The Best of…Call the Samaritans for a Shoulder to Lean On

Published on December 24, 2001, Pawtucket Times

Chestnuts roasting on the fire. Green wreaths with red ribbons. Soothing Christmas music coming from speakers in shopping malls. Houses decorated with long strands of brightly colored lights. Decorated evergreen trees.

Got the Christmas spirit? Many do, but many don’t, especially if they are seniors.

With Christmas tomorrow, not everyone is feeling the holiday spirit. The holidays may be a very difficult time for seniors, particularly the elderly who have lost spouses and friends, have painful chronic illnesses or feel isolated or powerless, says Cynthia Barry, M.S.W, executive director of the Mental Health Association of Rhode Island. At this time “some may feel depressed and even suicidal.”

Even drinking during the holidays can put seniors at a higher risk of experiencing depression and thinking about suicide, Barry adds.

But the stigma of mental illness will keep older persons from seeking out needed treatment for their depression or suicidal thoughts, Barry says. Those who feel that they have a problem with depression should visit their local mental health care, neighborhood health canter, the family physician or even private practitioners re commended by their health plan, she says.

Carolyn Pellegrino, deputy director of Self Help, Inc., a nonprofit community action agency in the East Bay that provides senior case management to all upper East Bay communities and both Pawtucket and Central Falls, , notes that 60 percent of her older clients usually involve persons who just worry to those experiencing severe clinical depression.

“There’s a lot of depression out there,” Pellegrino says, adding that today’s seniors, who grew up in a different era, were told not to dal with their feelings of depression, “just get on with your life.”

Although depression, like heart diseased, is an illness, seniors will get treated for their heart disease, but not their depression, Pellegrino says. Oftentimes, a combination of medication and therapy can do wonders about a person’s depression, she states.

A newly released Public Service Announcement (PSA) tells seniors to seek out another resource to fight the holiday blues. Last week, WHJJ and B101 played a PSA featuring well-know songwriter Bill Withers who, after singing a few lines of his popular song, “Lean on Me,” urges his radio listeners “feeling low with nowhere to turn to contact The Samaritans.”

Directed to the lonely, the depressed and suicidal, the PSA is intended to raise the awareness of the existence of The Samaritans of Rhode Island, a nonprofit program dedicated to reducing the occurrence of suicide by reaching out to the despairing and lonely.

Denise Panichas, serving as The Samaritans’ interim executive director states the communication-based program, established in Providence in 1979, teaches volunteers to effectively listen to people who are in crisis. Conversations are free, confidential, most important anonymous.

A rigorous training program teachers volunteers to feel and think without expressing personal judgements or opinions, Panichas says, noting that the listening technique, called “befriending,” calls for 90 percent listening and 10 percent talking.

Last year, more than 20,o00 Rhode Islanders called The Samaritans, Panichas said. The Samaritans, Panichas said. “It doesn’t matter what the problem is, be it depression, suicidal thoughts, seeking resources for mental health services in the community or being lonely and just needing to talk,” she said.

Panichas notes that The Samaritans also offers other needed resources to caregivers and older Rhode Islanders. “We do community education programs and also have our peer-to-peer Safe Place Support Group for those left behind by suicide.

For seniors who are looking for something to do with their time, the art of “befriending” is something that anybody can do. Becoming a compassionate listener to someone in need.

Herb Weiss is a Pawtucket-freelance writer who covers health care, aging and medical issues. He can be reached at hweissri@aol.com.

Presidential Commission Kicks off Social Security Reform Debate

Published in Pawtucket Times on December 17, 2001

Amid the nation mobilizing for a global fight against terrorism, a sliding economy with a rising unemployment rate, the President’s Commission to Strengthen Social Security last week released its bipartisan plan to fix the ailing Social Security program.

With elections looming next year, Congress will be forced to turn it attention to politically sticky domestic issue, how to modernize and restore the fiscal soundness of the Social Security program.

Finishing up its seven months of work, the 16-member Presidential Commission, divided evenly among Democrats and Republican, voted unanimously to sent its 165-page final report in draft form to the Bush White House. Two days after the panel released its report, House Republicans threw two bills into the legislative hopper, mirroring several of the recommended approaches. The Social Security debate has begun.

While the Commission estimates that it will cost at least $2 trillion to revamp Social Security, it does not identify where the funds will come from.

Specifically, three approaches were suggested by the federal panel as a way of bringing reforms to the Social Security program. All involved the creation of voluntary personal accounts with a premise that workers investing in these accounts would ultimately receive higher retirement benefits by their investing in the social market. Meanwhile, two plans seek provide better retirement benefits by their investing in the stock market. Meanwhile, two plans seek to provide better benefits to low-income workers. All plans would seek to restore the fiscal stability of Social Security.

Senior advocacy groups are now weighting in on this highly visible and controversial policy issue that will likely become a key election issue next year. “None of the three draft plans put forward by the Commission today achieves the goal set out by the President, closing the gap in the program’s solvency over the next 75 years. None of the plans explain how it will achieve solvency. These plans do not change the fact that private accounts expose future beneficiaries to unnecessary risk and widely varying outcomes in retirement security,” charges Max Richtman, executive director of the National Committee to Preserve Social Security and Medicare.

Furthermore, with the push to privatization through individual accounts, the Commission does not address the issue of the impact to the existing Social Security program if moderate and higher-wage earners pull their money out of the system, states Richtman, stressing that the Commission does not see to have considered the potential impact of such an adverse selection on the stability of the program.

“With privatization, the devel is always in the details, and the Commission has failed to provide adequate details,” Richtman adds. ”They have not provided the nuts and boots of how the plans would work and how they would affect real people.”

According to AARP CEO William Novelli, a number of questions remain unanswered by the Commission report, specifically, “the long-term financing of benefit guarantees, particularly if current budget projects and market rates of return prove to be overly optimistic.”

When the Social Security debate begins, Novelli calls for other reform proposals to be considered, such a diversifying the Social Security Trust Funds’ investments by including federally-backed debt instruments, along with raising the wage base for payroll taxes and adding newly hired state and municipal employees to the program.

U.S. Rep. T. Matsu (D-CA), Ranking Member of the Social Security Subcommittee of the House Ways and Means Committee agrees with the concerns of senior advocates. Restoring solvency of the Social Security program by workers investing part of their payroll tax in the stock market is a flawed approach and not the best strategy to restore the fiscal integrity of the Social Security program, he says.

Privatization of Social Security would either require benefit cuts or a large infusion of federal dollars, warns U.S. Rep. Patrick Kennedy (D-RI), who serves on the House Appropriations Committee and sits as a member of the House Aging Caucus.

The Rhode Island Democrat who gives the Commission report a thumbs-down, states, “There is no question that we need to encourage American’s to save more for retirement, but while we do this, we should not throw the ‘baby out with the bath water’ by raising the retirement age, diverting the Social Security Trust Fund into privatization schemes or cutting benefits to seniors.” The four-term Congressman, whose legislative district has a large elderly constituency plans to make Social Security reform a key for his campaign in the upcoming elections next year.

Jeff Neal, a spokesperson for U.S. Sen. Lincoln Chafee (R-RI), tells All About Seniors that the senator does not necessary support or oppose some amount of privatization. “No amazingly specific proposal has come forward, been debated or has been thoroughly analyzed yet, Neal says. “Until that happens, it is impossible to determine if it is a good idea or not.”

Neal adds that Sen. Chafee believes that all the Democratic concerns need to be debated and resolved before Congress goes forward with any plan. “Democratic talking points look at the Commission work as a very simplistic level. Social Security is possible, besides the Medicare program, the most complex federal program, and a great deal of debate and input from both sides will be needed to tackle the solvency issue,” he says.

“Rhode Islanders need to step up and take credit for being leaders in the best social reform, notably Medicare,” urges AARP Executive Director Kathleen S. Connell. The late Democratic Congressman John Fogery and Aime J. Forand were the moving forces to create the is key federal program to protect the health and well-being of America’s seniors. “It is up to the current Rhode Island delegation to pick up the torch and lead the efforts to enact meaningful legislation to preserve and protect the Social Security program.”

The Best of…Research Confronts Nursing Homes’ Pain-Management Problems

Published December 10, 2001, Pawtucket Times

Nobody says that old age is easy, especially for those who ultimately end up being admitted into a nursing facility. And for those residing in facilities, there is a very high probability of being in pain, Brown University researchers say. One of the first nationwide research studies reported in the Journal of the American Medical Association last April that pain is “prevalent, persistent and poorly treated in nursing facilities.”

According to the JAMA study, nursing facilities across the country provided “woe-fully inadequate pain management” with a large majority of the residents ultimately experiencing excruciating severe pain just months after admission. Furthermore, the researchers acknowledged that the study results may even “underestimate the actual pain burden.

The study noted that for those able to report on their pain, the rate of persistent pain in Rhode Island facilities was 46.4 percent. Nationally, the rate is 46.7 percent. For those in pain, persistent pain left untreated experience impaired mobility, depression, and a reduced quality of life, the researchers say.

The Rhode Island Quality Partners, Inc., Brown University Researchers and 18 Rhode Island nursing facilities came together last year to confront this issue by improving how nursing facility residents are assessed for pain and how pain is managed. At a press conference held last month, it was reported that all facilities participating had put into place pain policies and procedures, which included both the use of medication management and non-drug interventions like massage, music and aroma therapies and heating packs.

During the 15 month study, the participating nursing facilities attended two-hour educational seminars each month. The seminars were conducted by the project partners and, with the assistance of nurse facilitators, each facility began to develop pain policies and procedures, and worked with the project partners to implement the treatment protocols.

Preliminary findings show a nearly 10-fold increase in the rate of comprehensive assessment of pain among the 18 nursing facilities, as well as a five-fold increase in the use of pain intensity scales to monitor the resident’s pain. Translation. Nursing facility residents benefited from the facility’s efforts to confront this care issue.

“Some Rhode Island facilities watch previously inactive residents begin to participate in a variety of activities. Others found that residents could cut back on some of their medications once their pain was well controlled,” stated Dr. David R. Gifford, principal clinical coordinator with Rhode Island Quality Partners.

“Nursing facilities were able to get together, share and work closely with each other to try to improve pain management, despite the staffing shortages, inadequate Medicaid reimbursement despite all the other regulations they are trying to comply,” Gifford told All About Seniors. “The participating facilities deserve credit for putting the time and resources into the project to improve an area of care that every one is concerned about, that is inadequate pain management.”

“Both scientific and professional literature clearly tell us that pain management has been an area that can be controlled but it has not been,” states Wayne Farrington, Chief, Facilities Regulation, at the State’s Health Department. “Sadly nursing facility residents have been living with unnecessary pain and implementing the best practices that were determined by this research project will greatly enhance the quality of life in 103 Rhode Island facilities.”

Hopefully, the states nursing home industry will disseminate the methods and practices identified as being successful by this research project to every facility in the state. At least in Rhode Island, nursing facility residents should not be suffering from unnecessary pain.

Herb Weiss is a Pawtucket, Rhode Island-based writer covering aging, health care and medical issues. This article appeared in December 10, 2001 in the Pawtucket Times. He can be reached at hweissri@aol.com.