Long-Term Care Planning Kit that includes a CD with the real-life planning stories.

The people described here are composites drawn from a variety of real-life scenarios; they illustrate the range of personal circumstances people might find themselves in and the different forms that “long-term care planning” might take. There is no “one-size-fits-all” plan. As you read these examples, think about your own circumstances and the types of options you might want to consider.

Mrs. F is 81. She has osteoporosis, arthritis, and high blood pressure. Otherwise she is basically healthy, but frail. She lives on a limited, fixed income and does not have significant assets to draw upon to help her meet her long-term care needs. She has been living in a modest one-bedroom rental unit, but is finding it difficult to maintain her apartment on her own.

Plan:
Pay for modifications to daughter's home (outfit spare bedroom and second bathroom for Mrs. Friedlander).
Move in with daughter.
Establish "Advance Directive" and create "Durable Power of Attorney."
"My daughter and I, we have a good time together. I know that until my time comes she'll be with me, helping me. It was hard to talk about some of this, but I feel good that she understands. I worked all my life and I want to be at home. I don't want to be in any hospital or nursing home."

Mrs. W is 78. Since having a stroke several years ago, she depends on a wheelchair to get around. She and her husband still live in the three-bedroom house they bought when they were first married. The home's value has increased dramatically since they bought it and they are lucky to have paid off the mortgage a few years ago. The upkeep of such a large home is taking a toll on both her and her husband.

Plan:
Sell home and use the resulting proceeds to move to a Continuing Care Retirement Community when she and her husband turned 75.
With no children, the Wielands decided to establish a Charitable Remainder Trust to pay for their care and willed the remainder of the trust after they both passed away to the California Horticultural Society.
“George and I were fortunate all our lives. We both worked and managed to save. We don't really have any family. Both of us were only children and we never had any of our own. We wanted to be able to stay together as long as we could, but be sure that the other would be cared for, no matter who was first to go.”

Mr. C is an 82 year old widower. He lives in the modest home in which he raised his children. He has prostate cancer and has had a pacemaker for the past two years. At this point he is still able to take care of all his physical needs and he is very keen on remaining at home to receive the care he needs, because of all the wonderful family memories it holds for him. But his income and assets may not be enough to pay for the care he needs at home.

Plan:
Stay at home and receive care there if necessary.
Pay for care with a combination of savings and a reverse mortgage.
Son and daughter to coordinate care and repay the reverse mortgage loan amount when it is due (upon Mr. Curley's death or when and if he needs to permanently move out of the home). His children can keep the house in the family if they wish, after paying off the loan amount from other financial resources they or Mr. Curley have, or they can sell the home and use the proceeds to pay off the loan amount. They are allowed to keep any additional funds from the sale of the home that exceed the loan amount to be repaid.
“I know I'm not gonna be around forever. But I told my kids I was going nowhere! I want to be in my own place. Me and the dog. My son lives here in town and my daughter is only a few miles west. We worked it out so the house can help pay for care if and when I need it and then it's theirs when I'm gone. I don't want to be a burden to no one, but they're good kids and this way I get to see the grandkids too. They mow the lawn. This house has important memories for me, but once I'm gone, the kids already have their own places; they don't need or want this house, so I like the idea of putting the home's value to work for me!”

At 46, Ms S had the opportunity to purchase long-term care insurance as a Federal employee. She has chosen coverage that will allow her to be cared for at home, in an assisted living facility, or in a nursing home if necessary. She bought the policy now since the cost is based on her age when she buys it. Waiting would only mean higher premiums and the possibility that she might develop a health condition that would cause her to be declined for the insurance. She does not want to have to rely on her family to pay for or provide care for her if and when she needs it. She likes being independent and having peace of mind that comes from planning ahead.

Plan:
Purchase long-term care insurance, which she pays for through an automatic deduction from her bi-weekly paycheck.
Prepare a living will so that her family will know her preferences and wishes for care and life support if she becomes unable to communicate or carry out her preferences on her own.
Speak with daughter and niece and specify her preferences for care.
“Long-term care insurance is a great deal for someone like me. I have a daughter and a niece I'm close to, but I don't want to become a problem for them; they have their own busy lives. This way, we're there for each other, but when the time comes that I get sick or very old, they will know what I want and I've set up a plan ahead of time. I don't want to worry and I don't want them to worry.”

# # #

2009-03-21T12:13:00.000-07:00

Cost of Long-Term Care

Long-term care is expensive. One year of care in a nursing home, based on the 2008 national average, costs over $68,000 for a semi-private room. One year of care at home, assuming you need periodic personal care help from a home health aide (the average is about three times a week), would cost almost $18,000 a year.

Costs for long-term care services vary greatly depending on the type and amount of care you need, the provider you use, and where you live. For example, many care facilities charge extra for services provided beyond the basic room-and-board charge, although some may have “all inclusive” fees. Home health and home care services are usually provided in two-to-four-hour blocks of time referred to as “visits.” An evening, weekend or holiday visit may cost more than a weekday visit. Some community programs, such as adult day service programs, are provided at a per-day rate, and rates may differ based on the type and variety of programs and services offered.

Who Pays for Long-Term Care?

Consumer surveys have revealed some common misunderstandings people have about which public programs pay for long-term care services. Many people believe they can rely on Medicare to pay for any long-term care services they will need. However, Medicare only pays for long-term care if you require skilled services or recuperative care for a short period of time. Medicare does not pay for what comprises the majority of long-term care services – non-skilled assistance with Activities of Daily Living.

Medicaid is the joint Federal and state program that pays for the largest share of long-term care services, but only if you meet financial and functional criteria. Other Federal programs such as the Older Americans Act and Veterans Affairs pay for some long-term care services, but only for specific populations and in specific circumstances.

Most forms of employer-sponsored or private health insurance, including Health Maintenance Organizations (HMO) or managed care, follow the same general rules as Medicare. If they do cover long-term care, it is typically only for skilled, short-term, medically necessary care. Therefore most people who need long-term care end up paying for some or all of their care on their own out of their income or assets.

There are, however, an increasing number of private payment options that help to cover the costs of long-term care services. These include long-term care insurance, reverse mortgages, and other options.

It is important to understand the differences among the public programs and private financing options for long-term care services. Each public program and each private financing source has its own rules for what services it covers, eligibility requirements, co-pays, and premiums.

2009-03-15T11:59:00.000-07:00

Where is Long-Term Care Provided?

Long-term care, often associated with institutional care, is provided in many different settings. But, most long-term care is actually provided at home – either in the home of the person receiving care or at a family member's home. It’s estimated that individuals currently turning 65 may need 3 years of long-term care in their lifetime, with almost 2 years of that care provided at home. The majority of care that is provided at home – about 80% - is provided by unpaid caregivers.There is also an increasing amount of long-term care available in the community through programs such as adult day service centers, transportation services, and home care agencies that often supplement care at home or provide respite for family caregivers.
For people who cannot stay at home, but who do not need the level of care provided in a nursing home, there are a variety of residential care settings, such as assisted living, board and care homes, and Continuing Care Retirement Communities (CCRCs). Nursing homes provide long-term care to people who need more extensive care, particularly those whose needs include nursing care or 24-hour supervision in addition to their personal care needs.

Caregivers

A caregiver is a family member, partner, friend, or neighbor who helps care for an elderly individual or person with a disability who lives at home. In 2004, there were more than 44 million caregivers age 18 or older in the United States - about 21% of the adult population – providing care for an adult family member or friend. Approximately 60% of caregivers are women. Thirteen percent (13%) of caregivers caring for older adults are themselves aged 65 or over. The typical caregiver is a 46-year-old woman who is married and employed, and is caring for her widowed mother who does not live with her.Caregivers provide a vast array of emotional, financial, nursing, social, homemaking, and other services on a daily or intermittent basis. A 2006 study of caregivers found that on average caregivers spend 21 hours a week giving care. Half of them have intensive caregiving responsibilities, performing at least one activity of daily living, such as bathing and feeding, for their care recipients. Twenty-six percent (26%) perform three or more of these activities. Eighty percent (80%) of caregivers perform activities like fixing meals, doing housework, and providing transportation to medical appointments.

Home and Community-Based Services (HCBS)

Home and community-based services (HCBS) describe a range of personal, support, and health services provided to individuals in their homes or communities to help them stay at home and live as independently as possible. Most people who receive long-term care at home generally require additional help either from family or friends to supplement services from paid providers. This is because so much of the care needed is personal care: help with activities such as bathing and dressing, help managing medications, or supervision for someone with a condition such as Alzheimer's disease.

Some of the most common home and community services are:

Adult Day Service (ADS) Programs, designed to meet the needs of adults with cognitive or functional impairments, as well as adults needing social interaction and a place to go when their family caregivers are at work. They provide a variety of health, social, and other support services in a protective setting during part of the day. Adult day centers typically operate programs during normal business hours five days a week; some have evening and weekend hours. These programs do not provide 24-hour care.

Case managers/geriatric care managers, health care professionals (typically nurses or social workers) who specialize in assisting you and your family with your long-term care needs. This includes, but is not limited to assisting, coordinating, and managing long-term care services; developing a plan of care; and monitoring your long-term care needs over extended periods of time.

Emergency response systems, which provide an automatic response to a medical or other emergency via electronic monitors. If you live alone, you wear a signaling device that you activate when you need assistance.

Friendly visitor/companion services, which are typically staffed by volunteers who regularly pay short visits (under two hours) to someone who is frail or living alone.

Home health care/home care are two different services, which may be provided by a single agency or separate agencies. Home health care typically includes skilled, short-term services such as nursing, physical or other therapies ordered by a physician for a specific condition. Home care services are most often limited to personal care services such as bathing and dressing, and often also include homemaker services such as help with meal preparation or household chores.

Homemaker/chore services, can help you with general household activities such as meal preparation, routine household care, and heavy household chores such as washing floors, windows or shoveling snow.

Meals programs, which include both home-delivered meals (so called “Meals-on-Wheels”) or congregate meals, which are provided in a variety of community settings.

Respite Care, which gives families temporary relief from the responsibility of caring for family members who are unable to care for themselves. Respite care is provided in a variety of settings including in the home, at an adult day center, or in a nursing home.

Senior Centers, which provide a variety of services including nutrition, recreation, social and educational services, and comprehensive information and referral to help people find the care and services they might need; and

Transportation services that can help you get to and from medical appointments, shopping centers and access a variety of community services and resources.

Facility-Based Long-Term Care Services

There are numerous types of facility-based programs that provide a range of long-term care services. Some facilities provide only housing and related housekeeping, but many also include help managing medications, assistance with personal care, supervision and special programs for individuals with Alzheimer's disease, or 24-hour nursing care. The services available in each facility are often regulated by the state in which the facility operates (for example, some states do not allow some types of facilities to include residents who are wheelchair bound or who cannot exit the facility on their own in an emergency). Facility-based care is known by a wide variety of names, including board and care, assisted living, adult foster care, Continuing Care Retirement Communities (CCRCs), and nursing homes.

Facility-based service providers include the following:

Adult Foster Care

Adult foster care can be provided for individuals or for small groups of adults who need help functioning or who cannot live safely on their own. The foster family provides room and board, 24-hour availability, help managing medications, and assistance with Activities of Daily Living. Licensure requirements and the terminology used for this type of facility vary greatly from state to state.

Board and Care Homes

Board and care homes, also called residential care facilities or group homes, are smaller private facilities, usually with 20 or fewer residents. Most board and care homes accept six or fewer residents. Rooms may be private or residents may share rooms. Residents receive meals, personal care and have staff available 24 hours a day. Nursing and medical attention are usually not provided on the premises. State licensure and the terminology used for this type of facility vary greatly.

Assisted Living

Assisted living is designed for people who want to live in a community setting and who need or expect to need help functioning, but who do not need as much care as they would receive at a nursing home. Some assisted living facilities are quite small – with as few as 25 residents – while some can accommodate 120 or more units. Residents often live in their own apartments or rooms, but enjoy the support services that a community setting makes possible, such as:
up to three meals a day;
assistance with personal care;
help with medications, housekeeping, and laundry;
24-hour security and onsite staff for emergencies; and
social programs.
The cost of assisted living varies widely, depending in part upon the services needed by the resident and the amenities provided by the facility. Assisted living is regulated in all states, however, the requirements vary.

Continuing Care Retirement Communities (CCRCs)

Continuing Care Retirement Communities (CCRCs) are also called life care communities. They offer several levels of care in one location. For example, many offer independent housing for people who need little or no care, but also have assisted living housing and a nursing facility, all on one campus, for those who need greater levels of care or supervision. In a Continuing Care Retirement Community, if you become unable to live independently, you can move to the assisted living area, or sometimes you can receive home care in your independent living unit. If necessary, you can enter the onsite or affiliated nursing home. The fee arrangements for CCRCs vary by the type of community. In addition to a monthly fee, many CCRCs also charge a one-time “entrance fee” that may be partially or completely refundable (often on the sale of the unit).
Nursing Homes

Nursing homes, also called Skilled Nursing Facilities (SNF) or convalescent care facilities, provide a wide range of services, including nursing care, 24-hour supervision, assistance with Activities of Daily Living, and rehabilitation services such as physical, occupational, and speech therapy. Some people need nursing home services for a short period of time for recovery or rehabilitation after a serious illness or operation, while others need longer stays because of chronic physical, health or cognitive conditions that require constant care or supervision.

2009-03-07T09:58:00.000-08:00

Para español lea más abajo

Dear Friends,

President Obama signed the federal stimulus plan to help states and their residents rebound from the current recession. Funding for health care is a significant part of the package. Washington State's share is expected to be $2.06 billion over the next two years. However, there is danger that lawmakers in Olympia will take the money with one hand, but then turn around and still make deep cuts to the health care safety-net with the other. That's just wrong. E-mail your legislators to demand that they use this new federal health care funding to stop cuts to the health care safety-net. We agree with President Obama when he said, "These funds are intended to go directly toward helping struggling Americans keep their health coverage." Now more than ever, we can not afford to weaken our health care safety-net programs such as the Basic Health Plan. This past Sunday, the Tacoma News Tribune ran a guest editorial outlining the need to ensure federal dollars from the economic stimulus go to strengthen our state health care programs. Take a minute to read it now, http://salsa.wiredforchange.com/dia/track.jsp?v=2&c=CADe3mKwrad6EiWUPy%2BGlSyKEMTT2jSo then e-mail your lawmakers. Wanna have an even bigger impact? Please join us next Wednesday, March 11, in Olympia to speak directly to your legislators about the need to strengthen our health care programs. This is your last opportunity to register, so sign-up today!

El Presidente Obama firmó el plan de recuperación económica para ayudar a los estados y la gente que vive en ellos para que puedan salir de la recesión en la que se encuentran. El dinero para la cobertura de salud es una parte significativa del paquete. La parte que el estado de Washington recibirá es $2.06 miles de millones en los próximos dos años. Sin embargo, existe el peligro de que los políticos en Olympia tomen el dinero con una mano y luego hacer recortes en los servicios de salud que son críticos para nuestras comunidades. Eso no lo podemos permitir. Mande un correo electrónico a sus legisladores para exigir que usen este dinero federal para cobertura de salud para detener los recortes a los servicios de salud. Estamos de acuerdo con el Presidente Obama cuando dijo que, "este dinero es para que vaya directamente a ayudar a los Americanos que están sufriendo para que mantengan su cobertura de salud." Hoy más que nunca no podemos permitir que los que los servicios y programas críticos de salud como Basic Health Plan sean debilitados. El domingo pasado el periódico Tacoma News Tribune publicó un editorial que habla de asegurar que el dinero federal que viene del paquete de estimulo económico vaya directamente a reforzar los programas de salud en nuestro estado. Haga un espacio en su tiempo para leerlo y mande un correo electrónico a sus representantes. ¿Gusta crear un mayor impacto? Venga con nosotros el próximo miércoles 11 de marzo en Olympia para que hable en persona con sus representantes sobre la importancia de reforzar nuestros programas de salud. Esta es su última oportunidad para inscribirse, ¡así que anótese hoy mismo!

With over 35,000 members across the state, Washington CAN! is the state's largest grassroots community organization. Washington CAN! fights for progressive social change at the local, state, and national levels, with a focus on issues that most directly affect the lives of Washington residents. Our mission is to achieve economic fairness in order to establish a democratic society characterized by racial and social justice, with respect for diversity, and a decent quality of life for those who reside in Washington State.

2009-02-28T12:57:00.000-08:00

What is Long-Term Care?

Long-term care is a variety of services that includes medical and non-medical care to people who have a chronic illness or disability. Long-term care helps meet health or personal needs. Most long-term care is to assist people with support services such as activities of daily living like dressing, bathing, and using the bathroom. Long-term care can be provided at home, in the community, in assisted living or in nursing homes. It is important to remember that you may need long-term care at any age.

You may never need long-term care. This year, about nine million men and women over the age of 65 will need long-term care. By 2020, 12 million older Americans will need long-term care. Most will be cared for at home; family and friends are the sole caregivers for 70 percent of the elderly. A study by the U.S. Department of Health and Human Services says that people who reach age 65 will likely have a 40 percent chance of entering a nursing home. About 10 percent of the people who enter a nursing home will stay there five years or more.
Medicare and Long-Term Care:

While there are a variety of ways to pay for long-term care, it is important to think ahead about how you will fund the care you get. Generally, Medicare doesn't pay for long-term care. Medicare pays only for medically necessary skilled nursing facility or home health care. However, you must meet certain conditions for Medicare to pay for these types of care. Most long-term care is to assist people with support services such as activities of daily living like dressing, bathing, and using the bathroom. Medicare doesn't pay for this type of care called "custodial care". Custodial care (non-skilled care) is care that helps you with activities of daily living. It may also include care that most people do for themselves, for example, diabetes monitoring. Some Medicare Advantage Plans (formerly Medicare + Choice) may offer limited skilled nursing facility and home care (skilled care) coverage if the care is medically necessary. You may have to pay some of the costs. For more information about Medicare Advantage Plans, look at the Medicare Personal Plan Finder.

Medicaid and Long-Term Care:
Medicaid is a State and Federal Government program that pays for certain health services and nursing home care for older people with low incomes and limited assets. In most states, Medicaid also pays for some long-term care services at home and in the community. Who is eligible and what services are covered vary from state to state. Most often, eligibility is based on your income and personal resources.

Choosing Long-Term Care:
Choosing long-term care is an important decision. Planning for long-term care requires you to think about possible future health care needs. It is important to look at all of your choices. You will have more control over decisions and be able to stay independent. It is important to think about long-term care before you may need care or before a crisis occurs. Even if you plan ahead, making long-term care decisions can be hard.

2009-02-23T16:30:00.000-08:00

HEALTH PROVISIONS IN THE AMERICAN RECOVERY AND REINVESTMENT ACT OF 2009: FREQUENTLY ASKED QUESTIONS

The American Recovery and Reinvestment Act of 2009 includes important investments in health information technology and in research on the comparative effectiveness of various health care tests and treatments. These investments will quickly grow jobs in the health care sector and eventually improve the quality of health care for every American. Unfortunately, incorrect rumors about these provisions and their likely effects threaten to undermine these good policies.

Following are the most Frequently Asked Questions – and accurate answers – about how health information technology provisions in the American Recovery and Reinvestment Act will work:

Health Information Technology

Q: What will the “National Coordinator of Health Information Technology” do?
A: Under this bill, the National Coordinator of Health Information Technology will set minimum standards for the technology systems your doctor may choose to store and maintain your medical records – making sure, for instance, that the systems are configured to keep your information from getting loose to the public, but still allowing your various doctors to share the information easily and confidentially. The coordinator will also work to support doctors and hospitals as they transition to electronic records. Actually, the Office of the National Coordinator of Health Information Technology is not even new. President George W. Bush created the office by Executive Order a number of years ago. The bill simply codifies the office and gives it a specific job.

Q: Will the health IT director have any influence on the decisions doctors and patients can make together about tests and treatment?
A: Absolutely not. This position’s function is to make sure that doctors and other health care providers use good, secure technologies as they change their record-keeping systems from paper to computers.

Q: Will the government have access to my electronic medical record?
A: No. Federal law makes your medical records – whether they’re on paper or in a computer – confidential to you and your health provider.

Q: What‟s the “meaningful use” of health IT? Does this bill say that my doctor has to use health information technology and provide only certain treatments to me, or risk a penalty from the government?
A: To improve the quality of American health care, it’s important for doctors and providers to move to an electronic system of records. This will reduce medical errors, improve efficiency, and help doctors for a single patient work together better to keep that patient healthy. The bill requires health providers to be “meaningful users” of health IT by 2015 – meaning, they have to have a system of electronic records to achieve these goals. This bill does not, however, require physicians to follow any particular treatment guidelines, protocols, or other research in order to meet the “meaningful use” standard. They just have to have electronic records by 2015.

Comparative Effective Research

Q: What is comparative effectiveness research?
A: Comparative effectiveness research compares clinical outcomes, or the “clinical effectiveness,” of alternative therapies for the same condition. More evidence on what works and doesn’t work can help patients and doctors make better health care decisions together, thus improving the quality of patients’ care, improving efficiency by focusing on what works, and ultimately saving money throughout the health system.

Q: Why should the government be doing this research?
A: Right now, much of health care research is funded by companies trying to sell a drug or treatment. The comparative effectiveness research provisions in the Senate economic recovery legislation are designed to allow unbiased research that simply gets the facts – and the provision will create jobs in the research sector as well.

Q: Can the government use the results of this research to tell me, or my doctor, what tests and treatments I can or cannot have?
A: Absolutely not. In fact, the Senate bill specifically prohibits the government from making any coverage decisions based on this research, or even from issuing guidelines that would suggest how to interpret the research results. The sole aim is to disseminate the results of the research to the public, so that patients and their doctors can make the best decisions for their specific situations, together.

Q: Will this bill allow the government to apply the results of comparative effectiveness research to deny me end-of-life care or medicines that I choose?
A: Absolutely not. In fact, the Senate bill specifically prohibits the government from making any coverage decisions based on this research, or even from issuing guidelines that would suggest how to interpret the research results. The sole aim is to disseminate the results of the research to the public, so that patients and their doctors can make the best decisions for their specific situations, together.

Q: Is there some kind of health care "czar" in this bill with access to this comparative effectiveness research and my electronic medical records, who might make decisions about what my doctor or insurance company can do about my medical treatment?
A: No. Comparative effectiveness and health IT are separate in this bill. There’s no crossover in the administration of these provisions, research, or technology.

2009-02-14T13:22:00.000-08:00

Legislative update

ESHB 1694 - the “pre-emptive” budget cutting bill that passed the House last week was heard in the Senate Ways and Means Committee on Wednesday, and while it has yet to be scheduled, it may see executive action this week. Thanks to all of you who have continued to communicate your concerns. In testimony before the Ways & Means Committee, the Washington Health Care Association pointed out that the proposed cuts go into effect in the last two or three months of the FY 2009, leaving very little time for providers to make adjustments to their budgets. WHCA continues to argue that providers will not be able to reduce payments for fixed operations costs. The only area of flexibility is in staffing where approximately 65 percent of the costs occur and the result will be layoffs and job losses that will impact direct care to the state’s most vulnerable. The job loss cannot help but impact unemployment costs, health care costs for the uninsured and put more stress on our food stamp and welfare programs, and comes at a time when the long term care industry is one of the few significant sectors of job growth in this country. WHCA also shared concerns with those Senators who do not serve on Ways and Means, and reminded them that the Obama economic stimulus package will result in millions of dollars of unanticipated federal matching funds from the nursing home and boarding home portion of the FMAP (Federal Medical Assistance Percentages), many times greater than the targeted $2.4 million GF-S (General Fund – State) cuts for nursing facilities and $375,000 GF-S cuts for boarding homes. It is important that we continue to remind legislators that these new resources make nursing home and boarding home rates cuts unnecessary.

Legislative discussions regarding both the 2009 Supplemental Operating Budget and 2009-2011 Biennial Operating Budget continue. This week, WHCA has a number of key meetings with legislators and legislative staff to discuss the enhanced FMAP revenues from the federal economic stimulus package. WHCA’s goal is to ensure that those monies are used to ensure stable and adequate funding. Nursing home and boarding home rates continue to fall short by over $18 per resident day, and the $92 million total funds cuts proposed in the Governor’s budget for nursing homes will have a detrimental effect on quality of resident care.

St. Francis wants to encourage you to continue your communications efforts with your legislators regarding all of these issues. As a reminder, you want to make sure that your communications are factual and non-aggressive in nature. While we may be disappointed in the vote of House members who voted in favor of budget cuts in ESHB 1694, it’s important that we avoid assessing blame for these actions. The leadership in the House is locked up in support of the proposed cuts until they have a better picture of the state’s revenue picture and the economic stimulus package. We have heard there may be an effort to backfill cuts with the enhanced FMAP dollars.

The supplemental and biennial budget proposals are slated for release following the March revenue forecast and caseload updates; then it will be more important than ever that your contact your legislators to oppose cuts to nursing homes and boarding homes.

Here is contact information for our elected officials:

Senator Dale BrandlandRepublican Whip(R) 42nd LEGISLATIVE DISTRICT
Olympia Office:203 Irv Newhouse BuildingPO Box 40442Olympia, WA 98504-0442(360) 786-7682Fax: (360) 786-1999
E-mail form: http://apps.leg.wa.gov/memberemail/MailForm.aspx?Chamber=S&District=42

Rep. Doug Ericksen(R) 42nd LEGISLATIVE DISTRICT
Olympia Office:425B Legislative BuildingPO Box 40600Olympia, WA 98504-0600(360) 786-7980
E-mail form: http://apps.leg.wa.gov/memberemail/MailForm.aspx?Chamber=H&District=42&Position=1

Rep. Kelli Linville(D) 42nd LEGISLATIVE DISTRICT
Olympia Office:204 John L. O'Brien BuildingPO Box 40600Olympia, WA 98504-0600(360) 786-7854
E-mail form: http://apps.leg.wa.gov/memberemail/MailForm.aspx?Chamber=H&District=42&Position=2

2009-02-08T13:18:00.000-08:00

Getting Enough Sleep

by Susan Churchill

According to the National Sleep Foundation (NSF), more than two-thirds of older adults suffer from sleep deprivation and many American adults don't get the minimum amount of restorative sleep needed to stay alert and maintain a healthy body.

Sleep is vital to good health and to mental and emotional well being. The NSF reports that people who don't get enough slumber are more likely than others to develop psychiatric problems and to use health care services. Sleep deprivation can negatively affect memory, learning, and logical reasoning. It puts stress on the cardiovascular and musculoskeletal system and makes us more prone to injuries. There is even new research that shows that successful weight loss occurs only if a person is getting enough sleep.

Not getting adequate sleep can also be hazardous and dangerous. More than one-half of adult drivers -- some 100 million people -- say they have driven drowsy in the past year, according to NSF polls. About one out of five of these drivers -- 32 million people -- say they've fallen asleep while driving. Each year drowsy driving causes more than 100,000 car crashes, 1,500 deaths, and tens of thousands of injuries, reports the National Highway Traffic Safety Administration.

To avoid the pitfalls of insufficient sleep, make sure to get at least 7-10 hours of slumber each night. Kids need more sleep, depending on their age. We all lead very busy lives and our chores and responsibilities sometimes seem endless. However, if you rely on cutting back on sleep to help accomplish more in your day, you are possibly setting yourself up for some serious health problems. Getting adequate sleep is a commitment and sometimes we have to plan it into our day just as we plan for meals, work and exercise. Sometimes it means shutting off the TV an hour early and simply going to bed. Providing your body with the amount of sleep it needs is an important step to a healthier life.

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Susan Churchill, PT, is Director of Therapy at St. Francis.

2009-01-31T11:02:00.000-08:00

8 Secrets of Successful Weight Loss
by Susan Churchill

Once you've lost weight, keeping it off actually gets easier with time, according to a new study that details the eight secrets of successful long-term weight loss. About one in five overweight people who try to lose weight are successful at losing at least 10 percent of their body weight and maintaining the weight loss for at least a year.

By studying these so-called "successful losers," researchers say they've identified eight common sense weight loss strategies critical to long-term weight loss success. In the study, researchers analyzed the weight loss strategies of the more than 4,000 members of the National Weight Loss Registry who lost an average of 73 pounds and kept it off for an average of five years.

A little more than half lost the weight with some help from a commercial weight loss program, doctor, or nutritionist. The other half did it on their own. Nine in 10 of them lost weight through a combination of diet and exercise, and only 10 percent did it through cutting calories alone.

In maintaining their weight loss, researchers say the successful losers shared eight major strategies.

1. Get Active and Stay Active. Men and women who have kept the weight off report a high level of physical activity. The most popular form of exercise is walking, followed by cycling, weight lifting, and aerobics. Women reported burning off an average of 2,545 calories a week in physical activity. Men reported an average of 3,293 calories per week. This is equivalent to about an hour a day of moderate-intensity activity, such as brisk walking.

2. Eat a Diet Low in Calories and Fat. Successful losers report consuming an average of 1800 calories per day with 24 percent of those calories from fat. The participants generally eat out less than 2.5 meals per week on average. They also averaged less than one meal a week in a fast food restaurant. Researchers say most people tend to underestimate their calorie intake. Keeping a journal and being dedicated to portion control are both strategies that were helpful in weight loss.

3. Don't Skip Breakfast. More than three-fourths of the registry members eat breakfast every day, and only 4 percent say they never eat breakfast. A typical breakfast is cereal and fruit. Eating breakfast can increase your metabolism, helping you burn more calories during the day. It also helps avoid overeating later in the day.

4. Hit the Scales. Catch 'Slips' before they turn into bigger problems. Successful losers report weighing themselves regularly (44 percent weigh themselves daily and 31 percent hit the scales once a week). The researchers write that frequently checking your weight allows you to catch small weight gains and hopefully take steps to correct them. Gaining a couple of pounds here and there was common among registry participants. But those who were able to prevent an extra pound or two from adding up were more likely to maintain their weight loss successfully over the long term. Only about one in 10 successfully recovered from a weight gain of more than two to four pounds.

5. Maintain a Consistent Eating Pattern. Most registry members say they eat the same way on weekdays and weekends. About four in ten are stricter about dieting during the week than on the weekends and about half are stricter during non-holiday times than on holidays. The researchers did find that people who were consistent about their diet were more likely to keep the weight off.

6. Drink Water. Sipping water before and during meals helps successful losers eat less and feel full.

7. Graze, don’t gorge. Eating smaller, more frequent meals keeps blood levels from dipping and spiking and overall results in consuming fewer calories throughout the day.

8. Commitment over time. Dedication to the fact that there is no “quick fix”. There are no short cuts to permanent weight loss. Losing weight, like any other goal takes dedication and hard work. But successful losers reported that after 8-12 months they found they were in a rhythm that was not difficult and the results were well worth the work and commitment.

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Susan Churchill, PT, is Director of Therapy at St. Francis.

Budget cuts threaten long-term care

2009-01-16T16:23:00.000-08:00

Dear Families and Friends of Our Residents:

We need your help. You are a vitally important advocate for our residents and staff, and we’d like to invite you to become involved in the legislative process this year. The session began on January 12, 2009, in Olympia We are asking you to actively advocate for long-term care funding.

Governor Christine Gregoire has released a proposed budget that will be devastating to Medicaid recipients in long-term care. While this is only one step in the state’s budget development process, it is imperative that your legislators keep the commitment to our seniors by fully funding Medicaid care and services.

Our lawmakers need to hear that quality, affordable long-term care is important for all Washington citizens. Adequate funding is essential if seniors are to receive the care they deserve. Continued underfunding drives high staff turnover, which has impacts both financially and in the quality of care. When the state fails to adequately fund its Medicaid program, there is a financial impact on people who have planned to pay for their own care.

We all have a stake in this discussion. Please join us in holding our legislators accountable.

1) Provide us with your e-mail address so we can keep you informed about legislative actions that will impact Medicaid recipients in long-term care.

2) E-mail our district legislators with a message to keep the commitment to quality long-term care in Washington nursing homes and assisted living communities. We have enclosed a sample message for your ease of communication.

3) Call the toll-free legislative hotline – 1-800-562-6000 – and ask them to fully fund long term care.

4) Write a letter to the editor of your local newspaper in support of long-term care funding and a sustainable care system.

Here is contact information for our elected officials:

Senator Dale Brandland, Republican Whip (R) 42nd LEGISLATIVE DISTRICT
Olympia Office:
203 Irv Newhouse Building
PO Box 40442
Olympia, WA 98504-0442
(360) 786-7682 Fax: (360) 786-1999
E-mail form: http://apps.leg.wa.gov/memberemail/MailForm.aspx?Chamber=S&District=42

Rep. Doug Ericksen (R) 42nd LEGISLATIVE DISTRICT
Olympia Office:
425B Legislative Building
PO Box 40600
Olympia, WA 98504-0600
(360) 786-7980
E-mail form: http://apps.leg.wa.gov/memberemail/MailForm.aspx?Chamber=H&District=42&Position=1

Rep. Kelli Linville (D) 42nd LEGISLATIVE DISTRICT
Olympia Office:
204 John L. O'Brien Building
PO Box 40600
Olympia, WA 98504-0600
(360) 786-7854
E-mail form: http://apps.leg.wa.gov/memberemail/MailForm.aspx?Chamber=H&District=42&Position=2

Sample letter/e-mail:

Dear (Representative/Senator),

As the (daughter, son, spouse, etc.) of a resident in one of Washington’s nursing homes, it is important to me that you understand that our seniors need your help during this legislative session. The Governor’s proposed nursing home budget cuts may lead to closure for some nursing homes. For others, it will mean a significant reduction in capacity to assure health, safety and quality of care for residents.

A stable, quality system of long-term care is good for residents, workers, and all of us who may someday need nursing home care. Cuts in funding now will have long-term consequences on our ability to meet the needs of the elderly population.

The Legislature has promised to protect our state’s most vulnerable citizens. Please confirm your commitment to quality care and do what is necessary to assure access for Medicaid residents in nursing homes.

Please let me know how you stand on this issue.

Thank you,

(Name)

Thank you for your help and support.

Tonja Myers,
Administrator