Eastern Agency on Aging: Editorial Page

Blaine House Conference on Aging October 15, 2008 Augusta Civic Center

Keeping Aging Mainers Healthy, Safe, Engaged and Supported I am sure you have heard that Maine is the “oldest” state in the union. What are we doing to plan for our elders? How are priorities set and by whom? What do the elderly really need? To address these issues, the second Blaine House Conferences on Aging will be held on October 15, 2008 at the Augusta Civic Center in Augusta, Maine. This will be an all day event. The Eastern Area Agency on Aging is looking for representatives who are outspoken and passionate about elder issues to serve as grassroots community member delegates. We have a limited number of delegate slots available, and of course, we want to make sure we fill each position. This is a one day event and depending on distance and travel time, there may be reimbursement and overnight accommodations available. It is extremely important that Eastern Maine be represented at this important conference. What will you do as a delegate from Eastern Area Agency on Aging? The 100 + delegates from all the Maine agencies on aging will divide up into small groups to discuss one of the selected topic areas and produce resolutions that will help guide state officials and legislators when developing elder policy in Maine. There will be refreshments and a lunch provided as well as networking with peer delegates from across the state. This is an exciting event! The topics that will be used to build policy related resolutions on are as follows: Family Caregivers Paid Caregivers Community Involvement/Volunteerism Creative Housing and Assisted Living Elder Abuse Employment Healthy Aging Transportation Energy Costs Resolutions developed from these topics will be used to help form legislative actions in the next two years. If you are interested in being part of this important grassroots effort meant to improve the lives of Maine’s elderly, then please give me a call at 941-2865, extension 121 or 1-800-432-7812, extension 121. I cannot wait to sign you up!

Be careful of some salespeople

The State Health Insurance Assistance program (SHIP) program is interested in hearing about seniors experiences with Medicare Advantage plans also known as Medicare Part C.

We have heard from many folks that there has been challenges with insurance salespeople in their communities. EAAA wants to remind folks that salespeople should not be going to homes without an invitation (also called "cold calling") to sell Medicare Advantage plans.

Please let us know what your experiences have been and how these new Medicare private insurance products are being marketed.

Thanks, Val Sauda, Director of Community Services

Snow Shoveling

The Holidays are joyous if you have a great family, good income and all the resources to enjoy life. Sadly, not everyone has these precious resources and many of our elderly residents are finding this year to be one of the most challenging on record because of fuel prices, which affect being able secure other necessities of life, such as food and medicine.

Persistent low temperatures and a few significant snowstorms have taken a toll on our seniors. Many cannot get out of their homes to get mail or even receive home delivered meals or other deliveries. More importantly, emergency medical personnel cannot get in. If you are a high school or college student in search of something to do this winter, and want to make a positive impact in your community, look around your neighborhood and see if there are houses that haven’t been shoveled out.

You would be giving a great gift to those in need by clearing a path in and out of their homes. Or call Eastern Area Agency on Aging. We could quickly put your good will to work in our EAA-Z fix program where we could direct you quickly to seniors who need the help most. In many cases older people don’t have family living in the area to help them which means they are in desperate need of help from others. There are people who graciously volunteer to shovel out hydrants.

We need your help, also, to shovel out elderly people who may stranded in their homes. And speaking of good will, after reading an article in the New York Times about the harsh challenges of surviving winters in Washington County, people from all over the country have reached out to help by contributing to a fund we manage. One hundred percent of the donations go to providing fuel to desperate seniors. Your help is needed on many levels so please give us a call at 1-800-432-7812.

Noelle Merrill

Executive Director of EAAA

Fuel Assistance

Fuel costs are soaring this year already and we are seeing seniors begin to feel the pinch throughout the coverage area. I am interested in knowing how you are doing this heating season and what things you have needed to do to help cover the rising cost of fuel.

Eastern Area Agency on Aging in an effort to help seniors who are out of options for fuel assistance is accepting donations to assist those people with the cost of heating this winter season. Donations can be made to EAAA-emergency fuel fund. We will make sure that the funds go to the seniors who need help the most.

Val Sauda, Director of Community Services

A story of Self Advocacy

A couple of months ago I wrote about my husband’s mother, Marie, who had to move to Maine from Arizona when her husband/caregiver passed away unexpectedly. I’d like to continue the story because I think it helps to hear how others solve problems. And if it motivates anyone to ask for more than just what’s prescribed in their care setting, then my story is worth writing.

Fortunately, my husband and I have been able to incorporate Marie’s needs into our lifestyle and things are going pretty well. Because she has sufficient resources in the way of income and long-term care and health insurance, there are no financial issues. But there have been many significant health care issues, which run the course from where do we find Tucks to “hospice or no hospice.”

Marie came to Maine and enrolled in hospice, having no diagnosis other than failure to thrive. She also had a condition that required fluid to be removed from her stomach regularly.

Little did we know that because she was in hospice, she couldn’t be admitted to the hospital for that procedure, as it was not associated with her “diagnosis.” So, shortly after coming to Maine she had to withdraw from hospice in order to be admitted to the hospital for the procedure.

On an average of every ten days, Marie had to go through the hospital emergency room process in order to be admitted. She had to be transported by ambulance because she is bedridden in a second floor room. Routinely, EMTs had to pick up and return Marie after her stay the hospital. This went on for many visits. Marie was getting tired.

She continually asked me if we could just get someone to come to her room to do the procedure. I, of course, answered no. “There is no way anyone could do this in your room,” I explained.

“There are very few doctors who even make house calls, never mind perform hospital level procedures in a home.”

I even went so far as to ask the assessing nurse to set Marie straight once and for all and to inform her in no uncertain terms that she could either continue living in her current setting and have the ambulance staff carrying her up and down the stairs every 10 days, or she could consider a nursing facility because there was never going to be a doctor that would come to her room and do that procedure!

Sometimes being too sure of yourself doesn’t pay off.

One day a doctor from the hospital called and told me that if Marie were to rejoin hospice, he would be willing to come to her apartment and do the procedure on a volunteer basis! She had suggested it to him and, he, after considering it and double checking with his insurer, agreed to do it. He had the equipment shipped to her home. Now he comes, sometimes after work and sometimes before work, every 7-8 days.

This has been such a gift to our family I cannot even describe how grateful we feel. And I have learned to never say never.

The set-up is a gift to Marie as well. Her anxiety and stress levels have been significantly reduced and she has a newfound confidence in healthcare providers. And best of all, she and the rest of the family has been given back some hope, which is invaluable. Marie’s new relationship with her doctor has educated all of us on the value of asking for what you need, even in the face of naysayers. Being vocal may not always work, but it is worth a try and you never know.

Now, we don’t know if this doctor is the forerunner of new concepts in physician care or if he is just an angel. But the lesson in all this is, thinking about what would work best for you and then letting your healthcare professionals know, can reap its own rewards.

I would venture to say that there are probably more doctors like this than we know about, but they won’t help you if you don’t ask. And who knows, the person you talk to may just be the one to make it happen.

If there is something you don’t understand about your care or your family member’s care, be sure to ask the people who are working with you. If you are a stressed family member and cannot get a straight answer from anyone, contact Eastern Agency on Aging and our Family Caregiver Program.

I know it has helped us to be able to share stories and learn about the options that my husband and I needed to consider for his mother.

If you have a story like this, we would love to hear from you and have the ability to share it with many.

Advancing the Mission of Meals for ME, the Nutrition Program of the Eastern Agency on Aging

Autumn is in the air. As temperatures dipped into the 40s for the lows last month, we all know what’s coming our way. In fact, EAA’s intake office has already received calls about fuel assistance. And we are here to help with that need.

But the topic of this article is Nutrition and EAA’s Meals for ME program. It is our largest and one of our oldest programs. While you may be familiar with the program, let’s test your knowledge.

1. The program is only about food for low-income elderly.

NOT TRUE. This is not the purpose of the program and in fact, qualification to participate has nothing to do with low income. Yes, if we had waiting lists, we would have to give priority to those who needed it most, but there are no income requirements for this program.

If you are age 60 or older, you automatically qualify to have lunch in one of our 48 community dining rooms, as does your spouse regardless of age.

All we ask is that you contribute a portion of the full cost of the meal.

If you are at least 60 or disabled, unable to cook, have no way to provide yourself with a meal, can not leave your home without assistance, you probably qualify for home delivered meals.

The suggested donation is $3.00. However, you may eat at any of our community dining rooms no matter what your age if you pay for the full price of the meal.

2. Meals must be eaten at the dining rooms.

NOT TRUE. In fact, Meals for ME provides “take out” but you must make a reservation AND pay the full price of the meal which is $5.00. Per the federal regulations, meals offered at the donation level are only for those who participate in the group dining setting.

3. Meals for ME is a federal program and therefore does not really need money.

NOT TRUE. Eastern Agency on Aging has never received enough federal and state money to provide meals everyone who wants or needs it.

Meals for ME provides life support in the form of home delivered meals, and life improving options like socialization and education in the form of community dining.

EAA is dependent upon the donations from everyone who dines with us, whether home delivery client, dining room participant or volunteer.

On average, we cannot produce, package and deliver these meals to you without at least an average of a $3.00 donation from each and every person. Every dollar of every Meals for ME donation is put back into the Meals for ME program.

Those of you who donate more than the $3.00 are helping people who simply can not donate yet desperately need the meal. And for that, we thank you.

Just like every other consumer, Eastern Agency on Aging must also pay constantly rising prices for food and paper goods, which is a huge part of the program budget.

Because of Eastern Agency on Aging’s rural nature, the current cost of producing and distributing a meal averages a little over $6.00.

Not only do we depend on donations, we are extremely reliant upon the volunteers who coordinate our dining rooms, deliver meals to our homebound disabled and elderly and the multitudes of other tasks they do.

Do you want to do something really meaningful? Trust me when I say we need you and there is a volunteer opportunity in the meals program near you. Just give us a call.

On another note:

In order to make the program more cost effective, beginning in September, we are phasing out our Bangor Kitchen and will begin purchasing meals from Jeanie Marshal Foods of Bangor.

Jeanie Marshal has already been providing the meals for Lincoln and Newport with glowing feedback. The reports are very positive. Jeanie Marshal currently produces high quality meals for private jets and cruises as well as other senior programs. This partnership will help us serve the rapidly growing number of seniors in the Bangor area.

Along with wonderful new menus, we will also offer more programming to our dining rooms. An important part of the Meals for ME program must include nutrition and health education, and activities that encourage people to people socialize.

It has been proven that these options improve the health of older persons. Staying home alone is often the fast track to depression and poor dietary habits, paving the way for chronic disease.

Don’t let that happen to you, get involved now.

We are planning many informational meetings in the next year that will inform you about the locations and the schedules of our many community dining rooms.

The following prediction is staggering: statistics show that in the next ten years the number of people age 65 and older will double in the region that we serve. Eastern Agency on Aging is committed to serve everyone who needs our services, and we will do whatever is necessary to make our programs to grow.

So please, join us for a meal. Or if possible, help us serve or deliver a meal. And by all means, if you are lucky enough to be financially comfortable, please share with those who are less fortunate.

Trust me when I tell you that there will never be enough federal and state money to serve the seniors of tomorrow. And even if there were, the restrictions would be vast.

As we develop our area plan for the state in 2008, we are looking to the residents of Eastern Maine to help us keep this valuable program on track.

If you have ideas, comments or suggestions, don’t hesitate to give me a call or drop me a line. We are here to serve you.

Gateway to the New World of Aging Conference in San Francisco by Noëlle Merrill, Executive Director

Imagine having an inexpensive device that speaks up and reminds you to take your medication or that alerts an emergency response team if your cane hits the floor? These are some of the innovations that were predicted in San Francisco at last month’s National Association of Area Agencies on Aging Conference. San Francisco and its surrounding area is the birthplace of many incredible computer related innovations, so none of the attendees had a difficult time imagining that there were people working on ways to help keep us all at home in the future - safely and effectively.

In regards to housing, I attended a workshop that covered how to discuss housing options with seniors. Look for Eastern Agency on Aging to offer some informational sessions on how to make choices about your housing needs. I have always been baffled at the variety of housing options, that while different from one another, use the same description. This accounts for why many people give up soon after starting to research assisted living, residential care, retirement communities, continuum of care communities and nursing homes. As I mentioned in last month’s article, making decisions for long-term living arrangements is an extremely important task that many people put off until it’s too late. If you need to start that search, be sure to call us at Eastern Agency on Aging. We are here to help you sort through the options.

The conference key note speaker, Josefina G. Carbonell, the U.S. Assistant Secretary for Aging, spoke about the modernizing of the Older Americans Act by discussing “Choices for Independence.” While currently a demonstration project, Choices aims to strengthen the nation’s capacity to promote the dignity and independence of older people and meet the challenges associated with the aging of the very large baby boomer generation. It also aims to supplement the President’s New Freedom Initiative and Administration's policy for modernizing Medicare and Medicaid by strengthening the Act’s role in promoting consumer choice, control and independence in long-term care. You can see examples of change in Medicare by looking at the new preventive care checklist now available for consumers.

Eastern Agency is already involved in the Choices program as the pilot for the first Aging and Disability Resource Center - locally known as the DASH (Disability and Aging Services Helpline) Network - in the State of Maine. DASH is one stop shopping for service needs in Eastern Maine. The Choices concept hopes to help individuals make informed decisions about their long-term support options, provide more choices for people at high risk of nursing home placement and enable older people to make behavioral changes that will reduce their risk of disease, disability and injury as they age. Josefina received a standing ovation for her advocacy work in the effort to re-authorize the Older Americans Act this year.

While in San Francisco, I visited the famous International Hotel where in 1977, the city of San Francisco used “eminent domain” to evict all the elderly Asian Americans living there in order to make room for more high rise hotels and office buildings. It was hard for many of us on this tour to imagine that city officials could be so cold hearted towards the elderly! Because of the tragic circumstances of the eviction, no corporation ever built on that site.

Eventually a Chinatown Community Development Center was formed and with help from the city and other governmental entities, it was able to rebuild low income elderly housing in the same location 28 years later. Housing in San Francisco is very scarce and expensive with the average home costing about $700,000. Because of the high cost of housing, there is a waiting list of at least 500 people for a room or apartment in any low-income housing setting in the San Francisco area.

Eastern Agency on Aging was in the spotlight during this national conference as well, winning three achievement awards for Vest Dressed for Safety, Senior Talk, a half-hour radio show hosted by Carol Higgins that airs on WVOM, 103.9 at 6:30 a.m. on Saturdays and on WABI AM910 at 8 a.m. on Saturdays and 9 a.m. on Sundays, and for The Editorial Page, an interactive page where people can comment on our editorials. See home page of our website for the Editorial Page and please share your thoughts with us.

I was very proud to be able to represent our agency in receiving accolades for these innovative programs.

Long Term Care Decisions...Who Will Make Yours?  by Noëlle Merrill, Executive Director

When is the right time to start planning for your long term care needs?  It is never too early. This month I want to talk about this sensitive topic by relating the story of my own family’s recent experience. 

Discussing who will care for you and how is almost as difficult a topic for aging parents as the birds and the bees conversation was when their children were young.  I think many parents, when queried by their own children about their plans when they become too frail to live on their own, respond as my in-laws did by saying “don’t worry, we have it all worked out.”  I have heard this over and over again from my friends when they talk about concerns they have for their own parents.

What happened in my family’s case is that long term care plans were never made because they felt that it was too early.  Mind you, they were both in their 80’s last time they repeated this mantra to us.  My father-in-law would often say, “we are thinking about moving to a progressive place, where you can age in place.”  He said this as his wife became so frail that she needed nursing home level care. To their credit, they did take care of many things such as their wills, powers of attorney and they even had purchased long term care insurance.  What they never considered is who, how and where  care would be provided for one of them if the other passed away. 

Then the unthinkable happened.  My mother-in-law became bedridden due to a mix of ailments and my father-in-law decided to care for her in their home. Staff hired by their children were let go when we left.  A weekly trip to the emergency room became commonplace, but still he chose to do the caregiving alone.  They owned a home in an adult community iin a state very far from all their children and with no aging in place options such as assisted living or residential care.  Many of their friends had already passed away or moved to facilities elsewhere.  After a particularly difficult month of care for his wife, my father-in-law succumbed to a reoccurrence of cancer with very little warning.  His wife was left alone and bedridden with almost no options.  She couldn’t stay in their home anymore and had to leave.  Her children had no option but to make decisions for her because the only place she might be able to stay in her home state was a nursing home and this choice would have broken everyone’s heart.

We brought her to Maine.  Her home had been in the southwest for almost 30 years and in a matter of 10 days after her husband died, she found herself in Maine, surrounded by strangers in a place that she did not choose.  I don’t think they would have believed this would happen if you had asked them even two months ago.  Many couples think they will pass away at the same time or that the frailer person will succumb first.  Eastern Agency on Aging’s Family Caregiver staff tell me that what happened in my family is a common story.  The healthier spouse dies first because of the hard work and stress involved in caring for a loved one.  The spouse left often has no choice but to allows others to make the decisions.

I hope that readers will think about re-opening those conversations with family members regarding the long term care choices they would prefer. 

And if you want to learn more about the options that are available in any given situation, call Eastern Agency on Aging.  We strive to be the best source of information, options and services for everyone as they grow older. 

Something to Consider before Enrolling in a Medicare Advantage Plan

            Medicare Advantage Plans, or Medicare Part C, have been presented to America’s seniors as an alternative to Original Medicare with a prescription drug plan and a standard medigap policy.  And it does sound good.  Many cost little more than the Part B premium, and the coverage can be comparable to what people are used to, depending on the type of plan.  However, Medicare beneficiaries need to be sure it’s the right decision before they make the change to a Medicare Advantage Plan.

            Now, I’m not trying to say that people shouldn’t choose Part C. It is a personal choice, and while I’ve been learning a great deal about Medicare in the few months I’ve been working for the Eastern Agency on Aging, I certainly don’t know all there is to know.  My father, who lives in New Jersey, has a Medicare HMO plan with a well known national insurance company.  He’s happy with the coverage, and it meets his needs.  Unfortunately for the people who live in this agency’s coverage area, the same variety of plans that are available in other parts of the country—indeed, even other parts of the state—aren’t available here.

            But still, my dad knew about the plan before he got into it.  (In fact, the availability of this plan has factored into his decision to move to different areas.)  He knew what to expect, and he didn’t have to worry about trying to cancel his enrollment and go back to original Medicare or about switching to another plan.

And switching plans during the Annual Coordinated Enrollment Period, November 15^th to December 31^st, or during a special enrollment period is an option, but it’s not necessarily without complications.  Over the past month I’ve met with two people who had decided to participate in a Medicare Advantage plan and quickly decided to go back to Original Medicare.  The plan had a thirty day cancellation policy allowing the return without penalty.  One took two weeks to decide to go back, and the other only took a couple of days.  Both cancelled during the thirty day window, and both have had months of aggravation since.   I’ve helped both of them file the same type of complaint with Medicare—within days of each other.

Both people received timely letters from the plan acknowledging their disenrollment status and stating that they would be returned to original Medicare on the same date.  Both of them also received letters from the Centers for Medicare and Medicaid Services stating that their coverage under original Medicare would continue.  The problem is that there is a four month gap in the dates for both people.  Four months of doctor’s appointments and even multiple hospitalizations and no one to bill for them.  The plan tells the medical providers to bill Medicare, and Medicare tells them to bill the plan.  Luckily, for both people, the providers have understood the situation.  They know what a complex system Medicare is and how long things can take.  They’re helping their patients deal with it.  They’re letting them take the time with Medicare—and get our help—while the bills pile up, unpaid.

But can you expect that kind of patience from your providers?  Do you want to have to rely on it?

I’m not saying that this will happen to everyone, and I don’t want to scare people away from Medicare Advantage Plans.  There are many satisfied customers whom we haven’t heard from because they don’t need help with Medicare’s automated phone system or help navigating through a plan’s complex contact information.  I’m saying that it would be wise to compare plans and insurance companies.  Research them and get some objective information.  Perhaps learn about their customer service rankings.  Try to be as sure as possible that the plan is right for you before making a change.  But you still never know until you do it.

If you have had problems, though, or even if you would like help finding information about different plans.  Come into the agency, e-mail us, or give us a call. We can help.

Ted Perrin

ADRC Information and Referral Specialist

DATE: May 25, 2007 TO: Friends of Eastern Agency on Aging

FROM: Virginia Fortier, President of the Advisory Council of Eastern Agency on Aging

RE: Washington County Open Forum June 15, 2007

The Advisory Council of the Eastern Agency on Aging is charged with the mission of determining the elder service needs in the agency coverage area, which includes all of Washington County.

The Advisory Council seeks your input and has scheduled an open forum for Friday, June 15, 2007 from 9:30 – 10:45 a.m. at Kimball Hall (Portside) at the University of Maine at Machias.

Kimball Hall is located at 9 O’Brien Avenue. The meeting will be an informally facilitated conversation about existing services for the elderly and future planning for the elder wave in Washington County.

We welcome brief presentations about current services. We welcome new ideas and strategies. The information from this discussion will be part of the Advisory Council formal meeting which will follow.

Space is limited, so please R.S.V.P. by Wednesday, June 7, 2007 to Vanessa Field at 207-992-0126