Shirley is a tireless friend

Like clockwork, Shirley comes by EVERY Sunday to visit my Dad and bring him First Holy Communion. She is unwavering in her dedication to bring sunshine into my Dad’s world. Here she is with Dad on his 96th Birthday. I Love Shirley!

Seniors Trade Cars for Rides in New Chicago Test

INDEPENDENT TRANSPORTATION NETWORK City to test program in May on N.W. Side

BY FRAN SPIELMAN City Hall Reporter/fspielman@suntimes.com

Edgewater resident Betty Steinke, 77, was recently forced to give up her driver's license because of the severe visual impairment known as macular degeneration.

That left her 84-year-old husband as her only chauffeur. But it won't be long before Leroy Steinke is off the hook.

After two years of planning, City Hall is ready to roll out a pioneering program that will allow seniors to donate their cars to a new nonprofit agency in exchange for free rides around the clock.

The Independent Transportation Network is the brain child of Katherine Freund, whose 3-year-old son was run over by an elderly motorist in 1988 while playing outside their Maine home.
"When our family recovered, I said, how do I keep this from happening to other people? How do I fix it?" said Freund, whose son is now a healthy 23-year-old.
"Everybody's family has some older person struggling with this issue. People need an escort in and out of the car. They need someone to carry their packages or fold their walker. You cannot rely on adult children to leave their jobs every day to do this."

Before going citywide, Chicago's program is expected to debut in May in a district that starts on the Northwest Side and swings around to include five hospitals in the Illinois Medical District on the Near West Side.
AARP will send out a mass mailing next month to seniors in nine primarily Northwest Side ZIP codes, urging them to donate their cars or join ITN Chicago in exchange for a yet-to-be determined fee similar to a cab fare. A list of the pilot communities can be found at itnchicago.org.

If the Kelley Blue Book value of the donated car is $10,000, the senior will get credit for $10,000 worth of free rides. Donated vehicles will be sold, with the proceeds used to subsidize rides and the program, partially funded by a $125,000 state grant.
Initially, volunteer drivers will use their own cars after passing a road test and undergoing criminal background checks and screening for moving violations. Over time, the Chicago chapter of a network that began in Portland, Maine, and expanded to include Los Angeles, San Diego and Orlando hopes to reach agreement with a car-sharing service.

"Our goal is to fill a niche for seniors who probably should not be driving but don't want to be confined," said former Aging Commissioner Joyce Gallagher, who's spearheading the program and hopes to take it citywide in three to five years.
"I'm not trying to get them off the road. They are off the road. We're just trying to help them through the situation they find themselves in."
The first ride is expected to be provided in May by Leroy Steinke, chairman of the 23-member ITN Chicago board.

"I'm still able to drive. I have friends in their 90s who still drive. But there are people who can't. And they no longer have access to family members who can accommodate their needs," Steinke said.
"This would literally be a door-to-door accommodation."
When now-ousted Gov. Rod Blagojevich gave free mass transit rides to seniors, Freund called Gallagher and asked if Chicago wanted to back out.

But an appearance at a Northwest Side senior citizen center put Freund's concerns to rest. She asked an audience of 130 how many people felt their mobility needs were being met by public transportation. Three hands went up.
"What that tells me is that all of our existing systems were not built for people who live to frail old ages," she said.

Dad is 96 today!

Bring on the cake
Bring on the candles
Bring on the party hats
Bring on the cards
Bring on the gifts
Bring on the friends
Bring on the blessings!!!!!!!!!!!!!!

Glad To Be Here With Dad

Today, I met with Dad’s new social worker and his latest hospice nurse. I am glad I was here to answer all their questions and learn about his newest medicines and applications.

Here in Chicago The Same March Dates As Last Year

I just realized I came here last March 12-17-----also for Dad's birthday. He will turn 96 on Sunday.

BTW, It was 76F when I left Miami and 19F when I landed in Chicago.

Annual Caregiver Conference-Today, I Attended My 4th in Three Years

I found today's caregiver conference as helpful as they always are. I am re-posting what I wrote two years ago. The learning is as relevent now.

Blog caregiver conference repost
May 24, 2007

Gathering Information At the Fearless Caregiver Conference

I am feeling invigorated and empowered after attending the ninth annual Fearless Caregiver Conference, held yesterday in Ft Lauderdale. Two months ago I attended this conference when it was held in Miami.

At both conferences, I benefited significantly from the opportunity to learn from professionals in all aspects of elder care who presented products and services and shared their wisdom about caregiving. I was also able to connect with other caregivers who have dedicated a significant part of their lives toward caring for their aging loved ones. While I learned a lot, I realized how much I've already learned as a result of being a solo long-distance caregiver for more than two years now. During the question and answer sessions, I realized I could have contributed some wisdom to every single discussion.

Fearless caregiver conferences, hosted across the country, bring together caregivers and elder care experts, to share their knowledge and experience. These conferences, generally free to the public, are offered by several dozen sponsors and exhibitors who wish to provide information on the plethora of products and services available to assist caregivers in making the best decisions in giving the best care for their aging loved ones.

The format for these helpful conferences consist of an exhibit area, where more than 35 exhibitors provide caregiver information on some of the following: long-term care insurance, Alzheimer's disease, hearing a technology, personal emergency response systems (PERS) monitoring services, assisted living facilities, nursing home facilities, home health care services, reading and vision products, breast cancer research, hygiene products, blindness prevention, hospice services, geriatric care management services, transportation, helpful literature and many more. In addition, a panel of experts delivered presentations on specific areas of long-term caregiving and they shared their wisdom in a lively question and answer session designed to solicit rich discussion helpful to all attendees. The AARP even provided comprehensive training manuals for caregivers in both English and Spanish.

Gary Barg, a noted speaker, writer and publisher on caregiving issues created the Fearless Caregiver Conferences. He is an inspiration to me providing a forum where elder care experts and experienced caregivers can share their knowledge with others. He draws upon his experience as a caregiver since 1995.

I learned some key information during yesterday's event:

---I learned a whole new definition of hospice that dispels the commonly held myths and misconceptions. My impression was that hospice means sending your loved ones to an institution where they will die—sooner rather than later. When my Moms doctor advised me she was a candidate for hospice in February 2005, I unequivocally rejected the notion of separating her from her husband, friends, and unfamiliar surroundings. The new model of hospice entails caring for terminally ill loved ones wherever your loved one lives with a focus on care vs. cure. Hospice professionals will provide services in their home. The reality is that most people prefer to remain in their home, rather than moving to an impersonal institution staffed with strangers.

Since my Mom has been diagnosed as hospice ready, there are a plethora of resources available to our family free of charge. I spoke with a representative from VITAS, the country's largest provider of end-of-life care, who informed me that daytime respite care, prescription medications, and even equipment we are paying for are available to us at no cost. I will certainly explore.

---I also found out there is caregiver assistance program (CAP) training at North Broward held on a regular basis. Because this training, scheduled for four consecutive days, is funded by a federal grant, it is provided free of charge, and even includes meals. I will investigate the training schedule and register for the sessions.

---In most cases, if your loved one has reached a certain level of incurability, it is best to avoid hospitals altogether. Even in some emergency situations, it is best to find solutions at home. It was acknowledged that often, older patients receive minimal attention in emergency rooms and often hospital patients fall victim to other diseases during their stay.

---I learned that there are no conclusive tests to diagnose Alzheimer's disease. Based upon clinical results and patient history information, physicians simply draw conclusions. Although there is also no definitive understanding of the cause of Alzheimer's, genetic links have been established.

---Depression plays a major role in Alzheimer's disease-- primarily because of grieving losses-- loss of self, loss of independence, and loss of hope for a bright future. It is perfectly normal for someone with Alzheimer's disease to suffer from depression, and there are many helpful antidepressants prescribed to treat this heavy condition.

---Reverse mortgages can serve as a helpful solution for some clients.

---In dealing with Alzheimer's patients, the best medicines are empathy and unconditional love.

---Caregivers provide billions of dollars (est. $250 billion) of uncompensated eldercare.

I highly recommend that you consider attending one of these helpful conferences. Attending such an empowering conference will allow you to gather a bundle of information, all under one roof, and all you have to invest is three to four hours of your time. They even include breakfast, a nice lunch, and a dessert break—all for free or a nominal entry fee.


Keep your eyes and ears open for caregiver conferences. Consult your local alliance for aging agency via The National Association of Area Agencies on Aging (n4A.org) or Fearless Caregiver Conference at caregiver.com for details.

Too Few Seniors Receive Much-Needed Home Care:

AARP report finds Medicaid limits access

Here is an interesting article that exposes the shortfalls in care for the largest segment that needs care: seniors who are not developmentally disabled.

By Trish Nicholson - July 11, 2008 - AARP Bulletin Today

Even though most older Americans would prefer to receive care at home rather than in nursing homes, many states have been slow to reform their Medicaid programs to make that choice widely available. Instead, most states have done a much better job of using Medicaid dollars to help people with developmental disabilities remain in their homes and communities than to help older people and adults with physical disabilities.

Those are among the findings in A Balancing Act: State Long-Term Care Reform, a report released July 11 by the AARP Public Policy Institute. The report is the first ever to examine Medicaid spending specifically for older people and adults with physical disabilities, as distinct from other groups needing long-term care.
The study yielded surprising data. “We really didn’t realize how far behind services for older people were, compared to services for people with developmental disabilities,” says Enid Kassner, the institute’s director of independent living and long-term care, and lead author on the report.
For years AARP researchers had examined annual data from the federal Centers for Medicare & Medicaid Services showing the extent to which states were balancing Medicaid dollars between nursing home care and home- and community-based services. It appeared that states were making steady progress toward offering alternatives. “But when we broke out the numbers,” Kassner says, “there were pretty dramatic differences in serving different populations.”
Seventy-five percent of Medicaid spending on long-term care for older people and adults with physical disabilities goes to nursing home care. In contrast, most Medicaid dollars for people with developmental disabilities go toward services that can help them live independently.

A major barrier to leveling the playing field is Medicaid’s institutional bias. Medicaid is required to provide nursing home care for ailing older adults who are impoverished. The program is not required to provide home- and community-based care, even though it is often less expensive than nursing home care.
“This is backwards,” Susan Reinhard, senior vice president of the Public Policy Institute, said in a statement when releasing the report. “People are entitled to more costly nursing home care, but not to care in their homes.”

Despite federal rules that hinder states’ ability to balance Medicaid funds between nursing home care and home- and community-based services, a handful of states have succeeded in tipping the scales. In 2006 Alaska, Oregon, Washington and New Mexico spent more than half of their Medicaid long-term care budgets for older people and adults with physical disabilities on services that allow them to live at home or in the community.

These successes, Kassner says, “have shown that it can be done. It is not mission impossible. But it really takes a lot of work, and it takes a commitment from state officials. They have to embrace the philosophy that people have the right to control their own care. If the state doesn’t believe that, they’re not going to make it happen.”

Nationwide Medicaid spending on home- and community-based services for older people and adults with physical disabilities increased by 65 percent from 2001 to 2006, while Medicaid spending on nursing home care increased 16 percent. But nursing home funding began at higher levels, and the rate of change was not evenly distributed among the states. Indeed, more than half the states boosted funding for nursing home care more than for home-based services. If recent rates of change continue, the nation will not reach a 50-50 spending balance between the two types of care until 2020.

Changes in funding are not the only indicator of progress, however, because of differences in cost. The amount of Medicaid dollars that can pay for home care for nearly three people on average can only pay for nursing home care for one.
AARP researchers therefore also looked at changes in participant data over a five-year span, from 1999 to 2004. A state might be behind the national average in terms of spending yet may have reduced the number of people in nursing homes while boosting the number receiving in-home care. “We would call that a partial success,” Kassner says.

The report includes a two-page profile of every state, with pie charts showing how the state compares to the national average in terms of balancing funds and a table showing changes in participant data. Each profile describes programs and progress within that state.

AARP will host an Innovations Roundtable in August, inviting state officials and advocates to use the report and share information on best practices.
Because Medicaid is the primary payer for long-term care, how a state uses those funds can affect its long-term care infrastructure. If most of a state’s Medicaid budget goes to nursing home care, the market for entrepreneurs to develop businesses offering in-home care may be inadequate. As a result, even people who pay for long-term care out of their own pockets may have a hard time finding in-home services.
On the other hand, among states that have invested in home-based care, several have established a “single point of entry” to the long-term care system, providing one place where state residents can go to get all the information they need about options for care, whether they are eligible for Medicaid or not.

The national trend toward apportioning some Medicaid funds for home- and community-based services—which began in the 1980s—got a boost from the U.S. Supreme Court in its 1999 Olmstead decision. The high court rejected the state of Georgia’s appeal to keep two women with mental illness and mental retardation in a state psychiatric hospital long after treatment professionals recommended their transfer to a less restrictive community-based setting.

“Older people don’t want to be in institutions, either,” Kassner says. “AARP will have to ramp up its advocacy to remove the disparity in services for different populations. If we’re not going to fight for this, who will?”