Do You Need a Geriatric Care Manager?

When my mother had dementia and I helped her age at home, I basically did everything myself. I coordinated all the care. I didn't know about geriatric care managers. I did get help from Family and Children's Aid (as it was called then), who sent the Visiting Nurse to my mom once a month and provided an incredible home health aide.

Today, many families turn to care managers to assess an older adult's needs and provide and execute a care plan. The managers can be expensive -- charging $100+ per hour. The New York Times recently ran an article about them, which is well worth reading.

When I sent the article to my fellow board members of Aging in Place in Darien ("AIP" in Darien, CT), I learned a lot from two people: Beth Paris, who is the Darien Senior Center Coordinator, and Inta Adams, who is in Darien's Social Services Department:

Beth said that care managers usually just do information and referral, not case management. She wanted to make sure that we all knew about SWCAA's care management. SWCAA is the Southwestern Connecticut Agency on Aging.

Inta said:
"We do know of geriatric care managers in this area, and they provide a valuable service at a cost.( about $100 per hour, which can add up quickly)
Our Darien Social Services office provides evaluation, guidance, information on available resources and services for AIP to family members,spouses,and adult kids at NO COST... Many calls we get are from adult kids seeking advice about available services for their parents.
We are not available 24 hrs. as some care managers might be, but we respond to all work hour calls, and try to involve the family to make the final decisions based on available information."

Going Home From a Nursing Home

Did you know that in more and more states that Medicaid will help fund home health aides so that you can leave a nursing home and get help at home? This is really welcome news, which was featured in an article in the New York Times on September 19, 2009.

I took my mother out of a nursing home and enabled her to live in an apartment with home health aides caring for her for a good five years. Those years were a blessing to her. In Connecticut, we now have laws that enable the Medicaid money to follow the patient. This is very helpful to families and individuals, while being fiscally prudent. Aging at home tends to be much more cost-efficient than aging in a nursing home.

Here is the link to the article and a synopsis:

Helping Elderly Leave Nursing Homes for a Home
Published: September 19, 2009
More states are aiming to disprove the notion that once people have settled into a nursing home, they will stay.

ALOFT - Rural/Small Town Aging in Place

ALOFT - Active Living Over Fifty, which is in northern Westchester, NY, cuts across eight small towns to connect older adults who want to stay in their homes with all the support systems that already exist through towns and agencies. It is a membership organization that also provides social activities and does advocacy. The members are encouraged to connect to their town, houses of worship and other organizations -- and to connect with each other.

ALOFT does not compete with town services. However, through very active task forces, the organization is zeroing in on improving the delivery of services more efficiently and effectively, specifically taking on health care (encouraging more home health care in the area), transportation, intergenerational activities, livable communities/housing/land use, and more.

They are advocating for the region and towns to find ways to creatively stretch tax dollars in helping people age in place. They loosely follow the BHV model.

Go to the website to learn more.

End of Life Symposium Information

Conference: "Dignity & Choices, A Symposium on End-of-Life Advocacy."
In Washington on 13 and 14 October. National Press Building. Jane Brody is
the Keynote Speaker. Full information:

AARP Is Wrong About Health Care Bill

AARP is wrong to support the new health care bill. The proposed health care reform bill will seriously harm any older adult not yet covered by Medicare who is an entrepreneur, freelancer, business owner, starving artist or part-time worker. We need a plan that lets people self-insure for the small stuff but protects us from catastrophic health care costs -- in other words, a high deductible plan. That is the only plan that is reasonable for people who can barely afford insurance now. It also makes people think twice before approving lots of tests or running to the doctor for the sniffles. It puts control in the hands of the consumer. But the current plan outlaws high deductible plans. This is crazy.

In states like NY where high deductible plans are outlawed, insurance for a part-time worker or freelance individual is $1,000 per month. In states like CT where they are allowed, the cost is $100 per month. For my daughter who is a nursery school teacher, even $100 per month is hard. She lives in MA, where her premiums are 40% higher than CT and are rising at 16% annually, even with a high deductible plan. (So much for Massachusetts's claim that costs are under control there. And, no, she cannot get subsidized insurance from the state. They turned her down on a bureaucratic technicality.) She can barely make ends meet. This is not right. There are AARP-aged people in similar situations.

The new bill is misguided. It will have highly detrimental, unintended consequences that are far reaching across the economy as it puts health insurance further out of reach for those not employed in a corporation or government system. And it will make people even more insulated from the true costs of medical care. This will not help get costs under control.

We need to get health care costs under control and to put more power of choice into the hands of consumers. We need a plan that people will want to join because it is affordable and protects them from catastrophic costs -- not because they'll be taxed if they don't buy one. The plan before Congress does not do this.

I'm not going to renew my AARP membership because I don't want to belong to an organization that is so short sighted.

Can Suburbia Be More Livable?

The Wall Street Journal (Saturday, Sept. 19, 2009) ran a huge article on how communities can help older adults age in place by making the community more senior friendly - Making Suburbia More Livable.

Things that make suburbia really nice when you're young - privacy, spread out houses, driving everywhere -- make it very hard when you're older. When you can't drive, you can become isolated. A house with lots of land is hard to take care of. When you need help with everyday tasks, being far from the centers of care and transportation make things really challenging. That's why many older adults move to life care communities, senior living, assisted living, etc.

But as more people age and more people want to age in place, the suburbs may have to change. Some are being redesigned and rebuilt in certain areas of our country to create a space where senior can live independently without leaving the community.

I've love to see this happen in Darien, CT, where I live. We have one area that could be conducive to a mixed-use area that could have market-rate and affordable senior housing, shops, restaurants, activities, outdoor greenways and a social center. I'd love to see our big, local developers join together with town leaders to make something like this happen in the business district of Noroton Heights. Our senior center is in Noroton Heights, so it could be a fine tie-in, especially if the senior center could get some renovation at the same time.

I'm probably dreaming. But in any event, the article in the Journal is really worth reading and pondering. Maybe you can do something in your community. Here is a link:

Financial Strain of Caring for Parents

When you need to take care of your older parents, it can be a drain on your emotions and your finances. I know this from first-hand experience. After a massive stroke, which left my intelligent mother permanently confused, I cared for her for eight years. I found her a nursing home after her hospital stay. But after 6 months, she begged me to take her out.

I did, finding her an apartment and a series of home-health-care aides to watch over her. Eventually, Babe (my mom) needed round-the-clock care, and we found a good nursing home for her. During all this, I had to manage her finances. I was an only child, and all the other relatives were dead, so in some ways, this made things a little easier. But I worked in NYC and later had a baby, so I had demands on my time.

My experience is one reason I have become so involved with Aging in Place in Darien. It's also why I found this article in the New York Times --
Taking Care of Parents Also Means Taking Care of Finances,

Friends Can Make You Healthier

Here is a link to a fascinating article on how friendships can help you age successfully and stay healthier. The more friends you have, the better off you are.

Interestingly, friends can influence you in a positive way -- quitting smoking, losing weight -- or negatively -- not studying when a student, gaining weight to the obese stage.

The article was in the New York Times and is based on the long-running Framingham Heart Study in Framingham, Massachusetts. People who stuck around Framingham and basically aged in place have done very, very well.

Family gets help from vets’ group- The New Haven Register - Serving Greater New Haven, CT

Family gets help from vets’ group- The New Haven Register - Serving Greater New Haven, CT

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Practical Assisted Living Structures

The first PALS unit is about to be installed at the East Haven home of a Vet. PALS stands for Practical Assisted Living Structures. It's great for anyone who wants to stay in their home but needs the bedroom and bathroom to be accessible and safe.

You can attach a PALS unit to your home. Later, when it isn't needed, it can be removed. I think this is great for older people or disabled people of any age. I started doing some consulting work for the company that makes and installs the PALS units and have been so impressed with what they do and their management.

They have a great story and are really doing good by helping out one Veteran in particular.

You can read more about this at: