Obama Administration Announces HUD housing assistance for people with disabilities and elderly

More here.

Advocates: Elder abuse allegations need police investigation

Nursing home advocates are citing examples of cases that fell between the cracks for years as examples of why the present system of handling elder abuse allegations requires change in Texas.

Their primary concern is the lack of police investigation when an allegation of elder abuse is made. The lack of coordination has resulted in cases lingering for years in the system. It also appears that the classification used for cases may fail to offer sufficient protection.

Currently, elder abuse allegations are handled by an agency unless found to be serious. If a case is then considered "priority one", a joint investigation is done with local police. However, a case where a nursing aide witnessed a co-worker grab a resident from his wheelchair, slamming him into bed was deemed a priority two case. Police were called, but there was a lack of followup with statements. Although priority two cases are supposed to receive a response within 14 days, only one third presently do.

This is an egregious situation, considering that vulnerable nursing home residents remain in the same setting without any guarantee of outside help or intervention in the present system.

The advocacy group said it favors joint investigations for all abuse and neglect allegations, but such efforts could face questions about the costs and increased workload on law enforcement.

Beth Ferris of Austin, also with the nursing home advocacy group, said state law should be changed to require elder abuse training for law officers.

via dallasnews.com

Dignity wheelchair allows in home care

Dignity Medical Devices first product release is a growing line of wheelchairs that allow the occupants of the chair to toilet throughout the day without the need for bodily transfer. via PRnews.com

The Dignity wheelchair was invented by Greg Johnson, whose mom has MS, and realized the issues she was dealing with. The use of the chair frees up caregivers and allows the person to regain independence and privacy. It will reduce falls as well and allow some people to avoid nursing home care.

The video below shows how the product works. The user remains seated, rolls over a regular toilet, pulls a lever which drops the center of the chair seat, adjusts her clothing and toilets. The chair, unlike a commode, allows use of a bathroom toilet directly. The front footrests and the height of the chair have been adjusted for easy clearance.




The website can be found here.

Seniors' falls from walkers and canes studied

A study showing that over 47,000 seniors are treated for falls annually from walkers and canes stated that more need to be shown how to properly use the devices safely, suggesting doctors do so prior to prescribing the mobility devices.

I have another take on this issue. I can't tell you the number of times I've been out and seen folks using canes or walkers when they clearly appear to be in need of a wheelchair. They may lack balance or the stamina, causing them to veer or stumble in a crowd. I'm not questioning the selection of the device for them some of the time, but it's clearly not working out in public in crowds.

I know many of my friends with long term disabilities use more than one type of mobility device, so when I see this, it makes me wonder if doctors are suggesting to seniors that a scooter or wheelchair might be a good idea for longer distances, although a cane or walker works at home. Such an approach might not only prevent falls, but maximizes the mobility of the person. It may conserve their energy so that when they are home alone, they are less likely to fall.

In order for this approach to work, however, we need to get beyond the stigma of using certain devices and certainly have to stop treating their use as an indication of not trying hard enough or failing at recovery. Certainly maximizing function is a good thing, but it becomes counterproductive when someone suffers multiple falls and resultant injuries, as I often see.

Family caregiver contracts: a solution for some

The NY Times features an article about an arrangement some families are finding workable: when a son, daughter or other family member can be available for caregiving in the home, but can't afford to lose income, a caregiving contract can be drawn up between a parent who needs in-home care and that person.

Although the idea is somewhat new, it can make sense in a few ways, according to the article and elder law attorneys who were interviewed, since it is a legitimate way of providing in home care, while at the same time it allows the family member to continue to earn money for his or her own retirement.

Elder lawyers have been discussing care contracts or caregiver agreements for years, but interest has picked up since 2006, when Medicaid eligibility requirements tightened. As parents “spend down” their assets to qualify for Medicaid, which pays for most nursing home care, they face stiff penalties if they simply give family members money.

With a formal caregiving contract, however, elders can show that they were paying for services rendered, said Richard Kaplan, a University of Illinois law professor who has studied care contracts: “Money can be transferred to younger relatives without triggering a penalty.” Assuming, of course, that those relatives legitimately take on the task.

via newoldage.blogs.nytimes.com

More on the Abilities Expo

First of all, let me provide the schedule. This weekend it is in Edison NJ, ending today. It will be in Anaheim, CA the weekend of May 29-31; in Chicago, IL the weekend of June 26-28 and Atlanta, GA the weekend of November 4-6, 2009.

This year's expo seemed to have more accessible vehicles on the floor, with different variations. There was a crossover from Toyota, with a turny passenger seat and scooter lift in the back, as well as the rear and side entry vans, a Honda Element and others. Quickie, Colours, TiLite, Permobil, Rascal, Pride, Top End and Invacare were all there with wheelchairs and scooters.

I purchased a TeleStik reacher because,for the first time, it was quad friendly. It came with a cuff that requires no hand movement. The TeleStik has an adhesive disk to pick up items (washable when it loses its sticky power), a magnet and a hook and can be used extended or while shorter for things like elevator buttons, etc. I plan on attaching it to my power chair now that I can use one with the adaptation. It cost $25. They can be found online at www.telestik.com or reached toll free at 877-299-2982.

There was a fashion show by a company called Lega Wear, which tailors clothes for those with disabilities. If you send them your measurements, choose colors and a design, they will deliver the clothes to you. They can be found online at www.legawear.com Their business suits were very nice, but out of my price range at $450.

I'm happy to report that the accessible bathroom situation improved. There was a handicap stall with a door. They did keep the double toilet with a curtain set up as well, which was used for those with scooters who couldn't fit into the handicap stall.

The expo is under new management. There seemed to be more exhibitors than last time I went, with more of an emphasis on senior products as well as disability products. There were still more people with disabilities and their families than seniors, but we did run into an older couple who goes every year to check out products. So if anyone has a product that falls into these categories, it's important to remember that as baby boomers age, these events will cover both markets.

The special events included a job fair on Friday, a fashion show and wheelchair sports exhibitions. There are also valuable workshops offered by professionals.

On a personal note, I met Mark from Wheelchair Junkie and thanked him for all of his work on behalf of power chair users, writing articles that educate and inform and also being kind enough to answer questions to keep people rolling. He also blogs here. author Gary Karp was there signing autographs, but there was too much of a crowd for me to say hi. He does, however, have a great smile. I ran into a few wheelchair tennis friends, which is also fun. And I got to see the accessible racing car I blogged about last week, yellow hubcaps and all.

There were a few offerings that stood out in my mind. See and Be Safe offered reflective safety products by Drive Master. I definitely put those on my wish list. I was also interested in the Quadriciser, from which you can exercise on a padded seat or from your own wheelchair (depending on the model). It puts you through a range of motion exercises and would enhance overall health. I watched folks trying it out over the course of the day and was amazed at the number of individuals and disabilities it addresses. I wish more gyms and health centers would buy these items and provide usage at an hourly rate since so few are able to get them.

So here's a video from See and Be Safe. I hope some of you get to go to the expos near you.

3 arrested in nursing home deaths in California

The L.A. Times reports that

In an elder abuse case described by one investigator as the most outrageous he has ever seen, three former top managers at a Kern County nursing home have been arrested in the deaths of three residents who allegedly were given needless doses of psychotropic medications.

The state attorney general's office contended in a criminal complaint that more than 20 residents at a skilled nursing center run by the Kern Valley Healthcare District were drugged "for staff convenience."
...
The complaint paints a bleak picture of a facility dominated by nursing director Hughes, 55, who is accused of seeking to drug all but the most docile residents. Medical director Pormir, 48, allegedly rubber-stamped Hughes' orders for medication, failed to examine patients and was "either willfully or naively ignorant" of his proper role, according to the complaint. Pharmacist Hayes, 51, told investigators that she went along because Hughes had wide experience in psychiatric hospitals, the complaint says.

According to the article, medication was ordered for residents who "glared at" former nursing director Hughes or "spoke disrespectfully".

Medicaid change would encourage putting spouse into nursing home

According to this New York Times article. a change in Medicaid law by outgoing President Bush has been delayed until March by Governor Paterson, in hope that President Obama will overrule it.

For 20 years, federal law has protected married couples from having to choose between divorcing or becoming impoverished when one spouse needs expensive nursing home care, allowing the healthier spouse to retain assets and income while the sicker one’s care is covered by Medicaid.

New York has extended this same rule to couples where one requires at home care.

Now, the federal government has ruled that New York has been too generous in applying the income protections to people at home, forcing several thousand couples to make a stark choice by March.

Advocates say the number of couples affected is close to 4,000.

The advocates say that the federal interpretation makes little sense.

“The root of their interpretation is that Congress wanted to give states the option of extending these protections, but only to those whose incomes are so low that they would have no income to share with their spouse,” Ms. Bogart said. “It would be so absurd that no one would ever qualify.

Home Health Aides: Why Hire from an Agency?

The first of a three part series in the NY Times concerning home health care aides and agencies, which consists of an interview with the head of Partners in Care, an affiliate of the Visiting Nurse Service of New York that is run by Marki Flannery.

An excerpt :

Part of the answer lies in understanding that there are for-profit home health care agencies and not-for-profit agencies. The biggest difference between those two types of organizations is how they make business decisions. For-profit companies often select the kind of cases that will make them the most money and turn away other cases. Or, they don’t employ certified home health aides at all. Their people are not trained to do the same things for you as are certified aides. A not-for-profit agency doesn’t turn away cases.

...It is also important to learn about the full set of resources that a home health care agency can offer you because health care situations can change overnight.

...So, if your elderly mom’s condition worsens and care is needed that will be covered by Medicare, we coordinate that care so your mom gets the medical attention she needs and Medicare covers the cost. Or, if your mom needed care that was initially covered by Medicare but now her condition has improved and Medicare will no longer pay, you can transition your mom to care you pay for privately while keeping the same home health aide.

Information for seniors, caregivers and loved ones

The National Senior Citizen's Law Center has materials and information on assisted living and Medicare Part D.

It also includes a link to J&J's Strength for Caring, connecting caregivers. The resource center provides information about housing, money, financial planning and insurance as well as pointing families and caregivers toward more materials. There is a message board area as well.

Changes in Drug Co-Pays for Medicare Plans

The Wall Street Journal runs an article stating that many Part D drug benefit Medicare plans announce shifts in their terms, including co-payments and a sharp rise in premiums and recommends that people take another look at their plan in light of these changes. Beneficiaries may elect to change plans during the fall open enrollment period, running from November 15 to December 31.

As an example:

the country's biggest Medicare drug plan, AARP MedicareRx Preferred, sponsored by UnitedHealth Group Inc., is expected to boost average premiums by 18% next year to $34.92 a month, according to an Avalere analysis of pricing in five big states. The plan, which had 2.7 million beneficiaries nationwide as of August, will have the same $7 average co-payment for generic drugs. But consumers buying brand-name medications on the insurer's preferred-drug list -- such as cholesterol drug Lipitor and Nexium for heartburn -- will have to shell out $36.40 in average co-payments, up 21%, for each purchase, according to the five-state study.

Humana Inc.'s PDP Enhanced plan, the third largest, will see a 51% average rise in premiums. Average co-payments for generics will surge 75% to $7, and 60% to $40 for preferred brand-name drugs.

The government does not regulate prices on Part D plans. For more information, click on the link above for a detailed article that should help you navigate through the best plan for yourself or your parents or loved one.

[For further information and assistance on Part D plans, visit the Center for Medicare Advocacy.]

See also a Guide for Dual Eligibles (on both Medicare/Medicaid)

Seniors in trouble with housing

Many of you out there are contacting me because you are facing changed financial circumstances due to parents losing money in retirement accounts. The plan to go into assistive housing or a private senior housing community may no longer be affordable for your family. The question becomes: can the rest of the family pitch in? Sometimes not. If so, I'd like to refer you to a resource.

You can search for subsidized housing for seniors. (You enter the State, county or city where you need housing, whether for yourself, a parent or loved one.) You'll get a list of units your parents can rent that are based on your parents' income . Check the requirements of each facility: for example, with some of them, if your parent(s) currently own a home they need to sell , they can move into certain units , sell their home and their rent is determined accordingly. They do not, however, need to own a home by any means to get into these units! This housing can keep loved ones near you in a way that is affordable and safe and make the transition easier for everyone.

Although this arrangement does not offer the same services as assisted living, it may be a housing alternative that should be checked out by a family. There are many rules and guidelines that determine the rental cost for each resident, but the good news is that as income diminishes and medical costs rise, the rent may be adjusted.

You can also check for information with your county department of the aging and social services to see what type of housing would be most suitable. If you are a senior on your own and need information, do not be afraid to call and ask questions. You can find the information you need in one phone call that may take you months to find by yourself, or, worse yet, lose financial ground while delaying action. As difficult as change may be, there are advantages to facing a situation realistically and taking timely action.

[This is provided for informational purposes only and should not be relied on as professional advice.]

Gardening & Other Recreational Aids

A friend of mine always tells me how therapeutic gardening is for her, and how when she first was diagnosed with arthritis she struggled to find items she needed. So I just received a magazine listing some new gardening items for those with arthritis and dexterity issues from aidsforarthritis.com and would like to pass them along! The three items below can be found there.

Bionic Garden Gloves, that improve grip strength by 50% Item 7-05

Upper Hand, a handle you can attach to your garden tools giving more leverage, power and control Item J46

Outside faucet turner, to give better turning leverage for outside faucets, hot water heaters, well pumps, valves under basins, and on water line shut off valves in basements, etc. Can be carried around and transferred. Item E26

You can find more gardening tools here, such as easy grip trowels, hoes and an arm support cuff, among other items.

For other recreational items for those with disabilities who'd like to fish, bowl, cycle, golf or swim, etc. check out Access to Recreation.

Please feel free to leave more links in the comments, if you've found information you'd like to share.

[Disclaimer: This is not an endorsement of their products, but for informational purposes only. I don't receive any compensation from the companies.]

A heck of a way to treat senior citizens.....

Elderly residents of Kingsborough Extension, run by the NY city Housing Authority , are having their lives ruled by malfunctioning elevators and elevator failures.

Elevators stall, trapping residents in them, or don't work at all, causing some residents to stock up on food in case they can't get out. Or residents have to rely on one single working elevator with long waits.

For years, the building’s malfunctioning elevators have ruled the daily lives of residents, forcing elderly men and women to cancel doctor’s appointments, push their strength to the limit by taking the stairs and spend hours stuck inside their apartments or outside on the benches waiting for elevator mechanics to arrive


They also say that the figures for elevator breakdowns given by the agency seem low based on their experiences. I'm wondering how long it takes to repair an elevator that's out of service and how many days a month the elevators are actually working properly, which should be the look everyone is going for.

Elevator problems have long frustrated Kingsborough Extension residents, despite a number of failed elevator inspections, complaints from residents and the death of an 89-year-old woman in 2005 that some residents blame in part on the faulty elevators.

The problems have become so routine there that several residents talk casually about getting stuck inside the building’s elevators from 20 minutes to an hour.

...

Kingsborough Extension had a total of 151 elevator failures in the 2007 and 2008 fiscal years, the most of any of the city’s 42 housing developments for the elderly, according to data from the Housing Authority. That works out to about 3.14 breakdowns each month per elevator car, the highest rate in the developments for the elderly, though Kingsborough Extension residents said the agency’s numbers seemed low.

Of the Housing Authority’s 343 developments, the Wagner Houses in East Harlem had the most failures in the 2007 and 2008 fiscal years — 2,132 — and the Manhattanville Houses in West Harlem had the most per car, averaging about 6.2 each month. via nytimes.com

Relatives say 79 year old woman with disabilities in China sentenced to labor camp

Disability Nation reports on the case of two elderly women, one who is nearly blind and uses crutches to ambulate, who have been sentenced to labor camp as part of a re-education program after applying to protest their housing eviction.

Perhaps you caught the NBC Nightly News Report earlier this week that examined the process that China established through which citizens could petition for the right to protest at three specially appointed locations during the Olympics. It turns out that of 77 requests filed by citizens that none of them were granted. Further, it appears that some who have made these requests have been arrested or, as in this case, sentenced to re-education programs which appear to be nothing more than a quick and convenient way to punish people without allowing the individuals any rights or chance to defend themselves.

Wu Dianyuan, 79, and her neighbor Wang Xiuying, 77, were notified Sunday that they were to serve a yearlong term of re-education through labour, said Wang’s son, Li Xuehui. Officials did not specify a reason and still had not acted on the order, he said. via Disability Nation

A spokeswoman for the re-education through labor program denied having either woman's name on record.

[image description: Wu Dianyuan, standing on crutches, and Wang Xiuying are pictured standing on a brick walk on a street with an officer nearby.]

God bless Lorna Page

The 93 year old first time UK novelist is using the proceeds from her book to help keep elderly friends out of nursing homes.

She said: "It's pathetic. It seems to me that in those places people just spend their time alone in one room and people come in and give them food.

"Either that or they just go down to a room and sit at the edge of it. They don't seem to talk to each other at all, they're just sort of there. That's not living."

Mrs Page wrote her book, A Dangerous Weakness, three years ago. via bbc.co.uk

Page had written the book -- about a woman who becomes embroiled in a bitter power struggle after receiving an seemingly innocent invitation to spend Christmas in Switzerland -- three years ago but had stored it in a suitcase. via yahoo.com

Her daughter in law was the impetus for getting the book published. Page is now working on a book of short stories and her son, daughter in law and one friend already live with her. She looks forward to bringing more friends into the home she's purchased.

God bless her.

Nursing Home Reform

'In long term care, love matters'.   

This seems to be the mantra of a PBS piece about a new kind of nursing home for elder care, that attempts to do away with many of the institutional-like aspects. There are debates about feasibility from financial and other points of view in this article - go ahead and read it and see what you think.

h/t NJCIM

No doubt in my mind that we need to look at nursing home reform and alternatives to institutionalized care.

Another recent news piece about nursing home abuses is here.  A night shift nurse was arrested, suspected of sexually abusing over two dozen elderly or disabled nursing home residents while working there. Some of the victims have since died.

Ruling cuts back employers' responsibilities toward seniors

A recent ruling will allow employers to cut back health care benefit packages to seniors in their employ.

The Equal Opportunity Commission ruled Wednesday that employers may cut back or eliminate benefits for people over 65.

Doctor says society's view of elderly as burden adds to stress of caregivers

There is a move to label caregiver stress as a syndrome under DSM IV, but one doctor states that he opposes it since caregiver stress results from the way society views caregiving as a burden.

"Vitaliano isn't sure giving caregiver syndrome the status of an official diagnosis would be a good thing. He argues that if "caregiver syndrome" were listed in the Diagnostic and Statistical Manual of Mental Disorders (a text published by the American Psychiatric Association that defines all mental health disorders) it could stigmatize those that have it. "Caregiver stress is directly related to the way our society views the elderly and the people who care for them,"Vitaliano says. Today, caregiving is viewed largely as a burden in this county. If it were viewed as more of a societal expectation and people were willing to offer more support, fewer caregivers would suffer in isolation, he says.

Others think giving caregiver syndrome an official name would be helpful. Kathryn Anderson, a researcher in families and chronic illness at Florida International University, argues that caregiver stress should be named a syndrome because it would help caregivers seek the help and resources they need. Naming it a syndrome would encourage health professionals to develop better treatment strategies and require health insurers to pay for treatment, she believes." via CNN

One of the key things said here is about the isolation of caregiving that often results from a lack of support from the community. Not only does it cause isolation for the caregiver but for the person who is the recipient of care.

I recall talking to several caregiver groups, where the major concern was how a daughter of an elderly person was suffering burn out. When I'd ask if she had siblings, invariably she'd smile and reply "Yes, but they don't help mother. She's my burden." I'd also discover after asking questions that she wasn't receiving any help from local agencies or friends.

I asked her if her elderly mom had any friends who were able to get around and she looked at me quizzically but said yes. "Call them, invite them over," I urged her.

I received a call within a few months from the woman who told me that two of her mother's friends were now helping out and it had made an enormous difference in the situation. Not only was she getting assistance in caring for her mother's physical needs, but her mother was much happier and less isolated too.

"I never realized what good friends my mom had - or what a good friend she has been to others," she admitted.

This wouldn't have been possible as long as the woman continued to see her mom as a burden.

Home grocery delivery -my experiences

I noticed this morning there was an article about how Amazon Grocery is starting up an at home grocery delivery area (called Amazon Fresh- in a very small test area). I mention this because I've had great success using home grocery delivery services.

Those of us who rely on personal care assistants need to find ways to free up their time so they can help with other tasks. One of my friends uses her precious pca's hours only for grocery shopping - it eats up almost four hours a week by the time the pca drives to the store, shops, and puts away the groceries. I save several hours a week of my pca's time. It's true she still has to put away the groceries, but that's much faster than going to the store and shopping!

Home grocery delivery is also great for people with disabilities who don't have a pca ( and seniors). I've seen people struggling in grocery stores and have told them, for a ten dollar fee, that unlimited bags of groceries can be brought right to your door. Most ask me for the phone number right away! One woman told me she struggles in the store, then struggles bringing the groceries in from her trunk once she's home. Ten dollars seemed like a good deal as she thought about that.

Many have asked me how it works. Generally you order online (there are a few who take orders via fax/phone). Using the search function, you browse for the items you need and select them. (There's a way to keep a list of previous orders which may save time in future orders). Then you provide your billing information, pick a delivery time and check out.

If the cost is a concern to you, there are occasional coupons offered that give you a break in the delivery fee. I also find that ordering biweekly saves me money. Although I'd prefer weekly orders, I've come up with a list for a biweekly order that works out well and it saves me two delivery fees a month. I've found that the prices of items are pretty competitive in most cases, although there are some items that would be cheaper if I went to the store. But I'm sure using a grocery delivery service saves me money on groceries because I'm not doing the 'impulsive' buying I would if I was in the store. The list I keep allows me to add items, but because I see it in writing, I'm less likely to buy too much or add items I don't really need.

Hope this information is helpful to anyone who is struggling with getting groceries in the house. As the number of services grows, keep checking your area for available companies.