Rhode Islanders Will Benefit for Long-Term Care Improvements

Published in Pawtucket times on April 5, 2004

An AARP membership application just arrived last week, inviting me to join the nation’s largest senior advocacy group.

AARP’s invitation to join clearly announces my major milestone in my life, when my June birthday officially pushes me into my 50s.

Celebrating my 50th birthday is no problem for me on a personal level, especially with my philosophy that, as with wine, one gets better with age.

But, as a writer on health care and aging issues, I see problems as to how I might access needed home and community-based services or nursing hoe care in my later years, especially if the state does not fix its problematic long-term care deliverly system.

The graying of Rhode Island’s population is taxing the state’s existing long-term care delivery system and will continue to do so for years to come. In response, state policymakers have taken a Band-Aid approach in trying to fix the fragmented system.

Already the Ocean State’s senior population, ages 60 and over, comprises more than 18 percent of the state’s total population. Gov. Don Carcieri and state lawmakers should be very concerned that Rhode Island’s population continues to age at the same time its long-term care delivery system needs an immediate overhaul.

Everyone knows it is extremely difficult for caregivers and seniors to negative the Ocean State’s long-term care system. Just ask any aging baby boomer (persons born between 1946 and 1964), and many will say that it is extremely difficult to find the needed programs and services to k eep mom and dad at home.

Today, many adult children who are juggling careers and raising children are also shouldering additional caregiving responsibilities to their olde parents. Even if their parents have been able to put a little money aside for their retirement, their children see their inheritance quickly being whittled down by thousands of dollars a month, all spent on costly pharmaceuticals and long-term care services.

Money can buy you anything in life, including home and community-based care and nursing home services.  Staying independent at home is still difficult for may moderate-income Ocean State seniors who cannot pay or find providers , especially with the Department of Elderly Affair’s (DEA) co-pay program not being fully-funded.

DEA’s co-pay program aids more that 1,500 frail seniors who do not qualify for the state’s Medicaid program, but who require ongoing services to remain in their homes. This funding helps pay for certified nursing assistants, who assist seniors with bathing, meals, shopping, laundry and light house keeping. DEA’s co-pay program slso provides subsidies for adult day care.

Last October, DEA’s freeze on new admissions to its co-pay program left more than 200 frail seniors on a waiting list for home and community based services.

While Gov. Carcieri recently gave an additional $ 200,000 in funding to DEA’s co-pay program in his 2005 budget, senior advocates have warned this amount is not enough. It is estimated this additional funding will serve 60 to 80 seniors out of the 200 persons currently on the waiting list.

Meanwhile, DEA has even put a freeze on new admissions to its respite program, which enables caregivers to take a break from the grueling physical and psychological demands of taking care of a frail elderly family resident.  This freeze will continue for the rest of this fiscal year, and nobody is sure how long the freeze for this initiative will last.

Hugh Hall, chair of the R.I. Health Care Association, tells All About Seniors that nursing homes will also be especially hit hard as state funding continues to diminish at the same time as  the cost of services and regulatory requirements increases.

“The state’s budget crisis is causing the governor to not meet a commitment in restructuring an antiquated Medicaid reimbursement system that pays for the care provided to 75 percent of the 10,000 frail residents in nursing homes,” said Hall.

This year, Carcieri, citing budgetary constraints, did not keep his promise to move forward with Part Two of the Medicaid reimbursement restricting, said Hall.

“This will have serious effects on the financial viability and quality of care provided in more than 70 small nursing homes throughout the state,” he said.

The huge budget deficient will continue to force Carcieri’s and state lawmakers hacking of many worthy programs and services previously funded in the state budget.  However, the state’s 2005 budget must adequately fund DEA’s co-pay and respite initiatives that keep frail seniors at home in their communities through the use of less costly home and community-based services.

The state must also keep its promise to adequately fund the state’s nursing homes for providing the needed medical care to those who are too sick to stay at home.

Hopefully, in 15 years, when I reach my next milestone – turning 65 – the state policy makers will have hammered out a much improved long-term care delivery system.

A commitment by Carcieri and state lawmakers to fix today’s fragmented long-term care delivery system will have long-range consequences, ultimately beneiting aging baby boomers, their children, and their children’s children.

Indeed, all future generations in this state will ultimately benefit from sound long-term care policy.

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.

Alzheimer’s News often Confusing to Interpret

Published in Pawtucket Times on March 26, 2001

Everyday hundreds of thousands of caregivers scan newspapers, senior papers, Time, Newsweek, Modern Maturity or even National Enquirer in hopes of learning a little more about new, effective treatments for Alzheimer’s Disease.

Oftentimes it is confusing to determine which treatments are promising and which ones that are not, due to the diverse opinions in the research community. For instance, one article might report on Vitamin E; others might state how Ginko really improves your memory and is good for Alzheimer’s patients to take. Others might describe studies that indicate that estrogen replacement therapy is not really an effective treatment for Alzheimer’s Disease for some women. Or some might even warn the reader “Don’t eat off of aluminum plate

s” because research seems to indicate that an accumulation of heavy metals, such as aluminum, in the brain may surely cause Alzheimer’s.

Here are some helpful tips for unraveling the mysteries of Alzheimer’s Disease as reported in media.

Beware of glitzy headlines. Time limitations keep people from reading every article in their daily, weekly or monthly newspapers. As a result, many readers just quickly scan the headlines for information. Don’t judge an article by its glitzy title. The content of an article is much more balanced than the headline that is catchy and written to draw the readers in.

Look for authoritative commentary. You can consider an article more credible when it provides multiple quotes on the indications of an Alzheimer’s treatment. The reporter has done a good job in reporting if there is authoritative commentary on the significance of the study.  Two likely sources might be staffers from either the National Alzheimer’s Association  or the National Institutes of Health, a major funder of Alzheimer’s research studies.  Remember that the National Alzheimer’s Association’s point of view tends to be less biased and a more reliable opinion that those of researchers that have ties to a pharmaceutical company that issued the press release.

Disputes on findings. Keep in mind that even if a research study is reported there might be those persons who believe that the study is not well designed or has major research flaws. On the other hand, the study might just be accepted by the scientific community as a solid study. However, there might still be serious disagreements about how to interpret the results or how to classify it. Some researchers might consider it a major study while others would categories it as a minor one.  A well-researched article will include the quotes of those who oppose the findings.

Are you still confused by how to cull articles for tips on safe and effective treatments for Alzheimer’s? Where do we go from here? Caregivers should view any articles written about new Alzheimer’s treatments as informational in nature. The article can open the door to the researcher community and it now becomes your responsibility to do homework and find out more details about what the research findings indicate.

If the article describes the results of an actual published research study, obtain the scientific journal with the published study and carefully read it. If the findings are reported from a presentation at a conference, attempt to track the researcher down for more information.  Finally, cruise the Internet and check out the official Web sites of the Alzheimer’s Association or the National Institute of Aging to determine if they can provide information about a reported new treatment.

Finally, don’t hesitate to call your local chapter or the National Alzheimer’s Association to solicit their comments. They will gladly share all the information they have. Remember these groups closely monitor research studies and their implications for treatment.