SENIORcare2023 Michigan Chronicle
How to Take Control of Your Life The Health Care, Active Aging & Caregiver Edition
Unlocking the Golden Years:
A Guide to Active Aging
and u yo use n tio y can er a rm amil d lat o f n I ur f an yo now
SENIORcare 2023 The Health Care, Active Aging & Caregiver Edition: Taking Control of Your Life Taking control of your life doesn’t mean controlling everything that happens. It means confidently moving forward with your own goals and priorities, while embracing change as an inevitable part of life. Here are some ways to maintain a fulfilling and rewarding life as a seasoned adult: Connect with others – One of the best ways for seasoned adults to maintain independence is by staying social. Building strong relationships and meaningful social connections can give you a greater feeling of purpose and belonging, which in turn can boost your overall health and quality of life. Volunteer and give back – There are many benefits for seniors when they volunteer. Improved mental health: Volunteer work can help seniors reduce their chances of developing mental health issues such as depression and anxiety, especially for those who live alone. Explore new activities and learning opportunities – There are many advantages to continuing the practice of learning. Studies show that when seniors learn a new skill, such as playing an instrument, learning a new language or a new technology, it strengthens connection within the brain, and it keeps dementia at bay. Maintain your hobbies and sports – Seasoned adults with an active lifestyle are less likely to develop certain diseases. Participating in hobbies, sports, and other social activities may lower the risk for developing some health problems, including dementia, heart disease, stroke, and some types of cancer. Travel more – Traveling provides a path to a healthier aging process. Traveling as a seasoned adult decreases the likelihood of forming a severe illness from heart disease. It can also contribute to being less stressed and depressed. Seasoned adults are more likely to live longer if they can maintain a sense of control over the role that is most important to them. Stay Positive, Active, and Take Control!
Hiram E. Jackson
Publisher, Michigan Chronicle Chief Executive Officer, Real Times Media 2 SENIORcare | October 2023
Who Takes Care of the Caregiver?
I
By Ebony JJ Curry, Senior Reporter
n Michigan, a staggering one million family caregivers are logging over one billion hours of unpaid work each year. According to the Family Caregiver Alliance, the value of these services is a monumental nine billion dollars. So, the question looms: Who takes care of the caregiver when the caring becomes too overwhelming?
lines between professional duties and personal emotions. While it might offer more flexibility in terms of hours and duties, it can also be emotionally taxing, as caregivers often grapple with the weight of their loved one’s health challenges without the separation a professional setting might offer. Additionally, financial compensation is often absent when caring for a family member, adding another layer of complexity to the decision.
Imagine for a moment the dreams of your youth. An author, an astronaut, an architect, an actor – the aspirations we had for our future selves likely didn’t factor in juggling personal, professional, and caregiving responsibilities. But for many, like Tamica Harper, this has become a lived reality.
The 2020 report from the National Alliance for Caregiving and AARP painted a concerning picture, highlighting that nearly 53 million Americans are offering unpaid care to adults with health or functional needs. Alarmingly, 21% of these caregivers describe their health as “fair to poor.”
Caregiving, whether for an aging parent, a partner battling cancer, or any other loved one with health needs, is an endeavor fraught with stress.
The paradox here is glaring: caregivers, often so committed to the well-being of another, neglect their own health. This self-neglect can spiral into guilt, stress, and burnout. Preventative measures start with self-care. Harper captures it well: “Being a caregiver has challenges such as taking care of complete care patients... The advantage is the fulfillment that comes alone with providing care.”
The emotional, physical, and mental toll that caregiving can take is often described as “caregiver burnout.” Symptoms might manifest as fatigue or anxiety but can escalate to conditions as severe as depression. Harper, a caregiver with a decade of experience, says, “The challenge of working for an agency is caring for many patients in a short amount of time, patients come on and off service frequently and sometimes it’s difficult to establish a bond or working relationship. The challenge of a loved one working as a caregiver is providing care that isn’t always compensated for, especially when the caregiver must take time off their jobs if employed.” Working for an agency as a caregiver often presents a structured environment where caregivers are assigned to multiple patients, possibly on a rotational basis. This structure may provide some benefits, such as a consistent paycheck, potential training opportunities, and a level of professional distance from the patient. However, it can also come with challenges, such as less flexibility in scheduling and the emotional toll of frequently changing patient assignments, which might hinder establishing deep bonds. In contrast, caring for a loved one introduces a deeply personal dimension to the role. The bond is pre-existing, and the emotional stakes are higher, often blending the
Tamica further emphasizes the importance of balance, “Caregivers can experience self-care by having a good work-life balance. Taking time off is very important not only for the physical but also for mental health.”
OakGov.info/OlderAdults In Oakland County, we are committed to providing access to a whole host of services for all of our residents, including our growing population of older adults. It’s why we created an Office of Older Adult Services last year to educate our residents about the improvements and expansions of services we offer older adults, who continue to grow at a greater rate than the population of children in the county and state. It’s why we invested more than $10 million toward expanding and improving access to senior services, including a $5 million investment in grants for improvements at Senior Centers across Oakland County. And it’s why we continue to focus on public health programming, home repair and eviction protection and affordable housing initiatives. To learn more about the services Oakland County offers to older adults, visit oakgov.info/olderadults or contact our Chief of Older Adult Services, Jim Ellison, at ellisonj@oakgov.com or 248-858-0593.
Accept Help: Understand the importance of delegation. Let others share the burden.
Our older residents have contributed so much to our families, businesses, neighborhoods and communities. It’s now our responsibility to provide them with the tools and resources they need to live their best lives.
Seek Community Support: It mitigates the feelings of isolation that caregivers often battle.
With gratitude,
But what does self-care really entail? Here are some suggestions:
Prioritize Personal Wellness: The adage of putting on your own oxygen mask before assisting others holds true here. Practice Self-compassion: Remember, being a caregiver, whether for a loved one or as a profession, is demanding. Treat yourself with kindness and patience.
DAVID COULTER Oakland County Executive
Caregivers must remember that selfcare isn’t an indulgence; it’s an absolute necessity. As the challenges grow, so should our commitment to our own well-being. After all, only a replenished soul can give wholeheartedly. SENIORcare | October 2023 3
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Helping Seniors and Their Families for Almost 50 Years Call us. 800-852-7795. We’re ready to help. We are a nonprofit focused on supporting seniors so they can live independently and safely wherever they call home. We provide a network of services and programs which include: • In-home care services
• Support for family caregivers
• Meals on Wheels
• Caregiver educational classes
• Help finding housing
• Health and wellness classes
• Help finding transportation
• Medicare counseling
Medicare Help Our unbiased volunteer counselors are ready to help you understand your choices during Open Enrollment! Appointments by phone or Zoom. Call 800-803-7174 to schedule.
Serving Livingston, Macomb, Monroe, Oakland, St. Clair and Washtenaw counties. Visit aaa1b.org
4 SENIORcare | October 2023
Nonprofit Helps Seniors Remain at
HOME
We can all use a little extra help sometimes. This can be especially true for older adults, who may find themselves in need of additional support as they age. The Area Agency on Aging 1-B (AAA 1-B) is a nonprofit community resource that does just that— it provides services and resources to help seniors live independently and with dignity in their own home or with family caregivers. The agency serves a six-county region that includes Livingston, Macomb, Monroe, Oakland, St. Clair and Washtenaw counties. Its services include government-funded in-home care programs for those that qualify, health and wellness classes, Medicare assistance, help finding transportation, classes and support programs to assist people who are caring for an aging loved one, and a free information & referral phone line that helps connect people with resources. The First Place to Call When a Older Adult Needs Help The agency sees itself as the first place seniors and family caregivers should call when they need help, and its Resource Specialists answer over 40,000 calls a year. These Resource Specialists are both compassionate and knowledgeable. They can help people understand if they might qualify for one of the programs and services offered by the agency, and also give them to referrals to other organizations that might be able to help. Support for Caregivers Support for family caregivers is also a focus. Caring for an older parent, grandparent, spouse, sibling or
friend can be joyful — but it can also be hard. The agency has several programs to help give caregivers the knowledge, guidance, and empathy they need. Their free Caregiver Coaching program matches caregivers with a compassionate volunteer for one-on-one support. Coaches can help caregivers find resources and also lend a listening ear. The agency also offers 1-day workshops and classes, like the six-week “Powerful Tools for Caregivers,” that give caregivers practical coping skills and help them learn how to care for themselves while caring for their loved one. Help with Medicare Right now, during Medicare Annual Enrollment, the agency’s Medicare Medicaid Assistance Program (MMAP) is offering free, unbiased one-on-one counseling to help people understand their plan choices for next year. Annual Enrollment runs from October 15 – December 7, and it’s the one time of year that most people can make choices on their Medicare Part D coverage for the upcoming year. Beneficiaries can also make choice regarding Medicare Advantage plans during this time. A yearly review of your Medicare options may help beneficiaries save money. To make an appointment with a volunteer MMAP counselor, call 800-803-7174. Most of the agency’s programs are geared to people who are 60 and up or who are caring for someone 60 and older. If you or someone you know someone who needs assistance, you can call the agency at 800-852-7795 or visit their website at aaa1b.org. SENIORcare | October 2023 5
The Advantages of Establishing a Living Trust:
G olden Years: Unlocking the
A Guide to Active Aging
By Lynzee Mychael, Multimedia Journalism
Aging is an inevitable part of life, but it doesn’t have to mean slowing down or losing one’s zest for life. Active aging is a concept that emphasizes staying engaged, healthy, and socially connected as we grow older. It’s about embracing life’s later stages with enthusiasm and planning for a fulfilling and enjoyable future. Active aging is not only beneficial for those experiencing it but also serves as an
6 SENIORcare | October 2023
inspiring model for younger generations. It teaches them that growing older is not something to fear but rather an opportunity to look forward to. It underscores the importance of nurturing health, relationships, and personal growth throughout life. There are four key aspects of active aging: estate planning, meal planning, exercise classes, and dating, and each plays a crucial role in promoting a vibrant and
purposeful life in your senior years.
Estate Planning: Securing Your Legacy
Estate planning is a fundamental step in active aging. It involves making decisions about the distribution of your assets and property to ensure your legacy is preserved according to your wishes. While it may not be the most glamorous topic, it’s essential for your peace of mind and for the well-being of your loved ones. One aspect of estate planning is creating a will that outlines how your assets will
■S treamlines the process, reduces costs and minimizes complications by bypassing probate. ■ Potentially eliminates the necessity for guardianship in cases of incapacity. ■S afeguards the confidentiality of your estate’s details. ■C onsolidates your assets within a single plan for convenient management. ■P ermits the holding and management of assets for minor children or individuals with special needs. ■O ffers protection against potential creditors’ claims on a beneficiary’s inheritance. ■ T ypically, it presents a greater challenge for contestation compared to a simple will. ■ I t can be amended, adjusted, or revoked at any time as your circumstances change. ■ T his may lead to reduced or zero Federal Estate Tax obligations. ■G rants comprehensive control both during your lifetime and posthumously, providing enduring peace of mind.”
be distributed after your passing. This document not only ensures that your possessions go to the right people but also helps prevent disputes among family members. Moreover, it can reduce the financial burden of estate taxes and legal fees on your heirs. Another crucial part of estate planning is establishing power of attorney and healthcare proxies. These documents designate individuals who can make financial and medical decisions on your behalf should you become unable to do so yourself. Having these arrangements in place ensures that your wishes are respected, even in times of incapacity. “Meal Planning: Nourishing Your Body and Mind Nutrition plays a pivotal role in active aging. As you age, your body’s nutritional needs change, and making informed choices about your diet becomes increasingly important. Meal planning is not only about providing your body with the right nutrients but also about enjoying the pleasures of food. Consider consulting with a nutritionist or dietitian to create a meal plan tailored to your specific needs. A balanced diet rich in fruits, vegetables, lean proteins, and whole grains can help maintain energy levels, support cognitive function, and manage chronic conditions like diabetes and heart disease. One notable initiative for seniors is Meals on Wheels, operating across communities nationwide through local programs. This program delivers hot meals to homebound individuals aged 60 and older on weekdays, providing one-third of the Recommended Daily Allowance (RDA). Additionally, Focus Hope has become a staple in the community with programs aimed at helping seniors gain access to quality food options. These food boxes contain a selection of essential food items, including pantry staples and fresh produce. The aim is to ensure that seniors have access to balanced and nutritious meals that contribute to their overall health and well-being. Meal planning can also be a social activity. Consider joining a cooking class or club that focuses on healthy recipes for seniors. Sharing culinary experiences with others can not only improve your cooking skills but also provide opportunities for social interaction and connection. Exercise Classes: Staying Physically and Mentally Active Regular physical activity is a cornerstone of active aging. Exercise classes specifically designed for seniors can provide numerous benefits, such as improved strength, flexibility, balance, and mental well-being.
Staying active can help you maintain independence, reduce the risk of falls, and manage chronic conditions like arthritis and osteoporosis. John “JC” Jones, owner of JC Jones Bootcamp, boasts a remarkable 45-year tenure in the fitness industry. With a business model that is all about transformation and medical diagnosis reversal, he understands the importance of staying active while aging and pushing through medical adversity to become a better you. “You must stay active,” said Jones. Keeping your body moving is the key to health and longevity. Don’t be defined by your age or your illness. I’m over 60 years old, and I can get out here with the best of them. Remember, health and wellness is mostly mental. Stay motivated and stay educated about wellness and nutrition. Your body is your temple. Move at your own pace, but make sure you move.” Moving at your own pace is essential. Look for local senior fitness programs or classes that suit your interests and fitness level. These may include yoga, tai chi, water aerobics, or even dance classes. Regular attendance not only keeps you physically fit but also provides a social outlet where you can make new friends who share your commitment to active aging.
Exercise isn’t limited to the physical realm. Mental fitness is equally important. Consider engaging in activities that challenge your brain, such as puzzles, crosswords, or learning a new skill. Keeping your mind sharp through mental exercises can help prevent cognitive decline and enhance your overall quality of life. Dating: Pursuing Companionship and Romance Dating in your senior years may not be something you’ve thought about for a while, but it’s a valuable aspect of active aging. Companionship and romance can bring joy, connection, and a sense of fulfillment to your life, regardless of your age. Today, there are many ways to meet potential partners, both online and in person. Senior-specific dating apps and websites cater to the unique needs and interests of older adults. Additionally, local community centers and social groups often host events and activities where you can meet like-minded individuals. Dating as a senior can be a different experience than in your younger years, but it can also be more relaxing and enjoyable. You have a lifetime of experiences to share, and you can focus on finding someone who aligns with your values and interests. “In my senior years, I’ve come to appre-
ciate that the beauty of dating is not limited to youth,” said Carol Robinson, a Detroit Resident and widow who has embraced dating in the last six years. “Dating is a lifelong odyssey filled with the art of connection, the warmth of shared experiences, and wisdom that can only be found in the mist of our years. As seniors, we bring a wealth of life lessons and a unique perspective to the dating world, moving our romantic pursuits with our experiences. It’s a journey where every encounter is an opportunity for growth and every connection is a testament to the enduring capacity of the human heart to love, regardless of age.” Active aging is not a one-size-fits-all concept. It’s about tailoring your lifestyle to ensure that your later years are fulfilling, vibrant, and purposeful. Estate planning, meal planning, exercise classes, and dating are all essential components of this holistic approach. By securing your legacy, nourishing your body and mind, staying physically and mentally active, and pursuing companionship and romance, you can embrace the aging process with enthusiasm and create a fulfilling and enjoyable future for yourself. Remember that active aging is about taking proactive steps to make the most of the years ahead, ensuring that they are truly golden. SENIORcare | October 2023 7
“Until we get older ourselves or witness the struggles of a loved one, most seldom pay attention to the challenges that come with growing older,” says Ronald Taylor, President and CEO, Detroit Area Agency on Aging (DAAA). Instead, Taylor wants the public to know about DAAA’s work while they can still make lifestyle changes to live longer and extend their independence.
The Detroit Area Agency on Aging
More Than Meals On Wheels 8 SENIORcare | October 2023
“Area Agencies on Aging across the country have long been the trusted source for information and resources related to aging issues,” Taylor explains. “Now, we are aligning with healthcare providers to help reduce illness and ultimately reduce medical costs.” For many, DAAA offers a home and community-based care option for persons who are Medicaid Waiver eligible for their long-term care. It is a less costly and preferred alternative to nursing home care, and it ensures that participants get personalized care to meet their needs for independence. Also, new efforts are underway. Innovative nutrition services are offering more food options to meet cultural preferences; and collaborations with local food partners have fueled more responsive emer-
gency food distributions. Caregiver support has expanded with a portfolio of free classes and services, including caregiver assessments and training, a self-care program for caregivers, and tools for understanding and managing caregiver responsibilities. And, telehealth services are connecting more people to regular health monitoring. DAAA’s advocacy focuses on the social and economic determinants of health that impact aging – including the stresses that come from food insecurity, inadequate housing, limited education, transportation barriers, job readiness, and more. The agency has teamed with AARP and MPHI, the Michigan Public Health Institute, to create an Inclusive Health Care Taskforce, currently recruiting individuals and organizations to identify priority initiatives. The needs are outlined in DAAA’s three reports on Dying Before Their Time, and they are underscored by the numerous deaths of people of color during the COVID-19. Ron Taylor was CEO of DAAA less than 18 months when the pandemic arrived. It was his leadership, along with numerous health and community organizations, that triggered a campaign for in-home COVID vaccinations, allowing several thousand homebound residents to stay healthy and avoid the deadly virus. DAAA works within an integrat-
ed care system that combines delivery, management, and organization of services related to diagnosis, treatment, care, rehabilitation and health promotion across multiple systems – supported by a network of 100+ providers. And through a network of senior and recreation centers, DAAA promotes evidence-based classes to foster health and independence ranging from preventing falls to managing chronic diseases. “It’s the access to quality healthcare for all people that drives us,” says Taylor. “We want to help simplify what is often a complicated system for older adults. The goal is to reduce health disparities and achieve health equity.” “We live in a society with outdated stereotypes about older people,” says Taylor. “As our agency brings innovation, modernization, collaboration and transformation to our programs, we need other sectors of the community to offer social and educational opportunities to help bridge the generations. All of us are the architects of this community, and all of us are growing older. So, as I like to say when it comes to building community, We Are Stronger and Better When We Are Together!” Learn more by calling the Detroit Area Agency on Aging, 313/446-4444 or visit www.DetroitSeniorSolution.org.
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living often comes with a more predictable monthly expense, encompassing room, board, and daily non-medical care, which averages thousands per month. However, these facilities might have additional costs based on care levels or unexpected fee hikes. In contrast, in-home care charges by the hour, allowing for some flexibility in managing costs based on hours of service required. Still, the cumulative costs can escalate, especially if roundthe-clock care becomes necessary. Both options often face limited insurance coverage, with many policies excluding or minimally covering these long-term care services, leaving families grappling with out-of-pocket expenses or navigating complex state-funded programs. “Although most insurances don’t cover in-home care, there are some resources available such as the Michigan home help program which is mostly funded by Medicaid,” said McKitchen. “This type of program makes it possible for seniors who are on fixed incomes to remain at home but unfortunately most people don’t know about this program or don’t know how to apply for it.” Senior In-Home Care
$enior Care: The Cost of
Assisted Living vs. Aging in Place
By Ebony JJ Curry, Senior Reporter
Nearly 60% of older adults will need some form of long-term care, according to the Administration for Community Living. As the inevitable approaches, we find ourselves at a crossroads, pondering: Assisted living or in-home care? The answer is not straightforward; understanding the ins and outs of both options can lead to a better-informed decision. Understanding Assisted Living For seniors wishing to retain a semblance of independence but requiring non-medical assistance for daily activities, assisted living offers a compromise. Such communities give residents the luxury of a private apartment or room while ensuring access to essential care services. In these environments, one can enjoy shared spaces, dine in common areas, engage in activities, or unwind in a cinema room or library. Jerrell McKitchen, an experienced Registered Nurse who runs Premier Senior Home Care, highlights: “A major advantage of assisted living facilities is a community like environment, this serves well for seniors who may have lost a spouse or don’t have close relatives that live nearby.” Additionally, some of these communities boast lux10 SENIORcare | October 2023
urious amenities like spas and bars. They also ensure 24-hour staff presence and often provide up to three meals a day, housekeeping, and transportation. The modern paradigm of assisted living has notably shifted over the past two decades, moving from an institutional to a communal feel, promoting emotional and mental well-being. The Financial Aspect of Assisted Living McKitchen pointed out the financial challenges that can come with assisted living. “The average cost of inhome care is $25.00 per hour, and the average cost of an Assisted Living facility is $7,000 per month depending on the needs,” McKitchen said. However, insurance complications arise. Most health insurance policies exclude coverage for assisted living. Yet, there are exceptions, like long-term care insurance or the Veterans Administration’s Aid and Attendance program, designed for eligible wartime veterans. Unfortunately, Medicare doesn’t shoulder long-term assisted living or nursing home care costs. Meanwhile, Medicaid’s coverage is state-dependent, generally covering personal care but excluding room and board. The financial burden associated with senior care, whether in assisted living or in-home care, is substantial, albeit characterized by different nuances. Assisted
Senior in-home care stands out for its personal touch. However, there are challenges. “One major challenge faced with in-home care is the financial resources. Most insurances don’t cover these costs, leaving seniors that are mostly on fixed incomes or loved ones to pay out of pocket. Assisted Living facilities are only covered if an individual has long term care insurance or through personal savings. Another challenge is staff shortages, most agencies and assisted living facilities are faced with the task of recruiting and retaining qualified staff most in part due to the number of baby boomers who are now seniors.” said McKitchen. On the flip side, inhome care shines when it comes to treating seniors with Alzheimer’s or Dementia. The familiarity of home settings significantly benefits them. “Most seniors with these diseases respond very well to staff if they are taken care of in their homes,” McKitchen added. A significant percentage of the Black community, as McKitchen noted, opts for in-home care. “Based on past experiences, the Black community usually chooses to receive services at home. We usually hear stories about the significance of their homes and the beautiful memories tied there,” he shared. This sentiment is not just an observation; McKitchen experienced it personally. “In my personal experience, prior to my grandmother’s passing our family chose to take care of her at home until she required skilled care. In doing so the last memories we have of her are surrounded by family and loved ones in the comfort of her home,” he reflected. The Decision Ahead Choosing between assisted living and in-home care is more than just a logistical decision; it’s emotional and deeply personal. It requires weighing financial implications, assessing the level of care needed, and considering the emotional well-being of the senior involved. With both options presenting distinct advantages, the decision often boils down to personal preference and circumstance. In the face of such a significant decision, it becomes imperative to ask: What would you choose for your loved ones or yourself?
The Unsung Heroes: Understanding the Role and Unique Challenges of Black Caregivers By Lynzee Mychael, Multimedia Journalist There is a famous quote by Rosalyn Carter that states, “There are only four kinds of people in the world. Those who have been caregivers. Those who are currently caregivers. Those who will be caregivers, and those who will need a caregiver.” Caregivers play a vital role in our society, providing essential support and assistance to individuals who require help with their daily needs. These caregivers are often classified into two main categories: “formal” and “informal.” While formal caregivers are trained professionals who provide care for payment, informal caregivers, also known as family caregivers, offer their services without financial compensation. Although a heavy role, those who take on the role of caregiver shoulder the responsibility of offering physical, emotional, and sometimes financial assistance to those in need by carrying out a diverse range of tasks. These tasks involve helping with daily activities, ensuring proper medication management, coordinating medical appointments, and providing essential companionship and emotional support. Formal caregivers are professionals who have undergone training and education to offer specialized care. They may be employed by home health agencies or other healthcare institutions, ensuring that their care meets specific standards and guidelines. On the other hand, informal caregivers, often referred to as family caregivers, are individuals who provide care to their loved ones without receiving monetary compensation. Their motivation is rooted in a deep sense of responsibility and compassion. Family caregivers typically offer support within the comfort of their homes, making their care deeply personal and often tailored to the unique needs of their care recipients. Raven Harvey, a Licensed Practical Nurse who has been in the geriatric industry for 13 years, says that being a caregiver in any sense of the word is rooted in sacrifice and love. “Anyone I have taken care of has become like family to me. In my role as a caregiver, I have always felt the need to advocate and ensure that families can feel comfort that their family member is in the best care. My drive behind wanting to get into the medical field with a concentration on geriatric patients was born out of the understanding that there are many seniors that go without quality care.” Analysis of data from the National Health and Aging Trends Study (NHATS), a nationally representative survey, reveals that a significant portion of older American parents requiring assistance with daily activities at home are not receiving the support they need.
The findings from these NHATS-based studies highlight the intricate web of challenges faced by older Americans in need of care. Disparities in caregiving quality and accessibility persist, affecting those with in-home caregivers, individuals living with dementia, and those in stepfamilies. These disparities impact not only the physical well-being of seniors but also their overall quality of life. It mainly underscores the importance of caregivers. “When my grandma needed assistance for my sick uncle, I felt obliged to step in,” said Harvey. “It marked my first experience as a caregiver within my own family. Immersing myself in the role of a caregiver for a loved one gave me a different point of view. It demanded an intense level of dedication and care, pushing me to set aside my professional side and assume many roles - that of a family member, an aide, a mediator, and much more. This experience deepened my compassion for people thrust into similar circumstances. While I have experience, I couldn’t help but empathize with those who, as ordinary people, find themselves balancing the responsibilities of caregiving with the demands of their daily lives.” The journey of caregiving can be a challenging and emotionally taxing experience, often requiring support, resources, and guidance to ensure the well-being of both the caregiver and the care recipient. In these complex situations, many individuals and families have found solace and assistance in the Program of All-Inclusive Care for the Elderly (PACE). The PACE Program: A Solution for Family Caregivers The Program of All-Inclusive Care for the Elderly (PACE) is a comprehensive care model designed to address the unique needs of seniors, including those of Black caregivers and their loved ones. PACE offers the following benefits: Holistic Care: PACE programs provide a holistic approach to healthcare, encompassing medical, social, and emotional needs. This can alleviate the burden on family caregivers by offering professional support and services tailored to seniors’ specific requirements. Community-Based Care: PACE is centered around community-based care, allowing seniors to receive services while remaining in their homes. This can be especially valuable for family caregivers who wish to honor cultural preferences and keep their loved ones in familiar surroundings. Multidisciplinary Teams: PACE programs bring together a team of healthcare professionals, including doctors, nurses, social workers, and therapists, to create a personalized care plan for each participant. This relieves caregivers of the sole responsibility for making healthcare decisions.
Respite Care: PACE programs often include respite care services, providing caregivers with much-needed breaks to attend to their own health and well-being. Cultural Competency: Many PACE programs prioritize cultural competence, recognizing the importance of understanding and respecting the diverse needs and backgrounds of participants, including Black seniors and caregivers. When families and individuals turn to the PACE program, they are met with a holistic approach to caregiving solutions. PACE provides not only essential medical care but also a supportive community that values the well-being of both caregivers and care recipients. It ensures that participants receive the right care at the right time, thereby improving their quality of life. The PACE program offers a promising solution by providing comprehensive, community-based care that addresses the specific needs of Black seniors and their caregivers. As we continue to advocate for better support and resources for family caregivers, it is crucial to recognize the invaluable contributions of Black caregivers and ensure that they have the tools and assistance they need to provide the best possible care for their senior relatives. Caregivers, whether formal professionals or informal family members are the unsung heroes of our society. Their tireless dedication to improving the lives of those in need is a testament to the strength of the human spirit. While formal caregivers receive specialized training and compensation for their services, informal caregivers, driven by love and compassion, provide care without expecting financial rewards. Recognizing and appreciating the vital role of caregivers is essential to ensuring that they receive the support and acknowledgment they truly deserve. Their unwavering commitment and selflessness serve as a beacon of hope and compassion in the world of caregiving. SENIORcare | October 2023 11
Michigan’s Little-Known PACE Program Provides
Alternative Care for Elderly
I
By Andre Ash, Digital Anchor
t’s a program that has been around for 50 years, providing all-around care to senior citizens in Michigan. PACE (Program for All-Inclusive Care for the Elderly) is a program that dates back to 1973 when its origins took shape in San Francisco. The idea was born after Asian families on the West Coast city were concerned about nursing homes being the only source of care for their elderly family members. An adult daycare and other services were developed as a result, starting a blueprint that would inspire programs across the nation. In 1994, the local Detroit area became one of the first pilot projects for the PACE program, partnering with Henry Ford Health System to bring an alternative to the traditional forms of healthcare for the elderly. Currently, Henry Ford Health owns 55% of PACE Southeast Michigan, while the organization Presbyterian Villages of Michigan owns 45%. PACE Southeast Michigan was created to provide fam-
ilies with professional healthcare providers and the flexi- tions, hospitals, and other areas. bility to meet healthcare needs while also helping elderly The eligibility for participants is residents who are 55 participants continue to live in their own communities. years and older, residing in Southeastern Michigan – par“This is about enhancing wellbeing,” says Mary Na- ticularly in Wayne, Oakland, and Macomb counties – who ber, President & CEO of PACE. “The people we care for are currently living safely at home, according to the critemay never get all the way well, but if we can enhance ria of “safely” for the state of Michigan. their wellbeing and manage their medical condition, “The people we take care of are nursing home-eligithat’s the best of both worlds.” ble, but they don’t want to go to nursing homes. They
PACE is a program that is regulated by Medicare in want to stay in their homes and we are that alternative,” partnership with the state Medicaid department. The Naber says. program provides the participants with health insurance The eligibility is also targeted toward low-income parthrough said agencies while simultaneously serving as ticipants making less than around $2,700 a month. the participant’s primary healthcare provider. “Most people don’t want to be in a nursing home, PACE provides elderly participants with all they need ever. It’s institutional, there’s many perceptions around medically, psychologically, and spiritually as an alterna- staffing, levels of safety, and most people just want to tive to the nursing home system. be in their own homes. It’s the last phase of their life for The nonprofit agency is made up of a team of experts many of them and we want to enhance their wellbeing who specialize in the care of older people. They will and make sure their life is a vital as it can be until the end.” partner with a potential participant and their family to PACE’s regional Detroit programs serve 1,700 elderly develop the most effective plan of care, all with the goal participants at seven centers in Dearborn, Eastpointe, of keeping the elderly participant healthy and engaged Pontiac, Southfield, Sterling Heights, and two Detroit lowith a level of comfort. cations in Rivertown and on the city’s northwest side. An PACE prides itself on having a team of community liai- eighth center will be added this year in Clinton Township, sons, too, who each reach out to the community through and a ninth is planned next year for Westland. senior apartment complexes, churches, senior associaThe local program prides itself on having 1,800 staff members who serve as bus drivers, nursing aides, social workers, behavioral health specialists, and more.
“There is no out-of-pocket and we provide all their care, all their specialty care, we make all the appointments for specialty care. Participants are assigned a nurse case manager and a social worker, as well as a care team to take care their needs.” PACE Southeast Michigan has been committed to providing comprehensive care with the use of Medicare, Medicaid, and private funds to cover all medically necessary care and services. The program has helped ease the burden and worry for families of what is covered and how much one may have to pay. This sometimes little-known program has kept the focus on the participating senior citizen and their families. For years, providing a team of healthcare professionals across Southeast Michigan, helping the elderly to make important healthcare decisions. PACE is available for all low-income seniors, regardless of their level of need. As their focus has been on caring for a small sector of participants, they emphasize getting their employees to establish personal relationships with their elderly participants to better understand their living conditions and specific areas of need. For more information about PACE, visit pacesemi.org.
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Caregivers will find support and resources at the Alzheimer’s Association When a person is diagnosed with Alzheimer’s life changes very quickly for all involved. The role of caregiver can be an overwhelming task. According to the 2023 Alzheimer’s Disease Facts and Figures Report, there are 388,000 individuals providing unpaid care to someone with Alzheimer’s or dementia in Michigan. They are providing 872 million hours of work – the highest average amount of hours per caregiver in the U.S. -- estimated at a value of more than $17 billion.
“It is crucial that caregivers receive assistance, resources, and support,” said Jennifer Lepard, president and CEO of the Alzheimer’s Association Michigan Chapter. “Caring for a loved one with Alzheimer’s or dementia can be an overwhelming responsibility. It is important they know that they are not alone. The Alzheimer’s Association is there for caregivers with free educational programs, support groups and other resources.” Some of the programs that the Association provides for caregivers include: ■ Virtual or in-person support groups across the state. ■ Educational programs that provide information on what to expect as a caregiver during each stage of Alzheimer’s, communication strategies, behavioral changes, financial and legal information and more.
As people go through the journey of caregiving, it can be isolating and emotional. Depending on the family structure of the patient and caregiver, some people may feel hesitant, guilty or embarrassed to ask for help or even talk about their experience as a caregiver.
■ Consultations with counselors to create a care plan and discuss common concerns Along with educational and social like wandering, safety, communication is- support, there is also financial support sues and driving. available. The Association offers respite ■ Social engagement activities for those in care scholarships, providing financial asthe early stages of the disease and their sistance for those in need of caregiving caregiver, including museum tours, class- assistance. es, and concerts.
“We are a phone call or email away,”
said Lepard. “Please don’t hesitate, we are here to help and support you.” To learn more about all of the programs and resources the Alzheimer’s Association offers, visit www.alz.org/gmc or reach out to our helpline at helplinegmc@alz. org or 800.292.4900.
If you care for someone ith lzheimer’s disease, memory loss or dementia, you are not alone. e’re here day or night - henever you need us – offering reliable information and support. Free 24/7 Helpline: 800.272.3900 | helplinegmc@alz.org | alz.org/care SENIORcare | October 2023 13
Benefits and Challenges of
Medicare in America Benefits of Medicare
Access to Healthcare
By Jeremy Allen
M
edicare has been a cornerstone of the U.S. healthcare system since its inception in 1965. As a federal health insurance program, it provides essential health coverage to millions of seniors and certain younger individuals with disabilities. While the benefits of Medicare are undeniable for the most vulnerable citizens in society, the program also faces significant challenges that have evolved over time. When Medicare was established in 1965, it was fought tooth and nail by insurance companies (and many others, including the American Medical Association and future President Ronald Reagan). The overwhelming Democratic majority in Congress was able to overcome this opposition due to the landslide election results of 1964, but only through weakening the initial proposal. Medicare was established with a requirement that beneficiaries pay 20% of their health care costs out-of-pocket and with other limitations, such as no coverage for prescription drugs, dental care, etc. Insurance companies quickly began selling Medicare Supplemental policies, and by the 1980s, the federal government had to step in to provide oversight of these policies, which, in many cases, took advantage of beneficiaries through high deductibles and co-pays. As healthcare costs rose, Medicare’s funding mechanism struggled. Elected officials, reluctant to raise payroll taxes or premiums to cover the costs, succumbed to the claims of insurance companies that they could cut costs and established Medicare Part C, initially known as Medicare Choice, but now marketed as Medicare Advantage. Enrollment in Medicare Advantage programs was less than 10% of all Medicare beneficiaries in 2010 but is now approaching 30%.
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One of the most significant benefits of Medicare is the access it provides to healthcare services for millions of Americans. It ensures that older adults and individuals with disabilities can receive medical care, including doctor visits, hospital stays, preventive screenings, and more, without facing crippling financial burdens. This access to healthcare promotes overall well-being and quality of life among beneficiaries. Comprehensive Coverage Medicare offers comprehensive coverage that includes various aspects of healthcare, which can be divided into four parts: Part A: Hospital Insurance Part B: Medical Insurance Part C: Medicare Advantage Plans Part D: Prescription Drug Coverage These components ensure that beneficiaries have access to hospital care, medical services, prescription medications, and the option to choose private health plans that often offer additional benefits, such as dental and vision coverage. Preventive Care Medicare encourages preventive care by covering a range of services, including mammograms, vaccinations, screenings for diabetes and cancer, and wellness visits. By promoting early detection and prevention, Medicare aims to improve overall health outcomes and reduce healthcare costs in the long run. Financial Protection Medicare provides financial protection for beneficiaries by capping their out-ofpocket expenses. While there may still be copayments, deductibles, and premiums, these costs are typically lower than what individuals might face with private insurance, ensuring that healthcare remains affordable for seniors and individuals with disabilities.
Broad Network of Providers
Medicare has a vast network of healthcare providers, making it easier for beneficiaries to find doctors, specialists, and hospitals that accept their coverage. This broad network enhances convenience and choice for Medicare beneficiaries, allowing them to receive care from their preferred healthcare providers.
Challenges of Medicare Rising Healthcare Costs One of the most pressing challenges facing Medicare is the continuous rise in healthcare costs. As medical expenses increase due to factors such as inflation and advances in technology, Medicare’s ability to provide comprehensive coverage while keeping premiums and deductibles affordable becomes increasingly challenging. The rising cost of healthcare puts strain on both the program and beneficiaries. Fiscal Sustainability Medicare is funded primarily through payroll taxes collected from workers and their employers. With an aging population and a decreasing ratio of workers to retirees, there are concerns about the long-term fiscal sustainability of the program. As the number of beneficiaries grows, Medicare’s financial burden on the federal budget becomes a matter of concern for policymakers. Coverage Gaps Despite its comprehensive nature, Medicare does not cover all healthcare services. There are notable coverage gaps, including long-term care, dental care, and hearing aids. These limitations can leave beneficiaries vulnerable to high out-of-pocket expenses, particularly in areas where they need specialized care or support for chronic conditions. Complex Program Structure Medicare’s program structure can be complex to navigate, with different parts, plans, and enrollment periods. This complexity can lead to confusion among ben-
eficiaries, making it challenging for them to choose the most suitable coverage options. Many beneficiaries require assistance from counselors or family members to make informed decisions. Physician Payment Rates Medicare’s physician payment rates have been a source of concern for healthcare providers. The program’s reimbursement rates are often lower than those offered by private insurers, leading some healthcare providers to limit the number of Medicare patients they accept. This can result in access issues, especially in areas with a high concentration of Medicare beneficiaries. Healthcare Disparities Medicare has made significant strides in reducing healthcare disparities among racial and ethnic groups. However, challenges remain in addressing disparities related to access, quality of care, and health outcomes. Medicare needs to continue efforts to improve equity in healthcare access and outcomes for all beneficiaries. Fraud and Abuse Medicare is vulnerable to fraud and abuse, which can result in significant financial losses for the program. Scammers and fraudulent healthcare providers sometimes exploit weaknesses in the system to submit false claims. Medicare must continually enhance its fraud detection and prevention efforts to protect both the program and its beneficiaries. Medicare has been a vital pillar of the American healthcare system for over half a century, providing essential health coverage to seniors and individuals with disabilities. As Medicare continues to evolve, policymakers must address these challenges to ensure the program’s sustainability and effectiveness in meeting the healthcare needs of an aging population and the most vulnerable people in society. By addressing these challenges and building on its strengths, Medicare can continue to play a crucial role in providing access to quality healthcare for generations to come.
Coverage
that Cares:
together and present overlapping barriers to health and wellness.
Helping isolated adults access the medical, working to break. part of Tom’s personalized follow-up mental health and social support they need care,AsRaluca and another CCA Health MichEvery person is unique and has their own set of health needs. For individuals facing significant medical, mental health, or social support challenges, a helping hand can make a big difference. Having a team of nurses, community health workers, and care navigators on your side to help connect you to the services you need may improve your long-term health and quality of life. CCA Health Michigan’s care professionals are passionate about advocating for their members, helping them break down barriers to care. For Raluca, a CCA Health Michigan care partner and registered nurse, building trust with members is key. “What helps the most is really listening to our members and taking the time to understand what they need. It lets them know that we care.” By listening, Raluca can also develop a personalized care plan designed to address a members’ unique needs. “It’s important to get to know each member and to meet them where they are,” she said, noting their care plan must account for their reality and
any struggles they may be facing. Not long ago, Raluca met with a member named Tom* at a local emergency department (ED). Tom had been a frequent visitor to the ED and had been admitted several times. During this face-to-face meeting, Raluca did a comprehensive evaluation of Tom’s needs. She also developed a rapport with him. It was during this meeting that she learned that Tom came to the ED for more than just medical treatment. He admitted coming there often because he knew it meant getting a warm welcome and a warm meal. By taking the time to better understand all of Tom’s needs, not just his chronic conditions, Raluca learned that he was struggling with food insecurity, as well as with anxiety and depression. He didn’t have a social support system at home that could help him with day-to-day tasks. Tom also lacked the ability to access the healthcare services he needed in a timely way. His mental and social challenges affected his physical health, and vice versa, creating a cycle that health organizations like CCA Health Michigan are
igan Care partner, Shannon, also a registered nurse, began checking in on him every other week. They developed a plan, coordinated his care, connected him with the appropriate health professionals, and ensured he had transportation to his medical appointments. Sometimes, Raluca and Shannon went with Tom to his appointments to make sure he understood his follow-up instructions. Beyond helping Tom with his medical needs, Raluca and Shannon also connected him with local community resources designed to provide companionship for older, isolated adults. To help him with food insecurity, they set him up with Meals on Wheels so he would have regular, nutritious food delivered to his home. Comprehensive care management that embraces the whole health needs of an individual can make a positive difference in the lives of people who experience diverse medical, mental health, and social challenges, especially people who are alone and isolated. Tom is just one of many people in our community who experience multiple adverse conditions that all come
With the help of CCA Health Michigan’s care team, Tom has reduced his emergency department visits and inpatient admissions. Raluca and Shannon’s home visits helped improve Tom’s emotional health, too, as he expressed feeling less lonely and isolated. Tom eventually felt empowered enough to start taking better care of his health. CCA Health Michigan has proven expertise in serving individuals with significant needs through Medicare Advantage plans for those who qualify for Medicare and those who are dually eligible for both Medicare and Medicaid. CCA Health Michigan has a contract with Medicare and a contract with Medicaid. Renewal of these contracts is required for enrollment. *Tom is a pseudonym to protect the privacy of CCA Health Michigan’s member.
Learn more about CCA Health Michigan’s Medicare Advantage plans by visiting www.ccahealthmi.org.
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