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Last Modified 07/22/04

CARE Connection – April 2009

Update Trainings Quickly Approaching

 Make your reservations now!!  The 2009 CARE trainings have been scheduled!

 The schedule is as follows:

• Thursday, April 9 – New Training in Plainville

• Tuesday, April 21 morning – Update Training in Plainville

• Tuesday, April 21 afternoon – Update Training in Hill City

• Wednesday, April 22 morning – Update Training in St. Francis

• Wednesday, April 22 afternoon – Update Training in Colby

• Tuesday, April 28 – Update Training in Hays

• Thursday, April 30 – Update Training in Downs

Another new assessor training will take place this fall.  No more update trainings will be held in 2009. 

We will discuss Elder Sensitivity, the services offered in the Explore Your Options publication, and review the assessment forms, release of information and certificate.

If you think you may have an old copy of the CARE assessor manual, please let us know and we’ll bring you new, improved pages.

It is highly recommended for CARE assessors to attend update training so they become more familiar with community resources and receive all pertinent assessment technique updates.  Please call the Area Agency on Aging at 1-800-432-7422 or (785) 625-2037 to reserve your spot!

Improving Communication and Understanding for People Working with Clients Affected by Alzheimer’s Disease

Erin and Chris Bonitto traveled to Logan to present a workshop about “Excellence in Dementia Communication and Understanding.”  Many of the tips and methods Erin discussed will be very beneficial when helping clients with dementia.

Most of us have lost our cars in unfamiliar parking lots or our keys…but do we all have dementia?  Definitely not.  Age Associated Memory Impairment is the irritating, but non-life changing lapse in memory that occasionally occurs in healthy adults.  Many times these are referred to as “Senior Moments.”

Dementia involves both cognitive impairment and aphasia, apraxia, agnosia or intellectual functioning disturbances.  Alzheimer’s disease accounts for 75% of cases of dementia.

The Alzheimer’s Association has compiled a list of 10 warning signs that often lead to a diagnosis of Alzheimer’s disease.  These signs include:

1. Memory loss

2. Difficulty performing familiar tasks

3. Problems with language

4. Disorientation to time and place

5. Poor or decreased judgment

6. Problems with abstract thinking

7. Misplacing things (in unusual places)

8. Changes in mood or behavior

9. Changes in personality

10. Loss of initiative

 People with Alzhiemer’s disease are not childish; they are child-like.  This is extremely important to remember when working with a client with Alzheimer’s disease.

Clients affected by Alzheimer’s disease have many strengths remaining.  These strengths include:

1. Procedural memories (folding and sorting)

2. Long-term memory (being stranded in a blizzard years ago)

3. Automatic responses (singing)

4. Social rituals (handshake)

5. Desire for genuine contact (caring for lifelike doll)

6. Ability to pick up on others’ moods

7. The desire to have a sense of purpose

8. Individual strengths (sense of humor, desire to nurture)

Participants in the workshop also received a list of “Communication Strategies for Dementia.”  Some of these tips include:

• Describing simply what you will be doing

• The 7 & 7 Rule – Communicate 7 words.  Wait for 7 seconds for the person to respond.

• Use positive communication – avoid “No”

• Laughter – especially at yourself – is helpful.

• Never “correct,” debate, or argue.

• Make eye contact.

“Stepping into the person’s world” is a very effective way to communicate with people with Alzheimer’s disease.  A recommended book is “The Best Friends Approach to Alzheimer’s Care” by Virginia Bell, MSW and David Troxel, MPH.

For more information, please contact the Alzheimer’s Association of Central and Western Kansas 800-272-3900 or online at www.alz.org/centralandwesternkansas

Check it out!!  Additional Alzheimer’s disease articles are available online at http://www.agingwellmag.com/tablecontents.shtml  A free subscription to the paper copy of this magazine is available.

Assessment Process Reminders

As our schedules become more hectic, it’s easy to make simple errors on CARE assessments.  To avoid the dreaded “Missing or Conflicted Information” fax, please review this list of common CARE errors.

The 2-Page Assessment Form

• Use the client’s Social Security Number (make sure it does not belong to their spouse)

• Use the client’s legal name (no nicknames)

• Fill out each question in the PASRR section – if none apply, check “none”

• Mark guardianship only when you can prove there’s a guardian.  Note where guardianship papers can be found in comments or fax them with the CARE assessment.

• Only 0, 1, and 9 may be used to code the cognition section.

• Note the number of falls in both the last month and last 6 months.

• ADLs and IADLs are coded with 1-4

• Referrals are coded 0-6.  Before indicating a 0, please call the AAA.

• Tell the client / representative about the follow up process so it’s not a shock when we call.  Provide enough information so we can contact someone 30 days later.

The Certificate

• Be sure to have the decision maker initial that they received the NWKAAA HIPPA information.

• Check that the dates are correct.

• Sign it legibly – if your signature is difficult to read, you may print your name in the assessor number blank.

• We do not use assessor numbers anymore.

The Release of Information

• Someone is providing information – if it’s only the client, please indicate that too.  List all information sources consulted.

• If someone refuses to sign, please indicate it on the form.  It shows you tried, but the client chose not to.

Remember – Explore Your Options and CARE Brochure too!!

What’s Happening at the Area Agency on Aging?

Several programs are offered through the Area Agency on Aging.  Here’s a brief description of each – and how they can help our CARE clients.

CARE

Okay, we all know this one!  Additional information for clients can be found in the pink brochure.

HOMESTEAD Nutrition Project

This program provides balanced meals for seniors in a fun congregate setting.  In addition to the hot meal, most sites offer a variety of activities, such as playing cards, dominos, or games, crafts, and special celebrations.

A short assessment is filled out when the person eats at the center the first time, and must be renewed annually.  A $2.75 contribution per meal is suggested. 

Seniors with physical or social disabilities can benefit from the home delivered meals program.  To begin home delivered meals, call the Area Agency on Aging.  A short intake will be done over the phone.  A more in-depth assessment will be required by a qualified HNP assessor to verify that the client meets the program criteria for home delivered meals.  A $2.75 contribution is suggested.

People under 60 can utilize this program, too.  Those under 60 must pay the full cost of the meal, which is $5 at the site or $5.35 for delivery.

These prices are subject to change – contact the Area Agency on Aging or local nutrition site for current pricing.  Additional information about the Homestead Nutrition Project can be found in the yellow brochure.

Information & Assistance

If you have a “where can I find ________ for someone over 60 in the NWKAAA service area” question, this is the service for you!  Call the Area Agency on Aging to be connected to a knowledgeable person who can provide referral information for a variety of senior services within our 18-county area.

Check the online calendar for a schedule of community events the Area Agency on Aging will be attending.

Area Agency on Aging News

This is the annual newsletter discussing services, programs and issues of interest to seniors that is available from the Area Agency on Aging.  Please contact the Area Agency on Aging if you wish to receive the newsletter or have any address changes.

SHICK (Senior Health Insurance Counseling for Kansans)

Our SHICK volunteers help seniors with insurance concerns ranging from Medicare Part D to supplemental insurance.  Their services are provided free of charge.  Please encourage clients to call first and make an appointment.

During the November 15 – December 31 Medicare Part D open enrollment period SHICK volunteers are able to assist clients who want a comparison of the available drug plans and enroll them in the plan they choose.  The client must make the decision – SHICK volunteers are only allowed to present the information in an unbiased, understandable way.

If you or someone you know would like to become a SHICK volunteer, please contact the Area Agency on Aging.  SHICK training dates and locations will be available at a later date.

In-Home Services

Senior Care Act (SCA) and Home and Community Based Services (HCBS) allow many Kansans to remain in their homes for a longer period of time, reducing the need for nursing facility care.  Services that may be available include

• Personal care services

• Homemaker services

• Respite services

• Chore services

• Other support services.

A sliding fee scale determines the cost of Senior Care Act services.

When you make a referral to the Area Agency on Aging, please have the following available:

• Client’s permission – we are unable to provide services for individuals who don’t want them, no matter how much they would benefit from the services.

• Client’s name and address

• Client’s date of birth

• Client’s social security number

• Client’s total liquid assets

• Client’s family size

• Client’s emergency contact person

• Other pertinent information.

A short intake will be done over the phone.  The information will be given to the case manager for the in-home program that best fits the client’s needs and financial situation.  The case manager will call the client to schedule an appointment for a more in-depth assessment.  The assessment takes approximately an hour and a half.  A safe plan of care will be developed to provide adequate services for the client to remain in their home.  Clients who have a co-pay will receive a monthly statement.

All services are subject to available funding.  Additional information about Senior Care Act services is provided in the blue brochure.  HCBS services are described in the yellow brochure.

Money Follows the Person (MFP) may be an option for some clients to transition from nursing facility care back to the community.  Eligibility requirements for the MFP Demonstration Grant  include

• Resident of NF for 6 months or longer

• Functionally eligible

• Meet age requirements for waivers (FE, PD, TBI and MR/DD are eligible, however the requirements listed here are specific to clients using FE and PD services)

• Medicaid eligible for 30 days prior to MFP

• Plan to move to residence that they rent/lease, live with family or own home.  Currently client cannot live in ALF/RCF, Homes Plus, Boarding Care or Group homes and utilize the MFP Demonstration Grant funds.  MFP Grant customers wanting to go into an ALF or other residential care setting cannot use grant dollars; however, the customer can use the MFP Proviso dollars.

• Client wants to go home.

Additional information about MFP was discussed in the Winter KDOA CARE Newsletter.  It is available online at

http://www.agingkansas.org/ProviderInfo/Newsletters/Care/JanMar2009CAREnewsletter.pdf

Caregiver Support Program

The caregiver support program is available to assist people caring for older loved ones at home.  The services available for each situation are unique and depend on available funding.  A monthly newsletter is available.

More information can be found in the green Caregiver Support Program brochure.

“Is this the nursing home to choose?”

Choosing a nursing home is an important and often emotional decision.  The following checklist provides an objective way to compare nursing homes.  Each person has a different situation; not all of these are applicable.  However, ask or think about some of these things, to provide clarity for decision-making.

• Is the home located conveniently for family & friends to visit?

• Does the home have an active resident and family council?

• Does the facility offer rehabilitative services, such as physical/occupational therapy, mental health services, or respiratory therapy?  Do licensed professionals provide these services?  How frequently do therapists offer services in a facility?

• Are residents clean and properly dressed?  Do they seem happy/smile?

• Are residents treated with dignity and respect?

• Does the facility practice consistent assignment of staff to a resident?  Are call lights/calls for help answered quickly?

• Do staff members at all levels interact well with each other?  Do they smile?

• What nursing staff will be present at night, on weekends or during holidays?

• Are the activities offered for residents compatible with your loved ones interests?

• Is the home clean, in good repair, and provide a safe environment, inside and outside?

• Is the home free of persistent, unpleasant odors?

• Are rooms and common areas pleasant and functional?

• Can residents bring furniture and personal mementos for their rooms?

• Is there a room where residents and visitors can have privacy, parties or other social time?

• Does the home have a good reputation in the community, and have the support of community volunteers?

• Are meals appetizing and attractively served?  Can residents eat what and when they wish?

• Can residents make decisions about daily routine, such as when to get up or go to bed, or when to bathe?

• Does the facility focus on helping resident maintain independence and function?

• Will the facility allow you to see the state inspection report?  Does the report show a satisfactory history of providing good care?  Do they reasonably account for change to correct problems?

• How does the facility ensure quality care, and correct problems if they occur?

You can learn much by observing how staff and residents interact.  If you have time, you should visit at various times of the day and on weekends to see if there are differences in staffing and care.  Ask to stay for a meal if possible.  Is the food appetizing?  Are residents who need help given assistance in an unhurried manner?

Additional information on choosing a good quality nursing facility is available in the KABC booklet “Consumer’s Guide to Kansas Adult Care Homes” online at www.kabc.org.  KABC has significant current information about all licensed long-term care homes available for consumers.  Please call toll-free 800-525-1782, or email info@kabc.org to inquire or order.

Information based on “Consumer’s Guide to Kansas Adult Care Homes”, and a 2007 “Best Times” article by Ed Schulte.

This article appeared in the February 2009 edition of the Kansas Advocate News, page 3, published by the Kansas Advocates for Better Care.