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50 Bloomfield Avenue, Hartford, CT 06105
Tel: (860) 233-9897 / FAX 233-1333
Email: firstunitarian@ushartford.com
Reverend Barbara Jamestone, PhD
AGING GRACEFULLY
A RESOURCE FOR USH FAMILY AND FRIENDS(What is this? AGING GRACEFULLY, a resource guide to aging issues for USH members, family, and friends, has been compiled by the Aging Resource Ministry (ARM) of the Caring Network. This guide lists numerous Federal, State, and Local services available to Seniors as well as practical advice on how and when to seek advice. The Guide is available in print-call the Meeting House Administrative Assistant, Rosie Rindfleisch, or Diana Heyman of the Caring Network for a copy. )
TABLE OF CONTENTS
1. INTRODUCTION
2. WHEN TO ACT
A. Emergency
-Caring Network
-911
-211
H. Environmental (housing) Information
5. Conclusion
If you or your friends or family members are blessed with longevity genes, the prospect of a longish stay on this planet can be a happy one. On the other hand, however, a longer life span undoubtedly brings with it the necessity of dealing with the issues of aging. In many ways, dealing with life’s other certainties, death and taxes, is much easier. Aging presents a broader reach of issues with some potentially unpleasant consequences. Whether we face that prospect with confidence or with fear and uncertainty, depends on how well prepared we are in advance.
The purpose of this manual and accumulated material is:
• to identify the major issues which may require decisions and/or advance planning, and
• to identify resources which will help in making those decisions and determine the best action to take.
The good news is that there is a wealth of information available in print, by phone, on web sites, from professionals, as well as from National, State, and local agencies. And we, as members of USH, are particularly fortunate in that there are individual member professionals with expertise in specific areas who have volunteered their time as consultants should the need arise.
The decision to begin to research information and to look for answers is commonly triggered by one of three circumstances:
I. A realization or acceptance of situations that, up to this point, were not evident.
II. A life changing event has occurred. (e.g. illness, hospitalization, injury. Death of a spouse.)
III. An interest in planning ahead to prepare for the future.
The following examples of each of these three situations may help you recognize the reality of situations you may be facing and point out the kinds of resources you need to pursue.
a. Realization on your part:
• Noticeable change in functional capabilities.
• Noticeable change in cognitive state.
• Noticeable change in activity level.
• Realization that daily tasks are becoming more difficult and time consuming (e.g., getting dressed, preparing a meal, balancing a checkbook.)
• Apprehension about trying new things or venturing outside familiar territory.
b. Life-changing events:
• Diagnosis of a chronic debilitating event (e.g., Alzheimer’s, Parkinson’s, Arthritis, Osteoporosis.)
• Diagnosis of terminal illness (e.g. Cancer.)
• Medical event (e.g., heart attack, stroke.)
• Daily medication becomes required.
• Weekly doctor visits become necessary.
c. Planning ahead:
• Knowing what signs to look for that may suggest functional challenges (physical and mental).
• Understanding living environment alternatives and care options in order to be prepared if, or when, a change may be appropriate or necessary.
• Ensuring needed legal documents are executed and up-to-date
• Understanding one’s wishes, and the roles, responsibilities and expectations of family members.
• Developing a financial or retirement plan.
• Evaluating insurance coverage options.
• Creating a legacy of memories while still possible.
The message then, is: recognize and accept changes when they occur, but plan ahead for dealing with them while there is still time.
3. MENTAL HEALTH DISORDERS IN OLDER ADULTS
Because of the frequency of mental health disorders in older adults and the devastating financial and emotional toll they take on loved ones and caregivers, it is important to recognize and distinguish between those disorders and the normal effects of aging. Certainly a professional diagnosis should be sought, but the following analysis may be helpful.
Mental health disorders can occur throughout the life span. Some may occur for the first time in later life. Treatment is available.
The most common new disorders in later life are disorders of mood, thinking, and cognition (brain function). Any change in a person’s behavior or ability to function requires evaluation.
DELIRIUM:
Delirium is a medical condition that has behavioral symptoms which include sudden confusion, disorientation, restlessness, hallucinations, poor concentration, not able to rest or sleep. Delirium is reversible. Often the cause is medical in nature such as a urinary tract infection, upper respiratory infection or a side effect from medication. Symptoms require prompt medical evaluation.
Your primary care health provider is the first level of evaluation.
If the symptoms are severe and there is a threat to the person’s safety or the safety of others, this is a medical emergency – call 911 for the person to be evaluated in the emergency room. The cause of this sudden change needs to be identified and treated.
DEPRESSION:
Depression, one type of mood disorder, is marked by a loss of interest or pleasure in living. Depression is a treatable condition.
Common Symptoms are:
• Persistent sadness, tearfulness, discouragement, irritability
• Lack of energy, decreased interest in usual activities
• Lack of concentration which can affect short term memory
• Sense of worthlessness
• Persistent thoughts about death or suicide
• Change in appetite – too much or too little, often with significant weight loss
• Change in sleep pattern – trouble falling asleep or staying asleep
• Multiple physical complaints
Note: Many older adults will experience and identify the above symptoms, however, will deny feeling depressed. If the symptoms are present for at least two weeks, evaluation is needed.
The symptoms of depression can be mild or severe.
Treatment for depression:
The first level of evaluation or treatment may be with the primary health care provider. Many older adults have positive, trusting relationships with their primary health care provider and negative ideas about being evaluated by a mental health professional. This may be the first step and the primary provider may chose to refer to a geriatric psychiatry specialist.
Treatment is often a combination of anti-depressant medications and talking with a therapist/counselor.
Settings for treatment include: out-patient (office or clinic); partial psychiatric treatment programs (day treatment programs – NOT adult day care); and in-patient hospitalization. Be aware that the nature of in-patient hospitalization is acute care and short hospital stays.
ALERT: When a person experiences suicidal ideas, the person should not be left alone and requires urgent or emergency evaluation. If the person sees a mental health professional, contact that person. If not, call 911 and have the person evaluated in the emergency room where a psychiatric evaluation can be done and treatment recommendations made. If there is immediate risk, call 911.
MEMORY CHANGES AND OTHER COGNITIVE CHANGES:
Older adults are at risk for developing changes in memory and other cognitive or brain functions.
Memory changes are common in older adults. When memory problems interfere with daily living, it is time to have the memory changes evaluated. There are many possible causes and it is not always Alzheimer’s Disease.
When the cause of the memory changes is identified, then treatment options can be identified and pursued.
Be aware that sometimes the person with cognitive changes is not fully aware of the changes or denies the changes are present. Some cognitive changes have a very gradual onset over a fairly long period of time. Again it is important to have an evaluation.
Evaluations can be sought from the primary health care provider, a neurologist, a geriatric medical doctor or a geriatric psychiatrist. An accurate diagnosis leads to appropriate treatment, education about the condition, guidance about living with the condition, and planning for the future.
OTHER MENTAL HEALTH CONDITIONS:
There are many other mental health disorders that require evaluation and treatment.
A GOOD RULE OF THUMB IS THAT IF THERE IS A CHANGE IN BEHAVIOR, PERSONALITY, MOOD, THINKING, AND/OR FUNCTIONING, IT IS TIME TO SEEK EVALUATION AND TREATMENT.
A. Emergency - physical or psychological:
• call 911
• call your local police Dept. for “Well Being Check” if concerned for someone who has not answered the door or telephone in a reasonable period of time
• call 211 for referral to closest psychiatric mobile response team.
B. General Resource Information:
• USH Caring Network. Call the Society Office at
860-233-9897
• Dial 211 or look in the Community Living section of your telephone directory for the 211 listing of services or go to www.211.org and click on 211 finder.
• Dial 311-If you live in Hartford. This is the 211 Info line specific to Hartford.
• Town resources. Contact Social Services for help with access to programs and services for Seniors including: choosing a Medicare plan D, energy assistance, rent rebate, access to Meals on Wheels, Friendly Visitor program, Voluntary Drivers, etc.
There are many. Most have links to other agencies. The most informative ones are:
• Dept. of Health and Human Services
• Eldercare Locator
WWW.eldercare.gov. or 1-800-677-1116
• National Institute on Aging
• Administration on Aging
• Center for Medicare and Medical Services
• First Gov for Seniors
• American Association of Homes and Services for the Aging
WWW.aahsa.org or 1-202-783-2242
Most state agencies are interconnected and will provide links to other helpful sites. Among the most informative are:
• CT Dept of Social Services, 1-888-385-4225
- Elderly Services Div., 1-800-443-9946 or
WWW.ctelderlyservices.state.ct.gov
- Aging Services Unit (for excellent explanation of elderly housing options), 1-800-443-9946 or
• CT Commission on Aging, 1-860-240-5200 or
- Long Term Care Division
• North Central Area Agency on Aging, 860-724-6443
This excellent non-profit agency has operated in the Hartford area for 30 years to enhance the quality of life for older adults by ensuring that they have access to quality, cost effective, services. They access the same database as 211 and can provide information about all Federal, State and most local agencies.
• Senior Ombudsman, Michael Michalski, 1-860-723-1390
Look in the Government/Municipal Guide in your telephone directory for listings under:
• Commission on Aging
• Human Services
• Handicapped Services
• Social Services
A number of excellent reference books have been donated to the Society Library. They are easy to read, detailed, helpful sources of information on all aspects of aging. Included are:
“The Caregiver Resource Guide” by Charles Puchta, CSA This is the most comprehensive guide available which addresses the many issues to be faced as a result of aging, illness, or injury.
“Aging America Resources” also by Charles Puchta, CSA This is similar to the above but written for the aging individual rather than the caregiver.
“Aging Well” by George E. Vaillant, M.D. This book reports on the landmark Harvard Study of Adult Development that covers 50 years of observation of life choices, health, and happiness of hundreds of individuals. It reveals an extraordinary set of conclusions about how one can lead a happier, more fulfilling life in old age.
“You and Your Aging Parent” by Barbara Silverstone and Helen Kandel Hyman. This is an oldie but goodie. It is regarded as the first book to recognize that the problems of the elderly can not be considered apart from the needs of their middle aged children. It broke new ground in exploring the emotional and intergenerational conflicts that many families have to deal with.
“The 36 Hour Day” by Nancy L. Mace, M.A. and Peter V. Rubins, MD, M.P.H. This is a family guide to caring for persons with Alzheimer’s Disease, related Dementing Illnesses, and Memory Loss later in life. It provides practical and specific advice needed to make care easier, improve quality of life, and lift the whole family’s spirit.
“When Your Loved One Has Dementia: A Simple Guide for Caregivers” by Joy A. Glenner, Jean M. Stehman, Judith Davagnino, Margaret I. Galante, and Martha L. Green. Eighty per cent of persons with dementia live at home, and the family members caring for them are often overwhelmed by the enormous responsibility and complexities of care. This book is designed to support the caregivers and help them understand the needs and feelings of the person for whom they are caring. A central focus is the goal of sustaining a loving family relationship between the caregiver and the patient.
“What if It’s Not Alzheimer’s: A Caregiver’s Guide to Dementia” by Lisa Radon. This is a comprehensive guide dealing with frontotemporal dementia (FTD), one of the largest groups of non-Alzheimer’s dementias. This highly accessible reference work is divided into four parts. Beginning with a discussion of the medical facts, part one defines and explores FTD as an illness distinct from Alzheimer’s disease. Also considered are clinical and medical care issues and practices, as well as such topics as finding a medical team and rehabilitation interventions. Part two focuses on managing care and examines daily routines, including nutrition, exercise, socialization, adapting the home environment and behavioral issues. Part three centers on caregivers’ resources. Finally, part four stresses the need for caregivers to take care of themselves as well as their loved ones with FTD.
“Talking to Alzheimer’s: Simple Ways to Connect When You Visit a Family Member or Friend” by Claudia J. Strauss Few books manage to balance suggestions and loving sympathy as well as “Talking to Alzheimer’s”, a concise and comprehensive guide to communication with both paid caregivers and their patients. While the title suggests focus on a specific disease, the recommendations are appropriate for any family struggling with serious communication issues, whether those issues are the result of stroke, surgery, disease, or an accident.
“A Caregiver’s Guide to Alzheimer’s Disease: 300 Tips for Making Life Easier” by Patricia Callone, Babara Vasiloff, Roger Brumback, Janaan Manternach, Connie Kudlacek
Written for patients, their families, and caregivers, the practical information here will help readers understand what is physically happening to the brain so they can empower their own special skills and talents throughout the disease process. The book is divided into three sections that correspond to the progression of Alzheimer’s, and the unique challenges encountered at each stage.
These books and other informative pamphlets are in the Library stacks adjacent to David’s Den. Please feel free to borrow and use them. Please also feel obliged to return them when they have served their purpose.
The following is a list of agencies and organizations that provide evaluation, treatment, or referral to other sources.
• call 211 for referral to the nearest psychiatric response team in an emergency situation.
• call the North Central Area Agency on Aging
860-724-6443 for referrals.
• Jewish Family Services 860-236-1927
• The Center for Geriatric and Family Psychiatry, Inc.
860-657-3056
• The Institute of Living Geriatric Program 860-545-7200
• UConn Geriatric Clinic 860-679-8400
• MD’s specializing in geriatric mental health:
Jonathan Greenberg, MD 860-232-2900,
Dale Wallington, MD 860-313-5380
There are a wide range of options depending on the needs of the individual. They include:
1. Modifying the home to make it safe to continue living there. Helpful resources include:
• acquiring Home Medical aids to promote bathroom safety and ambulatory aids for mobility.
Contact Accessible Home Medical Supplies
860-726-9600.
• monitoring devices to call for help in case of an emergency or accident.
Contact Lynn Dean, Managing Director,
Direct Link 203-269-5552
• Contact CT Community Care, Inc.
This organization has worked for over 25 years to help elderly clients remain at home.
1-800-654-2183
2. Arranging for Home Health Care and other services at home. Contact:
• CT Dept of Social Services about the CT Home Care Program for Elders, 1-800-445-5394
• Jewish Family Services Care at Home Program,
860-233-4470
• Companions for Living, LLC, 860-413-9306 or www.companionsforliving.com
• CT Community Care, Inc. 1-800-654-2183 or www.ctcommunitycare.org
• Care Management Associates, 1-800-654-2183 (offers 30 minute complimentary phone consultation)
• Family Home Services, LLC. 860-570-1276
• Companions and Homemakers, 1-800-348-4663
• CT Visiting Nurses Association, 1-800-528-6664 or www.connecticutvna.org
• Angel Touch Care, LLC. 860-677-2705
3. Move to an Assisted Living Facility
We are fortunate to have in our area so many quality options for choosing an Assisted Living Facility. There are, however, many factors which must be considered in selecting an appropriate facility. An excellent guide for making a decision may be obtained from the Assisted Living Federation of America. (ALFA).
The guide defines assisted living, the residents, the communities, typical costs, the care provided, philosophy, how to find an assisted living residence and an exhaustive consumer checklist for evaluating a residence.
The guide may be accessed on-line at: www.alfa.org/files/public/ALFAchecklist.pdf.
or requested by telephoning ALFA at 703691-8100
or by e-mail to info@alfa.org.
For a listing of the Assisted Living facilities in CT, go to www.ctassitedliving.com and Click on “Providers”.
Additional information may be obtained by calling the
CT Assisted Living Association (CALA) at 203-772-7781.
4. Move to a Nursing Home
The Human Services Nursing Home Compare Tool is an excellent guide for use in determining which facility is the best one in your area. Go to: www.tinyurl.com/2yepdf
I. Legal and Financial References
This is a most difficult topic about which to provide references because of the complexity and personal nature of the issues.
• contact the USH Caring Network by calling the Society office at 860-233-9897. Your request will be referred to one of several member professionals who have volunteered their services for our congregation.
• consult your own or a friends’ attorney and/or financial advisor for references to someone with expertise in geriatric issues.
Other useful contacts include:
• The Consumer Law project for Elders, which provides free legal assistance in CT to individuals 60 or over.
• Protective Services for the Elderly which works with clients 60 and over to investigate abuse, exploitation, and to recommend services if needed. 860-723-1003.
• Senior Ombudsman - Michael Michalski, 860-723-1390.
The following list contains useful suggestions and recommendations that may help simplify the information gathering process.
• Visit the USH library and browse the books and pamphlets dealing with the issues of aging.
• Call the USH Caring Network 860-233-9897 to inquire if volunteer assistance is available from a Society member.
• Call the North Central Area Agency on Aging 860-724-6443 for information about almost any Senior issue and about the many State and Federal programs available to seniors. Specifically, the Benefits Check Up program is available to adults 55 and older with limited or moderate incomes. Go to www.benefitscheckup.org/link/ncaaa or call the Agency and a volunteer will help you complete the confidential survey.
• If you are a caregiver, consider hiring a Geriatric Case Manager to evaluate your family member’s needs and recommend the appropriate actions. While there is some expense involved, the expert evaluation and recommendations, the follow up on the care provided, and the peace of mind afforded, are well worth the investment.
To find a Case (or Care) Manager, contact The North Central Area Agency on Aging at 860-724-6443 or the National Association of Professional Care Managers at
520-881-8008, www.caremanagers.org,
or e-mail: info@caremanager.org.
• Consider the CT Statewide Respite Care Program if your family member has Alzheimer’s or other dementia. If certain age, income and asset eligibility requirements are met, the program offers the caregiver an assessment of services needed including adult day care, home health aids, companion/homemaker, and nursing care. Contact: CT National Family Caregiver Support Program 1-800-994-9422 for specific details. Also contact the CT Association of Adult Day Care Centers 860-828-8653 for additional information.
• WHAT TO DO IF YOU ARE NOT WIRED?
Finding resources, accurate information, and the latest updates on services and programs can be difficult if you are not computer savvy or don’t have access to the Internet. Experts suggest that the best place to look for help with aging issues is the North Central Area Agency on Aging. 860-724-6443. The issue of access is something they take very seriously and the agency works very hard to provide information to those who do not have access on-line.
• Miscellaneous personal recommendations from USH members:
- Dr. Ralph Rosenberg, 860-677-5533, 53 W. Main St. Avon He is an internist with a geriatric specialty.
- George Bickford, atty. 860653-3325, Granby. He is a lawyer specializing in senior issues.
- Sunrise Assisted Living, 22 Simsbury Rd. , W. Hartford, 860-523-9899
- Seabury Assisted Living, 860-286-0243, www.seaburyretirement.com
- Shady Oaks Assisted Living, 344 Stevens St., Bristol, 860-583-1526
- Virginia Connelley Congregate Senior Housing, 1600 Hopmeadow St., Simsbury, 860-658-1147
- Laurel Gardens at Fairway Crossing, 1824 Manchester Rd., Glastonbury, 860-647-1695 They provide a variety of Assisted Living arrangements and a memory care facility for those with Alzheimer’s disease and other dementias.
- Vitas Healthcare Corp. E. Hartford, 860-920-6000, provides caring Hospice services.
- Companions and Homemakers, Inc., 613 New Britain Ave., Avon, 860-677-4948
- “Services for Seniors”, published by the town of West Hartford. An excellent referral for agencies and services. Call 860-561-7561 for a copy.
- Lifeline-personal response and support system.
860-269-6889
- Direct Link-in home monitoring system. 203-269-5552
- Independent Living Aids-a catalog of devices and products to support an active, independent life. 1-800-537-2118, e-mail: can-do@independentliving.com
- Accessible Home Medical Supplies-delivers products for home care needs. 12B Mountain Ave., Bloomfield,
860-726-9600
A word from our Minister:
Dear friends,
The little volume you hold in your hand is an example of ministry at its best. A need was perceived by folks at the Meetinghouse, who then immediately responded by giving their time and talents to this worthy project. The human experience is one of continual transition, and those transitions are accomplished more smoothly when we can take the arm of another. The ARM (Aging Resource Ministry) of the CARING NETWORK has created this resource book to be an arm for us as we traverse the aging transition. Inside its pages are the names and talents of many agencies and people, some of whom are our own members, who stand ready to assist you in a variety of ways. Other helpful vehicles will include the soon to be started ‘Pastoral Care Associates’ program. You are not on a solitary journey, but one we all make, and one we want to make together.
Warm regards,
Rev. BJ Jamestone
and finally:
Although every effort has been made to verify the accuracy of the information in this pamphlet, there is no warranty expressed or implied as to the efficacy of the agencies and individuals listed herein.
Special thanks are due those who assisted in the compilation of this material. Specifically, Janice Newton, Sue Smolski, Kayla Costenoble, Marye Gail Harrison, and Harriet Elish. And very special thanks to Anne Bailey for the layout and design work.
This effort is dedicated to the memory of my parents, Lee and Max Palmer.
Betty Palmer
Let us know of any comments, errors and corrections - thanks (revised 12/05/07)