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2020

CAREGIVER SOLUTIONS A Resource for Family Caregivers

Articles • Directory of Providers • Support Services • Books and Resources


50plus Living Virtual Open House – “Visit” mature living communities and service providers from the comfort of your home or office.

Aug. 15 – 31, 2020 Who will want to check it out: • Boomers preparing for the future • Caregivers considering alternatives for loved ones • Seniors who want to be aware of their living and care options

Why you will want to log on: • Learn about living and care options available • Connect with multiple living communities or care providers • View videos and / or photos of campuses • Ask questions and have them answered on a personal basis, virtually • Be knowledgeable in order to make informed decisions • Make an appointment for an in-person tour when convenient

Plan now to visit the Virtual Open House!

50plusLivingVirtualTour.com Residence and Care Providers — see how you can be a part of this exciting complement to our brick-and-mortar events! Call your marketing consultant or contact Christianne Rupp at 717.285.8126 or email crupp@onlinepub.com.


caregiver solutions 2020 Publisher

Donna K. Anderson

Editorial

Vice President & Managing Editor Christianne Rupp Editor Megan Joyce Contributing Writers Lori L. Dierolf Barbara Elaine Goll Marion Niglio Kanenson Kathleen Kauth Jim Miller Lisa M. Petsche Caroline Smith Barry Sparks

Art Department

Production Coordinator Lauren Phillips Production Artists Renee McWilliams Connie Molitor

Business Development

Senior Marketing Consultant Josh Binkley Marketing Consultants Brittney Bonagura Cassidy Galeone

Events Manager Kimberly Shaffer Business Manager Elizabeth Duvall

Copyright © 2020 On-Line Publishers, Inc. All rights reserved. All listings and advertisements have been accepted for publication on the assumption that the information contained in them is true and accurate and that all merchandise or services offered in the advertisements are available to the customer according to the conditions warranted therein. The appearance of advertisements or products or services does not constitute an endorsement of the particular product or service. On-Line Publishers, Inc. disclaims any and all responsibilities and liability which may be asserted or claimed resulting from or arising out of reliance upon the information and procedures presented in this guide.

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Dear Readers, Thank you for picking up this copy of Caregiver Solutions or reading it online. Each year, the editorial committee considers many topics and must choose the ones they think will most help caregivers. I hope after reading this edition you will agree it contains an excellent array of topics covering concerns that many caregivers manage every day. Most caregivers consider what they do a matter of love. Although that’s true, many will also admit it can be very stressful due to other family and work obligations tugging at them. Add to that the additional stress that the recent pandemic put on everyone, and I’m sure you were stressed to the limit and wondering which way to turn. Caregiver Solutions provides information and guidance to assist in your caregiving journey. We appreciate that so many people shared their expertise and wisdom in the articles included in this edition. Caregiving can have a financial impact on the caregiver. Please make sure to check out the Caregiver Support Programs offered through state and federal governments on page 19. Eligibility requirements and assessment criteria are included. You may be eligible for some assistance. Inside, you’ll find two pages of books for suggested reading. Sometimes you may feel helpless, and a book can offer tips for some of the same things you are experiencing or even let you know that you are not alone in your situation. There is also the Directory of Housing and Care Providers and a Directory of Ancillary Services. Be sure to check them out. Those communities, businesses, and organizations have your best interest in mind and would like to speak with you about their services. You may not feel like what you do is appreciated or noticed, or perhaps your loved one isn’t able to acknowledge gratitude. We would like to thank you for all you do.

Christianne Rupp Editor

Contents 12 Home Caregivers

4 Caregivers Are

May Suffer from Compassion Fatigue

Allowed to Cry?

6 Community

14 Combatting Loneliness

HealthChoices Explained

in Seniors

8 What Older Diabetics Should Know About Coronavirus

9 Living with

Parkinson’s Disease

10 Eldercare Mediation

Setting Families Up for Success

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16 Frequently Asked Questions

18 How Medicare Covers Ambulance Services

19 Caregiver Support Programs

20 Expert Advice on

22 Depression and Dementia

24 Organizing Your Personal Affairs

26 Good Reads 28 Directory of Housing & Care Providers

30 Directory of Ancillary Services

31 Support and Information

Negotiating the Caregiving Dynamic

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Caregivers are Allowed to Cry? Coping with Difficult Feelings By LISA M. PETSCHE

Caring for an aging relative can involve physical, psychological, emotional, and financial demands. Caregivers may experience a variety of distressing emotions along the way. Read on for the most common ones and the reasons for those feelings. Guilt – Because unlike their relative, the caregiver enjoys good health; many have not, until recently, been significantly involved in their relative’s life; they have mixed feelings about their role as a caregiver; or they have made promises they’re not sure they’ll be able to keep.

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Resentment – They’ve had to make personal and financial sacrifices; the relative has treated them badly in the past; their relative is demanding and critical; family members aren’t helping out; or family members are critical of the care provided. Frustration – Often due to the helplessness of being unable to change the course of their relative’s illness; personality differences between them and their relative; having to contend with “nuisance” behaviors, such as repetitive questioning; or being unable to reason with their cognitively impaired relative.

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Anxiety and fear – Their charge may fall or, if their relative has dementia, household accidents, physical aggression, or wandering away from home may occur; or there are concerns about what the future holds in terms of their relative’s disease progression and care needs. Loneliness – Arises from social isolation; feeling no one understands what they’re going through; having to do things alone that they used to do with their relative; or being unable to relate to their relative in the usual ways due to changes in their cognition. Sadness – Because their relative is gradually losing their abilities and perhaps also their personality; joint plans for the future must go unrealized; or they can’t imagine life without their relative. Anger – Because their relative is ill or disabled, is overly dependent on the caregiver, or refuses recommended medical equipment or community support services. Feelings of anger may be directed toward their relative, family members, healthcare providers (continually finding fault with them), or God, or they may be non-specific. Caregivers may also be angry at themselves for taking on the caregiving role or for not being more assertive with the care receiver, family members, or health professionals. While a certain degree of caregiving-related stress is inevitable, when left unchecked it can lead to burnout. Physical warning signs include fatigue, memory problems, sleep difficulties, significant weight loss or gain, frequent illness, and development of chronic health problems. Some emotional red flags are frequent crying, frequent irritation by small annoyances, difficulty controlling one’s temper, feeling overwhelmed, feeling inadequate, and feeling hopeless. In severe cases, burnout can lead to abuse of the care receiver; this signals the need for immediate help.

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Coping Strategies If you are a caregiver, read on for some strategies to help keep stress manageable. • Look after your own health. Find something relaxing you can do daily to give yourself a break, perhaps enjoying a cup of tea, reading, writing in a journal, or listening to music. • Stay connected to your friends; your faith community, if applicable; and other supportive groups. • Focus on your relative’s abilities, not disabilities, and the things you can still do together. • Acknowledge your relative’s right to make decisions you disagree with (provided they are mentally capable). • Let go of past grievances. Seek counseling if necessary to help you move forward in your relationship with your relative. • Don’t promise your relative you will never place them in longterm-care, because you don’t know what the future holds. • Take things one day at a time. Recognize there will be good days and not-so-good days. • Join a caregiver support group. • Don’t try to do it alone. Accept offers of help. If they’re not forthcoming, ask other family members to share the load and be specific about what you need.

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Lisa M. Petsche is a social worker and a freelance writer specializing in boomer and senior health matters. She has personal experience with elder care.

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Community HealthChoices Explained By CAROLINE SMITH

More than 420,000 Pennsylvanians have transitioned into Community HealthChoices. Does this affect you or someone you care for? Chances are it does, and below is a guide on what this means for them. Community HealthChoices (CHC) has been a hot topic across Pennsylvania for the last three years as a new statewide mandate came out changing the way we provide care and services to those in need, especially the elderly with low incomes, those in long-term nursing facilities, and adults with chronic physical disabilities. Changes occurred to our statewide Medicaid program, the services that can be received, and how they are being implemented. This new initiative has rolled out across the state of Pennsylvania in three phases beginning in 2018 (southwest), 2019 with the second phase (southeast), and the last phase in January 2020 (middle of the state — this was the largest geographical area). Community HealthChoices is Pennsylvania’s mandatory managed-care program for adults 21 and older who are eligible for both Medicaid and Medicare, older adults, and those receiving long-term supports and services through physical disability waivers, now known as the CHC waiver. If someone you care for meets one or more of these qualifications, they have been automatically enrolled in CHC. There are several exceptions — people who will not be enrolled into CHC even if they meet the criteria above. These exceptions are those in a state-operated hospital, such as a veterans hospital, and those approved for Office of Developmental Program waivers, such as the consolidated waiver or person/family-directed services, LIFE program, and autism waiver, as well as those in the Act150 program or those in the OBRA waiver. There are three managed care organizations (insurance companies) that are overseeing the state and the services provided under CHC. These insurance companies include PA Health & Wellness (Centene), AmeriHealth Caritas/Keystone First, and UPMC for You. These insurance companies are responsible to coordinate services and take the confusion out of your care. If someone you care for is enrolled in CHC, they will be asked to choose one of these “plans” or insurance companies.

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If they do not choose a plan, a plan will be chosen for them, there to help guide you through these changes and get you what and they will have the opportunity to change plans, if they so you need to be healthy, safe, and independent. choose, as often as once per month. There is no open enrollment For more information on Community HealthChoices, please period and everyone has the opportunity to choose and change contact the UDS Resource Center by calling (888) 837-4235, use their plan at any point. the state number at (844) 824-3655, or visit the CHC website at Like others in the state, you might be thinking, “Why is www.enrollchc.com. You can also reach out to the managed care this change is happening?” The purpose of CHC is to provide organizations at: better coordination of services to improve the quality of your healthcare experience and to serve more people at home and in • PA Health & Wellness: 844.626.6813 their communities rather than in facilities. Each person enrolled in CHC will be assigned a service coordinator to help them get the • AmeriHealth Caritas/Keystone First: 855.235.4976 services they need. Once they have chosen a managed care organization or • UPMC for You: 866.407.8762 insurance company, participants can then request a service coordination agency by simply calling into the insurance company to request United Disabilities Services or any specific agency for service coordination; otherwise, one will be assigned to Caroline Smith is a program specialist of strategic growth and navigation with United Disabilities Services (UDS), a nationally accredited, you. nonprofit organization that provides service coordination among other No services that were previously received through the services. UDS can answer your questions and give you more insight so physical disability waivers or the adult Medicaid package are you will be able to talk with your care receiver. For more information, being reduced. In fact, additional services are being included in please visit their website at: www.udservices.org. CHC that were not available before, such as housing and pest eradication. Medicare is also not affected by CHC at all. Another change occurring with CHC includes getting another insurance card. It Are you a person with a disability or an older adult? is important to remember not to get rid of any of your existing insurance cards. This YOU HAVE OPTIONS! Community HealthChoices card does not replace another. When you or someone you care for goes to the doctor or the hospital, they should take all of their insurance cards with them and present them to the front desk each time. The PA Link to Aging and Disability Resources is Important: If you have Medicare and your source for long-term living support services. Medicaid, you will not need to change any medical providers as long as they accept The PA Link can provide person-centered Medicare. Medicare will pick up the first counseling to help 80% and CHC will pick up the remaining you access a network 20% of the bill, no matter which managed of private and public care organization you choose or which community resources your medical providers contract with. Otherwise, you will want to be sure providing choices to the insurance company you choose is in seniors and those living line with your current waiver and medical with a disability. providers. Community HealthChoices brings on a lot of changes and new opportunities to those who need assistance to remain independent. Your managed care organization and service coordinator are

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Call: 1-800-753-8827

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What Older Diabetics Should Know about Coronavirus By JIM MILLER Dear Savvy Senior, My husband and I are both in our late 60s and have diabetes. We would like to find out if our diabetes increases our risk of getting the coronavirus. – Concerned Diabetics Dear Concerned, Currently, there’s not enough data to show that people with diabetes are more likely to get coronavirus (COVID-19) than the general population. But the problem for diabetics is that if you do happen to contract the virus, your chance of developing serious complications is much higher. This is especially true if your diabetes isn’t well controlled. Here’s what you should know. Diabetic Risks Health data is showing that about 25% of people who go to the hospital with severe COVID-19 infections have diabetes. One reason is that high blood sugar weakens the immune system and makes it less able to fight off infections. Your risk of severe coronavirus infection is even higher if you also have another condition, like heart or lung disease. If you do get COVID-19, the infection could also put you at greater risk for diabetes complications like diabetic ketoacidosis (DKA), which happens when high levels of acids called ketones build up in your blood. Some people who catch the new coronavirus have a dangerous body-wide response to it, called sepsis. To treat sepsis, doctors need to manage your body’s fluid and electrolyte levels. DKA causes you to lose electrolytes, which can make sepsis harder to control. How to Avoid COVID-19 The best way to avoid getting sick is to stay home as much as you can. If you have to go out, keep at least 6 feet away from other people. And every time you come back from the supermarket, pharmacy, or another public place, wash your hands with warm water and soap for at least 20 seconds. Also wash your hands before you give yourself a finger stick or insulin shot. Clean each site first with soap and water or rubbing alcohol. To protect you, everyone in your house should wash their hands often, especially before they cook for the family. Don’t share any utensils or other personal items. And if anyone in your house is sick, they should stay in their own room, as far as possible from you. 8

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The CDC also recommends that you stock up on medications and diabetes-testing supplies to last for at least a month. The same goes for grocery supplies and other household necessities. Also know that Medicare is now covering the cost of telehealth visits, so if you have questions for your doctor, you can ask by video chat or phone instead of going into the office. If You Get Sick The most common symptoms of COVID-19 are a dry cough, fever, or shortness of breath. If you develop any symptoms that are concerning, call your doctor about getting tested. If you find that you have contracted COVID-19, the first level of care is to stay home and check your blood sugar more often than usual. Check your ketones, too. COVID-19 can reduce your appetite and cause you to eat less, which could affect your levels. You also need more fluids than usual when you’re sick, so keep water close by, and drink it often. You should also know that many over-the-counter medicines that relieve virus symptoms like fever or cough can affect your blood-sugar levels one way or the other. So, before you take anything, check with your doctor. And be aware that if you start experiencing severe shortness of breath, high levels of ketones, or DKA symptoms like severe weakness, body aches, vomiting, or belly pain, you need to see your doctor or get to an emergency room right away.

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Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior.org. Jim Miller is a contributor to the NBC Today show and author of The Savvy Senior book.

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Living with Parkinson’s Disease By MARION NIGLIO KANENSON A diagnosis of Parkinson’s disease can be overwhelming and even somewhat isolating. However, more and more resources are available to people with Parkinson’s disease to support them and their families and caregivers. It is critical to have those supports in place early on in the disease. Not only are those with Parkinson’s disease coping with the disease, but their caregivers are as well. Welcoming support from others helps to ease the burden. Approximately 1 million people in the U.S. are living with Parkinson’s disease, as are more than 10 million people worldwide. Approximately 60,000 Americans are diagnosed with Parkinson’s disease each year. Parkinson’s disease is a chronic and progressive disease. It is a neurodegenerative movement disorder that causes symptoms of tremors, rigidity or stiffness of the muscles, and slowness of movements that can progress over time. Many symptoms of Parkinson’s disease are unrelated to movement; these are non-motor or “invisible symptoms,” which are common. These symptoms can cause sleep problems, fatigue, constipation, anxiety and depression, and a soft or low voice. Symptoms can fluctuate, causing “on and off” periods throughout the day. By exercising, obtaining adequate sleep, and getting proper nutrition, those with Parkinson’s disease can improve mobility and quality of life. It is very important for people with Parkinson’s disease and their family and caregivers to reach out for the support of others through local support groups, national Parkinson’s disease nonprofits, educational materials, and many resources available in their communities. Attending a local support group can help you to understand that you are not alone and that someone else is in a similar situation. Members in a support group help each other feel nurtured and comforted. You can gain knowledge and tips about the disease and even new lifelong friends throughout your journey. As an active member of your care team, educate yourself about Parkinson’s disease, find a healthcare professional you are comfortable with, and talk with your doctor and loved ones to decide on treatments. As a caregiver of someone with Parkinson’s disease, educate yourself about symptoms, the progression of the disease, and treatments. Remember to take time for yourself, as you are vital in maintaining the quality of life for your loved one. In central Pennsylvania, there are several support groups, exercise groups, and educational symposiums. Caregivers and their care receivers who have been affected by Parkinson’s disease can join a community of support at the Harrisburg Area Parkinson’s Disease Caregiver Support Group. I started this support group 10 years ago, and we continue to www.BusinessWomanPA.com

meet every third Thursday of the month from 6-8 p.m. at the Linglestown Giant community room. You can also join the Parkinson’s disease support group at the Helen M. Simpson Rehabilitation Hospital, which provides available community resources for those with Parkinson’s disease. Below is a list of resources, including online resources to educate the community and raise awareness for those with Parkinson’s disease and also their caregivers: • Pennsylvania Chapter of the American Parkinson’s Disease Association, www.apdaparkinson.org • PD Fitness at Home, www.parkinsonsfirstpa.com – Online fitness classes • Parkinson’s Foundation, www.parkinson.org – Provides people with Parkinson’s disease and caregivers access to local resources and services • Help with Parkinson’s, www.helpwithparkinsons.com – A local nonprofit offering podcasts While progressing through the stages of Parkinson’s disease as the patient or caregiver, learn all you can about the disease early on so you can make informed decisions now and as needed in the future to live better every day. Fortunately, no one has to feel isolated when dealing with Parkinson’s disease. Help, support, and advice are readily available so you don’t have to take this journey alone.

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Marion Kanenson started the Harrisburg Area Caregiver Support Group 10 years ago. Her father had Parkinson’s disease for almost 30 years, and she realized there was a need for support for primary caregivers, like her mother. As the disease progressed, more outside supports were necessary. Caregivers need to know they are not alone on this journey and that they need to take time for themselves. Meetings consist of speakers, education, and an empathetic listener, a shoulder to cry on, lots of hugs, and even chocolate! caregiver solutions 2020 BUSINESSWoman

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Eldercare Mediation Setting Families Up for Success By KATHLEEN KAUTH When it comes to discussing end-oflife issues, very rarely are all members of families on the same page. Often times, adult children don’t want to think of their parents aging, their parents may not be thrilled with the thought either, and both groups may wish for the comfortable status quo to be maintained. However, if there is one thing that humans have learned, it’s that everything changes. Death and dying are as much a part of the life cycle as birth and living. Identifying how an individual wants to spend their final years and communicating that message to family and friends is an important task. When elderly parents experience a health crisis, adult children sometimes revert to their worst 12-year-old selves. There is a certain amount of panic about knowing that your parent is experiencing age-related conditions. That reality cements the knowledge that they may not have much longer with their parents in their life. This realization tends to bring up longburied emotions, resentments, fears, and conflicts within families. Those conflicts can be between siblings, children and parents, and even spouse to spouse. Unresolved conflicts can blossom anew during a health crisis, complicating any attempts to understand how the older adult wants (or would want) to proceed. An eldercare mediator can be brought in as an objective third party to help resolve some of those conflicts and move the discussion forward. Eldercare mediators should have training or experience in both mediation and gerontology to be able to properly assist families dealing with this type of conflict. So how does an eldercare mediator help a family successfully navigate these issues? One of the best ways is to educate families on the importance of having conversations about end-of-life wishes before there is ever an issue.

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Starting the Conversation The general rule of thumb about aging is that you should communicate your wishes early and often to your family and those who will be involved. Eldercare mediators are also very effective at facilitating family conversations, before a crisis hits. When a situation is hypothetical, it is far easier to set aside emotions and talk rationally. The more frequently families have these discussions, the easier they become. Once decisions have been made and put into writing, families have a tool to use if/ when a crisis hits. That tool can be adjusted as life situations change and will mitigate the stress and trauma of the crisis.

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Who Should Be Involved? One of the first steps to setting up a successful family facilitation is to identify all the parties who will be involved. Children? Friends? Caregivers? The older adult(s) in question need to give careful consideration to who they want weighing in. The mediator should meet with the older adult(s) first to establish communication and rapport. The discussion should focus on what is important to the adult(s), how they have lived their lives, and how they picture living their remaining days. The conversation should then move into a discussion of who they want involved and how they want them involved. Gentle probing into relationship issues between them and children and between siblings should be used to help understand family dynamics. If a family member is going to be kept out of the discussions, it is important to understand and be able to communicate why to that person. Based on these discussions, the mediator needs to connect with each person involved and have similar discussions with them, identifying their concerns, conflicts, and comfort levels. A group meeting is then set up with all parties involved attending.

• W ho has access, account locations/passwords

Group Meeting This can be extremely difficult when there are geographical distances separating family members. Mediators should be ready to offer conference calling, Skype, or other communication methods. Detailed notes need to be taken and distributed to participants after the meeting. The mediator’s main role is to introduce the topics that need to be covered and to promote honest, open discussions of each topic that result in a decision about how that particular topic is to be handled. Each meeting will be different based on the needs and interests of the families with whom the mediator is working. The main goal is to identify who will be involved, how they will be involved, and if they are able and willing to provide the support needed to fulfill the wishes of the older adult. Some of the more common topics are:

Wrapping Up This is just a small sampling of the conversations that need to be held, and they certainly cannot happen all at once. The mediator will help identify which are most pressing, which are easiest to solve, and which will take more concerted time and will adjust each session to address a few smaller issues and one bigger issue. Getting agreement on a smaller issue will help pave the way for agreement on the larger ones. Several smaller sessions with concrete plans established will have a greater chance of longterm success than one marathon session that tries to address everything. Finally, all the participants will be reminded that these discussions are blueprints that may need to be changed as the older adults’ needs change. Using the communication methods established in the group meetings, families will be on firm ground to adjust accordingly.

Legal Issues • Powers of attorney • Advance directives • Wills • Trusts, etc. Financial Issues • How much money is available for care

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• Long-term care insurance • Medical insurance information • Monthly bills • Taxes Medical Issues • Doctors’ visits and/or home care • Medication management • Medical records • Interventions desired or not • Hospice, hospital, or home Living Arrangements • Living alone in the current home or relocate • Community living, move in with family, or home companions and house care

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Eldercare mediation is a specialty focus of K.T. Beck Enterprises. Eldercare mediation is working with families who are navigating the often contentious decisions related to the aging process. The goal is to help family units develop stronger methods of communication and understanding of how the older adult wants to live out their life. www. ktbeckenterprisesllc.com

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Home Caregivers May Suffer from Compassion Fatigue By BARRY SPARKS

As the population continues to age and the cost of senior living facilities and in-home care rises, more family members are becoming caregivers. Most American adults say a family member is caring for their aging parent, who needs help handling their affairs or caring for themselves. These family members are called informal caregivers, and they are not paid for their services. According to the Bureau of National Labor Statistics, there are 40.4 million unpaid caregivers of adults ages 65 and older in the United States. Most home caregivers love the person they are caring for. They often believe their love is limitless. Although they typically lack previous experience, they assume the role of caregiver in order to help. Many, however, will experience compassion fatigue, a term unfamiliar to them. “Compassion fatigue is a secondary traumatic stress disorder, which occurs when the caregiver accepts the trauma of the other person and takes it on as their own,” says Lois Polcha, Duncannon, Pennsylvania, a licensed social worker and PennCares trainer for compassion fatigue. 12

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“That creates high levels of emotional stress, indifference, and overall disinterest in other people’s problems. It’s very similar to post traumatic stress disorder (PTSD).” Polcha says compassion fatigue is different from burnout. She says burnout is about being worn out and emerges over time. Burnout is typically linked to specific conditions and stressors in the work and/or home environment. It can be resolved by making changes in one’s situation. People suffering from compassion fatigue, however, can’t separate themselves from the problem. “Unfortunately, most home caregivers don’t realize when they are suffering from compassion fatigue,” says Polcha. “In addition to unawareness, there is also denial.” According to the Compassion Fatigue Awareness Project, “Denial is one of the most detrimental symptoms because it prevents those who are experiencing compassion fatigue from accurately assessing how fatigued and stressed they actually are, which prevents them from seeking help.” Polcha recommends home caregivers take an assessment test online called ProQOL. It provides a snapshot of where the home caregiver is in regards to compassion fatigue. www.BusinessWomanPA.com


Signs of compassion fatigue include: •F  eeling burdened by the suffering of others •B  laming others for their suffering • I solating yourself •L  oss of pleasure in life • I nsomnia •B  ottling up your emotions •F  eelings of hopelessness or powerlessness •P  oor self-care •D  enial •E  xcessive use of alcohol or drugs Once you realize you are in the throes of compassion fatigue, it’s important to ask for help. It is, however, one of the most difficult things for caregivers. “People want to help, but you need to let them know how they can help,” says Polcha. “Do you need someone to go grocery shopping or do you need a morning off? Unfortunately, many caregivers think they just have to buck up and carry on.” By the time most people have reached the compassion fatigue stage, they have begun to neglect their own self-care. “There’s a natural tendency not to care for yourself when you are caring for others,” she says. “But, ignoring yourself can have a negative impact on your patient.” Polcha suggests home caregivers find ways to incorporate self-care into their daily activities. It may be making time for meditation, prayer, or yoga or establishing time to decompress after work by journaling, deep breathing, or reflection. Changing your perspective and being grateful are two other ways to combat compassion fatigue. “Look for the positives instead of the negatives,” offers Polcha. “Avoid the ‘woe is me’ attitude, and don’t be a martyr. Find things, small and large, to be grateful for.” Other suggestions to prevent compassion fatigue include: show compassion to yourself by being kind, soothing, and comforting to yourself; develop a healthy diet, exercise regularly, and get restful sleep; and develop positive coping strategies. Dr. Beth Hundall Stamm, who developed the ProQOL compassion-fatigue assessment tool, says that through awareness and healthy self-care, those who experience compassion fatigue can start to understand the complexity of the emotions they’ve been juggling and, most likely, suppressing. She recommends the following for those suffering from compassion fatigue: • Enhance your awareness with education

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• Take positive action to change your environment “The good news is that compassion fatigue isn’t terminal,” stresses Polcha. “You may have lost your compassion, but you can get it back. It’s important to remember that other people have recovered from compassion fatigue.” Although home caregivers aren’t professionals, they bring important attributes to the job. “Caregiving can be taught, but love is the most important element,” comments Polcha. “By being aware of compassion fatigue, taking steps to prevent it, and developing a self-care plan, you can be the best caregiver you can be.” www.BusinessWomanPA.com

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Combatting Loneliness in Seniors By BARBARA ELAINE GOLL Loneliness affects more than 42 million older Americans, according to the American Psychological Association. While living alone does not inevitably lead to loneliness, it can be a contributing factor. Social contact typically decreases with age, due to retirement, spouse and friends dying or moving away, lack of mobility, and physical limitations. When an entire peer group is experiencing these naturally occurring changes, it is easy to see why there is a decline in the number and quality of relationships as we age. Loneliness is a very personal experience. Loneliness comes with different causes and implications for every individual. This makes addressing the problem complex. Loneliness is a negative emotion defined by the quality and quantity of relationships that we have versus those we long to have. It is based on an individual’s values, needs, wishes, and feelings. Loneliness can create a persistent loop of negative thoughts and feelings that can wear us down and push others away. “Loneliness is tricky because someone has to tell you their negative emotions,” says Kerstin Gerst Emerson from the Institute of Gerontology. “Diagnosis depends on asking questions, not a blood test or MRI.” It is a subjective feeling of social separation. When one does not feel they have value, self-worth, or a purpose to their lives, it can lead to loneliness and depression. Loneliness can be defining and devastating to the lives of the elderly. I realized the devastation of loneliness when my mother made a comment after a holiday family gathering, stating that she felt alone and not a part of conversations. She also felt that what she might have to say was not important and that the conversations she had with others were just small talk. At the nursing home where I worked, I saw the pain on residents’ faces as they told me how lonely they were feeling, even though they were participating in a group activity at the time. Loneliness is personal, and these feelings are all valid. Loneliness has a harmful impact on mental and physical health. When loneliness becomes a lifestyle, research shows it can cause depression, risk of heart disease, high blood pressure, Type 2 diabetes, weakened immune system, anxiety, and dementia. These are not issues to be ignored. The Center for Cognitive and Social Neuroscience suggests that the connections with loneliness and health risks lie in harmful lifestyle choices such as eating poorly, inactivity, and smoking. What can be done to combat loneliness in seniors? As family, caregivers, and community members, we can help 14

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our seniors become less lonely and more engaged. Here are some helpful suggestions: 1. Encourage seniors to express themselves while being a good listener. Ask them to tell you more about past interests and activities. Try to rekindle and adapt past interests and hobbies to fit their current abilities. 2. Use information learned from inquiring conversations to create an individual plan to decrease loneliness. Be creative with ideas and offerings in your community, clubs, and groups. Be prepared to nudge a little bit outside of their comfort zone. 3. Foster relationships between generations through visits and technology, such as email and Facetime or Skype. Help grandchildren learn wisdom, childhood stories, and family history from grandparents. Have them show grandparents how to use their cellphone or computer more easily or help them correspond with friends and distant family. 4. Visit as often as possible and engage in meaningful conversation. Give your full attention and really listen and hear what they have to say. Take a walk, read, sing, or listen to favorite songs or play a board game. If unable to visit often, you can write, call, or use technology. 5. Seek out and attend activities of interest with the senior, especially for the first few times. Local senior centers and the Area Agency on Aging are a good place to start. 6. Let seniors teach you something. When a former art professor moved into the nursing home where I was working, I empowered him to teach a basic sketch class to the residents. This brought worth and value to his life as well as the lives of the other residents who learned how to draw. Older individuals love to pass on knowledge. 7. Get seniors out of their home by going to restaurants, Sunday church service, the theater, shopping, visit with a friend, or taking www.BusinessWomanPA.com


a drive. Fresh air and a change of scenery can do wonders. 8. Help facilitate connections with old friends who may not be able to visit anymore through letters, in-person visits, or emails. 9. Encourage seniors to volunteer. Volunteering can be very rewarding, and seniors have a lot of skills and wisdom to contribute to their community. This is a great social connection and adds purpose, worth, and fulfillment to their lives. Volunteer search sites include: JustServe (www.justserve.org), RSVP of the Capital Region (rsvpcapreg.org), and Create the Good (createthegood.aarp.org). 10. Take a class, such as exercise, computer, or another educational topic of interest. Many community colleges offer free lifetime learning classes for seniors. It is a great way to create new connections. 11. Community planners and local authorities must take action and create policies that place emphasis on healthy aging. Allow communities to support our older adults and the aging process as well as those living with dementia. Dementia Friendly America and Age-Friendly Cities are initiatives that focus on communities working together to support our older Americans. Reducing loneliness in all generations is derived from strong and loving relationships we have with others. Let’s try to help our seniors create and preserve these relationships throughout their lives and show them how valuable they truly are.

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Barbara Goll has a passion for educating and helping people attain a higher quality of life while aging in place. Goll is a valued member of Homeland at Home’s community outreach team, offering a variety of short talks on nutrition and age-related issues, including her “My Reflections” workshop to help you think through many end-of-life care decisions. She has presented at 50plus EXPOs, civic organizations, community support groups, senior centers, aging forums, and more. Homeland at Home offers hospice, home health, and home care services in south-central Pennsylvania. Visit www.homelandathome.org for valuable information or to schedule a program.

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For Love of Family. Devotion. Compassion. Dignity. When your loved one needs help, join hands with Homeland. We are privileged to offer a continuum of care options and to be part of your caregiving team. To arrange a family meeting—at no cost or obligation—please call.

A CONTINUING CARE RETIREMENT COMMUNITY

1901 N 5th St., Harrisburg

717-221-7900

HomelandCenter.org

2300 Vartan Way, Harrisburg

717-221-7890

HomelandatHome.org

A Commitment to Excellence since 1867 caregiver solutions 2020 BUSINESSWoman

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Frequently Asked Questions How can I find out about caregiving resources in my community? There are resources with staff who can help you figure out whether and what kinds of assistance you and your care receiver may need. The local Area Agency on Aging is one of the first resources you should contact when help is needed caring for an older person. Almost every state has one or more AAAs, which serve local communities, older residents, and their families. In a few states, the State Unit or Office on Aging serves as the AAA. You can find your Area Agency on Aging in the Directory of Ancillary Services on page 30. If your care receiver lives in another community and you aren’t sure what county that is, you can also call the National Eldercare Locator, a toll-free service funded by the Administration for Community Living, at 800.677.1116. The Eldercare Locator can help you find their local or state AAA. Eldercare Locator operators are available Monday through Friday, 9 a.m. to 8 p.m., Eastern Time. When contacting the Locator, callers should have the address, zip code, and county of residence for the person needing assistance. The Eldercare Locator is also available online at https://eldercare.acl.gov. If your family member has a limited income, he or she may be eligible for AAA services, including homemaker home health aide services, transportation, homedelivered meals, and chore and home repair, as well as legal assistance. These government-funded services are often targeted to those most in need. While there are no income criteria for many services, sometimes you may have more service options if you can pay for private help. AAAs can direct you to other sources of help for older persons with limited incomes, such as subsidized housing, food stamps, Supplemental Security Income, and Medicaid. Supportive services for the person needing care can include both in-home and community-based services, such as: 16

• Transportation • Meals • Personal and in-home care services • Home healthcare • Cleaning and yardwork services • Home modification • Senior centers • Respite services including adult daycare If you are an employee covered under the federal Family and Medical Leave Act, and if you meet the eligibility requirements, you are entitled to take up to 12 weeks of unpaid leave during any one year to care for certain relatives. Will Medicaid help pay for home healthcare? Medicaid is a joint federal and state program that helps with medical costs for some people with low incomes and limited resources. To qualify for Medicaid, you must have a low income and few savings or other assets. Medicaid coverage differs from state to state. In all states, Medicaid pays for basic home healthcare and medical equipment. Medicaid may pay for homemaker, personal care, and other services that are not paid for by Medicare. For more information about what Medicaid covers for home healthcare in your state, call your state medical assistance office. If you need the telephone number for your state, call 800.633.4227 What is the difference between a nursing home and a personal care home? Nursing homes are licensed medical facilities that are inspected and licensed by the Pennsylvania Department of Health. They must meet both state and federal regulations. There is third-party reimbursement (Medicare and Medicaid) for those who qualify based on income. Personal care homes are residential facilities that offer personal care services, assistance, and supervision to four or more

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persons. They are inspected and licensed by the Pennsylvania Department of Human Services. A personal care home must have a license to operate in Pennsylvania. There are state licensing regulations that apply to personal care homes. These regulations are aimed at protecting the health, safety, and well-being of the residents. There are no federal regulations for personal care homes. There is no thirdparty reimbursement for personal care homes, but many accept residents of low income who receive Supplemental Security Income (SSI). Assisted living residences generally offer the same amenities as personal care homes. However, because of the higher level of care provided in an assisted living residence than in a personal care home, if a resident’s health declines and nursing care is required, the resident does not have to move and is able to “age in place.” Assisted living residences are required to offer living units with kitchenettes and private bathrooms. — Pennsylvania Department of Human Services Is there someplace I can get help with drug bills for someone in my care? Many senior citizens with low incomes are eligible for assistance with payment for their prescribed medications through PACE/PACENET programs. Who is eligible for PACE? • You must be 65 years of age or older. • You must be a Pennsylvania resident for at least 90 days prior to the date of application. • You cannot be enrolled in the Department of Human Services’ Medicaid prescription benefit. For a single person, total income must be $14,500 or less. For a married couple, combined income must be $17,700 or less. www.BusinessWomanPA.com


Prescriptions: Copay for generic drugs is $6; copay for single-source brand is $9. Who is eligible for PACENET? • You must be 65 years of age or older. • You must be a Pennsylvania resident for at least 90 days prior to the date of application. • You cannot be enrolled in the Department of Human Services’ Medicaid prescription benefit. PACENET income limits are slightly higher than those for PACE. For a single person, total income can be between $14,500 and $27,500. For a married couple, combined total income can be between $17,700 and $35,500. Prescriptions: Co-pay for generic drugs is $8; co-pay for single-source brand is $15. Call your local Area Agency on Aging office for forms, or more information or go to https://pacecares.magellanhealth.com. Effective Jan. 1, 2020, PACENET cardholders not enrolled in a Part D plan will pay a $35.63 premium at the pharmacy each month. Income qualification is based on prior year’s income and includes taxable and nontaxable sources. Assets and resources are not counted as income. — Pennsylvania Department of Aging What is the Extra Help Program? If your monthly income is up to $1,581 for singles ($2,134 for couples) and your assets are below specified limits, you may be eligible for Extra Help, a federal program that helps you pay for some or most of the costs of Medicare prescription drug coverage. You can enroll through the Social Security Administration, using either the agency’s print or online application, or at your local Medicaid office. If you are enrolled in Medicaid, Supplemental Security Income, or a Medicare Savings Program, you automatically qualify for Extra Help. You do not have to apply for this extra assistance. If you become eligible, you will get a special enrollment period to enroll in a Medicare private drug plan. See www. www.BusinessWomanPA.com

medicare.gov for more information. What is the APPRISE Program and where can I get more information? The APPRISE Program is a free program operated by the Area Agencies on Aging to provide healthinsurance counseling and assistance to Pennsylvanians age 60 and over. They can help you understand Medicare benefits by explaining Medicare, Medicare Supplemental insurance, Medicaid, and long-term care insurance. Program counselors can explain the Medicare appeals process, help you select a Medigap insurance policy, explain the Medicare prescription Part D benefit, and explain financial assistance programs. Call 800.633.4227 or your local Area Agency on Aging for more information. What is the waiver program offered through the Pennsylvania Department of Aging? There are several waivers available through the Pennsylvania Department of Aging for people aged 60 and older who meet the eligibility requirements and income limits. Each waiver has its own unique set of eligibility requirements and services. • Aging Waiver – Provides long-term care services to qualified older Pennsylvanians living in their homes and communities • Attendant Care / Act 150 – Information for mentally alert Pennsylvanians with physical disabilities •C  OMMCARE Waiver – Home- and community-based program developed for individuals who experience a medically determinable diagnosis of traumatic brain injury •C  onsolidated Waiver for Individuals with Intellectual Disabilities – Provides services to eligible persons with intellectual disabilities so they can remain in the community

recipients who have been determined to need “nursing facility level of care” but wish to remain in their home and community as long as possible (called PACE in other states) • OBRA Waiver – Provides services to persons with severe developmental physical disabilities, such as cerebral palsy, epilepsy, or similar conditions • Family Directed Support Waiver – Provides services to eligible persons with intellectual disabilities so they can remain in the community What services are available from Pennsylvania Area Agencies on Aging? Area Agencies on Aging, countyor multi-county-based agencies that partner with the Department of Aging, provide a wide range of services, such as assessment of need, care management, inhome services, transportation, protective services, adult daycare, and legal services. Services may vary from county to county, so it is wise to call your local Area Agency on Aging for particular services or programs. What is the Medicare Savings Program (MSP)? The Medicare Savings Program helps pay for Medicare premiums. In some cases, the Medicare Savings Program may also pay Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) deductibles, coinsurance, and copayments if a beneficiary meets certain conditions. What are Medicare Preventive Services? Early detection and treatment of health conditions can help reduce medical costs and maintain health. Many preventive care services are covered at a low or no cost. Talk to your doctor about preventive services available to you through Medicare.

• I ndependence Waiver – Provides services to persons with physical disabilities to allow them to live in the community and remain as independent as possible •L  IFE (Living Independence for the Elderly) – Managed care program for frail, elderly caregiver solutions 2020 BUSINESSWoman

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How Medicare Covers Ambulance Services By JIM MILLER

Dear Savvy Senior, How does Medicare cover ambulance services? About three months ago, my father took an ambulance to the hospital emergency room because he rarely drives anymore, and he just received a $1,100 bill from the ambulance company. – Surprised Senior Dear Surprised, This is a Medicare issue that confuses many seniors. Yes, Medicare does covers emergency ambulance services and, in limited cases, non-emergency ambulance services too, but only when they’re deemed medically necessary and reasonable. So, what does that mean? First, it means that your medical condition must be serious enough that you need an ambulance to transport you safely to a hospital or other facility where you receive care that Medicare covers. If a car or taxi could transport you without endangering your health, Medicare won’t pay. For example, Medicare probably won’t pay for an ambulance to take someone with a simple arm fracture to a hospital. But if he or she goes into shock, or is prone to internal bleeding, ambulance transport may be medically necessary to ensure the patient’s safety on the way. The details make a difference. Second, the ambulance must take you to the nearest appropriate facility, meaning the closest hospital, critical access hospital, skilled nursing facility, or dialysis facility generally equipped to provide the services your illness or injury requires. It also means that the facility must have a physician or physician specialist available to treat your condition. Thus, Medicare may pay for an ambulance to take you to a more distant hospital if, for example, you are seriously burned, and the nearest hospital doesn’t have a burn unit. Similarly, if you live in a rural area where the nearest hospital equipped to treat you is a two-hour drive away, Medicare will pay. But if you want an ambulance to take you to a more distant hospital because the doctor you prefer has staff privileges there, expect to pay a greater share of the bill. Medicare will cover the cost of ambulance transport to the nearest appropriate facility and no more. Non-Emergency Situations In limited cases, Medicare will also cover non-emergency ambulance services if such transportation is needed to treat 18

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or diagnose your health condition and the use of any other transportation method could endanger your health. Not having another means of transportation is not sufficient for Medicare to pay for services. Some examples here are if you need transportation to get dialysis or if you are staying in a skilled nursing facility and require medical care. In these cases, a doctor’s order may be required to prove that use of an ambulance is medically necessary. Ambulance Costs The cost for ambulance services can vary from several hundred to several thousand dollars, depending on where you live and how far you’re transported. Under original Medicare, Part B pays 80% of the Medicareapproved amounts for ambulance rides. You, or your Medicare supplemental policy (if you have one), will need to pay the remaining 20%. If you have a Medicare Advantage Plan, it must cover the same services as original Medicare and may offer some additional transportation services. You’ll need to check with your plan for details. How to Appeal If an ambulance company bills you for services after Medicare denies payment, but you think the ride was medically necessary, you can appeal (see www.medicare.gov/claims-appeals). Often, a lack of information about a person’s condition or need for services leads to denials. If you need some help, contact your State Health Insurance Assistance Program (SHIP), which has counselors that can help you file an appeal for free. To locate your local SHIP, visit shiptacenter.org or call 877.839.2675. For more information on this topic, call Medicare at 800.633.4227 and ask them to mail you a copy of the Medicare Coverage of Ambulance Services booklet, or you can see it online at www.medicare.gov/Pubs/pdf/11021-Medicare-Coverage-ofAmbulance-Services.pdf

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Jim Miller is a contributor to the NBC Today show and author of The Savvy Senior book.

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Caregiver Support Programs There are approximately 43.5 million people who provide unpaid caregiving to family members throughout the year. Americans are living longer, and as the population ages, the number of caregivers will also continue to rise in the coming years. Caregivers are an essential element in our healthcare system and, according to AARP, they account for about $470 billion worth of unpaid labor in the U.S. Caregiving already has become the new norm for many, as we find ourselves helping loved ones who are disabled, frail, or suffering from Alzheimer’s disease, Parkinson’s disease, and kidney and liver diseases, which have been on the rise.

Benefits & Services for Caregivers • Assessment of caregiver and care recipient needs • Respite care • Training in caregiving skills • Financial assistance to purchase caregiving-related supplies or services • Limited funding for assistive devices and home modifications • Benefits counseling on services available through local, state, and federal programs • Referrals to family support or disease-specific organizations, such as Children of Aging Parents or the Alzheimer’s Disease & Related Disorders Association • Assistance in completing benefits and insurance forms

Eligibility If you are age 18 or older and the primary caregiver* of a functionally dependent person who is age 60 or older, you may be eligible for assistance. If you are age 18 or older and the primary caregiver* of an individual who is age 18–59 with Alzheimer’s disease or other chronic dementia, or an individual who is under age 18 with chronic dementia, you may be eligible for assistance. If you are age 55 or older and the primary caregiver* of a relative who is under age 18 or a relative age 18­–59 with a non-dementia-related disability who lives with you, you may be eligible for assistance. *A primary caregiver is the one identified adult family member or other responsible person who has primary responsibility for the provision of care — including coordination of care and services — needed to maintain the physical and/or mental health of the care receiver. The caregiver may not receive reimbursement for personally providing caregiving services to the care receiver and must be actively involved with various aspects of care on a regular — but not necessarily daily — basis. For specific program information, please contact your local Area Agency on Aging or visit the Pennsylvania Department of Aging’s website at www.aging.pa.gov. www.BusinessWomanPA.com

Some research has shown that men are increasingly stepping up in their caregiving responsibilities, but women are still more likely to provide basic care (e.g., help with dressing, feeding, and bathing), while sons are more likely to provide financial assistance. The major focus of the Caregiver Support Programs is to reinforce the care given to people over the age of 60 or adults with chronic dementia. To determine the needs of both the caregiver and receiver, the package of benefits begins with an assessment. You could also take advantage of other benefits available, such as counseling, education, and financial information.

Assessment Criteria (Federal and State)

State No**

Federal No**

Caregiver must be related to the care receiver.

No

No***

Household income of care receiver is used to determine eligibility.

Yes

Yes

Care receiver must require assistance with two or more activities of daily living (ADLs).

No (1) ADL needed

Yes****

Maximum amount of monthly reimbursement for caregiver expenses (depending on the caregiver’s reimbursement percentage) is:

$200*****

$200*****

Maximum amount of reimbursement for home modification/assistive devices (depending on the caregiver’s reimbursement percentage and availability of funding) is:

$2,000

$2,000

Caregiver must have primary responsibility for the provision of care and be actively involved with various aspects of the care receiver’s care on a regular — but not necessarily daily — basis.

Yes

Yes

Caregiver must reside in the same household as care receiver.

**Unless care receiver is 18–59 years of age with a non-dementia-related disability, or the caregiver is 55 years of age and older caring for a child under age 18. ***Must be related by blood, marriage, or adoption if the care receiver is 18–59 years of age with a non-dementia-related disability, or the caregiver is 55 years of age and older caring for a child under age 18. ****ADL requirement does not apply if the caregiver is 55 years of age and older caring for a child under age 18. (The caregiver cannot be the biological parent of the child.) *****Up to $500 with documentation to justify need. caregiver solutions 2020 BUSINESSWoman

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‘Learning to Dance’ Expert Advice on Negotiating the Caregiving Dynamic By MEGAN JOYCE According to dementia expert Teepa Snow, a key element of fruitful and successful caregiving is the caregiver’s ability to live in and deal with the present reality while also keeping an eye to the future. Easier said than done, one might say. Snow acknowledges it’s not an easy balance to strike. Snow, MS, OTR/L, FAOTA, is the owner and CEO of Positive Approach to Care, which offers webinars, speaking engagements, onsite training, consulting, and workshops focusing on living well with dementia and supporting caregivers through the interpersonal dynamics of caring for a loved one with a changing brain. “If you know five individuals, then one of those people has dementia in their life somehow right now,” Snow said. “And the numbers are going to escalate phenomenally as those of us in the boomer generation are hitting that [age] 65 mark.” She offers the following essential tips for caregivers who are trying to get firmer footing in the constantly shifting sands of dementia caregiving. What Can They Do Right Now? “My first message to everyone is that dementia is this really complicated and ever-changing state of being in another person’s brain that we’ve typically known, and so it’s really hard for us to let go of what was, and what the person could do, and be very present in the ‘what can they do right now?’” Snow said. Snow cannot impress enough the importance of caregiving strategies based on what your loved one can do right now — not five years ago, not five months ago, not even yesterday. This is often a difficult mental shift for caregivers, who likely have decades’ worth of memories of their loved one’s abilities imprinted in their minds. “[As a caregiver], if they show me something different in their ability state, I’ve got to be able to take that in, recognize it for what it is — it’s not a ‘not trying’ or ‘not willing,’ it’s a ‘can’t do right now’ — and then I’ve got to be able to come up with a response, not a reaction, that moves us in a good direction, or I’m in trouble.” In adulthood, many of us have been through the process of helping people develop news skills — adding “tools in their toolkit,” as Snow puts it — such as raising children, training employees, etc. So when we approach the role of caregiver, we often operate under the assumption that the care recipient’s toolkit still contains all the tools they had acquired over their lifetime of learning. 20

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“These are people who had lots of tools, and now, all of a sudden, they’re missing their tools. And you want to point out: ‘Here’s the screwdriver; use the screwdriver.’ And they’re like, ‘It’s a what?’” Your Roles are Going to Shift Child, sibling, spouse, employee, friend … we already fill numerous roles in our various relationships. But when the role of caregiver gets added to the lineup — especially in a parent/ child caregiving relationship — the role shift can be especially unmooring. Snow remembers the disorienting experience when caring for her own mother. “Without realizing it, I’d really shifted roles with her; instead of being the daughter who’s great and comes by, I’ve become this really mean person who’s diminishing her,” she said. Piling on an additional and especially challenging role to the caregiver’s established lineup easily leads to feelings of overwhelm. “Keep looking in the mirror at yourself and start to figure out: ‘When is my care role exceeding my relationship role, and which one do I want to hold onto if I can’t do both? Which do I value more?’” This brings us to Snow’s second message to caregivers: Dementia is ever-changing — and you’re going to need help. Dementia is a Team Sport “Make a choice to get the right kind of help or support that’s needed,” Snow advised. “You can’t carry another person 24/7.” Snow recommends recognizing your own strengths as a caregiver as well as your weaker areas, and then partner up with family, friends, or professionals who complement your skills with their own differing gifts and expertise. “Figure out how to bring yourselves together into a team. Dementia is a team sport,” Snow said. “It’s ‘how do we work together to get somewhere, and what’s the goal?’” Also integral to the success of your team is “cueing up your supporters.” If, for example, your loved one’s doctor has recommended she discontinues driving, make sure your care partners know of and support the doctor’s reasoning so they don’t inadvertently throw your efforts under the bus. The presence of a supportive caregiving team helps ensure you continue to care for yourself as well. “What we don’t recognize is the role of isolation, stress, sleep deprivation, lack of exercising, and lack of taking care of your own brain that starts to accumulate over time, which just increases our www.BusinessWomanPA.com


own risk pattern,” Snow warned. “Get support in place before you need the support, know where to look before you’re desperate to find it — those are all really remarkably important but simple things.” Relationship Problems Will Likely Persist Snow sees caregivers sometimes hoping their new role will enable them to improve a previously strained relationship with their care recipient — and she cautions that may not be a realistic expectation. “There was probably a reason why you didn’t have a great relationship before, and unless you can really let go of that previous relationship, and unless they have totally forgotten the previous relationship … Unfortunately, that’s one of the kinds of memories that can hang out, even with dementia,” Snow said. When you notice you’re having trouble with your relationship dynamic, Snow said, it’s time to pause and pull back: Don’t keep going if it’s not going well. “You can get people [with dementia] to form new memories, and if they aren’t good ones, now they’ve built up a bit more of a wall between the two of you,” she added. “And it’s going to make the support you want to offer harder, and it’s going to wear you out.” Become Their Partner, Not Their Authority Figure “Sometimes you’re not the right authority. Sometimes you’re the one who needs to stand beside the person saying, ‘So, the doctor is saying we need to make some changes.’” Caregiving relationships, Snow said, are fraught with less tension when the primary caregiver is able to position herself as her loved one’s ally and let the doctor, social worker, or other professional be “the bad guy.” For example, instead of listing the reasons your loved www.BusinessWomanPA.com

one shouldn’t drive anymore or offering your opinion, Snow encourages caregivers to engage in active listening: Repeat out loud your care recipient’s concerns or questions and ask them what they remember about the doctor’s visit. “You’re not parroting it back; you’re actually absorbing it and letting them hear that you’re with them,” Snow said. Then discuss with your loved one the options the authority figure has presented, validating her frustration and selecting the best choice for right now. “For right now” becomes a key strategy, Snow said, as it doesn’t take away all hope and encourages your loved one to cooperate until you see the authority figure again. Also essential is the concept of substitution: Give the care recipient a job to do if another job is going to be taken away. For example, suggest that “for right now,” you do the driving and your loved one does the navigating. Snow calls this give-and-take strategy “learning to dance.” “Because me trying to get you to do something — unless I’ve been successful previously, good luck with that,” Snow laughed, adding that when it comes to driving, “people will get another key made, they’ll drive without a license, they’ll drive angry. Even with dementia, people are remarkably resilient: ‘You are not the boss of me!’” Snow finished by saying that if you are in a caregiving situation where you must be the authority figure, make sure your loved one has a friend and ally to talk to — even if it means that friend must field complaints about you. And if that friend is a friend of yours or a family member, take care to protect your relationship with that person. “Make sure you and the friend have an outside relationship where you can heal the wounds, because that can be an incredibly lonely and painful feeling, to always be cast as the mean one,” Snow said. “But it works when you have people who are working together.” caregiver solutions 2020 BUSINESSWoman

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Double-Whammy! Depression & Dementia By LORI L. DIEROLF It may not surprise you to hear that according to the National Institute of Mental Health, nearly 7% of American adults — an estimated 17 million people — will have at least one major depressive episode in their lifetimes. But did you know that 20% of people over the age of 65 have been impacted by depression? And, the age group with the largest number of suicides in the U.S. is men over the age of 75? In fact, 20% of all suicides in this country are committed by people over the age of 65, yet only 1 person out of 10 gets help for their depression, despite the fact that more than 70% of these individuals had seen their doctor within one month of their deaths.

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Depression is toxic to the brain, and it is three times more common in older adults living with dementia than those without dementia. Neither depression nor dementia is a normal part of aging, yet about half of all individuals affected by Alzheimer’s disease or another form of dementia will experience significant symptoms of depression at some point in their illness. When an individual has dementia, it can be extremely difficult for care partners to recognize the symptoms of depression in that person. This is partly due to the fact that the behaviors common in depression can be viewed as “normal” for a person with dementia. Individuals living with dementia are also less able to describe

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their own feelings or identify their own symptoms because they already have an impaired ability to communicate. What makes it even more difficult is the fact that symptoms of both illnesses are very similar. Shared symptoms include feelings of loneliness, forgetfulness, difficulty concentrating, social withdrawal, change in sleeping and/or eating habits, apathy, and loss of interest in activities. Untreated depression in persons with dementia can have a real impact on their quality of life. It can increase the rate of their cognitive decline and cause progressive difficulties with their daily living skills. This, in turn, can cause a need for more dependence on care partners and further loss of independence. Depression can also cause loss of interest in taking part in and enjoying activities. It can lead to increased anxiety, agitation, and changes in mood. There are several options available to treat individuals diagnosed with dementia and depression, including medication, counseling, therapy, and behavioral interventions. It is important to understand the cause of the depression in order to determine the most appropriate treatment. Generally, there are multiple factors at play, and every person is different, so certain interventions may be more effective for one person than for another. A number of nonpharmacological approaches have shown success in treating depression in those with dementia, including improving their cognitive function and increasing their physical abilities. The benefits of these non-drug approaches also include avoiding chemical side effects and drug interactions. While there is no “one-size-fits-all” activity to treat every person’s depression, here are some nonpharmacological suggestions for alleviating the symptoms in those with dementia:

of places he or she likes to visit, and do these things frequently. Suggestions include listening to music, sitting on a swing, and walking in the sunshine (which may increase the mood-elevating serotonin levels in our brains!). Exercise and other physical activity can increase energy levels, improve sleep and appetite, and impact a person’s selfesteem. This can include anything from light stretching exercises to working in the garden to pushing around the vacuum. Social interaction provides those with dementia the opportunity to express feelings and emotions and offers that human connection that can increase a person’s self-confidence and sense of purpose. Being connected to others — including pets — may allow them to maintain a more positive outlook, as well. If you suspect that you or someone you care for may be exhibiting symptoms of depression, it is important to get an assessment by a medical professional. For those living with dementia, an accurate diagnosis and appropriate treatment can have a critical impact on the individual’s quality of life.

r

Lori L. Dierolf is the president of Open Door Training & Development. She holds several certifications as a dementia care educator and can be contacted through her website, www.OpenDoorTraining.net.  

Support groups can be very helpful, particularly in the early stages of dementia when individuals are aware of their diagnosis and want to take an active role in seeking help or helping others. It can be especially encouraging to hear how others have learned to cope, which can help ease feelings of loneliness. Individual counseling may also be an option for those who may not feel comfortable in group settings. Predictable routines can foster the feeling of control and give an individual something to look forward to during his or her day. This also enables the person to schedule activities for times when they are feeling their best. Purposeful activities can enable individuals to make a contribution. Find activities the person enjoys or make a list www.BusinessWomanPA.com

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Organizing Your Personal Affairs Getting personal affairs in order is something every one of us should do — but somehow, something always seems to get in the way. The whole topic may just seem too confusing. You may not know where — or with whom — to start. To help you get organized, complete this record of personal affairs. Record of Personal Affairs ATTORNEY Name:___________________________________________________ Address: _________________________________________________ Telephone: _______________________________________________ ACCOUNTANT Name: ___________________________________________________ Address: _________________________________________________ Telephone: _______________________________________________ EXECUTOR Name: ___________________________________________________ Address: _________________________________________________ Telephone: _______________________________________________ STOCKBROKER Name: ___________________________________________________ Address: _________________________________________________ Telephone: _______________________________________________ Stock Certificates Located:___________________________________ BANK ACCOUNTS: SAVINGS/CHECKING Name and Type: ___________________________________________ Address: _________________________________________________ Name and Type: ___________________________________________ Address: _________________________________________________ Passbooks Located: ________________________________________ LIFE INSURANCE Name of Company: _ _______________________________________ Policy #: _________________________________________________ Policy #: _________________________________________________ Policies Located: __________________________________________ PENSION OR UNION PLAN Name of Company: _ _______________________________________ Address: _________________________________________________ Plan is Located: ___________________________________________ REAL ESTATE BROKER Name: ___________________________________________________ Address: _________________________________________________ Telephone: _______________________________________________ Deeds are Located: _________________________________________ SAFE-DEPOSIT BOX Name of Bank: ____________________________________________ Address: _________________________________________________ Telephone: _______________________________________________ In Whose Name? __________________________________________ Key Located: _____________________________________________ INCOME TAX RECORDS Located: _________________________________________________

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BUSINESSWoman caregiver solutions 2020

AUTOMOBILE REGISTRATIONS Vehicle: _ ________________________________________________ Registration Located: _______________________________________ WILL Original Located: __________________________________________ Copy Located: ____________________________________________ THERE IS NO WILL AND SUGGEST THE FOLLOWING BE ADMINISTRATOR OF ESTATE Name: ___________________________________________________ Address: _________________________________________________ Telephone: _______________________________________________ SPECIAL INSTRUCTIONS _________________________________ ________________________________________________________ BIRTH CERTIFICATES LOCATED _ _________________________ MARRIAGE CERTIFICATE LOCATED _______________________ FUNERAL HOME TO BE CONTACTED Funeral Home Name: _______________________________________ Address: _________________________________________________ Telephone: _______________________________________________ Prearranged Funeral Made: __________________________________ Prearrangement Contract: _ __________________________________ Contract Located: __________________________________________ CEMETERY INFORMATION Name of Cemetery Desired: __________________________________ Address: _________________________________________________ Telephone: _______________________________________________ Plot in Whose Name? _______________________________________ Plot Number: _____________________________________________ Section: _ ________________________________________________ Block: ___________________________________________________ Location of Deed: _ ________________________________________ CREMATION Disposition of Ashes: _______________________________________ FUNERAL SERVICE TO BE HELD Church: __________________________________________________ Funeral Home: ____________________________________________ Other: ___________________________________________________ Clergyman Name: _______________________________________________ Address: _____________________________________________ Telephone: _ __________________________________________ Music: _ _________________________________________________ Clothing: _ _______________________________________________ Visitation/Calling Hours: ____________________________________ Pallbearers Name: ___________________ Telephone: ________________ Flowers: _________________________________________________ Memorials: _______________________________________________ Lodge or Military Service/Contact Name: ___________________ Telephone: ________________ Other Personal Requests/Contact These People Name: ___________________ Telephone: ________________

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August 2019

MENTORING THE MILLENNIAL WORKFORCE

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BUSINESS magazine, a monthly publication focused on the interests of executives in Central Pennsylvania, highlights leaders in our community and offers information to advance a successful career and balanced life.

50plus LIFE, formerly 50plus Senior News, is a monthly newsprint magazine for and about the 50+ community. Editions in Chester, Cumberland, Dauphin, Lancaster, Lebanon, and York counties.

CAREGIVER SOLUTIONS

CAREGIVER SOLUTIONS is inserted in the July issue of BUSINESS magazine and offers invaluable information to the person managing the care of a loved one. It includes a directory of housing, care, and service providers.

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Good Reads Working Daughter: A Guide to Caring for Your Aging Parents While Making a Living By Liz O’Donnell Rowman & Littlefield Publishers Kindle, print Working Daughter is a revelatory look at who’s caring for our aging population and how these unpaid family caregivers are trying to manage caring for their parents, raising their children, maintaining relationships, and pursuing their careers. It follows the author, who was enjoying a fast-paced career in marketing and raising two children when both of her parents were diagnosed with terminal illnesses on the same day. In the challenges she faced and the choices she made, readers will learn how they can navigate their own caregiving experiences and prepare for when they are inevitably called on to care for their parents. Working Daughter sparks the conversation we so desperately need to have about women and the workplace. With 10,000 people turning 65 every day and a shortage of caregivers predicted in the next few years, it’s time we talk about how family caregivers and their employers will face the impact of a rapidly aging society. There are plenty of books about managing career and children, but little advice on how to balance career and parents — along with children, marriages, and friendships. Working Daughter provides a blueprint for women and a call to action for business leaders and policy makers. This book is for women who want straight talk and real advice about the challenges of eldercare, the choices they will need to make, the aspects of caregiving they can control, and that which they cannot. And finally, Working Daughter shows family caregivers how they can achieve the caregiver’s gain — the underreported but well-documented upside to caring for an aging parent. Caregiving While Keeping Your Job By Karen Owen-Lee Kindle, print Caregiving While Keeping Your Job focuses on employees

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caring for aging loved ones in declining health. The stress and hours spent in caregiving result in employees who are emotionally drained, late to work, and missing work altogether. Six out of 10 caregivers are full-time employees. Caregivers are caught between fear and anxiety for their loved one and the fear of getting fired from their job. Corporations need to address their lost revenue and productivity while the caregiver must address their stress and demands of keeping their job. Where do caregivers turn for help? What community resources are available? Caregiving While Keeping Your Job addresses: • The secrets to managing a parent’s finances, legal, and medical matters • How to determine how much leave time you’ll need to assess your senior’s condition and needs • Informative ways to conduct sensitive talks with senior family members • How to include other family members by creating a family action plan to care for your aging family member • How to plan for a future that will allow you to be a caregiver while staying employed Role Reversal: How to Take Care of Yourself and Your Aging Parents By Iris Waichler, MSW, LCSW She Writes Press Kindle, print Designed to help caregivers understand how to cope with and overcome the overwhelming challenges that arise while caregiving for a loved one — especially an aging parent — Role Reversal is a comprehensive guide to navigating the enormous daily challenges faced by caregivers. In these pages, Waichler blends her personal experience caring for her beloved father with her 40 years of expertise as a patient advocate and clinical social worker. The result is a book offering invaluable information on topics ranging from estate planning to grief and anger to building a support network and finding the right level of care for your elderly parent.

BUSINESSWoman caregiver solutions 2020

Soul of Caregiving: A Caregiver’s Guide to Healing and Transformation By Edward M. Smink, Ph.D. Soul of the Wounded Healer Kindle, print Who are the caregivers? We all are, for at the heart of being human is the capacity to care, to reach out to others, and to explore the relationships we build. The Soul of Caregiving is about us and how we, as caregivers, serve, even sacrifice, for those in need. Explore how we have the opportunities to partake in a kind of pilgrimage along the path of our experiences as caregivers. Who will be your guide on this journey? Unlike other pilgrims who have a guide assigned to them, you will soon discover it is your own soul guiding you. Professionally skilled as we may be to meet the needs of others, a fundamental core component of our busy lives as caregivers is the necessity to stop and rest. It is not a waste of time, but rather a luxury of time, to ponder, reflect, and grow from our experiences. This is not an easy endeavor in the midst of a whirlwind of activity. We, as caregivers, experience vulnerability, helplessness, fears, and pain over the traumatic events we experience because we care. We care about those whom we are called to serve. Compassion fatigue comes about because we care. The Unexpected Journey of Caring: The Transformation from Loved One to Caregiver By Donna Thomson, Zachary White, and Foreword by Judy Woodruff Rowman & Littlefield Publishers With a foreword by Judy Woodruff, The Unexpected Journey of Caring is a practical guide to finding personal meaning in the 21stcentury care experience. Personal transformation is usually an experience we actively seek out, not one that hunts us down. Becoming a caregiver is one transformation that comes at us, requiring us to rethink everything we once knew. Everything changes: responsibilities, beliefs, hopes, expectations, and relationships. Caregiving is not just a role reserved for “saints” — eventually, everyone is drafted into

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the caregiver role. It’s not a role people medically train for; it’s a new type of relationship initiated by a loved one’s need for care. And it’s a role that cannot be quarantined to home because it infuses all aspects of our lives. Caregivers today find themselves in need of a crash course in new and unfamiliar skills. They must not only care for a loved one, but also access hidden community resources, collaborate with medical professionals, craft new narratives consistent with the changing nature of their care role, coordinate care with family, seek information and peer support using a variety of digital platforms, and negotiate social support — all while attempting to manage conflicts between work, life, and relationship roles. The moments that mark us in the transition from loved one to caregiver matter because if we don’t make sense of how we are being transformed, we risk undervaluing our care experiences, denying our evolving beliefs, becoming trapped by others’ misunderstandings, and feeling underappreciated, burned out, and overwhelmed. Informed by original caregiver research and proven advocacy strategies, this book speaks to caregiving as it unfolds, in all of its confusion, chaos, and messiness. Readers won’t find wellintentioned clichés or care stereotypes in this book. There are no promises to help caregivers return to a life they knew before caregiving. No, this book greets caregivers where they are in their journey — new or chronic — not where others expect (or want) them to be. What To Do About Mama? Expectations and Realities of Caregiving By Barbara G. Matthews and Barbara Trainin Blank Sunbury Press Everyone is a potential caregiver — a role for which we are often ill prepared and which can overwhelm us. Where do we turn for assistance? What to Do about Mama offers guidelines to present and future caregivers, based on the “real-life” experiences of the co-authors and many other caregivers who have openly and honestly shared their challenges, their heartaches, and their joys in caregiving. It’s not a book by experts, but by people in the trenches. It will help you develop realistic

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goals and achievable expectations. Whether these stories come from those who are caregiving now or will in the future, they will resonate with you. Weary Joy: The Caregiver’s Journey By Kim Marxhausen Concordia Publishing Kindle, print Caring for a loved one with memory loss is full of harsh realities ... and unexpected joys. Caregivers often live in the shadow of their loved one’s needs with little time for themselves. They may feel isolated, lonely, and exhausted, and their own needs are left unmet. Every caregiver needs a caregiver. Weary Joy assures caregivers that they are not alone. The stories, explanations, tips, and devotional connections remind caregivers that they walk this journey with others and that their loved ones’ actions are part of their disease and not their personalities. Most important, caregivers will be reminded that even if their loved ones forget, their heavenly Father always remembers. Weary Joy helps caregivers do a better job of caring for themselves. Short, easy-to-read chapters cover a variety of topics that are common to caregiving situations. Discussion questions make a good starting point for conversations in a support group or with family members. And a checklist helps assess and navigate the caregiving journey. Alzheimer’s Through the Stages: A Caregiver’s Guide By Mary Moller, MSW, CAS Althea Press Kindle, print Alzheimer’s Through the Stages shows you what you can do for your loved one — and yourself — every step of the way. This book’s detailed descriptions of all seven stages of the disease are both helpful and comforting. With each section divided into three parts — what to expect, what to say, and what to do — this is one of the easiest-to-use Alzheimer’s books for caregivers. Alzheimer’s Through the Stages includes: • A Complete Guide – Go beyond other

Alzheimer’s books as you learn what’s happening and what you should do during all seven stages of the disease. • Easy-to-Use Advice – Detailed guides and sample dialogues help you handle everything from doctor visits to mood swings — making this one of the most useful Alzheimer’s books. • S elf-Care for Caregivers – Discover the importance of your own well-being and how taking care of yourself is critical to successful caregiving. Discover one of the only Alzheimer’s books that lets you concentrate on what matters most: caring for both your loved one and yourself. Coffee with Mom: Caring for a Parent with Dementia By Mike Glenn B&H Books Kindle, print Sometimes, life takes you places you don’t want to go. Dementia and Alzheimer’s is a journey no one wants to take, yet life doesn’t give us a choice. Author Mike Glenn’s mom didn’t want to be sick, and while she couldn’t overcome the devastation of disease, she wasn’t going down without a fight. She fought the illness, denying its presence. She fought the doctors, “Who were these idiots anyway?” And she fought him, “How come you think you’re in charge now?” Coffee with Mom is a book about a mom’s fight with dementia and the struggle of a son who wanted to help but didn’t always know how. Most of their conversations — and sometimes battles — happened during morning coffee. This book isn’t about knowing all of the answers. It is one son’s journey with his mom — a mom with Alzheimer’s and a son who did the best he could, and who wrote this story in hopes that you’ll find a few laughs for your journey, realize you’re not alone, and find the courage to do the best you can. So, pour yourself a cup of coffee, and join us on the journey. You’ll find yourself in the laughter and tears of not knowing what to do next and making a decision that you hope works out, knowing it’s the best you can do in the moment. In the end, that’s all that matters. “Do the best you can” is all love requires.

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DIRECTORY OF HOUSING & CARE PROVIDERS Bethany Village 325 Wesley Drive Mechanicsburg, PA 17055

717.766.0279 bvmarketingdept@asbury.org www.bethanyvillage.org

SpiriTrust Lutheran 1050 Pennsylvania Avenue York, PA 17404

717.854.3971 mwilliams@spiritrustlutheran.org www.spiritrustlutheran.org

Bethany Village is a not-for-profit retirement community. Numerous residential options are available as well as assisted living, memory support, and skilled nursing services. See ad on page 23

For 60 years, SpiriTrust Lutheran has been providing seniors throughout York, Adams, and Franklin counties with homes and services designed to meet their needs. See our ad and listings for locations and contact information. See ad on page 32

Homeland Center 1901 North Fifth Street Harrisburg, PA 17102

SpiriTrust Lutheran, The Village at Gettysburg 1075 Old Harrisburg Road Gettysburg, PA 17325 See ad on page 32

717.334.4443 jkeefer@spiritrustlutheran.org www.spiritrustlutheran.org

SpiriTrust Lutheran, The Village at Kelly Drive 750 Kelly Drive York, PA 17404 See ad on page 32

717.854.5010 bgrieb@spiritrustlutheran.org www.spiritrustlutheran.org

717.221.7900 info@homelandcenter.org HomelandCenter.org

Homeland Center, a continuing care retirement community, offers beautiful personal care suites, skilled nursing, rehabilitation, and dementia care. Our community outreach programs serve counties throughout the south-central Pennsylvania region, and include Hospice, HomeHealth, and HomeCare. See ad on page 15

Homeland Hospice, HomeHealth, 717.857.7400 and HomeCare info@homelandathome.org 2300 Vartan Way, Suite 270 HomelandatHome.org Harrisburg, PA 17110 Homeland at Home, a community outreach of Homeland Center, provides a continuum of At Home care services—from nonmedical personal assistance to wound care, teleheath monitoring, and physical and occupational therapy, as well as compassionate hospice care. See ad on page 15

Color Key For Directory of Caregiving Providers Independent Residences Personal Care Home Assisted Living Residence Dementia Units Nursing Care Community Rehabilitation Facility Respite Care Adult Day Center Home Care Services Hospice Care Palliative Care 28

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SpiriTrust Lutheran, The Village at Luther Ridge 2736 Luther Drive Chambersburg, PA 17202 See ad on page 32 SpiriTrust Lutheran, The Village at Shrewsbury 800 Bollinger Drive Shrewsbury, PA 17361 See ad on page 32

717.235.5737 pmitchell@spiritrustlutheran.org www.spiritrustlutheran.org

SpiriTrust Lutheran, The Village at Sprenkle Drive 1802 Folkemer Circle York, PA 17404 See ad on page 32

717.764.9994 bgrieb@spiritrustlutheran.org www.spiritrustlutheran.org

SpiriTrust Lutheran, The Village at Utz Terrace 2100 Utz Terrace Hanover, PA 17331 See ad on page 32

717.261.1251 edoub@spiritrustlutheran.org www.spiritrustlutheran.org

717.637.0633 lsterner@spiritrustlutheran.org www.spiritrustlutheran.org

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DIRECTORY OF HOUSING & CARE PROVIDERS SpiriTrust Lutheran® Home Care & Hospice See ad on page 32

800.840.9081 www.spiritrustlutheranhomecare.org

SpiriTrust ® LIFE 800.840.9081 (Living Independence For the Elderly) See ad on page 32 www.spiritrustlutheranlife.org

Visiting Angels 1840 East Market Street York, PA 17402

717.751.2488 information@visitingangelsyork.com www.visitingangels.com

Providing in-home, non-medical care to older adults in York, Lancaster, and Hanover. Specializing in dementia care for adults and their families. See ad on page 13

Visiting Angels 4607 Locust Lane Harrisburg, PA 17109

717.652.8899 717.737.8899 visitingangelshbg@comcast.net www.visitingangels.com

Care Options Home Health Care may be provided in a residential setting or as ancillary services wherever you call home. May be medical home health or non-medical services, such as light housekeeping, transportation to doctor visits, shopping, respite, and more. Hospice Care is for families living and coping with a life-limiting illness. Hospice provides professional treatment of pain and symptom management with support and counseling. Assisted Living Residences (ALRS) are designed to provide housing and supportive services to allow residents to “age in place.” As of January 2011, licensure requirements for ALRs became effective. Adult Day Centers offer programs in facilities or independent organizations for hourly or daily adult supervision. Retirement Communities and 55+ Adult Communities are planned for active individuals who are able to care for their own basic needs but want to live with other 50+ mature adults.

We are looking to the future and greeting you at these upcoming events. Please mark your calendar and plan to join us!

Nursing/Rehab Facilities offer skilled or intermediate levels of care. Intermediate Care Facilities are for individuals who can move around the facility on their own initiative, even in a wheelchair, and are not bed bound. Skilled Nursing Facilities are for patients who require 24-hour nursing supervision, many of whom are confined to bed for some portion of the day. Personal Care Homes offer food, shelter, and personal assistance or supervision. They are ideal for people who do not require the services of a long-term care facility but need help with transferring in and out of a bed, toileting, personal hygiene, and other activities of daily living. Respite Care provides normal caregiving opportunities on a shortterm basis. May range from personal to nursing care, at home or in a care community. CCRCs are communities offering a variety of living options in addition to comprehensive medical and nursing services.

S a f e ty g u id will be foll elines owed.

Women’s Expos — www.aGreatWayToSpendMyDay.com Dauphin County Aug. 29, 2020 Hershey Lodge Hershey

Lebanon County Sept. 19, 2020 Lebanon Expo Center Lebanon

Lancaster County Oct. 10, 2020 Spooky Nook Sports Manheim

Cumberland County Nov. 14, 2020 Carlisle Expo Center Carlisle

50plus EXPOs — www.50plusExpoPa.com Chester County To be Announced

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Dauphin County July 15, 2020 Hershey Lodge Hershey

Lancaster County Sept. 16, 2020 Spooky Nook Sports Manheim

York County Sept. 23, 2020 York Expo Center York

Cumberland County Oct. 14, 2020 Carlisle Expo Center Carlisle

Northern Lancaster County Oct. 27, 2020 Shady Maple Conf. Center • East Earl

Due to COVID-19, please be sure to check websites for updates. For more information, call 717-285-1350 or visit www.onlinepub.com/Events

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DIRECTORY OF ANCILLARY SERVICES AREA AGENCIES ON AGING Chester County Area Agency on Aging Cumberland County Aging and Community Services Dauphin County Area Agency on Aging Lancaster County Office of Aging Lebanon County Area Agency on Aging York County Area Agency on Aging See ad on this page

610.344.6350 717.240.6110 717.780.6130 717.299.7979 717.273.9262 717.771.9610 www.p4a.org

COMPLEMENTARY ASSISTANCE Cumberland County Aging and Community Services 1100 Claremont Road Carlisle, PA 17015

717.240.6110 aging@ccpa.net www.ccpa.net/119/AgingCommunity-Services

Provides service coordination for LTSS (Long-Term Services and Supports) Waiver Program participants in Cumberland, Perry, and Dauphin counties. Dauphin County Area Agency On Aging 717.780.6130 2 South Second Street info@dauphinc.org Harrisburg, PA 17101 www.dauphincounty.org Dauphin County Area Agency On Aging provides services to older adults who reside in Dauphin County and are age 60 or older.

Lancaster County Office of Aging Caregiver Support Program 150 North Queen Street, Suite 415 Lancaster, PA 17603

717.299.7979 800.801.3070 aging@co.lancaster.pa.us www.lancoaging.org

The Caregiver Support Program provides caregivers with benefits counseling and reimbursement for related expenses and home modifications.

DISABILITY SERVICES Pennsylvania Link to Aging and Disability Services 1100 Claremont Road Carlisle, PA 17015

800.753.8827 www.carelink.pa.gov

A shared, statewide approach for long-term service and support for all populations — regardless of age, income, or ability — including all payers: federal, state, local, and private. See ad on page 7

LEGAL Nikolaus & Hohenadel, LLP Barbara Reist Dillon, Wanda S. Whare 212 North Queen Street Lancaster, PA 17603

717.299.3726 bdillon@n-hlaw.com wwhare@n-hlaw.com www.n-hlaw.com

Areas of expertise include: elder law, wills, powers of attorney, living wills, medical powers of attorney, and estate settlement. Offices in Lancaster, Columbia, Elizabethtown, Strasburg and Quarryville.

Responding to the Needs of Americans 60 and Over

Advocacy. Action. Answers on Aging. www.p4a.org

Contact your local agency for assistance (See listings above). 30

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— Support and Information — AgingCare.com 239.594.3222 www.agingcare.com

Eldercare Locator 800.677.1116 www.eldercare.gov

All About Vision www.allaboutvision.org

Epilepsy Foundation of America 800.332.1000 www.epilepsy.com

American Cancer Society Response Line 800.227.2345 www.cancer.org

National Institute of Mental Health Information Line 866.615.6464 www.nimh.nih.gov National Library Service for the Blind & Physically Handicapped 888.657.7323 www.loc.gov/nls

EyeCare America 877.887.6327 www.eyecareamerica.org

National Parkinson Foundation, Inc. 800.473.4636 www.parkinson.org

American Diabetes Association 800.342.2383 www.diabetes.org

Family Caregiver Alliance 800.445.8106 www.caregiver.org

American Speech Language-Hearing Association 800.638.8255 www.asha.org

Guide Dog Foundation for the Blind 800.548.4337 www.guidedog.org

American Urological Association 410.689.3700 or 866.746.4282 www.auanet.org Arthritis Foundation Information 800.283.7800 www.arthritis.org

Medicare 800.633.4227 www.medicare.gov

Needy Meds 800.503.6897 www.needymeds.org Office of Minority Health Resource Center 800.444.6472 www.minorityhealth.hhs.gov PACE/PACENET 800.225.7223 www.aging.state.pa.us/aging

Medicare Rights 800.333.4114 www.medicarerights.org Medicare Telephone Hotline 800.633.4227 www.medicare.gov

Pennsylvania Department of Human Services 800.692.7462 www.dhs.pa.gov

CareCentral www.carecentral.com

National Alliance for Caregiving 301.718.8444 www.caregiving.org

Rural Information Center 800.633.7701 www.nal.usda.gov/ric

Caregiver Action Network 202.454.3970 www.caregiveraction.org

National Clearinghouse for Long-Term Care Information www.longtermcare.gov

RxAssist www.rxassist.org

Caregiver Media Group 800.829.2734 www.caregiver.com

National Council on Alcoholism & Drug Dependence, Inc. 212.269.7797 www.ncadd.org

BenefitsCheckUp 571.527.3900 www.benefitscheckup.org

Christopher & Dana Reeve Foundation 800.225.0292 www.christopherreeve.org Community Action Network www.caregiveraction.org Crohn’s and Colitis Foundation of America, Inc. 800.932.2423 www.ccfa.org www.BusinessWomanPA.com

National Health Information Center 240.453.8281 www.health.gov/nhic National Institute on Aging Information Center 800.222.2225 www.nia.nih.gov

Shriners Hospital for Children Referral Line 800.237.5055 www.shrinershospitalsforchildren.org Simon Foundation for Continence 800.237.4666 www.simonfoundation.org Veterans Administration 855.260.3274 www.caregiver.va.gov

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A Spirit of Service, A Legacy of Trust

Enjoy more time with those you love and less worrying about future “what-ifs” with SpiriTrust Lutheran’s® family of services. Our spirit of caring has enhanced the lives of seniors and earned the trust of thousands for nearly 60 years. SpiriTrust Lutheran® Life Plan Communities includes six campuses: • The Village at Gettysburg, Gettysburg • The Village at Kelly Drive, York • The Village at Luther Ridge, Chambersburg • The Village at Shrewsbury, Shrewsbury • The Village at Sprenkle Drive, York • The Village at Utz Terrace, Hanover These communities feature: • Maintenance-free retirement living in one of our residential neighborhoods • Support with daily activities in one of our personal care or assisted living neighborhoods • Specialized care in our memory support assisted living neighborhood • Short-term rehabilitation or nursing care in one of our skilled care centers

SpiriTrust Lutheran® LIFE, Living Independence for the Elderly, features a personalized program with medical and personal care assistance, recreation therapy, and social opportunities for those 55+. Services are conveniently provided in the participant’s home or at one of two LIFE Centers in Enola and Chambersburg. SpiriTrust Lutheran® Home Care & Hospice provides health care and related services to those striving to achieve the highest quality of life, as well as in-home medical, spiritual and emotional support from an interdisciplinary team of caregivers.

Come discover the SpiriTrust Lutheran not-for-profit, faith-based difference and expand life’s possibilities!

www.SpiriTrustLutheran.org

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