Study: Communication Gap Exists Between Elderly and Their Children

Published in the Pawtucket Times on May 21, 2001

Everyone knows that communication gaps oftentimes occur between teenagers and their parents. According to the findings of a newly released AARP study, this problem also occurs in the later years too, between elderly parents and their adult children.

The AARP study found that most adult children never talk with their elderly parents about their aged-related needs until a crisis occurs.

Of those surveyed, two out of three adult children have never had this conversation with their aging parents.

Additionally, the findings indicated that more adult children and their older parents believed that their parents had a problem that affected their independence.

Moreover, the researchers say that the elderly parents are more than twice as likely as their adult children to say that their offspring had given them no help when they had a problem in the past five years.  While many elderly parents would seek information f rom their adult children about how to live independently, one in three adult children don’t know what type of information to give their parents or even where to locate it.

Grace Lebow, Co.-Director, of Aging Network Services, a nationwide care management service based in Bethesda, Maryland, believes “it’s never too late to open up communication with your elderly parents.”

However, “Many aging baby boomers find it difficult to see their parents age and become less parental to them,” states the clinical social worker specializing in working with older persons.

“Sometimes both older parents and grown children will think they are protecting each other by not addressing delicate subjects such as finances, wills, medical, durable power of attorney, and prepaid funerals,” Lebow tells The Times.

“The longer you avoid discussing these sensitive issues, the harder it will become when a future crisis occurs.”

Adult children often complain that their parents avoid or even refuse any discussions. Meanwhile, even if elderly parents are willing to talk with their adult children, oftentimes it’s the aging baby boomer children who are the ones who are in denial,” Lebow says.

“The adult children must become more receptive to listening to their signals instead of changing the subject and turning off the conversation.” She urges the aging baby boomers to tune in and pick up the parent’s lead.

For both generations, Lebow calls each to “listen to each other and become open for discussion.”

Sometimes a sibling might block needed conversations about age-related issues.

To circumvent this obstacle, consider writing a letter to this sibling and to the elderly parent, Lebow recommends, stating your feelings and how important you consider holding a family meeting to discuss your older parent’s needs.

Or consider bringing in the family friend or professional to get the dialogue jumpstarted, Lebow adds.

“It may even take the personal experiences of a friend of the parent to bring the issues home to both the elderly parent and adult children.”

Professionals, like family physicians or lawyers, who the older person trusts might be brought into the communication impasse as an alley to discuss the importance and the need for taking steps such as signing a living will, durable power of attorney or the need for prepaid funerals.

Aging specialist Nora Jean Levin, quoted in AARP’s brochure “Family Conversations that Help Parents Stay Independent,” notes that a conversation can help “plan for the future.”

She recommends working with older parents to create personal and financial profiles, including information such as the parent’s Social Security numbers, insurance coverage, medical records, and financial status.  By gathering this information, you might uncover current or potential needs for help.

As your older parent’s health and financial needs continue to change over time, continue to keep up your conversations on a regular basis.

To receive a pamphlet, “Family Conversations that Help Parents Stay Independent,” call Betsy L. Draper, of AARP, at 617 723-7600; or for information on Aging Network Services or to order a copy of Coping with Your Difficult Older Parents: A Guide for Stressed Out Children, by Grace Lebow & Barbara Kane, call 301 657-4329.

Scully Selected to Head Federal Health care Agency

Published in the Pawtucket times on May 14, 2001

Thomas A. Scully, a Washington, D.C.-based health care association executive who holds a law degree from Catholic University and has previous experience on Capitol Hill as a senate staffer and as a high-level White House official, has been tapped by the new Bush administration to run the Health Care financing Administration (HCFA), the federal agency providing health care to 74 million Medicare, Medicaid and the State Children’s Health Insurance Program.

The nomination of Scully, president and CEO of the Federation of American Hospitals, a trade group that represents 1,700 for-profit hospitals, went to Capitol Hill in early May.  When confirmed as HCFA administrator by the U.S. Senate, Scully will replace Nancy Min DeParle, who left last October for a teaching stint at Harvard University. With her departure, a string of acting directors temporarily took the reins of the federal agency.

At press time, Jill Kozney, a spokesperson for Chairman Chuck Grassley of the Senate Finance Committee, stated that a confirmation hearing has not been scheduled yet. “Not every piece of paper work is in, but the chairman would like to act on the nomination as soon as possible,” the Senate staffer says.

A Washington Insider

As Washington insider, Scully brings a potpourri of health policy experiences to HCFA. The health care association executive comes with legal expertise gleaned from his legal practice, which focused on regulatory and legislative work in health care. Scully also brings an understanding of the intricacies of Capitol Hill, gained by serving as a staff assistant to U.S. Senator Slade Gorton (R-Wash.), and as associate director of the White House Office of Management and Budget (OMB) and later as deputy assistant to the president and counselor to the director of OMB under the senior Bush administration.

Ties to the former Bush administration were forged when Scully served on the communications staff of the Bush-Quayle campaign in 1988 and as deputy director of the congressional affairs for the president-elect’s transition team.

“Scully is smart, quotable, and politically savvy,” says Edward Howard, executive vice president of the Alliance for Health Care Reform. “He’s described as a problem solver rather than an ideologue,” Howard adds.

Howard expects Scully to turn his attention to internal problems at HCFA, because the agency has “substantial management problems.” He notes that HCFA has lost a number of good people and Congress will most certainly give the agency new tasks to handle.

“At least Scully will not have to spend one and a half years to learn about the programs he supervises, because he knows them well with his past OMB experience and at the Federation of American Hospitals,” Howard adds.

Bill Benson, former deputy assistant secretary for aging and president of the Maryland-based Benson Consulting Group, warns “Don’t look for Scully to, be much of a consumer advocate,” because he will be sympathetic to providers because of his ties to the hospital provider community.

“That does not mean Scully’s going to be in any position to get hospitals any more money but he will be more attuned to less regulation and more flexibility in rules, and regulations or health care providers,” Benson states.

According to Benson, one of Scully’s first tasks will be to carry out Health ad Human Service Secretary Tommy Thomson’s wish to reorganize HCFA because “this agency is one that everyone loves to hate, especially Republicans.”

Providers Rally Around Scully

Meanwhile, provider groups give thumbs up to Scully’s nomination as HCFA administration.

“Tom Scully has a unique combination of both real-world perspective and public service experience,” states Rick Pollack, executive vice president of the American Hospital Association. “That makes him a great choice for HCFA administrator.”

“From crafting Medicare regulation and budgets to building strong relationships with lawmakers on both sides of the aisle, Tom has the right mix of knowledge or the job,” Pollack adds.

In a letter being distributed to U.S. senators, who must vote to confirm Scully, Dr. Charles H. Roadman, II and AHCA Legislative Counsel Bruce Yarwood states: “As HCFA administrator, Tom Scully will have the responsibility for leading dramatic change.”

The opportunity for HCFA reform is the brightest it’s been in years,” Roadman predicted, expressing confidence that the controversial survey and enforcement apparatus will be closely scrutinized by Scully and the Bush White House.

In a public statement, the American Association of Homes and Services for the Aging’s senior vice president Suzanne M. Weiss states that her nonprofit provider group looks forward to working with the new HCFA administrator.

“As we look for ways to improve the current nursing home and inspection and enforcement system and reimbursement system.  We hope Mr. Scully will be o pen to our efforts in his new position,” Weiss says.

The Best Of…Day Services Help Seniors Stay at Home

Published on May, 7, 2001, Pawtucket Times

            Like apples and oranges, senior centers and adult day care are quite different.  But when viewed as complementary community-based services, each can be instrumental in keeping elderly Rhode Islanders independent and at home.

           While senior centers serve the independent older population, programs and services provided by adult day care centers are specifically designed for functionally or cognitively impaired adults.

          Senior centers can serve as “brokers” between the elderly and the surrounding community, creating access to a wide variety of programs and services, states Rick Ryan, former chair of the Washington, DC-based National Institute for Senior Centers and director of senior services for South Kingstown.

        According to Ryan, some people today still believe the myth that senior centers are drop-in centers or “play pens for the frail aged where persons are spoon-fed programs and services.”  Not true, he says.

        “Indeed we have come a long way,” Ryan noted, stating that “senior centers are not developed through a cookie cutting process.”  Programs across the nation are as varied and diverse as the older population that they serve.  In fact, he says, senior centers evolved in response to their surrounding communities and reflect the interest and values of those older adults who not only participate in their programs, but also help shape them.

        For those participating, Ryan stated hat senior centers offer a menu of activities, with older participants being allowed to develop and design their own programs. Activities can range from computer labs offering Internet access, yoga, line dancing, aerobics, playing cards, art classes or even shooting pool.

         Since the early 1970s, adult day care centers have existed. According to the National Association of Adult Day Services in Washington, DC., here are more than 3,000 adult day care centers currently operating nationally.

         “There are 16 state-certified adult day care centers in Rhode Island,” noted Ryan, who also is a member of the Rhode Island Adult Day Services Association, a group representing programs in all of the state’s 39 cities and towns.

         Ryan stated that adult day centers provide a comprehensive planned program of health, social and support services in a protective setting during daytime hours.  “Activities include mental processing programs such as current affairs and word association games to stimulate thinking more physical activities like volleyball, dancing and range of motion exercises.”

         Services at adult day centers are specifically designed to meet the individual needs of the elderly and strongly focus on ways to help relieve the stress of the caregivers.  Such programs are critical in assisting caregivers to maintain their loved ones at home in the community.

       Adds Sharon Rice, director of the Comprehensive Day Care Center, a program of the Jewish Seniors Agency, “One of the most important factors of a day care program is that adult children taking care of elderly frail parents don’t have to worry about how they can take care of their parents, work a full-time demanding job while caring for their children.”  She noted that most adult children prefer to have their parents “age in place” at home rather than have to institutionalize them in a nursing home.

   According to Rice, today’s day care centers in Rhode Island have undergone vigorous licensing procedures through the state’s Department of Elderly Affairs to ensure quality.

          Ensuring quality through licensure can increase the adult children’s willingness to place his or her parents in an adult day care program, she said.

         Currently, Rice states there are 30 frail elderly persons enrolled in her day care program, attending each day.  Although located in Wayland Square on Providence’s East Side, Jewish Seniors Agency program, established in 1974, also serves East Providence and nearby Pawtucket.

         Keeping a person at home is not always the best option. Rice says, because the older person becomes isolated. “Day care can promote friendship, social interaction and therapeutic activities,” she added.

        “Person with Alzheimer or related-dementia, Parkinson’s disease or  who have suffered strokes receive supportive services at the day care center from a registered nurse, a professional social worker, and a certified nursing assistant,” Rice added, noting that participants also are served kosher meals.

      When adult children are faced with care giving responsibilities for their loved ones they do have a choice – to keep the person at home and not in a nursing home, Rice quipped.  “Adult children should feel comfortable in knowing that they can keep a frail elderly family member at home and in the surrounding community.

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