Portfolio Piece: Kissito Grand Opening

KISSITO PACE

A Program of All-Inclusive Care for the Elderly

GRAND OPENING OCT 9, 2013 KISSITO PACE 1

About Our Cover Model Marian is an 86-year-old, feisty, funny and independent senior. She has lived in her trailer for more than five years and intends to remain there until, she says, “They carry me out in a box.” Her daughter wants her in a nursing home because she doesn’t think she’s safe. Marian disagrees, “I’m fine!” she said.

With PACE services both Marian and her daughter get their needs met—Marian can continue to live alone and independently.

Her daughter will know her mother is safe and cared for.

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Kissito PACE of Roanoke 5251 Concourse Drive Roanoke, VA 24019-3081 Hours of operation: Monday - Friday 8a - 5p or by appointment For Driving Directions from Peters Creek Road/Valleypointe Parkway: • • • •

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Turn onto Valleypointe Pkwy Take the third left into the parking lot just before the Kissito PACE sign Go straight to the back of the parking lot Kissito PACE is the farthest building to your right.

Enrollment Specialist Phone: 540-904-2817 TTY 711 Fax: 540-682-5947 Email: paceinfo@kissito.org

Services: Primary Care, Therapy, Adult Daycare, Transportation, Comprehensive Healthcare Coverage Hours of Operation: Mon-Fri, 8 a.m. – 5 p.m., or by appointment Address: 5251 Concourse Dr., Roanoke, VA 24019 Phone number: 540-904-2817 TTY: 711

TOM CLARKE Chief Executive Officer Phone: 540.265.0322 ext. 116 Email: Tom.Clarke@kissito.org

SEAN PRESSMAN Executive Director PACE Phone: 540.904.2817 ext.113 Email: Pressman.Sean.Pressman@kissito.org

JOSH MCGILLIARD Vice-President of Business Development Phone: 265.0322 ext. 102 Email: Josh.McGilliard@kissito.org

ANDY DAMERON Vice-President of Rehabilitation Services and Operational Support Phone: 304.839.7176 Email: Andy.Dameron@kissito.org

ANGIE MATTOCKS Chief Nursing Officer Phone: 301.717.6863 Email: Angela.Mattocks@kissito.org

APRIL JONES Director of Community Relations and Enrollment at Kissito PACE Phone: 540.904.2817 ext. 108 Email: April.Jones@kissito.org

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Call 540-904-2817, Option 1, to speak to an enrollment coordinator today to schedule your tour and day of experience.

5251 Concourse Drive, Roanoke, VA 24019 KissitoPACE.org

KISSITO PACE A home and community based alternative to a nursing home 5

Jonathan Carrington Public Health Educator

Kellie Montgomery, RN Clinic Manager

Kristin Battin Physical Therapist

Tracy Davis Intake Coordinator

Emily Kennedy Social Worker

Melissa Garrett Home Care Coordinator

Emily Jones Recreation Therapist

KISSITO PACE STAFF Kissito staff welcome the opportunity to speak with the media and the public about their roles, background and services they provide as Kissito PACE Staff. Here is a list of staff members and a little bit about each one.

KISSITO PACE OCTOBER 2013

Kissito PACE Staff members are among the best qualified nurses, educators and professionals in the country. When Kissito set out to find health educators, social workers, nurses and physical and occupational therapists they searched around the country, including Roanoke.

All PACE staff have extensive experience, and/or degrees and certification in Gerontology. Our transportation staff do more than just drive participants to and from PACE. Howard Hartman spent 15 years as a Ft. Lewis Rescue Squad Member and a 911 dispatcher for the City of Salem.

Transportation Director Rob Almond has 12 years of experience in health care and more than 30 years experience working with parents, children and little league as a coach. Each and every staff memberKissitoPace.org brings something unique, remarkable and personal tomore their position here(540) at Kissito PACE. Call us for information 904-2817

YVETTE CANTRELL, RN PACE Center Manager Yvette is the first face most participants see since she manages the PACE Center. Yvette has a bachelor’s degree in nursing, and is most proud of her certification in Gerontology. She not only loves working with the elderly, she has a solid background in understanding and managing the health, social and physical challenges most elderly participants and their caregivers face day-to-day.

She is a member of the Interdisciplinary Team (IDT) Phone: 540.904.2817 Ext. 106 Email: Yvette.Cantrell@Kissito.org

KRISTIN BATTIN, PT Physical Therapist Extremely detail oriented and passionate about making sure every one of her patients gets the best care possible, Kristin is the go-to source for facts, details and the latest procedures, treatments and research in physical therapy. She is also a member of the Kissito PACE IDT Team.

Phone: 540.904.2817 Ext. 111 Email: Kristin.Battin@Kissito.org

KELLIE MONTGOMERY, RN Clinic Manager Kellie is responsible for the medical clinic at the PACE Center. She is in charge of administering medications, taking vital signs, and doing clinical assessments of all participants. She is in charge of the day-to-day medical and health needs of the participants and is a member of the IDT Team.

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Phone: 540.904.2817 Ext. 101 Email: Kellie.Montgomery@Kissito.org Call us for more information (540) 904-2817

MELISSA GARRETT, RN Home Care Coordinator Before seniors become participants, Melissa must first complete a home assessment to ensure that they can remain safely in the community with PACE Services.

She helps determine if, with PACE services and caregiver support, the participant is safe in their home.

She’s the first person to assess a participant’s safety in the home and is a member of the Kissito PACE IDT Team.

Phone: 540.904.2817 Ext. 102 Email: Melissa.Garrett@Kissito.org JONATHON CARRINGTON Public Health Educator Jonathon is responsible for educating the public in general about health issues, PACE, healthy living, and aging gracefully. He has a special interest in holistic aging and coordinating with churches and faith based communities and non-profiits about PACE services.

You’re most likely to find Jonathon out in the community rather than at the PACE building.

Phone: 540.904.2817 ext. 114 Email: Jonathan.Carrington@Kissito.org

MELINDA SWITZER, RD Dietician Melinda’s passion is diet and nutrition. She is an independent contractor and works as a Registered Dietician for health organizations around the state.

Email: mswitzerrd@gmail.com

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ROB ALMOND Director of Transportation Transportation is the front lines of PACE. Participant’s begin their days with PACE drivers and learn to depend on them as their most consistent point of contact for transportation, shopping and other mobile needs. Rob has worked in the health care field for 12 years in environmental service. Rob has also been a little league coach in the city of Salem for more than 30 years. He’s a member of the Kissito PACE IDT Team.

Phone: 540.904.2817 Ext. 116 Email: Rob.Almond@Kissito.org TRACY DAVIS Intake Coordinator Tracy is tenacious. She doesn’t get thrown off task easily, if at all. A country girl with a matter-of-fact approach to life and all its challenges, Tracy is an Intake Coordinator at PACE and goes into the community to determine if a potential participant’s home setting and needs make them eligible for the PACE program.

Phone: 540.904.2817 Ext. 109 Email: Tracy.Davis@Kissito.org

HOWARD HARTMAN Driver Howard comes to Kissito from a retirement community.

His background includes: 15 years as a Ft. Lewis Volunteer Rescue Squad member, warehouse supervisor for Kroger, and a 911 dispatcher for the City of Salem Police Department. He’s been happily married for 15 years and has one son, Jackson, age five.

Phone: 540.904.2817 Ext. 101 Email: Howard.Hartman@Kissito.org KissitoPace.org

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CHRISSY CARR Occupational Therapist Occupational therapy for the elderly means whatever activities are important to seniors seeking help, something Chrissy says not many people are aware of.

Occupational skills include any skills the elderly use throughout their day, including dressing, bathing, hobbies, cooking and managing their own lives. She is a member of the Kissito PACE IDT Team.

Phone: 540.904.2817 Email: Chrissy.Carr@Kissito.org EMILY JONES Recreation Therapist Emily may be the person with the Bingo games, art activities and crafts, but her job is not to entertain residents, but to engage them. With a background in Gerontology and Psychology Emily brings an awareness and skill level to her position that many Activities Directors don’t possess. By getting to know each participant personally, Emily is able to create a therapeutic environment as well as a fun one. Emily is a member of the Kissito PACE IDT Team.

Phone: 540.904.2817 ext 103 Email: Emily.Jones@Kissito.org EMILY KENNEDY, MSW Social Worker Emily is the Kissito PACE Center’s social worker. She’s also a computer and tech geek. While working for hospice before coming to Kissito PACE, she pioneered a program using iPads with various apps and games to help people with dementia focus better and regain some of their pre-dementia attention and awareness. Emily is a member of the Kissito PACE IDT Team.

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Phone: 540.904.2817 ext. 115 Email: Emily.Kennedy@Kissito.org Call us for more information (540) 904-2817

How iPads Are Changing the Lives of Seniors with Dementia

Above left: Emily Kennedy works with a potential PACE participant using an iPad and one of dozens of computer apps she’s discovered that help seniors regain focus and attention.

Social worker Emily Kennedy says her iPad is one of her most powerful tools. She uses it to help engage her clients, to stimulate conversation and to help them relax. Whether she’s sharing an app that simulates playing a piano, or helps identify bird songs, she says the technology is powerful.

“It doesn’t take that much to get most seniors to engage,” Kennedy said. “When they do respond it’s kind of with the same passion and attention a teen-ager would respond to a new video game. They really like the engagement with the pad.”

That engagement often translates into better communication with family members and staff.

“I think it forces them to be in the here and now,” Kennedy said. “They only have to focus on what’s happening right in front of them on

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that little screen. It clears their mind and makes them more aware.

Using apps that remind them of current or past hobbies, such as bird watching, or showing them photos or playing music from a time when they were younger can also trigger memories and make the person relax again. Because they’re in touch with something safe and familiar with their past they’re often able to take in what’s happening in the immediate moment with more ease.

“It’s really amazing how an iPad or any tablet and the right apps can literally change a relationship for the better,” Kennedy said. “I’m just glad I can be a part of making it happen.” ❖

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Lobby Sitting Room

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PACE—A Home Away From Home As the sign in one of the examining rooms at Kissito PACE says, “Having a place to go is Home. Having someone to love is Family.

Having both is a Blessing.”

For many PACE participants, the center will be both home and family. They may have a caregiver they live with or one who visits them, but PACE will likely become a home away from home. They will not only receive a hot meal and two snacks a day during their visit to the center, they’ll be receiving medical care and monitoring, physical and occupational therapy, and be able to socialize with their peers.

Rooms throughout the facility are designed with the idea that the center is meant to give participants the feel of home. From the theatre room where they can watch movies or television, to the sun room where comfortable recliners and seating is positioned for optimal sharing, talking, resting and being with friends, or even alone, PACE designers focused on creating a safe, comfortable atmosphere.

Theatre Room

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Kissito PACE Hair Salon

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Beauty Tips For Working With Senior’s Hair Care And Styling Most of us worry about balding or thinning hair as we age, and seniors are no different. Add dementia, medical issues and disabilities, or the inability to sit comfortably through a hair styling to the mix and something as simple as a shampoo or hair cut can become a challenge.

For many seniors with dementia a trip to the hair salon is no longer a pleasure, but a nightmare. They may not recognize the person in the mirror, or many may react violently to being touched or having their hair or head touched. As a result more family members opt to do their senior’s hair at home, or hire someone to come into the home to work with mom or dad.

While it might seem easier to just let personal hair care lapse, the fact is most of us, especially those of us getting older, feel rejuvenated with a hair cut, coloring or styling. We just feel better when we look good. That’s why it’s important to work in time for regular hair care and salon visits with seniors. If you can’t afford to have their hair done, then do it at home.

Understanding how to work with the senior in your care can make getting a haircut, or hair care a joy again

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Don’t Be So Serious Don’t take yourself or the hair styling session too seriously. It’s supposed to be a positive, life enhancing time.

Don’t be afraid to smile, laugh and even joke. Be positive, not derogatory. Talk about hair styles and whatever the senior wants to talk about. If they have dementia they may try to get out of the chair before the session is over. Don’t make a big deal of it, but gently remind them you aren’t finished yet.

Ask them to help by holding a brush or comb. Be patient. You may have to do this several times before you finish.

Keep It Simple Don’t try to do too much in one setting.

Maybe a “Day of Beauty” in the past was a treat for your senior, but several hours in a beauty salon may be too much now.

Schedule manicures, pedicures and hair cuts or styling on different days. Not only does it give your loved one a chance to get out more often, but keeping events limited to an hour or less means they’re more likely to tolerate the event rather than become bored, frustrated or agitated, particularly if they are showing signs of dementia.

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Use Caution With Dryers and Curling Irons Skin, like hair, thins as we age. The heat from a blower dryer or curling iron may now cause serious burns, not just simple discomfort. Pay particular attention to a senior’s response to any kind of heat or other hair care tool.

If they grimace or frown STOP! Ask them what’s wrong. Say, “I noticed you grimaced a little bit as I was combing your hair. Did I pull too hard?” Be gentle and matter-of-fact about your questions so they aren’t hesitant to share how they feel.

Notice the Condition of The Hair Thinning hair can be a sign of old age, but it can also signal other health issues. If you notice increasing or sudden hair loss, scalp swelling or anything that looks different or unusual, report it to their doctor if you are their caregiver. If you are working on the senior's hair as a professional, report it to their caregiver.

Keep Water and Room Temps Comfortable Like most of us, seniors with dementia, or seniors in general have good days and bad days. Choosing to reschedule or cancel a hair appointment may be the smartest thing you can do if your loved one is having a particularly bad day, or is fighting a trip to the salon.

Don’t cancel just because they’re agitated though. Try to determine if this is a

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passing mood or one that will dominate throughout the day.

If the fear or reluctance continues, try to find out what has changed. The senior may be fearful for some reason—perhaps a bad experience the last time they went to the salon, or a change in their health or mental condition may be part of the problem.

Check the room and water temperature Sometimes a person’s sensitivity to heat and cold may change, especially with the seasonal change from summer to fall or from winter to spring.

It’s a simple fix, but one many don’t think about. Instead of testing the water with your hands or fingers, use your inner wrist or arm or some other part of your body that may be more sensitive to temperature.

Find and test a baby shampoo to ensure that any soap that might get into their eyes and burn, doesn’t.

Test it yourself. Don’t rely on ads. If you take your senior to a salon as well as work on their hair at home. A bad experience with shampoo or a scalp burn may make them very resistant to getting any more hair care.

Be Realistic Very few men or women keep a full head of hair well into their 60s. Thinning, balding and ultra-fine hair is just a natural part of aging. When discussing a certain look or hair style with your senior be realistic with

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both them and yourself about how a style will look.

If your senior insists on a certain style you know their hair can’t sustain, suggest a wig. Find hair styles in magazines, or on other seniors that compliment or enhance the person’s appearance. Focus on makeup as well as hair and always tell the person they look beautiful.

Ignore the Critics No matter what you do, someone will insist you could do more to make your senior look better. The fact is many seniors don’t want their hair curled or styled or cut or dyed.

They may be perfectly happy with the style they’ve had for years. You can make KissitoPace.org

suggestions, but if they don’t want to try something different, leave them alone. It’s their hair and it’s one of the few things they feel they may have some control over.

Set the Mood Some seniors may show fear or confusion when you try to wash or fix her hair. This may be a temporary thing, or a new thing that will become a regular event.

Whichever it is, don’t attempt to wash, style or cut your senior’s hair if you’re feeling stressed or rushed. They’ll pick up on that and mirror your frustration, making everyone miserable.

Wait until you’re feeling calm and patient. No one ever died of unwashed hair.

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done, then distract them first. Bring out some old photos or put on their favorite music. Rub lotion on their hands and talk to them about their hair and make-up.

Distract the person first, if necessary.

Play some music the person likes. Do your best to act like their pending hair cut or style is no "big deal" There should be no sense of urgency or a need for you to get this done or not. Your aim is to reduce anxiety.

Get Help If you find yourself getting very stressed over your senior’s hair care, or you can’t handle another struggle with your senior, you may want to see if a local hair stylist makes house calls.

You may pay a little more for the trip, but it’s probably worth it in the long run if you can avoid the stress.

Check with local nursing homes or senior services organizations for a referral to a stylist who works with the elderly.

Use Dry Shampoos There are "dry" shampoos that can be sprayed or sprinkled on your senior's hair and brushed through the hair to collect oil and other residue. Try several brands to find one that works for you. Some are powder and some are foam and different brands work better on different people.

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Celebrate Success When you succeed, even in a small way, make a big deal of the results. If your senior hasn't gotten afraid of "the stranger in the mirror," which is common with Alzheimer's, show them how nice they look.

If mirrors have become a negative, then just tell her she looks beautiful, even if you just got to comb her hair and arrange it. Let other people know your senior just had their hair done and encourage them to brag and compliment him or her as well. It will make future maintenance easier.

Reward Them After you've done whatever your senior permits you to do with their hair, have some ice cream together, or another treat. If they are able, tell them you want to take them out and show them off. Do whatever you can to let them know that staying as well groomed as possible is fun.

You might want to go to lunch or dinner afterward, or offer a special treat immediately after the hair appointment or maintenance.

Go Easy on Yourself Seniors change from day to day and you’ll need to adapt because they can’t always adjust.

You may have to give in some days. Do so gracefully. Know that perfection may not

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be possible, or even desirable. If you are really worried about health issues – say even dry shampoo and an occasional real wash, or these other tips don't work — ask your doctor if he or she has more ideas.

The chances are good that the doctor will say you are doing fine.

Brushing Hair Many seniors don’t brush their hair because it’s painful. Their joints may hurt, or they may have a hard time reaching up to brush, comb or style their own hair.

If you’re a caregiver, friend or family member, this is one area where you can really connect with your senior in a positive, loving way by offering to brush their hair with them.

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Begin by getting and using a wide bristle brush, or wide toothed comb. Wider bristles go through hair easier and more gently. Begin by brushing from the ends of the hair to the scalp, holding the hair a little way up from the roots. The wider bristles will ensure you’re not pulling too hard.

If you do feel you’re pulling or your senior is uncomfortable, try placing your hand gently on their scalp to hold the hair down and keep it from being pulled.

Check in frequently, asking them if you are brushing or combing too hard. Ask if the grooming feels good or uncomfortable.

Take your time and work as slowly a rate as your senior feels comfortable with. ❖

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Kissito PACE Clinic Kissito PACE’s medical clinic is modern and equipped with the latest and greatest medical equipment and technology. The equipment, stations, aides and facilities are comparable to any physician’s office. The clinic is used for exams, physicals, and wound care. It’s available for immediate or acute care treatments.

Should a participant experience a life threatening event, the clinic is staffed with registered nurses, and a board certified Geriatrician. Staff can stabilize a patient while waiting on emergency medical services to respond.

They can also treat minor medical conditions and monitor participants who complain of not feeling well. Physical therapy platforms and more ensure participants get the best physical care possible.

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Kissito has a state of the art, walk-in, tiled shower for the ease and comfort of participants. The shower is available for participants who cannot shower safely at home by themselves, or for participants who prefer to shower at the facility where they can receive help from CNAs if needed.

Shower Room

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CENTERS FOR MEDICARE & MEDICAID SERVICES Quick Facts about PACE Programs of All-inclusive Care for the Elderly (CMS Publication No. 11341 January 2008)

What are Programs of All-inclusive Care for the Elderly (PACE)?

PACE is a Medicare program for older adults and people over age 55 living with disabilities. This program provides community-based care and services to people who otherwise need nursing home level of care. PACE was created as a way to provide you, your family, caregivers, and professional health care providers flexibility to meet your health care needs and to help you continue living in the community.

An interdisciplinary team of professionals will give you the coordinated care you need.

These professionals are also experts in working with older people. They will work together with you and your family (if appropriate) to develop your most effective plan of care.

PACE provides all the care and services covered by Medicare and Medicaid, as authorized by the interdisciplinary team, as well as additional medically necessary care and services not covered by Medicare and Medicaid. PACE provides coverage for prescription drugs, doctor care, transportation, home care, check ups, hospital visits, and even nursing home stays whenever necessary. With PACE, your ability to pay will never keep you from getting the care you need.

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Who can join a PACE Plan?

You can join PACE if you meet the following conditions: • You are 55 years old or older.

• You live in the service area of a PACE organization.

• You are certified by the state in which you live as meeting the need for the nursing home level of care.

• You are able to live safely in the community when you join with the help of PACE services.

Note: You can leave a PACE program at any time for any reason.

PACE services include but aren’t limited to the following: • Primary Care (including doctor and nursing services) • Hospital Care • Medical Specialty Services • Prescription Drugs • Nursing Home Care • Emergency Services • Home Care • Physical therapy • Occupational therapy • Adult Day Care • Recreational therapy • Meals • Dentistry • Nutritional Counseling • Social Services • Laboratory / X-ray Services • Social Work Counseling • Transportation PACE also includes all other services determined necessary by your team of health care professionals to improve and maintain your overall health.

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You should know this about PACE: PACE Provides Comprehensive Care.

PACE uses Medicare and Medicaid funds to cover all of your medically necessary care and services. You can have either Medicare or Medicaid or both to join PACE.

The Focus is on You! You have a team of health care professionals to help you make health care decisions.

Your team is experienced in caring for people like you. They usually care for a small number of people. That way, they get to know you, what kind of living situation you are in, and what your preferences are. You and your family participate as the team develops and updates your plan of care and your goals in the program.

PACE Covers Prescription Drugs.

PACE organizations offer Medicare Part D prescription drug coverage. If you join a PACE program, you’ll get your Part D-covered drugs and all other necessary medication from the PACE program.

NOTE: If you are in a PACE program, you don’t need to join a separate Medicare drug plan. If you do, you will lose your PACE health and prescription drug benefits.

You should know this about PACE: PACE Supports Family Caregivers.

PACE organizations support your family members and other caregivers with caregiving training, support groups, and respite care to help families keep their loved ones in the community.

PACE Provides Services in the Community.

PACE organizations provide care and services in the home, the community, and the PACE center. They have contracts with many specialists and other providers in the community to KissitoPace.org

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make sure that you get the care you need. Many PACE participants get most of their care from staff employed by the PACE organization in the PACE center. PACE centers meet state and Federal safety requirements and include adult day programs, medical clinics, activities, and occupational and physical therapy facilities.

PACE is Sponsored by the Health Care Professionals Who Treat You. PACE programs are provider sponsored health plans. This means your PACE doctor and other care providers are also the people who work with you to make decisions about your care. No higher authorities will overrule what you, your doctor, and other care providers agree is best for you. If you disagree with the interdisciplinary team about your care plan, you have the right to file an appeal.

Preventive Care is Covered and Encouraged The focus of every PACE organization is to help you live in the community for as long as possible. To meet this goal, PACE organizations focus on preventive care. Although all people enrolled in PACE are eligible for nursing home care, only 7% live in nursing homes.

PACE Provides Medical Transportation PACE organizations provide all medically-necessary transportation to the PACE center for activities or medical appointments. You can also get transportation to appointments in the community.

What You Pay for PACE Depends on Your Financial Situation If you qualify for Medicare, all Medicare-covered services are paid for by Medicare.

If you also qualify for your State’s Medicaid program, you will either have a small monthly payment or pay nothing for the long-term care portion of the PACE benefit. If you don’t qualify for Medicaid you will be charged a monthly premium to cover the long-term care portion the PACE benefit and a premium for Medicare Part D drugs. However, in PACE there is never a deductible or copayment for any drug, service, or care approved by the PACE team.

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K I S S I T O

For more information about PACE do the following: • Visit www.npaonline.org on the web. This website is sponsored by the National PACE Association.

• Visit www.medicare.gov/Nursing/Alternatives/PACE.asp on the web.

• Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.

Contact a Kissito PACE Enrollment Specialist: Enrollment Specialist Phone: 540-904-2817 TTY 711 Fax: 540-682-5947 Email: paceinfo@kissito.org KissitoPACE.org KissitoPace.org

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