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Gold Age

Magazine

Professional Trade Publication for Assisted Lifestyles in Minnesota

Cover Feature Story

Walker Place 2008 Volume 10

Also Inside: WAI Continuum • Staphacide • What’s Happening


Prose by Ekula Saq – Permobil user since 2001

C350 CORPUS The power you need for life in the fast lane. 1.800.736.0925 www.permobil.com


Contents Feature Stories

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Walker Place 16

WAI Continuum Living Architecture

21

Staphacide

16

21

Editorials/ In this issue 5 A Change for the Better

14 Physical Therapy Editorial

9 Five Things Families Can Do to Find and Keep Great DSPs

18 Who Will Take Care of Our Older Adults in the Future?

11 CaringbridgeÂŽ Announces Service Enhancements

20 Those Receiving Long-Term Care Services Have Rights

12 What’s Happening in Minnesota Gold Age Magazine

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Gold Age Magazine

Publisher: Ruth Tharaldson

Assistant Publisher: Jo Grussing Photographer: Stancampiano Imaging Production Managers: Bob Byers, Susan Koshiol, Mary Gohman Account Manager: Dawn Larson Graphic Designer: Carolee Scherbing Commercial Printer: Sunray Printing Inc. 25123 22nd Ave St. Cloud, MN 56301 1-888-253-8808 Contributing Writers: Joan Aasve, Sally Brown, Susan Cushing, Neil Johnson, Nancy McCulloh, J.A. Schwartz, GOLD AGE Magazine is published by Pavonis, LLC. Principle office: Phone:(952)873-5418; Fax:(952)873-5641 Email:info@goldagemagazine. com. COPYRIGHTŠ2008, Pavonis LLC. All rights reserved. Reproduction in whole or in part is prohibited without the permission of the publisher. Precautions are taken to ensure the accuracy of published materials, GOLD AGE Magazine cannot be held for opinions expressed or facts supplied by it’s authors. The advertisers, associate publisher, publisher, and Pavonis, LLC are not responsible or liable for misinformation, misprints or typographical errors.

Interested in spending your advertising dollars wisely? Please call: 952-873-5418 or email: info@goldagemagazine.com 4

Gold Age Magazine


A Change for the Better By Sally Brown

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n July of 2004, I rode in Minnesota’s first Red Ribbon Ride. I made that ride to honor my friend, Ron, who died from AIDS in 1996. As it turns out, that ride changed my life in profound ways. Having Cerebral Palsy means poor balance is a fact of life for me. So, as much as I have always loved bike riding, by the time I was close to 50, riding a bike was more scary than fun. A friend of mine suggested that I consider a three wheeled bike. Of course, I was incensed at the suggestion, but I really did want to make the ride, so reluctantly, I began to look for options. I started an Internet search and settled on a Tricumbent from Just Two Bikes (www.justtwobikes.com). The bikes are built in the JTB factory in Hugo, MN so Jim Mullner, who designs the bikes, worked with me to modify the bike so that I could ride it easily. At first, it was slow going and I was not sure that the ride would really happen. In the beginning, a five mile ride was an event, but with Jim’s patience and my stubborn resolve, my rides got longer and little by little, I got myself ready for the three hundred and fifty mile trip. I did make that ride. Did I ride every single mile, no. And I must admit that I was the very last one to finish the route on each of the four days that we rode, but the woman who crossed that finish line was not the same woman who had turned up her nose at three wheeled bikes almost a year earlier. I was different and my body was different. My body was much stronger- and thinner for sure, but the way I saw myself in the world was different too. Riding has moved me from a “watcher” to a “doer”. I now am much more convinced that moving my body keeps my brain younger. I had read countless articles about how active bodies are more creative and smarter but didn’t really believe it until I started moving. Bike riding has brought me much closer to being able to feel young again, without giving up all the wonderful things that come with age. Since that first ride, I have left corporate America to start a business, I have written a book, and I have become much more of the person I want to be. I have begun to embrace all the things I have always wanted to do that I would have never had the guts, or the experience to do at twenty, thirty or even forty. Nobody told me that the best years of my life would be after fifty. I was really expecting that I would be spending most of my time wishing that I was not aging. Some days I wish I had taken a more traditional route still collecting a paycheck and playing it safer, but not many. Most days, I am grateful for this bumpy ride. If you get on a bike, you will not have to blow up your life as you know it but it is a wonderful way to get moving and see what happens. I promise you that if you keep it up, you will change. There are so many great cycles to choose from and

finding the one that is best for you is half the fun. Riding most three wheel bikes is a lot like riding down the road in a lawn chair. I can take a nice long ride during the day and feel great to go out the same evening. I am not sore the day afterIn fact, when I see folks on traditional bikes and those little bitty seats, I sometimes wonder why you would choose to put in yourself through that- there is S:4.625 a better option. For additional information please contact: Sally Brown, Owner Every Kid Mobility, Inc. www.everykidmobility.com

GIVE. ADVOCATE. VOLUNTEER.

LIVE UNITED

Want to make a difference? Find out how at LIVEUNITED.ORG.

Gold Age Magazine

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Service

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Senior Living with a Tradition of Service, Style, and Grace

By Susan Cushing

Nestled within a quiet Minneapolis neighborhood, surrounded by Lake Calhoun, Lake Harriet, and the famed Rose Gardens, the sprawling Walker Methodist Campus offers a sedate and graceful tableau. An entire city block lined with elegant, stately buildings represents one of the most innovative Continuing Care Retirement Communities (CCRC) in the country. “Our residents worked hard yesterday, are living well today, and are anticipating tomorrow,” observes Campus Housing Director Chris Orr. “Walker Methodist engages seniors through vibrant living and enjoyment in every aspect of their lives. Our residents want to be engaged and we’re looking to build programs that are designed for a lifestyle of wellness and helping individuals continue to live long and meaningful lives.” Anticipating virtually every need and desire, caring staff offer a full spectrum of services including independent senior housing, supportive services (home health care), adult day services, short-term skilled nursing care /transitional care, long term nursing care, respite and even highly specialized geriatric memory care transitional care. Walker Place, the eight-story independent living community, features a wide variety of spacious apartments with choices of floor plans. “We’ve had tremendous success customizing apartments for residents,” notes Director of Marketing, Lynn Thoreson. “We offer several distinctive floor plans that offer up to 1,225 square feet of living space but some of our residents, moving from larger homes, have opted to take it even one step further and actually combine two apartments creating a dramatic living space offering two bedrooms, two baths, den and laundry room that extends over more than 1,800 square feet. But that’s one of the things that I love about Walker they are happy to work with residents to create exactly what they want. I’ve never worked for a company that’s so willing to listen to the customer’s requests.”

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In addition to living in a gracious, private apartment with available enclosed parking, residents of Walker Place may choose from many services including three daily meals, weekly housekeeping, laundry and others. Wellness clinics, health monitoring by a nurse, and emergency call system are a few items that ensure good health. Individual assessments determine what services are needed, and all services are tailored for each resident. Like a city unto itself, the idyllic setting also features a charming chapel and spiritual care, coffee shop, deli, gift shop, bank, fitness center, and more! Dining is a rich and tantalizing experience because all food is prepared fresh onsite by professional chefs.

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“We’re particularly proud of our cuisine,” Lynn notes. “Our chefs all come from country clubs or prized restaurants. Our residents are very smart people with refined tastes and appreciate not only our extensive and appetizing menus but also the elegant dining ambience.” A true testament to the ongoing efforts to provide premiere surroundings, the nationally acclaimed architectural team of WAI Continuum has been contracted to augment existing designs. “The spaces are being reorganized to encourage socialization which is a key criteria in providing a quality of life for a senior housing population,” explains WAI Vice President Scott Koester. “The spaces take on the hospitality focus being pursued by Walker in their repositioning of their entire campus. The dining areas are being reorganized to take advantage of the expanding dietary/restaurant menus and new informal areas will allow residents to meet and socialize while getting mail, a cup of coffee, visiting with a family member, or simply engage in watching activities happening around them.” “Our residents are intelligent individuals who realize they do not wish to make a lot of moves,” notes Lynn. “Here, a couple can continue to be close to one another regardless of their health care needs. Those living in Walker Place independent living apartments enjoy having health care services in their home and priority status when they visit our on-campus health center. “Life will always go on at 37th and Bryant,” she continues. “Walker Place is part of the unique continuum of care on the Walker Campus. Walker Methodist Health Center is next door through the connecting hallway. All home health care comes into their apartment allowing them to sleep in their own bed for as long as possible. If a couple does not happen to enjoy the same level of health at the same time, the one spouse can remain close-by in their apartment while the other is cared for in the health center and have the ability to bring them back to the apartment for a afternoon visit, meal or family event.” Included in the elegant Walker Place lifestyle: • Fine dining with chef-prepared meals, nightly menu choices, professionally served • Specialty soups, sandwiches, salads, and more served in the Walker Place Deli in old-world Italian decor • Concierge at front desk • 24-hour staff, emergency call system • Scheduled transportation • Housekeeping and maintenance • Small pets welcome • F.I.T. Club with personal trainer • Walker Health Services— individually tailored health and personal care

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• Continuum

of care with Walker Methodist Health Center next door for rehabilitation therapies, transitional care, and skilled nursing care • Daily “I’m O.K.” program • Indoor heated parking

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• Walker Place Salon • Atrium and landscaped courtyards • Enriching activities for all interests • Outings to theatre, concerts, shopping,

events, and more

Gold Age Magazine


Walker Methodist Health Center

At Walker Methodist Health Center, the staff takes pride in getting to know each one of our patients and residents and understanding the barriers that need to be overcome so residents can enjoy a more healthy and active lifestyle. In addition to providing quality, individualized medical care, we understand that our residents need, and want, to remain active and involved. Our services and our community are important to maintaining the body and mind. Transitional Care–whole-patient approach for shortterm rehabilitation is designed for those recovering from illness, injury or surgery, with the goal to return to a healthy and active lifestyle. Walker has the distinction of being the only Transitional Care Unit in the state that has an innovative partnership with the University of Minnesota. Walker Court–a supportive living community located within the Walker Methodist Campus. Designed for seniors to live as independently as possible. Walker Court offers an affordable alternative to assisted living. Memory Care Village– focuses on wellness rather than illness. By providing freedom of choice and movement whenever possible, The Village offers a warm and supportive environment for those with memory loss. Respite Care– provides short-term care at all nursing levels within the Health Center. Respite Care is ideal for those who need some transitional care between hospital and home. Indeed, as a Continuing Care Retirement Community (CCRC), Walker Campus provides virtually every service and facility to provide a comprehensive and nurturing environment. Senior housing, health services, and nursing care all on one beautifully landscaped campus where residents can receive the health care they may need today or in the future. Residents move into an independent living apartment, where they have the services and amenities to suit them today. If higher levels of care are required, they may receive services in their own apartment, and if skilled nursing is required, the health center is just steps away and residents receive priority admissions.

Walker Methodist is an attractive option for couples with differing health needs. Those who choose to live here understand that wellness is a way of life. “Our residents have been wise stewards of their finances all their lives,” observes Chris. “We continue to protect that lifestyle and conserve their resources. Walker Place is an entrance fee community. Depending on which option, the entrance fee is 90% or 100% returned to you or your estate when the apartment has been reoccupied.” Within this unique and caring environment, you’ll find wisdom and experience that has launched, managed, marketed, and operated facilities of every size and income level. This is a team offering hands-on experience with every level of care— independent living, continuing care retirement communities, assisted living, skilled nursing and others.

For additional information please contact: Walker Methodist Campus 3701 Bryant Avenue South Minneapolis MN 55409 Phone: (612) 827-8500 Fax: (612) 827-8535

Gold Age Magazine


Five Things Families Can Do to Find and Keep Great DSPs By Nancy McCulloh

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amilies caring for a loved one with a disability know first-hand that finding and keeping good Direct Support Professionals (DSPs) is not always easy. Many families struggle with the coming and going of DSPs. Some DSPs leave after only a few days and others leave after a few months. These constant changes affect the family’s quality of life as well as that of their family member. Families want good workers to show up, be on time, and stay on the job for longer than a few months. They need and want DSPs who are qualified, caring, creative, and competent. There are a number of things that families can do to increase their chances of finding and keeping good DSPs. The remainder of this article describes strategies for families in five key areas: finding a good match, using insiders, creating and using a Realistic Job Preview, interviewing that works, and keeping new staff.

Finding a Good Match The overall hiring goal is to find someone who is a good

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match for your needs and wants. There are a number of strategies that help you match the person’s skills and interests to your wants and needs. For instance, make a list of your wants and needs. Talk with DSPs who work for you to find out what skills are needed to do the job. Then figure out what is most important by ranking each item starting with the item that is most important and ending with the least important item. This will help you define clearly who you are looking for and what your expectations are. A better match means the needs and wants of your family member are more likely to be met by the person you hire.

Using Insiders Second, you must look in the right places to find the right DSP. Some families use agencies to help them find DSPs while others advertise in local newspapers or use Internet ads, fliers, and job postings. These outside recruitment sources are less effective, cost more, and can lead to applicants who do not continued on page 10

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Five Thinigs continued from page 9 match well with your needs and wants. Outside sources often don’t work because people who respond to these approaches usually do not fully understand what you expect. A better strategy is to ask DSPs who already work for you or other people who know you well to help you find new DSPs. This is called inside recruitment sources. Someone who knows you and your family member knows what it takes to do the job and can explain expectations to possible applicants. When DSPs understand what is expected on the job they have fewer unmet expectations and are less likely to leave soon after they start. Encourage “insiders” to recruit for you by offering recruitment bonuses such as money and other gifts. Recruitment bonuses can be set up so the insider gets part of the bonus when the new DSP completes orientation and part after they have been on the job for six months. Help insiders recruit for you by providing calling cards; these are business cards that help insiders tell others about the job. Insiders can give these cards out to the people they know who are interested in coming to work for you. Include a mini-job description (one or two statements about what you are looking for) and the name and number of the person they can talk to about the job.

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Creating and Using a RJP Tell applicants about the job by doing a Realistic Job Preview (RJP). A RJP is a recruitment strategy used to give

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applicants detailed and balanced information about what is expected of them on the job, what a typical day is like, your family as the employer, and the work setting. RJPs can be short videos, scrapbooks or photo albums, slide show presentations, or other formats that describe and illustrate the daily work of the DSPs you employ. RJPs tell applicants about both the fun parts of the job and the challenging parts of the job. Be sure to include what other DSPs who work for you say about the job, along with favorite moments and important duties. Share the RJP with an applicant before you offer them a job to help them make a good decision about accepting or not accepting a job offer. Applicants who are not a good match often decide they are not interested in the job after they’ve experienced a RJP.

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Interviewing that Works Interview applicants based on whether they can meet your needs. Review resumes and applications to make sure applicants meet minimum requirements. If they don’t, then don’t interview them. You do not have to interview every applicant. Before an interview, prepare a list of questions based on what you need and want DSPs to do on the job. Decide what type of questions will help you find the information you need to make a good decision about who to hire. Asking questions about past work behaviors (structured behavioral questions) will provide information about what the applicant will do on the job if you hire them. Ask about real situations and how continued on page 17


CARINGBRIDGE® ANNOUNCES SERVICE ENHANCEMENTS

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aringBridge has launched several significant userrequested service enhancements aimed at making personal CaringBridge Web sites easier to use, visually streamlined and more customizable. The new features will improve the overall site experience for patients and their loved ones. Multi-Language Capability To continue to fulfill its mission of “bringing together a global community of care,” CaringBridge now provides its Web service in English or Spanish. Authors and visitors can select their preference on the top right-hand corner of the screen on CaringBridge.org. Photos The highly-anticipated “Photos” section upgrade gives authors the ability to upload up to 51 photos and post them in “Journal” entries. A drag and drop feature was added to help authors organize photos and file size allowed per photo has increased. User-Friendly and Customizable To make CaringBridge even more user-friendly, authors will experience a simplified Web site creation process and improved inline messaging and tool tips throughout the site. Privacy setting descriptions are more clearly defined to help authors make sites as open or private as they want.

• Creating and posting a brief update or important message called a “Quick Note”

About CaringBridge CaringBridge is a nonprofit 501(c)(3) organization offering free personalized Web sites to those wishing to stay in touch with family and friends when facing a serious medical condition, treatment or recovery. CaringBridge’s mission is to bring together a global community of care, powered by the love of family and friends, in an easy, accessible and private way. CaringBridge is the conduit of information, hope, support and encouragement during a serious health condition. The goal is to ease the burden of keeping friends and family updated while also providing a way for them to send their love and encouragement. Nearly 150,000 CaringBridge Web Sites have been created and there have been over half a billion individual visits to those Web sites. ®

For more information please visit www.CaringBridge.org For further information contact: Melissa Holm CaringBridge, (651) 789-3375 mholm@caringbridge.org

Streamlined page designs, improved style templates, and new 1024 by 768 page resolution, come together to create an updated look and feel for CaringBridge. CaringBridge authors and visitors will notice many new features that make creating, viewing and updating sites effortless. The new “My CaringBridge” tab provides onestop access to sites created or visited, and important messages from CaringBridge. Using the “My Information” tab allows registered users to view and update their profile information. With the Author Services tab, authors can generate registered user reports, which they may now save to their computer for future reference. CaringBridge has added a number of new features to enhance the site editing process. Authors now enjoy: • Previewing page updates before they are posted • An expanded user session of two hours and partial entries are automatically saved • A new text editor that is compatible with multiple Web browsers • Adding up to ten links with descriptions within the “Resources” tab • More site style groups, including a "New This Month" category

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What’s Happening Volume 10 2008

Thursday, November 6, 2008; 8:30 a.m – 3:30 p.m. Anxiety Disorders Program Description:  This course will cover generalized anxiety disorder, post–traumatic stress disorder, panic disorder, and obsessive–compulsive disorder. Pre– registration Fee:  $79; $84 after October 30 on space–available basis. Location:  South Central College Conference Center, North Mankato, MN Presenters:  Karen Finck, RN, MS, CS Continuing Education Units:  6.6 contact hours for RN's and LPN's; 6 CEH's for Social Workers; 5.5 for Nursing Home Administrators, pending approval.  Certificates of Attendance for other professionals. Phone:  507-389-1162 Fax:  507-3896447 Email:   shirley.murray@mnsu.edu  (Shirley Murray, Director) Email:  christine.sieberg@mnsu.edu  (Chris Sieberg, Administrative Assistant) November 7, 2008; 9th Annual Women's Health Conference Holiday Inn Metrodome, Minneapolis, MN. Registrar: 952883-6225. Online: http://imehealthpartners.com. Number of credits pending

November 12, 2008; The 2008 Second Annual National Positive Aging Conference: Achieving Purpose, Meaning and Vitality in the Second Half of Life. Location: Great Hall, Coffman Memorial Union, 300 Washington Avenue, SE, Minneapolis, MN 55455. Cost:$150 includes a continental breakfast, lunch and all materials. Registration: Contact somer012@umn.edu or visit www.csh.umn.edu. Nov. 12-14, 2008; "Health Equality: Honoring Culture While Closing the Gap" , at Mystic Lake Casino and Hotel in Prior Lake, Minnesota. National experts on health disparities will speak at the "Health Equality: Honoring Culture While Closing the Gap" conference. The conference is sponsored by the Office of Minority and Multicultural Health of the Minnesota Department of Health. Registration for the conference is available online at: http://health.state.mn.us/ ommh/conferences/disparity08/index.html. November 13-14 2008; Road MAPS to Patient Safety: Accelerating for Change is in Minneapolis at the Northland Inn. Information is online at www.mnpatientsafety.org Novermber 14, 2008; Psychiatric Challenges for Today's Youth Holiday Inn Metrodome, Minneapolis, MN. Registrar: 952-

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883-6225. Online: http://imehealthpartners.com. Number of credits pending November 14-15, 2008; High Performance Physician: Preparing for an EMR Dates: Location: Methodist Hosp, Rochester. Registrar: (877)599-5119 Approved for 14 Prescribed Credits November 18-19, 2008; Care Providers of MN Convention Dare to be Great, Hyatt Regency Minneapolis November 19-21, 2008; Internal Medicine Review and Update 2008 Sponsor: University of Minnesota. Location: The Radisson University Hotel, Minneapolis, Minnesota Registrar: 612-626-7600 Online: www.cmecourses.umn.edu Approved for 22 Prescribed Credits November 20, 2008;. Emergency Medicine and Trauma Update Sponsor: HealthPartners. Location: Minneapolis Airport Marriott, Bloomington, MN. Registrar: 952-8836225. Online: http://imehealthpartners.com. Number of credits pending   November 20-21, 2008; The Midwest Rural Agricultural Safety and Health forum “Staying Afloat” in Davenport, Iowa. www. public-health.uiowa.edu/icash/programs/MRASH/2008/ index.htm Friday, November 21, 2008; 8:00 AM – 12:00 noon. Women's Health and Midlife:  What's it all about? Program Description:  The workshop will cover a variety of women's midlife health concerns, including peri-menopause, menopause, screening exams, midlife contraception, osteoporsis and more. Pre–registration Fee: $49;  $54 after November 14 on space–available basis. Location: South Central College Conference Center, North Mankato, MN Presenter:  Virginia Clementson, RN, WHCNP Continuing Education Units:  4 contact hours for RN's and LPN's; others will receive certificate of attendance. Phone:   507-389-1162
Fax:   507389-6447 Email:  shirley.murray@mnsu.edu  (Shirley Murray, Director) Email:  christine.sieberg@mnsu.edu  (Chris Sieberg, Administrative Assistant)


In Minnesota December 2, 2008; Brain Injury and Mental Health Workshop -- What Is Going On? Location: Duluth MN, Sheraton Duluth Hotel. Professional caregivers and front line supervisors should attend. For more information, visit http://www.arrm.org and look under “Dates to Remember” on the home page. December 4-5, 2008; 30th Annual Cardiovascular Conference Sponsor: HealthPartners. Holiday Inn East, St Paul, MN. Registrar: 952-883-6225. Online: http://imehealthpartners. com. Number of credits pending Minnesota’s physician workforce is rapidly approaching malefemale balance. Overall, only 30 percent of active Minnesota physicians are female, but females account for 56 percent of physicians under 35 and 41 percent of physicians aged 3544. As male-dominated cohorts of physicians retire, the overall female percentage will continue to increase. The median age of female physicians is 44, compared to 51 for males. From the Office of Rural Health & Primary Care MN Dept of Health The State Trauma Advisory Council recommended to Minnesota Department of Health Commissioner Dr. Sanne Magnan that Fairview University Medical Center in Mesabi be designated as a Level III and Sanford Tracy Medical Center as a Level IV trauma hospital. There are now 36 designated trauma hospitals, including 21 Critical Access Hospitals. Twenty-one hospitals have applications for designation in process with the Minnesota Statewide Trauma System. From the Office of Rural Health & Primary Care MN Dept of Health The Minnesota Ambulance Association has been working on its Minnesota Flex grant for Strike Team Training. The training formalizes Emergency Medical Service disaster response through the use of organized strike teams. A strike team was convened during the Republic National Convention, with nine ambulances stationed in the Twin Cities. The goal is for a team to be able to respond anywhere in Minnesota within four to six hours. L. Read Sulik, medical director for child and adolescent psychiatry of the St. Cloud Hospital/CentraCare Health System, has been named assistant commissioner for Chemical and Mental Health Services for the Minnesota Department of Human Services, effective November 3.

The Access Project reported in September that farm and ranch families are paying top dollar for health insurance that inadequately covers their needs and causes them significant financial risk. The National Association of Community Health Centers is offering a series of webcasts in October and November. Find them at: www.nachc.com/conferences-and-trainings.cfm The Minnesota Critical Access Hospital and Rural Health Conference is June 15-16, 2009 in Duluth, Minnesota Do you have a rural Minnesota photo we can use to promote the 2009 Conference? Please email it to health.orhpc@state.mn.us for consideration by the planning committee. Competitive Bidding Delay Becomes Law. WASHINGTON--, both the House and Senate voted to overturn President Bush's veto of H.R. 6331, the Medicare package that includes a delay of competitive bidding. The House voted 383 to 41 to override the veto in mid-afternoon. The Senate then took up the debate and voted to overturn the veto by a margin of 70 to 26. With each of the two chambers voting by two-thirds majorities to override the president's veto, the bill becomes law. Officially titled the "Medicare Improvements for Patients and Providers Act of 2008," the legislation delays the DMEPOS competitive bidding program to allow time for critical process improvements and other reforms to bidding and HME policy. The law also exempts complex rehab from the bid program and repeals the oxygen equipment transfer to beneficiaries mandated under the Deficit Reduction Act. To offset the savings CMS estimated it would incur from the bidding program, the act calls for a nationwide 9.5 percent reimbursement cut on the items included in round one of bidding. CMS will now have to rewrite the competitive bidding regulation to incorporate all of the law's specific requirements.

For What’s Happening submissions please call: 952-873-5418 or email us at info@goldagemagazine.com Gold Age Magazine

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Physical Therapy Editorial By J.A. Schwartz, PT

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s 2008 draws to a close, the average U.S resident can expect to live longer than at any other time in the history of this country. Given the recent advances in medical technology, pharmaceutical breakthroughs and a better understanding of nutrition and wellness, many Americans will survive into their eighth decade. That reality also comes with an expectation: that we are able to enjoy those extra years by staying healthy and physically active, both of which are important components of our quality of life. None of us are guaranteed bodies that will withstand the rigors of our chosen lifestyles indefinitely, but we do have avenues available to us that could well prove helpful in prolonging our functionality. As we age, there are inevitable changes in the integrity of our muscles, bones and joints, and we tend to get weaker and less flexible as a result. The battle to stay fit and to be in a condition to continue to pursue our chosen hobbies and pastimes is one that becomes ever more important as we have more years to enjoy them. Physical therapists could play a pivotal role in that effort to stay active, and they live and work in your local community. Physical therapists have a formal college education at a bachelors, masters or PhD level, and take post graduate training throughout their careers to stay up to date on the latest techniques and research. They are experts at managing pain, and helping restore function to joints and muscles that have been injured or weakened. Through the skilled application of their talents, joints that are stiff, or are limited by discomfort can be loosened and restored towards pain free functional use. Muscles that have atrophied from immobilization, inactivity or injury can be safely and effectively strengthened using simple, easy to perform exercises. Your therapist can design a personalized program that will address every aspect of your condition, and will be geared towards allowing you to resume those activities and pursuits which are most important to you. Typical therapy sessions last anywhere from 30-60 minutes, and most conditions can be managed within 6-8 visits to your therapist. Your physician can refer you to a physical therapist, or you could choose to attend physical therapy for up to 90 days without a physician’s referral under the new Direct Access law. Nearly all insurance plans cover physical therapy with or without a physician’s referral, including Medicare and Medical Assistance plans. Physical therapy can include the use of modalities such as ultrasound, thermal agents, electrical stimulation, laser or infrared treatment. Mechanical cervical and lumbar traction is also a part of most therapy practices, and can help to alleviate pain in those areas. Most therapists utilize a “hands on” approach, and will practice manual therapy that could include joint mobilization, myofascial release, soft tissue

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massage, manual muscle stretching, muscle energy techniques and trigger point release designed to achieve specific therapy aims. Each of these disciplines require years of training and practice to learn, and the skilled application of a combination of manual therapy, exercise and modalities help patients recover from painful conditions, allowing them to resume their active lifestyles. Many different health concerns can be effectively improved by the use of physical therapy: • Pain in the neck, upper back or lower back • Pain in the joints, including shoulders, elbows, hands, hips, knees and ankles • Muscular weakness or tightness • Headache pain and jaw and facial pain • Nerve pain, or numbness and tingling into the arms/hands or legs/feet • Balance disorders • Unsteady gait • Postural changes • Bursitis or tendonitis • Arthritic pain • Pain from car accidents Many therapy clinics offer specialized services to deal with diagnoses such as incontinence and pelvic pain. Programs designed to help dancers, golfers, gymnasts, runners, and many other types of sports specific concerns are also offered at local therapy clinics. Those injured at work or in motor vehicle accidents are commonly rehabilitated by physical therapists, who can tailor programs to meet the needs of the individual client, including helping to simulate actual job functions while in the clinic. If you’ve experienced pain that limits you in any way, or if you’ve grown weak or stiff from inactivity or an illness, the odds are very good that a physical therapist can help improve your quality of life. In most cases, just becoming more active or choosing to start an exercise program is an excellent way to address some of the changes that come with aging or illness. However, skilled guidance is always recommended when painful conditions are part of the equation, and physical therapists are uniquely qualified to insure that the course you follow will lead you to your desired destination. Make the choice to lead the active lifestyle you envision-and if the need exists, allow a physical therapist to help you along the way. J.A. Schwartz, PT Program Director LIFE Rehabilitation Services 600 Twelve Oaks Center Drive, Suite 638 Wayzata, MN 55391


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WAI Continuum

Offers Design Solutions for the Future by Susan Cushing

Living longer with increased vitality, baby-boomers have dramatically changed the face of aging. Forget the rocking chairs and quiet solitude! This is a generation who left an indelible fingerprint on history and who, you can be sure, will not “go gently into that good night.” With 27 years of award-winning experience in architectural design, WAI Continuum not only understands the needs and expectations of this new wave of retirees, but embraces their ideals with innovative and cutting-edge designs and strategic planning. Recognized specialists in the field of senior housing and healthcare design, their team of consultants create holistic environments that push the envelope and explore uncharted horizons. “With increased competition, changing demographics, and growing senior expectations, providers in all segments of senior housing and healthcare are being challenged by the industry to improve environments to reflect the changing philosophy of care,” notes WAI’s CEO David Wolterstorff. “While the 50's and 60's brought institutions for dying and the 80's and 90's brought convalescent homes, the future will demand the creation of holistic environments. Providers who will see greatest success will be those that meet each resident's total need - mind, body and spirit.” Not only does the WAI team offer strategic planning and design solutions to achieve this, but they have also introduced elements that positively impact various facets of operations as well. “We have a project that was designed about five years ago that focused on resident quality of life, but even we were surprised at the long term results.” explains Wolterstorff. “The owner reported to us that injuries were cut by more than half! He also reported an unprecedented 100% retention of

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staff saying that employees tell him that the improvement is such that they don’t even want to consider leaving. In addition, the satisfaction rating among the resident families was almost 100%. It’s tremendously satisfying to know that you have created something that’s so successful on so many levels.” Working as partners with providers is an important part of WAI design processes. They sit down, listen to the client’s needs, goals, and concerns and then offer a solution that often times exceeds all expectations. One example came as the result of asking the question: “How can we improve the quality of life for the residents while also helping the provider?” “As we explored this question, we realized that by creating a town center we could provide a wonderful environment for the residents with all the typical amenities such as restaurants, dry cleaners, etc.,” says Wolterstorff. “Further, by opening these services up to the general public as well, we would not only enhance the experience for the residents but also provide an additional source of income for the providers! So far, where this has been implemented it’s been tremendously successful and viewed as the classic ‘win-win’.” In a recent presentation before the Minnesota Chapter of NAHRO, WAI Vice President Scott Koester offered creative answers for affordable housing providers looking for what's new and what sells in senior housing design. “Our design team discussed the future of senior housing and how those trends can translate into affordable amenities that will draw tenants to a project for a quick lease up.” he explains. “The expectations of future residents and their families are far different than they were in the past. To meet those expectations, WAI taps into other networks to look beyond what exists in senior living today.” For more information, please call: 651.227.0644 or visit www.waicontinuum.com


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Five Thinigs continued from page 10 the person has handled them in the past. Situational questions ask what a person might do in a make-believe situation or what they would do if given two equally desirable/undesirable outcomes. Asking fact-finding questions will give you a clear picture about the person’s work history, education, knowledge and values. Avoid asking illegal questions (such as age, religion, marital status) by sticking to questions based on what the person needs to be able to do on the job. Make the process of deciding who to hire easy by setting up a scorecard and rating each person you interview. A scorecard has a list of important things you want and need in someone who works for you and your family member. Rate each applicant by how they answered the questions and decide who you will hire based on their score.

Keeping Them Once You Hire Them

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If you want new staff to stay on the job for a long time, make sure they feel welcomed and are trained to do what you need to have them do. Welcoming new DSPs helps them feel at ease on the job. Welcome them by showing them around and explaining any “house rules” on their first day. Introduce the whole family and other DSPs who work for you and your family member. Train them to do the job the way you would like it done. Learning a new job is not always easy. Your role

is to teach the new DSP. This can be difficult because different people learn in different ways. Find out the best way to teach someone something by asking the person how they learn best. When training DSPs remember the following steps: (1) Tell them what they are expected to do, (2) show them what they are expected to do, (3) have them do the job, (4) check to make sure they are doing the job, and (5) give them feedback about their work.

Conclusion Finding and keeping great DSPs can be challenging. Using these simple strategies can help to make the task easier. Another resource that families and individuals with disabilities may find useful is Find, Choose, and Keep Great DSPs, two toolkits designed for individuals with disabilities and families that provide easy-to-use tips and strategies to help people to find, choose and keep high quality DSPs. Anyone can download a free copy at www.ildspinitiative.com. Nancy McCulloh is a family member of a person with a disability, and a Program Coordinator with the Research and Training Center on Community Living, Institute on Community Integration, University of Minnesota, Minneapolis. She may be reached at mccul037@umn.edu or 612/626-7765.

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Who Will Take Care of Our Older Adults in the Future? By: Neil Johnson

T

hat is a question with which many of us are wrestling. As our parents age, the vast majority of them want to stay in their homes. Currently 90% of all care provided in the home is done by a family caregiver. According to Transform 2010 Report from the Minnesota Department of Human Services, for every one percent drop in the number of family caregivers it costs the overall care system $30 million. The average length of family caregiving is 4.3 years. But caretakers also work full time at their own jobs. In fact, one fifth of today’s workers are also elder caregivers. On average, long-distance caregivers – those who live more than an hour away from their loved one -- miss 20 hours of work per month. Given that the senior population is expanding as Baby Boomers reach 62, how are we going to meet the increased care needs resulting from this imminent age wave? To complicate matters, the home care industry is currently experiencing escalating shortages of nurses, therapists, home health aides and personal care attendants (PCAs). The average age today of nurses is 47; the average age of nursing professors

is 65. There is also an acute shortage of physical therapists, occupational therapists and speech-language pathologists as well as home care social workers. The Department of Employment and Economic Development has consistently listed PCAs and Home Health Aides as the fastest growing jobs on the market. Unfortunately, typical wages for these positions are now $9-12 per hour… hardly a living wage in today’s economy. Why is the pay so low? Agencies providing these services are reimbursed at about 40% of their costs by state-funded programs and cannot afford to pay higher wages. Reimbursement rates for Medical Assistance are set by the state legislature and rates for Medicare are set by Congress. Adding to the low wages is the high cost of gas. Gas prices have forced staff to re-think distances they are willing to drive, resulting in the need for providers to limit their service areas. So where to begin? We need to adequately fund these programs to recruit and retain staff. But it’s not enough to just add more money to the system. Who Will Take Care continued on page 19

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continued from page 18 First and foremost, we need to recruit people into eldercare at an earlier age, letting young people know that taking care of our older adults is a satisfying and rewarding career choice. Additionally, Baby Boomers can be valuable resources and part of the solution. Having the freedom to work flexible hours and having a means to give back to their community are job attributes that help engage Baby Boomers in eldercare. We need to do more to support family caregivers by giving them tools such as respite services, training, mentoring/ coaching, and advocacy. And we can encourage employers to offer flexible work schedules. This just makes good business sense… such flexibility of hours has been shown to decrease stress and increase worker productivity. Some changes in the caretaking process are happening already. Co-housing communities are forming in several cities in which neighbors share the duties of eldercare and pay a membership fee for home care aides. Member-owned health care cooperatives, such as Care Ventures in west central Minnesota, are taking shape. (Care Ventures is made up of 17 long-term care organizations). And there are currently 31 neighborhood-based block nurse programs in Minnesota. Further examples: The U.S. Administration on Aging is currently paying for service coordinators at 60 ‘naturally occurring retirement communities’ or NORCs. These are neighborhood blocks or apartment buildings where many

people have grown old together. And a few state Medicaid programs are giving the elderly vouchers to purchase home care services. Technology can certainly play a role in enhancing eldercare as well. Telehealth service management, electronic medical records, and a variety of assistive technologies can all improve service levels. For example, a nurse using telehealth equipment can potentially make up to 15 visits a day rather than the standard 5. Sensors can be placed around the home to remotely monitor a senior’s activities and movement. Finally, we need better ongoing training for people who do the important job of home care. Web-based education, for example, could enhance individual competencies and be integrated into the formal training & certification process. The task is enormous, but can be accomplished. Collaboration and cooperation between health care systems will be necessary. Partnerships among businesses, faith communities, educational institutions, health care providers and families will be essential. Similar to the adage ‘it takes a village to raise a child,’ consider that ‘it takes a community to care for its elders’. Only together can we ensure that our eldercare and home care systems meet the growing needs of the marketplace. In 2004, there were 36.3 million people 65+ in the U.S., or 12 percent of the population. By 2030, this number is expected to increase to at least 20 percent, or about 71.5 million. So we need to enlist that great and amazing trait that never fails -- American ingenuity -- to create a senior caretaking system that will serve us well both today and into the future. Neil Johnson is Executive Director of MN HomeCare Association, the statewide non-profit info resource for the home care industry. Neil can be reached at 651.635.0607 or njohnson@mnhomecare.org. Find further info on www.mnhomecare.org.

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Those Receiving Long-Term Care Services Have Rights By Joan Aasve

T

here are, in fact, federal and state regulations that have dictated a list of rights specifically for long-term care recipients. Through the years these federal and state regulations have evolved as it became clear that basic rights were violated, or seemed to disappear, once an individual was in a care setting – whether it was in a nursing home, an assisted living setting, a private residential home, or various other senior housing. The following categories briefly summarize these rights: • The Right to be Informed: of your rights upon moving in or in advance of receiving services; the name of the physician or other medical professionals providing your care; services provided. • The Right of Respect: to have care continuity by competent people; be free of abuse or neglect; receive assistance and answers to questions and requests. • The Right to Courteous Treatment: to express concerns about your care without fear of discrimination or retaliation;

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be treated with courtesy and respect for your individuality. • The Right to Privacy: in medical situations; financial affairs; personal cares; communication. • The Right to Individual Choice: receiving medical treatment or refusing treatment; participating in planning personal health care; using personal belongings and possessions; choosing a supplier of services and products; handling financial affairs, unless a court rules otherwise. You can view these rights in more detail and in various languages by accessing the following two websites: www. health.state.mn.us or www.eldercarerights.org. For example, the “Nursing Home Residents’ Bill of Rights” is summarized into 28 areas. There are separate “Bills of Rights” for nursing homes, assisted living settings, home care, hospice service settings, and hospitals. Besides ElderCare Rights Alliance, the following offices can be of assistance if you believe an elder’s rights are being violated. If you witness a crime or an elder is in danger call 911. continued on page 22


e d i c a h p a B R St E P U S M

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Finally

EETS ITS

Methicillin Resistant Staphylococcus Aureus Superbug. It sounds like something from a science fiction movie, but the unsettling truth is, MRSA is a strain of staph that is resistant to the broad-spectrum antibiotics commonly used to treat it and it can be fatal. In fact, there are now more deaths per year in the United States from MRSA infection than AIDS. According to Mayo Clinic research, most MRSA infections occur in hospitals, nursing homes, or other health care settings. Older adults and people with weakened immune systems are at the greatest risk. And, studies show that more than 75% of patients’ rooms are contaminated with the MRSA “Superbug”. These are disturbing facts for health-care providers, particularly those catering specifically to seniors. Potential financial impact to hospitals and nursing homes is huge, as CMS (Centers for Medicare and Medicaid Services) has published regulations which indicate that beginning in 2008, Medicare will not compensate hospitals for Hospital Acquired Infections (HAI) related claims because HAI’s are considered a hospital-preventable condition. Obviously, this is a serious situation and several different levels. If this were a science fiction thriller, now is when the hero would dramatically arrive on the scene. Well that hero has arrived in the form of Meditran Systems, a Minnesota company, providing a solution and defense against the deadly “Superbug”. Staphacide ™ is an EPA Registered colorless, odorless broad spectrum antimicrobial disinfectant and deodorizer that has been proven effective against some of the most dangerous bacteria, viruses, and fungi, yet is safe enough to apply directly to children's toys. “We believe that Staphacide™ will provide the tool to take control and purify your environment whether in an institutional, health care, day care, health club or locker room,” states Meditran Systems owner, Mark Josefson. “Staphacide™ provides highly effective broad spectrum efficacy with fast kills, NO hazardous chemicals. It can be applied in the presence of children and animals and emits no irritating fumes.”

MATCH!

The power inside Staphacide™ is SDC (Silver Dihydrogen Citrate). The SDC molecule attacks microbes in such a way that it is not only an effective disinfectant and deodorizer it is also environmentally safe, and nontoxic to humans and pets. The Staphacide™ two pronged attack is as follows: Unlike traditional antimicrobials, bacteria are actually attracted to SDC because they recognize citric acid as a food source. SDC can also act on an organism’s outer membrane. Silver ions are highly attracted to sulfur-containing thiol groups found in metabolic and structural proteins bound to the membrane surface. SDC targets these critical proteins and destroys their structure. “Meditran Systems has partnered with the exclusive Midwest distributor of Staphacide™ to provide the best training and the most reliable delivery of the product,” notes Josefson. “The safety of this product (the EPA has assigned their lowest toxicity rating EPA Category IV) coupled with its fast kill rate and 24-hour residual antimicrobial activity, make it the first choice of caregivers and those who have the responsibility for the safety and health of children, the vulnerable and the elderly.” Antibiotic-resistant bacteria have been the scourge of the practices of medicine for many years, particularly in the hospital and nursing home setting where 2 million patients in the United States are infected during their stay. Preventive action is the only proven method to protect and preserve lives. According to Josefson, that’s precisely his company’s objective. “Our mission at Meditran Systems is to provide the products that will improve the quality of life for the patient and provide the caregiver the most effective products to mange their environment and make their tasks easier.” For more information regarding Staphacide™ or the other fine Meditran Systems products, please call: 952- 201- 1463 or go to our website at:www.meditransystem.com Gold Age Magazine


Those Receiving continued from page 20 Minnesota Office of Ombudsman for Longterm Care: This office investigates concerns, resolves disputes, and advocates for consumers when rights have been violated. 800.657.3591. MINNESOTA DEPARTMENT OF HEALTH: If you witness a suspected violation of health department regulations, patients’ and residents’ rights or the MN Vulnerable Adult Act (maltreatment, abuse, neglect, or financial exploitation) report it to the Office of Health Facility Complaints. 651.201.4201 or 800.369.7994 STRATIS HEALTH: Serves as Minnesota’s Quality Improvement Organization, under federal contract (QIO). A health care provider may decide that a service a Medicare recipient is receiving will no longer be covered by Medicare. If a Medicare beneficiary disagrees with this decision they have the right to request a review of the care received from any Medicare-certified hospital, nursing home, home health agency, managed care organization, doctor’s office, or hospice. This request is an immediate review of any decision to terminate service covered by Medicare. Call the Stratis Health Medicare Helpline at 800.444.3423 (TTY: 800.627.3529)

Minnesota Attorney General’s Office: Answers questions about landlord and tenant rights, mobile homes, health care, cars, credit, unwanted mail, and phone calls, and numerous other issues. The Attorney General’s Office also provides free mediation to resolve disputes between Minnesota consumers and businesses and uses information from consumers to enforce the state’s consumer laws. Contact should be made in writing at:Minnesota Attorney General’s Office, 1400 NCL Tower, 445 Minnesota Street, St. Paul, MN 55101. Call: 651.296.3353 or 800.657.3787 (TTY 651.297.7206 or 800.366.4812) for direct assistance from a consumer specialist. MINNESOTA STATE BAR ASSOCIATION (MSBA): Provides the Lawyer Referral System program. This program provides the name(s) of lawyers who practice a particular type of law in a specified geographical area. There is no fee for receiving a referral from this system. However, lawyers who are part of this service agree to provide a free 30-minute initial consultation either by phone or in person. After the initial consultation, the lawyer will generally charge a regular fee. 800.292.4152 or www.mnfindalawyer.com.

For more information please contact: Joan Aasve • ElderCare Rights Alliance 952.854.7304 • www.eldercarerights.org

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