Caregiver Solutions 2014

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CAREGIVER SOLUTIONS 2014 PUBLISHER Donna K. Anderson EDITORIAL Vice -President & Managing Editor Christianne Rupp Editor Megan Joyce Contributing Writers Jason Alderman Joseph Banker, D.M.D. Jim Miller Lisa M. Petsche Douglas Scharre, M.D. Jack Sherzer Michelle Turner ART DEPARTMENT Production Coordinator Renee McWilliams Production Artist Janys Cuffe SALES Account Executives Sherry Bolinger Angie McComsey Jacoby Amy Kieffer Ranee Shaub Miller Sue Rugh Account Representatives Christina Cardamone Anne Hill Sales & Event Coordinator Eileen Culp EVENTS MANAGER Kimberly Shaffer ADMINISTRATION Business Manager Elizabeth Duvall Project Coordinator Loren Gochnauer Copyright © 2014 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.

Dear Readers, Do you call yourself a caregiver, or someone who “stops in to check on Mom or Dad”?

Caregivers (many of whom probably don’t even consider themselves a caregiver) run the gamut from spending a few hours a month taking a loved one to doctors’ appointments, making grocery runs, or taking care of mom or dad’s finances, to being responsible for more hands-on assistance such as changing soiled clothing, bathing duties, or even wound dressing.

Cognitive and physical skills can diminish with age and threaten a loved one’s independence. Today, many care receivers want to remain in their “home” as long as possible. That “home” could be the house they’ve lived in for years, a family member’s residence, or a retirement community.

As a family member or friend who isn’t compensated for the services provided to a care receiver, you are identified as an informal caregiver. Women are more often the informal caregiver in a family, frequently balancing caring for children living at home and a relationship with a significant other, while also working a full-time job.

This added responsibility puts further stress on the caregiver, and her life can become a balancing act that never ends.

A formal caregiver—someone who is paid for their services—can step in and take over some of your daily care demands. Although their assistance is paid for, it is imperative that you avail yourself of these services so your stress doesn’t become overwhelming. You can only help others if you take care of yourself first.

Caregiver Solutions offers different types of support though editorial content on a variety of topics; a Directory of Housing & Care Providers that identifies area living communities and healthcare options and the levels of services they offer; and a Directory of Ancillary Services, which are supplemental services that are often necessary for the health and well-being of your loved one.

The providers and organizations included in Caregiver Solutions are eager to discuss how they can assist in your caregiving responsibilities. Please give them a call.

Christianne Rupp, Editor

Contents 2014 4

Caregivers Can Take Steps to Prevent Depression

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Is Your Loved One at Risk for Falling?

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Is There a Connections Between Gum Disease and Alzheimer’s?

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On-Line Publishers, Inc. 3912 Abel Drive, Columbia, PA 17512 717.285.1350 • fax 717.285.1360 www.businesswomanpa.com

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The Pennsylvania Caregiver Support Program

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How Medicare Covers Alzheimer’s Disease

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‘Dad, give me your car keys!

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Involvement – The Best Defense Against Elder Abuse

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What to do When a Loved One Dies

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Resources

Free Service is Available to Veterans

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Directory of Housing & Care Providers

Frequently Asked Questions

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Directory of Ancillary Services

Aging in Place – Staying Home Sweet Home

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Support and Information

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Simple Solutions

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Caregivers Can Take Steps to Prevent Depression

By LISA M. PETSCHE

Throughout the country, family members and friends provide practical assistance and enhance the quality of life for disabled, ill, or frail seniors who might otherwise require residential longterm care. Typically, the caregivers are women.

The caregiving role can be physically, psychologically, emotionally, and financially demanding. While a certain degree of stress is inevitable, when left unchecked it can lead to the caregiver becoming run down or “burnt out.” Depression can be one result.

If you are a caregiver, consider the following strategies for keeping stress manageable and reducing your risk of developing clinical depression.

• Accept the reality of your relative’s illness so you can appropriately plan for the future.

• Learn as much as possible about the illness and its management, and educate family and friends.

• Keep positive. Focus on what your relative can rather than can’t do and on your strengths and successes as a caregiver.

• Do things that bring inner peace, such as meditating, praying, reading, writing in a journal, or listening to music.

• Develop a calming ritual to help you unwind at the end of the day.

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• Look after your health: eat nutritious meals, get adequate rest, exercise, and see your primary physician regularly.

• Stay connected to people whose company you enjoy.

• Simplify your life. Set priorities and don’t waste time or energy on unimportant things.

• If finances permit, hire a housecleaning service or a personal support worker or companion for your relative to free up some of your time and energy for self-care.

• Be flexible about plans and expectations. Take things one day at a time.

• Give yourself permission to feel all of the emotions that surface, including resentment and frustration. Remind yourself that you are doing your best and are only human.

• Don’t keep problems to yourself — seek support from a relative, friend, clergy member, or counselor. Or join a caregiver support group.

• Accept offers of help. Ask other family members to share the load and be specific about what you need.

• Get information about community support services and take full advantage of them. Information can be obtained from your local office on aging. www.BusinessWomanPA.com

Depression: An Overview Contrary to a long-held, popular belief, depression does not stem from personal weakness, and the depressed individual cannot “buck up” or “snap out of it.” Clinical or major depression is a medical illness that requires professional treatment.

There is considerable variation among individuals in terms of the constellation and severity of emotional, mental, and physical symptoms that are exhibited. The most common symptoms are: • Weight loss or gain • A change in sleep patterns • Feeling tired or lacking energy • Noticeable slowing of movements, speech, or thinking • Unexplained physical aches and pains, or exacerbation of chronic health issues • Difficulty concentrating, remembering things, and making decisions

• Feeling sad, and perhaps also crying easily, without any particular reason • Feeling guilty, incapable, unlovable, or hopeless • Lacking interest in activities that normally bring enjoyment • Withdrawal from social contact • Preoccupation with death or recurring thoughts of suicide If thoughts of self-harm or harming the care receiver occur, help should be sought immediately through community crisis resources.

If any of the other symptoms listed above persist for more than a few weeks and interfere with your ability to carry out daily activities, make an appointment to see your primary-care physician.

Depending on the severity of symptoms, treatment may involve counseling, medication, or a combination of the two. The sooner help is obtained for depression, the easier it is to treat.

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

• Feeling restless, anxious, irritable, or angry

Build your caregiver circle.

Many times the “best” care comes from an expanded care network and a caregiver who feels recharged and supported. Create a strong caregiver circle that supports you and your loved one’s needs. Messiah Lifeways offers more options for caregivers and the ones they love. Talk to the Messiah Lifeways Coach to learn more.

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Is Your Loved One at Risk for Falling?

By MICHELLE TURNER

As we age, balance and coordination can affect our overall health.

Symptoms can show up as early as age 40 when our walking stride starts to shorten. Having an abnormal or shortened gait causes stress on the circulatory system, which can affect blood pressure or cause it to rise.

It’s often not until after a loved one falls that we realize this one event can alter the rest of their life. A simple fall can set them back a few months or can even cause death.

New figures from the CDC stated that falls are the leading cause of fatal and nonfatal injuries to older people in the United States. More than one-third of adults ages 65 years and older (about 12 million people) fall each year.

Here is a simple checklist to see if your loved one (or you) is at risk for falling and tips on possible ways to prevent a fall from happening.

Does she walk with a full gait?

This means that one foot should travel behind the pelvis before the other foot is lifted to move the foot forward. When you are able to do this, the balance is good.

She should be able to stand and dress herself and go up and down the stairs without much thought.

Does she have a short gait?

This means that when she walks, her feet are in front of her pelvis.

For example, she might need to hold onto something to fully dress herself and she needs to stop and actually think about going up and down stairs with added support.

Does she shuffle?

This means that she no longer picks her feet up to walk. She can no longer fully dress herself while standing. She can only go up and down stairs one at a time.

Does she have a death grip?

While driving, is she holding onto the steering wheel as if she is going to take it with her? If she has a cane or a walker, does she use a full grip with both hands?

Is it often difficult to get in and out of chairs, a restaurant booth, or her car?

Are her fingers constantly splayed as if she is drying her nails?

If so, this means that she has already fallen or has come very close on several occasions. Her system is startled and is already bracing for impact.

If her hands are in this position while she is sleeping, this shows that she has fallen (possibly more than once) and she can’t relax even when she is lying down.

Does she touch the walls or furniture?

Does she need to touch something to make sure that she stays standing?

Is she a wounded bird?

Does she walk around with one or both arms bent, as if she is carrying around a purse?

The checkmark you’d like to see is the first box. If she is walking with a full gait, then her chances of falling remain low.

Walking with a nice stride, there is no concern for touching walls or worrying how she is going to get from the couch to the kitchen. Her conscious brain has concern for her balance or lack of balance.

If she answered no to the first one and checked one or more of the other boxes, consider the following: When is the last time that you looked at her medications? All medications have side effects. Some of those side effects can impair balance or cause symptoms that affect reactions that include drowsiness, headaches, and poor coordination. All medications come with information or warnings for possible reactions.

The good news is if her medication is causing her to have symptoms where she needs to think about her daily actions, there may be other medications that could be used that might be gentler to her body’s needs.

Whether she is at risk for falling or not, this is a good time to look for hazards in her home (and yours) as that is where most falls occur. Take a look around.

Take a moment to look at her feet and closet. I’m sure that I’m not the first person to recommend a good tie shoe.

The risk of falling rises when shoes are worn too high or too loose. Feet need a secure place on the ground that doesn’t include floppy or uneven soles.

If you have concerns about your loved one falling or she has already fallen, talk to her healthcare provider. The three of you can look at any physical concerns, such as vision or sugar levels, to rule out any medical issues that could be causing unsteadiness.

Work with a movement specialist if she has suffered a fall or you are starting to worry that she is at greater risk of a fall. A professional can personally evaluate how

she moves and suggest ways to develop ease of movement and balance.

There will always be a situation that might result in a tumble. If you follow these easy steps for a loved one or yourself, it will help keep her walking with ease and stability.

Michelle Turner, founder Movement Lesson, LLC, is a movement integration specialist and educator who provides a progressive therapeutic approach to teach the mind and body to more efficiently work in harmony, with the goals of achieving increased mobility, pain relief, and optimal health. Her extensive knowledge, dedication, and individualized approach enable her clients to move forward to a richer, more rewarding and fulfilling future.

www.movementlesson.com

When it is No Longer Possible or Practical to Live at Home W E W E L C O M E P E O P L E O F A L L FA I T H S

• Is there a brick missing from the front steps?

• Does she have rugs that curl in the corner?

• Does she need to navigate around furniture?

• Does she frequently find herself thinking about how to get out of the shower? This would be a great time to install a handgrip. Even if there is no concern now, a visitor may be at risk. www.BusinessWomanPA.com

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Is There a Connection Between Gum Disease and Alzheimer’s?

The Jury’s Still Out

By JOSEPH BANKER, D.M.D. The relationship between gum disease and other systemic diseases such as heart disease have been well established. But until recently, there was never evidence that there may be a relationship to Alzheimer’s disease.

A recent study from the University of Central Lancashire’s School of Medicine and Dentistry suggests that poor dental health and gum disease may be connected to Alzheimer’s disease.

There is a bacterium called Porphyromonas gingivalis found under the gums of patients with active gum disease. After research was performed on patients with dementia, that specific bacterium was found in the brains of a significant number of those patients.

Currently, the importance of this finding is being investigated. It remains unknown if the presence of the P. gingivalis caused the dementia, contributed to it, or had no relationship to it at all.

What is clear is that poor oral health has significant systemic ramifications. If the presence of this bacterium is found to be a significant factor in the progression of dementia, visits to the dentist will be 8

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considered even more important than ever.

How does the bacterium enter the mouth? The oral cavity is a highly vascular area, and bacteria can easily be absorbed into the bloodstream that circulates through the whole body. High bacterial levels in the mouth greatly increase the levels of bacteria entering into the bloodstream.

Routine care is always important, and professional cleanings help keep the numbers of these bacteria present low.

While seeing a professional is important, don’t forget to take care of your teeth at home.

One of the practices elders should pay special attention to is using an antibacterial rinse. The tongue harbors a significant amount of bacteria, and the use of a tongue scraper can be very effective in decreasing the numbers of these bacteria.

Also, old dental restorations should be evaluated and replaced as needed.

There are two people in my family who are prime examples of why you should be aware of your oral health.

My grandfather was a CPA who worked for the IRS. He was a very methodical man who was meticulous in everything he did. www.BusinessWomanPA.com

He had all of his teeth until age 81, when he fractured a tooth beyond repair.

Immediately after I removed that tooth, he asked, “What are you going to put there?”

I was stunned but learned a valuable lesson. Just because he was 81 was no reason to give up on his oral health. He lived his whole life with all of his teeth and wasn’t about to change that.

So, I fabricated a permanent replacement, which remained in his mouth until he passed away at 91. My grandmother is now 97 and still has every one of her teeth. They both took excellent care of their teeth and oral health, and their teeth lasted a lifetime.

Dementia was not an issue for either of them. Their optimal oral health likely helped extend the length and quality of their lives. Grandma still enjoys chewing her food while many of her friends struggle to eat with dentures!

Joseph Banker, D.M.D., is a member of the American Academy of Cosmetic Dentistry and The Crown Council. He has been named a top New Jersey dentist for five consecutive years and has contributed to Shape, Newsweek, and Good Housekeeping.

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The Pennsylvania Caregiver Support Program There are approximately 52 million Americans serving as caregivers of older adults. Adult family caregivers caring for someone 50+ years of age number 43.5 million, and 14.9 million care for someone who has Alzheimer’s disease or other dementia.

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, accounting for about $450 billion worth of unpaid labor in the U.S. in 2009.

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,

Benefits & Services for Caregivers • Assessment of caregiver and care recipient needs • Counseling on coping skills • Respite care

which have been on the rise.

Daughters are more likely to provide basic care (i.e., help with dressing, feeding, and bathing), while sons are more likely to provide financial assistance. A number of studies have shown that women caregivers are more likely than men to suffer from high stress due to caregiving.

The major focus of the Pennsylvania Caregiver Support Program is to reinforce the care being given to people over the age of 60 or adults with chronic dementia. To determine what your particular needs are, 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 ADLs.

No (1)

Yes (2)

Maximum amount of monthly reimbursement for caregiver expenses (depending on reimbursement rate chart) is:

$200

$300

Maximum amount of reimbursement for home modification/assistive devices (depending on reimbursement rate/cost-sharing chart and availability of funding) is:

$2,000

$2,000

Information to caregivers includes advice on how to access: individual counseling, locations of local support groups, and caregiver training to assist caregivers in making decisions to solve problems related to their caregiving role.

Yes

Yes

Caregiver must provide daily hands-on caregiving to care receiver.

Yes

Yes

Caregiver must reside in the same household as care receiver.

• Training in caregiving skills • Home chore caregiving skills • Financial assistance to purchase supplies or services • One-time grant for home adaptations • Benefits and 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 a relative who is age 18 to 59 with dementia, you may be eligible for assistance.

If you are age 55 or older and the primary caregiver* of a relative who is age 18 or younger and lives with you, you may be eligible for assistance. *A primary caregiver is the “one identified adult family member or other individual who has assumed the primary responsibility for the provision of care needed to maintain the physical or mental health of a care receiver and who does not receive financial compensation for the care provided.”

For specific program information, please contact your local Area Agency on Aging.

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**Unless care receiver is 19-59 years of age with dementia or other disability. www.BusinessWomanPA.com

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• Has stress taken over while you manage your family and your parent’s care?

• Are you afraid of how your parent’s illness is going to impact their life and yours?

• Is everyone overwhelmed by new responsibilities to ensure great care for Mom?

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• Have all the appointments, doctors, medications, decisions, tests, bills, and options gotten to be too much?

• Are you worried you’re not doing enough?

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How Medicare Covers Alzheimer’s Disease

By JIM MILLER

Dear Savvy Senior, What does Medicare cover when it comes to Alzheimer’s disease? My wife was recently diagnosed with early-stage Alzheimer’s, and I would like to find out what’s covered and what’s not.

— Researching Spouse

plan’s total drug costs against other plans to be sure you’re getting the best coverage.

The Alzheimer’s Association offers a chart on coverage for common Alzheimer’s drugs—go to alz.org and type “drug chart” in the search field to find it.

Dear Spouse, Most medical costs to treat beneficiaries with Alzheimer’s disease are covered by Medicare, but unfortunately, long-term custodial care costs that most patients eventually need are not.

Here’s a breakdown of what Medicare does and doesn’t cover when it comes to Alzheimer’s disease, along with some tips that can help you plan ahead.

Medical care: For the most part, ongoing medical care to diagnose and treat Alzheimer’s disease is covered by Medicare Part B, including visits to primary-care doctors and specialists, lab tests, speech and occupational therapy, home healthcare, and outpatient counseling services.

Medicare pays 80 percent of these costs, and you will be responsible for the remaining 20 percent after you’ve met your annual $147 Part B deductible.

Inpatient hospital care is also covered under Medicare Part A with a $1,216 12

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deductible and coinsurance. And, as part of healthcare reform, Medicare is also covering 100 percent of annual wellness visits, which include testing for cognitive impairment.

Medications: Most Alzheimer’s medications are covered under Medicare’s Part D prescription drug plans, but plans vary on copayments.

If you have a Part D plan, use the Medicare Plan Finder tool at medicare.gov/find-a-plan to compare your

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Long-term custodial care: Many seniors are surprised to learn that Medicare does not cover longterm custodial care.

This includes nursing-home care, the costs of assistedliving facilities, and adult daycare.

Medicare does, however, pay for some shorter-term nursing-home care, but only up to 100 days following a three-day inpatient hospital stay.

Hiring home help for bathing, toileting, and dressing (this is known as custodial care) is not covered by Medicare either unless your wife is also receiving skillednursing care or physical or occupational therapy to help with the recovery from an illness or injury.

To help with these costs, you may want to consider a long-term care insurance policy. Or if your income and assets are very limited, you may qualify for Medicaid. See longtermcare.gov for a breakdown of long-term care planning options. www.BusinessWomanPA.com

In today’s healthcare environment, you need your own advocate.

What can a private advocate do for you or your loved one?

Hospice: In the final stages of the disease, Medicare Part A covers nearly all aspects of hospice care, including doctor services, nursing care, drugs, medical equipment and supplies, physical and occupational therapy, homemaker services, counseling, and respite care.

To qualify, a doctor must certify that a patient has six months or less to live.

Other Insurance If you don’t have a Medigap (Medicare supplemental insurance) policy, you should consider getting one. A Medigap plan will help pay for things that aren’t covered by Medicare like copayments, coinsurance, and deductibles.

To search for plans in your area, visit medicare.gov and click on “Supplements & Other Insurance” or call Medicare at 800.633.4227 and ask them to mail you a free copy of the Choosing a Medigap Policy publication 02110.

Or, if you’re enrolled in a Medicare Advantage plan (like an HMO or PPO), your plan must give you at least the same coverage as original Medicare does, but make sure your doctors are in your insurer’s network to avoid excess costs.

Also find out whether you need a referral or prior authorization before getting care.

Financial Assistance If you can’t afford your Medicare outof-pocket costs, or need help with medication expenses, there are government programs that can help. Go to benefitscheckup.org to search, or contact your Eldercare Locator at 800.677.1116 to see who can refer you to local services to assist you.

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Involvement – The Best Defense Against Elder Abuse

By JACK SHERZER In our increasingly mobile society, it’s not uncommon for members of a family to be scattered across states or even time zones. Phone calls many times replace visits to parents or older relatives.

A disquieting fact of our modern age is that elder abuse is on the rise. A recent federal study found that as many as 10 percent of participants experienced abuse in the prior year.

Harrisburg attorney Melanie Scaringi, who focuses her practice at Scaringi & Scaringi, P.C., Harrisburg, on estate planning and elder law, has witnessed many of the ways elders can be abused by a combination of circumstance, opportunity, and criminal intent.

Almost always, the abuse is financial, although financial abuse can also lead to physical problems for elderly individuals. Sometimes the abuse is perpetrated by family members and other times by acquaintances when close family is far away. In most of these cases, the older person lives alone, often after a spouse has died.

Misplaced Trust “A classic example is when an elderly widow is befriended by a younger woman who has suddenly appeared in the elderly widow’s life,” Scaringi says, recalling an actual case.

This case began when a younger woman reached out to the older woman with an offer of help. The younger woman started taking her older friend grocery shopping and to hair and nail appointments. Later, the younger friend offered to help with the bills and balancing the bank accounts. She ultimately took over the handling of money and deposits.

Soon ATM withdrawals were being taken regularly by the younger woman, unbeknownst to the older woman (who was no longer reviewing her account statements because her new friend was handling her finances for her). It was not until this widow’s son came home to celebrate a holiday with his mother that the abuse was discovered.

Sadly, Scaringi says she has seen it many times: a “Mrs. Lonely Hearts” who loses a sizable sum from her life Continued on page 16 14

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How to report suspected abuse Anyone can report elder abuse. Pennsylvania has a statewide toll-free Elder Abuse Hot Line at 800.490.8505, or call your county Area Agency on Aging.

The Pennsylvania Association of Area Agencies on Aging, which has offices in all 67 counties, aggressively investigates reports of elder abuse and many times turns cases over to local prosecutors. The association has the power to examine bank accounts and other records when investigating cases of suspected elder abuse.

When the elderly fall prey to commercial schemes, the state Office of Attorney General boasts powerful tools to target, halt, and prosecute scams and other predatory practices aimed at exploiting older people. www.BusinessWomanPA.com

Responding to the Needs of Americans 60 and Over

ADVOCACY. ACTION. ANSWERS

ON

AGING.

Chester County 610.344.6350

Dauphin County 717.780.6130

Lebanon County 717.273.9262

Cumberland County 717.240.6110

Lancaster County 717.299.7979

York County 717.771.9610

www.p4a.org Contact your local agency for assistance

Involvement Continued from page 14

savings at the hands of a trusted friend who just seemed to appear in her life. Usually the elderly person has made no effort to initiate this new friendship. The entire friendship seems to be initiated by the younger person.

When it comes to elder abuse, the offender can be almost anyone. It can be a family member—a son, daughter, or grandchild seeking financial advantage and control. It can be a new friend at a lonely time. It can be a next-door neighbor or even a paid caregiver.

Warning Signs Sometimes, family members living in other cities with busy lives don’t discover the financial elder abuse until significant sums have been swindled. But Scaringi says there are warning signs to look for.

The first comes from simply listening.

If an older loved one suddenly starts talking about someone new, pay attention. Take a keen interest in who this person is— and what he or she wants. Determine whether this person has a family, whether this person has normal interactions with other individuals, or whether this person seems to be a loner who is solely focused on your older loved one.

Talk with your loved one about not revealing financial information to strangers who are offering to help. Make sure your older loved one is aware that there are people out there who are intentionally befriending and preying upon elderly individuals (particularly widows who maybe never handled their own finances before).

Scaringi recommends keeping in touch with trusted neighbors or longtime friends of your older loved one. They are excellent secondary sources of information on how your loved one is doing.

Make regular calls to the church or any group where the loved one is an active member. If you sense that your elderly loved one needs some help, figure out how to get her the help that she needs before she becomes so overwhelmed that she is willing to trust just about anyone who makes an offer.

Detecting Elder Abuse Elder abuse can be difficult to spot and difficult to prove.

Issues of mental competency, degrees of duress, and complicated family dynamics often combine to make each case a minefield of emotions, relationships, and subjective opinions.

Sometimes third parties simply take advantage of generous elderly benefactors. If the elderly individual is mentally competent and chooses to give her money or assets away despite the recommendations of others, that might not be elder abuse. It 16

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might simply be a competent elderly person who is making “bad” financial decisions.

For example, Scaringi tells of a case involving two adult ne’erdo-well grandchildren who had been raised by their grandparents. The grandparents allowed their grandchildren to continue to live with them for free as adults and would give them large sums of money on a regular basis, which drew the attention of the rest of the family.

The other family members were concerned the grandchildren were physically intimidating and emotionally manipulating the grandparents. After a full investigation, including face-to-face interviews with the elderly couple, it was determined that the grandparents were indeed spending lavishly on their adult grandkids, but there was no abuse. The couple was competent and freely choosing to support the grandchildren.

Contrast this with another of Scaringi’s cases, which involved a recent widow with no family members who lived nearby.

Within a year of her husband’s death, her neighbor offered help and convinced the widow that she first needed to sign a paper at a lawyer’s office to allow the neighbor to offer assistance.

It turns out that the document the neighbor had the widow sign was a deed transferring part of the widow’s land to the neighbor—for free!

When a visiting family member saw a garage being built on the property, the family member hired an attorney to investigate.

In this case, the elder abuse was clear cut, and court action initiated by the firm essentially “undid” the transfer.

Trust Your Instincts If you sense that something is wrong, or you suspect someone is manipulating or abusing your elderly loved one, consulting with an experienced elder law/estate-planning attorney is a good place to start.

The attorney can investigate the matter (or direct you as to how to go about investigating it) and can draft powers of attorney and other estate-planning documents that might be needed so that you or another appropriate individual can help your elderly loved one.

If necessary, the attorney can initiate actions to appoint a guardian to make decisions for your loved one if he or she is not mentally competent and can take court action against the abuser if appropriate.

“The main thing you can do to protect your elderly loved ones from abuse is to stay involved in their lives and to visit them with some regularity,” says Scaringi. “The people who are most likely to fall victim to elder abuse are those who don’t have family members who are looking out for their best interests.” www.BusinessWomanPA.com

Free Service is Available to Veterans Veterans and their surviving spouses are provided, free of charge, assistance with claims for service-connected disabilities, nonservice-connected pensions, emergency assistance, healthcare system enrollment, and other federal, state, and county benefits through the Department of Veterans Affairs.

The Department of Veterans Affairs also assists surviving spouses of veterans in applying for aid and attendance, pensions, dependency and indemnity compensation for service-connected deaths, and death benefits.

Vietnam veterans diagnosed with Type 2 diabetes, prostate cancer, chronic lymphocytic leukemia (CLL), Parkinson’s disease, ischemic heart disease, or hairy cell leukemia should contact the Veterans Affairs about filing a claim for disability.

Veterans diagnosed with amyotrophic lateral sclerosis (ALS), commonly referred to as Lou Gehrig’s disease, and surviving spouses of veterans who died as a result of any of these disabilities should contact the Veterans Affairs office to determine eligibility for benefits.

Cumberland County Neal Delisanti 717.240.6178 ndelisanti@ccpa.net Dauphin County Administration Building (fourth Floor) Tony DiFrancesco 717.780.6357 tdifrancesco@dauphinc.org Lancaster County Daniel Tooth 717.299.7920 dtooth@co.lancaster.pa.us Lebanon VA Medical Center 1700 South Lincoln Avenue Lebanon, PA 17042 800.827.1000 – Benefits 800.273.8255 – Crisis Line 877.222.8387 – Health Care York County Veteran Affairs Philip Palandro 800.441.2025, ext. 9218 papalandro@yorkcountypa.gov

Spread the Word Aid and Attendance Service — a free service This program provides financial benefits to qualified veterans and their spouses. Surviving spouses who are patients in nursing homes or assisted living facilities and who are determined by the VA to be in need of regular aid and attendance of another person or who are permanently housebound may be entitled to additional benefits.

Eligibility is based upon need. Contact the VA for assistance.

What are my obligations as a caregiver?

As the caregiver, you should make sure your loved one is in a safe and healthy environment, whether that is their home, your home, or a nursing home. He or she should be protected from any type of abuse—physical, mental, or financial.

Some documents that you should have in place are listed below.

• HIPAA authorization — The Health Information Portability and Accountability Act (HIPAA) keeps health information and records private. Your loved one must authorize in writing that you may receive their health information. Otherwise, their doctors aren’t obligated to share any details about their health with you, the caregiver.

What are some of the most important documents a caregiver should have in place?

The most common legal documents that every caregiver should have are:

You will need to have a copy from each doctor’s office. Sign it at the office and then keep a copy for yourself and the person you’re caring for. Of course, the doctor’s office will also have a copy.

• A Will – It should say what your loved one wants to do with his or her property, including how and when the assets will be distributed.

• Advanced Health Care Directive — This offers the assurance that your loved one’s decisions regarding his or her future medical care will reflect their values and wishes.

• Durable Power of Attorney for Healthcare — This gives you, the caregiver, the right to make healthcare decisions. It takes effect when a loved one becomes mentally incapacitated and is unable to make his/her own healthcare decisions. Your agent must act consistently with your desires as stated in the document.

• Durable Power of Attorney for Finances — This allows a caregiver to manage their loved one’s finances and takes effect when a loved one becomes incapacitated and no longer able to pay the bills, file tax returns, manage investments, and make other important financial decisions.

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What services are available from Pennsylvania Area Agencies on Aging?

Area Agencies on Aging, county- or multi-county-based agencies that partner with the Department of Aging, provide a wide range of services, such as assessment of need, care management, in-home services, transportation, protective services, adult daycare, legal services, healthcare counseling, and senior centers.

Services may vary from county to county, so it is wise to call your local Office of Aging for particular services or programs.

What is the Pennsylvania Caregiver Support Program?

Previously called The Family Caregiver Support Program, the Pennsylvania Caregiver Support Program’s major focus is to reinforce the care being given to persons over the age of 60 or adults with chronic dementia.

The package of benefits begins with an assessment to determine what benefits best meet your needs and the needs of the person receiving care. Then you will

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choose an option from available supportive services. Other benefits could also include counseling, education, and financial information.

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? To be eligible for PACE, you must be 65 years of age or older and a Pennsylvania resident for at least 90 consecutive days prior to the date of application.

For a single person, your total income must be $14,500 or less. For a married couple, your combined total income must be $17,700 or less.

Prescriptions: co-pay for generic, $6; co-pay for single-source brand, $9.

Who is eligible for PACENET? To be eligible for PACENET, the qualifications are the same as PACE. However, the total income for a single person can be between $14,500 and $23,500. A couple’s combined total income can be between $17,700 and $31,500.

Prescriptions: co-pay for generic, $8; co-pay for single-source brand, $15.

Monthly $40 deductible.

Call your local Area on Aging office for forms or more information.

What is PACE Plus Medicare?

Under PACE Plus Medicare, PACE/PACENET coverage is supplemented by federal Medicare Part D prescription coverage—offering older www.BusinessWomanPA.com

Pennsylvanians the best benefits of both programs. Older adults continue to receive the same prescription benefits while, in many cases, saving more money.

What is respite care?

Respite care provides relief from your caregiving responsibilities on a short-term basis, which could be for a day or two or even up to a month. Care may range from personal to nursing care.

Respite care may be offered through a local retirement community, through home care services, and through a statefunded program, such as adult daycare programs. Respite care offers you the ability to rest, relax, and regroup, confident that your loved one is the hands of trained and qualified professionals.

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 health-insurance 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.

They 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 800.783.7067 or your local Area Agency on Aging for more information. The services are free of charge.

I heard that communities must now be licensed as a personal care home or an assisted living residence. Is that true? www.BusinessWomanPA.com

Yes, that is correct. At the beginning of 2011, personal care and assisted living can no longer be interchangeable terms.

Specific requirements must be met, and communities (including retirement communities and CCRCs that offer those services) must be licensed as one or the other, although they can meet requirements and be licensed for both.

Do home care agencies need licenses too?

Yes, home care agencies (HCAs) and home care registries (HCRs) must now be licensed by the Department of Health to provide home care services, medical and nonmedical.

Are there caregiving tax breaks I can take advantage of?

You may be able to claim your loved one as a dependent on your tax return. To qualify for dependency, you must pay for more than 50 percent of your qualifying relative’s support costs for the year.

With changes occurring in the healthcare laws, it is advisable to check with your tax preparer to find out what you qualify for, such as medical deductions and a dependant-care credit.

waiver of certain Medicaid restrictions, allowing payments typically used for nursing-home care to be used for homecare services.

The consumer is able to choose which local organization or company/agency will provide the services. All service providers are certified by the Pennsylvania Department of Public Welfare to ensure that they meet Medicaid standards.

Some services/benefits that individuals can be approved for are: • Adult daily living services (adult daycare) • Attendant care (Personal Care) • Community transition services (moving assistance) • Companion services (escort) • Counseling • Environmental accessibility modifications (home and/or vehicle) • Financial management services • Home health services • Home medical equipment and supplies Meal delivery (hot or prepared) • Non-medical transportation

What is the waiver program offered through the Pennsylvania Department of Aging?

There are several waivers available through the Pennsylvania Departments of Aging for people aged 60 and older who meet the eligibility requirements and income limits.

Under the program, home- and community-based long-term care services can be provided as alternatives to nursing care. Services are funded through a special BUSINESSW

• Personal emergency response (PER) system • Respite care services (temporary caregiver relief) Are there any other online sources for additional information?

Yes. Visit www.heretohelp.pa.gov.

There is an abundance of information to be found at Here to Help on the PA Government Portal.

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Aging in Place – Staying Home Sweet Home

By CHRISTIANA CARDAMONE As a person starts to age and finds even the simplest tasks complicated by failing strength or wits, it is normal that they want to retain their dignity and independence as long as possible. Thanks to the new trend of aging in place, individuals who suffer from these complications and related issues are now able to stay in their homes longer and not be wrenched from familiar surroundings.

Aging in place is newer terminology used to describe creating or adapting a

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person’s home or choice of residence with necessary changes and modifications so they can live independently and comfortably. Many women are caregivers for older loved ones, and making sure that the care receiver’s home is safe as well as accessible is paramount to making the aging-in-place scenario feasible.

According to the most recent housing survey by the AARP, “Eighty-three percent of older Americans want to stay in their current homes for the rest of their lives.”

Unfortunately, most homes are not designed to accommodate people over age 65.

If you or someone you know is facing the decision to move or stay put, consider contacting a contractor who can do the necessary upgrades.

Although many general contractors are capable of making the necessary modifications, some become a Certified Aging in Place Specialist (CAPS), a specialized certification through the National Association of Home Builders.

These individuals have taken instructional classes from leaders in the construction industry to become better informed about the unique needs of older adults and have been trained in the universal design principles to design, build, and remodel homes so that they are barrier free.

Keith Davis, a CAPS in home modification and affiliate of 3-D Consultants, says that safety is the No. 1 rule, regardless of appearance or cosmetics. Davis said that modifications

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can range from highly extensive, such as creating an in-home hospital, to something as easy as installing entrance handrails or ramps.

Another up-and-coming concept in the home industry is visitability, which involves simple modifications to houses while they are being designed so that anyone who has a mobility impairment can visit. The three main criteria of visitability are: one no-step entrance into a home; doorways with at least a 32-inch clear space; and a first-floor powder room large enough to accommodate a person in a wheelchair.

There are ways to ensure that home modifications provide a safe environment while not diminishing the property value of the home. This concept, called “universal design,” blends the modifications and the existing construction together to create an aesthetically pleasing appearance.

One example, Davis says, would be to install a sloped, concrete sidewalk with nice landscape or a retaining wall, which would provide the same accessibility as a pressure-treated ramp while still being visually attractive. www.BusinessWomanPA.com

When starting the design and modification of your home, it is important to identify what changes need to be made.

The National Resource Center on Supportive Housing and Home Modifications offers checklists on the center’s website (http://gero.usc.edu/nrcshhm) that will assist in identifying the changes needed in each room of the residence. This list can then be taken to a remodeler who can further develop the plans.

Bathrooms can be one of the most dangerous rooms in a house due to lower levels of mobility, smaller spaces, and slippery surfaces. Some modifications that would bode well in a bathroom include a raised toilet seat, grab bars for entering and exiting a tub, a tub bench, and nonslip surfaces to walk on.

Bedrooms can be a very personal space for an individual, but with slight changes, they can still be safe and comfortable. One of the easiest ways to clear tripping hazards is to rearrange the furniture so pathways are unobstructed. This also includes positioning the bed to where it can be accessed from all sides but is still secured enough that if it were bumped, it would not move.

A few items that are important to have in reach from the bedside are a lamp or light switch and a telephone or contact device. It may also be a good idea to clearly list phone numbers that can be called in the case of emergency.

There are also devices that can be attached to a bed’s side to create bedrails so that the elder can have assistance when entering and exiting the bed.

These slight modifications of a space can go a long way, especially if your loved one is still capable of taking care of their daily hygienic needs. Being able to keep a www.BusinessWomanPA.com

sense of independence can help the morale, energy, and mind of someone in a caregiving situation.

When hiring a contractor to complete home modifications, remember some of the following points: Make sure the contractor is insured and licensed to complete the required work.

Check with your local Better Business Bureau and Chamber of Commerce to see if any complaints have been filed against

the contractor.

Be sure to get in writing the cost of the job and the specific work that will be done.

Aging in place is also on the minds of younger individuals who intend to stay in their current home as long as possible. If you’re thinking about making some home improvements/renovations, design them with an eye on the future, realizing that mobility and other issues come into play as one ages.

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‘Dad, give me your car keys!’

By DOUGLAS SCHARRE, M.D.

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It’s just not natural. Children are not supposed to set limits on their parents.

However, when adult children become the caregivers for their parents, one especially touchy subject can be when to tell Mom or Dad they can no longer drive. It can lead to strife, resistance, and very bad feelings all around.

Nevertheless, it is important for family members to keep an eye on their impaired loved ones to spot potential driving problems early. Driving is all about independence, and most people are very resistant to anyone taking away their independence. People with very early dementia symptoms are often still able to drive safely.

Therefore, it is tough for families and physicians to decide when the person has reached that point of being a danger to themselves or others on the road.

There are several articles published on how to make that determination, and the National Highway Transportation and Safety Administration (NHTSA) has an

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When driving is no longer safe, having the parent or grandparent stop driving is an extremely difficult conversation to have.

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excellent guide for families and for physicians on this area.

Office tests measuring cognitive skills that primary-care physicians use can help guide determinations of fitness to drive. There are also centers devoted to testing elderly drivers to ascertain if they are safe.

Even if the impaired individual is determined to still be a safe driver, it is important to consider restricting their driving to daylight hours, not in inclement weather, and only to familiar places. Close observation over time is critical and can determine when a repeat assessment is needed.

There are a few ways adult children or other family members can help assess driving skills.

• Have a family member ride with or follow the individual at least once a month to evaluate for impaired driving judgment issues.

• Monitor the mileage on the car. If the mileage is longer than the short trips they are taking, it could mean they are getting lost.

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• Look for any is new dents or scrapes as this can show that there is trouble when driving.

When driving is no longer safe, having the parent or grandparent stop driving is an extremely difficult conversation to have. One way to get the older driver to agree is to point out that it is unsafe for others on the road, and if they want to avoid hurting others, they should voluntarily stop driving.

Families can avoid being the bad guys by suggesting the person get a driving evaluation by a professional. If they won’t get the evaluations, talk to their doctor.

A doctor can help by writing a prescription that tells the patient to “temporarily stop driving.” They can explain that while they are evaluating the patient or while a new medication is being tested that it is best to hold off driving temporarily.

The doctor can also encourage the family to make driving impossible by taking the keys, disabling the car, or selling the car. If the situation is bad enough and the family won’t or can’t do these things, the doctor should send a letter to the state motor vehicles bureau informing them the patient is unsafe.

Remember, taking the tough action with Mom or Dad now is far better than dealing with the consequences of an accident due to unsafe driving later.

Douglas Scharre, M.D., is the director of the Division of Cognitive Neurology at The Ohio State University Wexner Medical Center. He is a board-certified neurologist with special interests in dementia-related behaviors and degenerative dementias. http://neurology.osu.edu/cognitive/scharre.html

www.BusinessWomanPA.com

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23

What to do When a Loved One Dies

By JASON ALDERMAN

Whether it’s expected or accidental, the death of a loved one can shake you to the core.

The last thing you want is to have to interrupt grieving to deal with mundane tasks, but unfortunately there are many actions that must be done on behalf of the deceased. Some must be taken immediately, while with others you can take your time and reflect on the best path to follow.

Here’s a checklist: If the death occurs under hospital or hospice watch, they will notify the proper authorities and help you make arrangements with the coroner’s office for transport of the remains. If it happens at home, call local police or 911 for

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assistance. If he or she was an organ donor, you’ll need to act quickly.

Reach out for help in making arrangements and locating key documents. Split up such tasks as contacting others who will want to know, taking care of pets, collecting mail, and safeguarding the deceased’s home if it’s now vacant.

Look for a will or other document that spells out the deceased’s burial or cremation wishes—many people make funeral arrangements in advance, even paying ahead of time. The funeral home can guide you through the paperwork process, such as placing an obituary and ordering death certificates.

Hopefully, the deceased prepared a will that names an executor to oversee the disposition of his or her estate; otherwise,

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the court will have to appoint one.

In sorting through their files, also look for: a trust; insurance policies; bank, credit card, mortgage, and loan accounts; safe-deposit box key; contact information for lawyer, doctor, accountant, or other professional advisors; and passwords to computer and other accounts.

Within the first few days, start notifying organizations with which the deceased had business or financial arrangements. In most cases you’ll be required to submit a certified copy of the death certificate, so be sure to order ample copies. You’ll need to contact: • Current or former employers for information about possible final wages, accrued vacation, retirement benefits, life insurance, or other death benefits.

www.BusinessWomanPA.com

• Social Security Administration. If they were receiving Social Security benefits, you’ll need to stop payment right away.

Funeral homes often do this, but be sure to ask.

• Once you’ve notified Social Security, they will contact Medicare to cancel benefits. However, if they were enrolled in a Medicare Prescription or Advantage Plan or had a Medigap policy, contact each to cancel coverage.

• Veterans Administration. Veterans, their immediate family members, and certain others may be entitled to burial at a national cemetery.

• Forward their mail to a secure address so

you don’t miss important correspondence.

assets are sold, in case of theft or damage.

• Cancel their driver’s license to avoid identity fraud.

• Close email accounts.

• Contact banks, credit unions, credit card issuers, and other lenders to close accounts—or, if you are a surviving spouse, to convert accounts to your name only.

• If they had a safe-deposit box and you don’t have the key, ask what documentation you need to gain access.

• Contact insurance companies to cancel auto and homeowner’s policies; however, consider keeping them activated until

• Cancel magazine subscriptions and utilities.

Finally, the executor will have to deal with issues such as locating beneficiaries, distributing inherited property, filing final tax returns, and settling outstanding debts. You’d be wise to work with an attorney who specializes in probate issues.

Jason Alderman directs Visa’s financial education programs. To follow Jason Alderman on Twitter: www.twitter.com/PracticalMoney

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Resources What to Do about Mama?

By Barbara G. Matthews and Barbara Trainin Blank www.sunburypress.com This is a book for caregivers by caregivers. Their intention is to provide information-based caregiver experiences, which will assist you in developing realistic goals and expectations.

Matthews and Blank identify common feelings of like experiences, and, conversely, different perspectives about like experiences.

In addition to their own life experiences, information was also gathered from other caregivers through a caregivers’ questionnaire, which is also included in the book. This book will get you thinking about the many issues that can and do arise.

Coping with Un-Cope-Able Parents

By Carol-Ann Hamilton www.balboapress.com Coping with Un-Cope-Able Parents offers an original approach for how to handle “un-cope-able” aging parents, complete with 12 innovative coping keys.

Hamilton hopes to provide support to the “Sandwich Generation,” otherwise known as baby boomers, who deal with the strain of caring for elderly parents along with their own families’ needs. After decades of experience, Hamilton has discovered and successfully tested 12 outof-the-box survival strategies and offers them in a hilarious, yet poignant, manner.

Donald’s Story: One Family’s Journey Through the Tangled Darkness of Alzheimer’s

By Gina Moreno Wilson, J.D. www.authorhouse.com From pre-diagnosis to the end, Donald’s Story tenderly illustrates the struggles and pain caused by the disease, as well as the persistent triumphs of the human spirit in the face of the Alzheimer’s diagnosis. Wilson provides an in-depth, personal look into an Alzheimer’s story.

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Wilson presents caregivers with concrete survival strategies and shares ways of balancing your personal and professional life in the face of extreme stress and adversity. Balancing the heartache, fatigue, and despair through attention to the caregiver’s own needs is imperative in preserving the ability and desire to continue providing compassionate care for another.

The Essential Guide to Caring for Aging Parents

By Dr. Linda Rhodes www.penguin.com Written by an expert on aging who cared for her own parents and in-laws, The Essential Guide to Caring for Aging Parents leads you through the eldercare maze.

Learn how to spot signs that a loved one requires special attention, get advice on ways to talk to your parents about their health, help arrange for their care, and address their needs and wishes.

All aspects of eldercare are also discussed, including living options, insurance, legal matters, and how to become your parent’s medical and financial advocate.

Finding Your Way: A Practical Guide for Family Caregivers – 250 Real Life Questions & Commonsense Answers

By Dr. Linda Rhodes www.lindarhodescaregiving.com Dr. Linda Rhodes is a former secretary of aging for the state of Pennsylvania. She is credited for initiating Pennsylvania’s Family Caregiver Support Program, which is often cited as a national model.

From senior housing and assisted living to long-distance grandparenting, handling caregiver stress, and eldercare benefits, Finding Your Way offers insightful answers to all of your questions throughout 424 pages. Easy to read and formatted by specific subjects for easy access.

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Caring for a Person with Alzheimer’s Disease By the National Institute on Aging www.nia.nih.gov/alzheimers/publication This easy-to-use guide from the National Institute on Aging is a comprehensive, 104page handbook offering easyto-understand information and advice for at-home caregivers of people with Alzheimer’s disease.

It addresses all aspects of care, from bathing and eating to visiting the doctor and finding respite care.

When Your Parent Becomes Your Child

By Ken Abraham www.thomasnelson.com When Your Parent Becomes Your Child tells the story of one family’s journey through dementia while offering hope to family members and friends that they might better understand the effects of the disease.

Abraham not only educates but also offers inspiration to help readers cope with and manage their family circumstances and deal with common concerns when caring for someone with dementia: memory loss, physical decline, personal hygiene issues, dangers of driving and living alone, aberrant behavior, and uncharacteristic attitudes.

They’re Your Parents, Too!

By Francine Russo www.bantam-dell.atrandom.com Written by a veteran journalist who chronicles life and how baby boomers live it, They’re Your Parents, Too! offers all the information, insight, and advice you’ll need to make productive choices as you and your siblings begin to assume your parents’ place as the decisionmaking generation of your family.

Filled with expert guidance from gerontologists, family therapists, eldercare attorneys, financial planners, and health workers; resonant real-life stories; and helpful family negotiation techniques, this is an indispensable book for anyone whose parents are aging. www.BusinessWomanPA.com

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Bayada Home Health Care provides home health aide and R.N./L.P.N. nursing services for adults in their own homes to help maintain independence. Shifts consist of three to 24 hours.

Bethany Village 325 Wesley Drive Mechanicsburg, PA 17055

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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.

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Bethany Village at Home 5225 Wilson Lane Mechanicsburg, PA 17055

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We offer customized personal care, housekeeping, companionship, and transportation services for adults 55+ in Mechanicsburg, Pa., and surrounding communities. Care given with respect and dignity while maximizing independence.

The Campus of the Jewish Home 717.657.0700 of Greater Harrisburg drizio@jhgh.org 4000 Linglestown Road www.jewishhomeharrisburg.org Harrisburg, PA 17112 See ad page 7

The Haven at Springwood 717.741.9919 2321 Freedom Way smundis@havenatspringwood.com York, PA 17402 www.havenatspringwood.org The Haven at Springwood offers a residence that encourages independence with services that promote “aging in place.� We provide both quality service and good value.

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Homeland Center 1901 North Fifth Street Harrisburg, PA 17102

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Homeland Center, a continuing care retirement community, offers beautiful personal care suites, skilled nursing, hospice, rehabilitation, and dementia care, all delivered by highly competent and compassionate staff.

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Homeland Hospice 2300 Vartan Way, Suite 115 Harrisburg, PA 17110

717.221.7890 homeland1@pa.net www.homelandhospice.org

Homeland Hospice, a service of Homeland Center, provides the highest level of care and support at the end stages of life while serving as a compassionate resource for families.

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Lutheran Retirement Village at Utz Terrace 2100 Utz Terrace Hanover, PA 17331 See ad page 31

717.637.0633 pmitchell@lutheranscp.org www.lutheranscp.org

Lutheran Social Services South Central Pennsylvania 1050 Pennsylvania Avenue York, PA 17404

717.854.3971 pmitchell@lutheranscp.org www.lutheranscp.org

Griswold Home Care Cumberland County 717.839.5727 david.rosen@griswoldhomecare.com 6 West Main Street Shiremanstown, PA 17011 www.griswoldhomecare.com Dauphin County 717.234.4009 4815 Jonestown Road, Suite 201 stephanie.carl@griswoldhomecare.com Harrisburg, PA 17109 www.griswoldhomecare.com Lebanon County 717.279.0702 200 Schneider Drive, Suite 3 angela.kritzer@griswoldhomecare.com Lebanon, PA 17046 www.griswoldhomecare.com See ad page 2

For 60 years, Lutheran Social Services 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 page 31 (Continued next page)

COLOR KEY FOR DIRECTORY OF CAREGIVING PROVIDERS INDEPENDENT RESIDENCES PERSONAL CARE HOME ASSISTED LIVING RESIDENCE DEMENTIA UNITS NURSING CARE COMMUNITY

www.BusinessWomanPA.com

REHABILITATION FACILITY RESPITE ADULT DAY CENTER HOME CARE SERVICES HOSPICE CARE

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DIRECTORY OF HOUSING & CARE PROVIDERS Messiah Lifeways 100 Mount Allen Drive Mechanicsburg, PA 17055

717.591.7225 life@messiahlifeways.org www.messiahlifeways.org

Messiah Lifeways offers more options for caregivers and the ones they love, including: support groups, workshops, free coaching, adult day, at-home services, and respite.

See ad page 5

Pleasant Acres Nursing & Rehab Center 717.840.7100 Elm Spring Residence mjhunt@yorkcountypa.gov 118 Pleasant Acres Road www.yorkcountypa.gov York, PA 17402 Skilled nursing and rehab services for short-term rehab and long-term skilled care. Also offering hospice services, independent living units, a ventilator care unit, as well as a specialized dementia unit.

Riddle Village 1048 West Baltimore Pike Media, PA 19063

610.891.3700 www.riddlevillage.org

Comprehensive Lifecare program with ideal Main Line location adjacent to Riddle Memorial Hospital. Multiple dining venues, expansive fitness area with indoor pool, and underground parking garage.

Shrewsbury Lutheran Retirement Village 717.235.5737 800 Bollinger Drive pmitchell@lutheranscp.org Shrewsbury, PA 17361 www.lutheranscp.org See ad page 31

Specialty Home Care 1251 East Chocolate Avenue Hershey, PA 17033

717.533.4400 info@specialtyhomecare.com www.specialtyhomecare.com

Up to 24/7 personal care, homemaker, and transportation services provided at home. Experienced, compassionate caregivers are why we are known as Hershey’s premier homecare company!

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REHABILITATION FACILITY RESPITE ADULT DAY CENTER HOME CARE SERVICES HOSPICE CARE

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StoneRidge Retirement Living 717.866.3200 440 East Lincoln Avenue stacia.dial@stoneridgeretirement.com Myerstown, PA 17067 www.stoneridgeretirement.com StoneRidge is a full-service CCRC in Myerstown, Pa. Since 1924, we’ve been providing quality senior care just a short drive from Reading, Lebanon, and Hershey.

See ad page 23

Tel Hai Retirement Community 1200 Tel Hai Circle Honeybrook, PA 19344

610.273.9333 awelsh@telhai.org www.telhai.org

The Village at Kelly Drive 750 Kelly Drive York, PA 17404 See ad page 31

717.854.5010 pmitchell@lutheranscp.org www.lutheranscp.org

The Village at Sprenkle Drive 1802 Folkemer Circle York, PA 17404 See ad page 31

717.764.9994 pmitchell@lutheranscp.org www.lutheranscp.org

Visiting Angels Living Assistance Services Hanover 104 Carlisle Street, Suite 1 Hanover, PA 17331

717.630.0067 hanoveroffice@visitingangelsyork.com www.visitingangels.com

Lancaster 717.393.3450 202 Butler Avenue, Suite 302 lancasteroffice@visitingangelsyork.com Lancaster, PA 17601 www.visitingangels.com York 1840 East Market Street York, PA 17402

717.751.2488 yorkoffice@visitingangelsyork.com www.visitingangels.com

See ad page 21

Visiting Angels 4607 Locust Lane Harrisburg, PA 17109

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

VNA of Central PA/ Crossings Hospice of the VNA 3315 Derry Street Harrisburg, PA 17111

717.233.1035 800.995.8207 www.vnacentralpa.com

www.BusinessWomanPA.com

AREA AGENCIES ON AGING 610.344.6350

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

717.240.6110 717.780.6130 717.299.7979 717.273.9262 717.771.9610 www.p4a.org

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

Areas of expertise include: elder law, wills, powers of attorney, living wills, and medical powers of attorney, estate settlement.

Offices in Lancaster, Columbia, and Quarryville.

Your local offices of aging act as advocates for Pennsylvania’s seniors—promoting their continued physical, social, and economic self-sufficiency.

GERIATRIC CARE SERVICES Wisdom to Health Caregiving with Confidence Serving Central PA See ad page 11

720.352.7040 bettsee@wisdomtohealth.com www.wisdomtohealth.com

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

SEARCH AND RESCUE Project Lifesaver 717.471.5750 Pilot Club of Lancaster, Inc. 717.572.2682 948 Spoon Avenue lisa_palmquist@verizon.net Landisville, PA 17538 www.pilotcluboflancaster.com Through the use of specialized equipment and personal transmitters, trained police quickly locate “at risk” children and/or adults with cognitive disorders who have demonstrated wandering behaviors.

HEALTHCARE CONSULTANTS Patient Advocates Lancaster 717.884.8011 Serving Lancaster County anne@patientadvocateslancaster.com and Surrounding Areas www.patientadvocateslancaster.com See ad page 13

HOME MODIFICATIONS Home Accessibility Outfitters 1111 North George Street York, PA 17404

THERAPIES ‘Floral Touch’ Horticultural Therapy 717.598.0347 Paula Swearingen, M.Ed., HTR paula@floraltouch.net Registered Horticultural Therapist www.floraltouch.net See ad page 13

717.885.5253 tom@haoutfitters.com www.haoutfitters.com

We can provide a complete range of home accessibility services and equipment to modify your home for improved access and livability.

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.

Respite Care provides normal care-giving opportunities on a short-term basis. May range from personal to nursing care, at home or in a care community. www.BusinessWomanPA.com

Adult Day Centers offer programs in facilities or independent organizations for hourly or daily adult supervision.

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 24hour nursing supervision, many of whom are confined to bed for some portion of the day.

Assisted Living Residences (ALR) 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.

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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.

CCRCs are communities offering a variety of living options in addition to comprehensive medical and nursing services.

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.

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Support and Information All About Vision www.allaboutvision.org

Eldercare Locator 800.677.1116 www.eldercare.gov

National Library Service for the Blind & Physically Handicapped 800.424.8567 www.loc.gov/nls

Alzheimer’s Disease Education and Referral Center 800.438.4380 www.alzheimers.org

Epilepsy Foundation of America 800.332.1000 www.epilepsyfoundation.org

American Cancer Society Response Line 800.227.2345 www.cancer.org

EyeCare America 877.887.6327 www.eyecareamerica.com

Needy Meds www.needymeds.org

American Diabetes Association 800.254.9255 www.diabetes.org

Family Caregiver Alliance 800.445.8106 www.caregiver.org

Office of Minority Health Resource Center 800.444.6472 www.omhrc.gov

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

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

PACE/PACENET 800.225.7223 www.aging.state.pa.us/aging

Medicare & Medicaid Services 800.633.4227 www.cms.hhs.gov

Pennsylvania Department of Public Welfare 800.692.7462 www.dpw.state.pa.us

Medicare Rights 800.333.4114 www.medicarerights.org

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

BenefitsCheckUp www.benefitscheckup.org

Medicare Telephone Hotline 800.633.4227 www.medicare.gov

RxAssist 401.729.3284 www.rxassist.org

CareCentral www.carecentral.com

National Alliance for Caregiving www.caregiving.org

Shriners Hospital for Children Referral Line 800.237.5055 www.shrinershq.org

Caregiver Action Network 202.772.5050 www.caregiveraction.org

National Council on Alcoholism & Drug Dependence, Inc. 800.622.2255 www.ncadd.org

American Urological Association 800.828.7866 www.auanet.org Arthritis Foundation Information 800.283.7800 www.arthritis.org

Caregiver Media Group 800.829.2734 www.caregiver.com Children of Aging Parents 215.355.6611 www.caps4caregivers.org Christopher & Dana Reeve Paralysis Foundation 800.225.0292 www.christopherreeve.org Crohn’s and Colitis Foundation of America, Inc. 800.932.2423 www.ccfa.org

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National Parkinson Foundation, Inc. 800.327.4545 www.parkinson.org

Simon Foundation for Continence 800.237.4666 www.simonfoundation.org

National Health Information Center 800.336.4797 www.health.gov/nhic National Institute on Aging Information Center 800.222.2225 www.nia.nih.gov National Institute of Mental Health Information Line 800.647.2642 www.nimh.nih.gov National Insurance Institute Helpline 212.346.5500 www.cancerandcareers.org/resources

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Mom Deserves Better than Living Alone “I’m concerned about mom... she’s stopped getting together with friends and her house isn’t as clean as it used to be. I’m also not sure she’s eating properly.”

A personal care residence at one of our Lutheran Social Services communities can provide more for your parent…. companionship, the comforts of home along with the perfect balance of independence and supportive services to help them maintain an active lifestyle. Personalized services include: • Assistance with daily routines • Three daily nutritionally balanced meals • Enriching social, cultural and recreational activities • Housekeeping and linen service Call one of our six not-for-profit communities today for more information on their services or to schedule a tour.

Gettysburg Lutheran Retirement Village Gettysburg | 717-334-6204 Luther Ridge Retirement Community Chambersburg | 717-264-5700

The Village at Kelly Drive York | 717-848-2585 Shrewsbury Lutheran Retirement Village Shrewsbury | 717-227-3000

Lutheran Retirement Village at Utz Terrace Hanover | 717-637-0633 The Village at Sprenkle Drive York | 717-764-9994

Community. Faith. Care.

Residential Living | Personal Care | Skilled Nursing Care | Rehabilitation

www.lutheranscp.org

Provider and leader of quality healthcare in Central PA for more than 147 years.

A Continuing Care Retirement Community

717-221-7902 1901 North Fifth Street Harrisburg, PA 17102

50 renovated Personal Care Suites.

Applications being accepted for a limited number.

Skilled Nursing Care Unit accommodates 92, including a 21-bed Alzheimer’s Unit.

www.homelandcenter.org

Exemplary personalized care that enables patients and families to live each day as fully as possible.

A Community Outreach of Homeland Center

717-221-7890 2300 Vartan Way, Suite 115 Harrisburg, PA 17110

www.homelandhospice.org

Focused on pain relief, comfort, and support for patients and families.

Providing hospice care in Cumberland, Dauphin, Lancaster, Lebanon, Perry, York, Adams, Franklin, and Juniata counties.

Call us for details on our full array of services.