MIG05-1_Wi_Editorial

Published quarterly by Michigan’s Area Agencies on AgingPublished quarterly by Michigan’s Area Agencies on Aging

Dementia

GenerationsTMWinter 2005Michigan

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DementiaAlso in This Issue:

■ Healthy Food Habits for the New Year

■ A Look at Area AgenciesAround Our State

Also in This Issue: ■ Healthy Food Habits

for the New Year■ A Look at Area Agencies

Around Our State

2 Michigan Generations

WINTER 2005 Published quarterlythrough a cooperative effort ofMichigan’s Area Agencies on Aging.

For information contact:Jenny [email protected]

Editorial Project Development:JAM Communications, Atlanta, GA

Design and Production:Wells-Smith Partners, Lilburn, GA

On the Cover:An estimated 200,000 persons inMichigan currently have dementia,and that number is expected to mush-room in the years ahead. Here’s an overview on diagnosis and treatment— plus lots of information to help caregivers. See story, page 4.

GenerationsMichigan

Winter 2005, Volume 2, #3 © 2005 by theMichigan Area Agencies on Aging. The informationcontained herein has been obtained from sourcesbelieved to be reliable. However, the Michigan AreaAgencies on Aging and JAM Communications makeno warranty to the accuracy or reliability of thisinformation. No part of this publication may bereproduced or transmitted in any form or by anymeans without written permission. All rightsreserved.

Whether you are an older adult your-self, a caregiver or a friend concernedabout the well-being of an older adult,Area Agencies on Aging (AAAs) areready to help. AAAs in communitiesacross the country serve as gateways tolocal resources, planning efforts, andservices that help older adults remainindependent.

AAAs were established under theOlder Americans Act in 1973 torespond to the needs of Americansaged 60 and over in every commu-nity. The services availablethrough AAA agencies fall intofive general categories: infor-mation and consultation, serv-ices available in the community, services in the home,housing, and elder rights. A wide range of programs isavailable within each category.

The services offered by Michigan’s 16 AAAs cover a

broad spectrum of needs, such as information and referral, case

management, in-home services,home-delivered meals, senior centers,

transportation, and special outreach. To read more about each of Michigan’s AAAs and the

services available, turn to page 10 of this issue. MI

Welcome toMichiganGenerations

Michigan is

divided into

16 AAAs,

each serving

a different

part of the

state.

They are:11

10 9

7

5

1A

1C2

8

14

6

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3C4

1B

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1A Detroit Area Agency on Aging

1B Area Agency on Aging 1-B

1C The Senior Alliance

2 Region 2 Area Agency on Aging

3A Kalamazoo Cty.Human Services Dept.Region 3A

3B Burnham-Brook Region IIIB Area Agency on Aging

3C Branch-St.Joseph Area Agency on Aging IIIC

4 Region IV Area Agency on Aging

5 Valley Area Agency on Aging

6 Tri-County Office on Aging

7 Region VII Area Agency on Aging

8 Area Agency on Aging ofWestern Michigan

9 NEMCSA Region 9 Area Agency on Aging

10 Area Agency on Aging of Northwest Michigan

11 Upper Peninsula Area Agency on Aging

14 Senior Resources of West Michigan

AAAs—Gateways to Community Resources

Winter 2005 3

CAREGIVINGNews&Notes

Surfing the NetEach issue of Michigan Generations offers

several Web sites of interest to olderadults and their caregivers … right at

your fingertips.www.agingresearch.org

spotlights the work of TheAlliance for Aging Research.Articles and information onscores of diseases or medicalconditions are available.

www.healthandage.com is sponsored by Novartis andoffers a well-rounded collection of educational pages on aging, a Q & A section and online health quizzes for seniors and caregivers.

Look for more helpful Web sites in the next issue of MichiganGenerations.

A study by the Harvard Medical School indicatesthat middle-aged women who ate large quantitiesof leafy green or cruciferous vegetables helped pre-serve their brain power years later. For example, the studyfound that women who ate eight servings a week of vegetables such asspinach did better on cognitive tests compared with women who ateonly three servings a week.

The results suggest that a veggie-packed diet slows brain aging.Thevegetables contain antioxidants that might help ward off damage to thebrain by free radicals, molecules thought to accelerate aging of the brain,researchers say.

Did you know that persons 50-plus are the fastest growingpart of the Internet audience — with 27 percent esti-mated to be active Web visitors?

Elderlaw of Michigan offers a LegalHotline for Michigan Seniors

where adults aged 60 and older cancall for confidential, basic legal adviceand information over the telephonefrom experienced elder law attorneys.

Hotline attorneys counsel seniorson how to complain, and how to getresults and solve problems. They canhelp with questions on: wills, pro-bate, protective services, Medicaid/Medicare, nursing home care, con-sumer issues, housing/real estate,

family law, insurance and pensions.Call Monday–Friday from 9 am to

5 pm. A receptionist will ask for yourname, telephone number, date of birth,number of persons in the household,average monthly income, race/ethnicityand nature of your problem. If you arecalling on behalf of a person 60 andolder, you will need to be their courtappointed guardian or have their powerof attorney to discuss their situation.

Ovarian cancer is the sixth most common cancerfor American women. Fourteen thousand Amer-

ican women die of the disease every year. Ovariancancer is hard to detect and can spread quickly, so it’scritically important to recognize the symptoms:

• abdominal swelling

• abdominal pain

• bloating

• indigestion, gas or nausea

• a feeling of pressure in your pelvis

• frequent urination

• unexplained changes in bowel habits (constipation or diarrhea)

• unexplained weight loss or gain

• a feeling of fullness even after a light meal

• abnormal bleedingIf you experience any of these symptoms, you

should talk to your doctor. Don’t forget to have agynecological checkup regularly. Medicare covers aPap smear and pelvic exam once every two years forall women or yearly for women at high risk for cervi-cal or vaginal cancer.

These helpful hints will reduce the risk of falling when slippery condi-tions exist:

WEAR BOOTS OR OVERSHOES WITH SOLES.Avoid walking in shoes that have smooth surfaces, which increase therisk of slipping.

WALK CONSCIOUSLY. Be alert to the possibility that you couldquickly slip on an unseen patch of ice.

WALK CAUTIOUSLY. Your arms help keep you balanced, so keephands out of pockets and avoid carrying heavy loads that may causeyou to become off balance.

WALK “SMALL.” Avoid a marching posture. Look to see ahead ofwhere you step.When you step on icy areas, take short steps, curlyour toes under and walk as flat-footed as possible.

HAVE SNOW REMOVED IMMEDIATELY before it turns to ice. Keepyour porch stoops, steps, walks and driveways free of ice by frequentlyapplying ice melter granules.

FreeLegal Advice

SILENT KILLERamong women

POWERSENIOR Food for Thought

Winter WalkingSafety Tips

1-800-347-5297FOR OLDER ADULTS

Dementia


MANY SENIORS FEAR DEMENTIA MORE THAN death. A diagnosis of dementiaforebodes a relentless progression of losses — loss of your memory, of yourmental and physical abilities and of your essence.

“My patients, by and large, would rather be told they have cancer thandementia,” says Dr. Kevin Denlinger, a family physician in Roscommon anda member of the Medical and Scientific Advisory Council for the stateAlzheimer’s Association. “For many of them, it’s the scariest and mosthopeless diagnosis they can think of.”

Yet, as the population ages, it’s a diagnosis more and more patients willhear. An estimated 2 million people in the United States suffer from severedementia and another 1 to 5 million have mild to moderate dementia. InMichigan, an estimated 200,000 persons currently have dementia. Since theincidence of dementia increases dramatically with age, the state — and theentire country — will undoubtedly see those numbers mushroom as babyboomers enter their senior years.

There is great hope, however. Today several medications are availablethat can slow the progression of symptoms. There is growing awareness ofthe needs of patients and of their caregivers, with corresponding servicesbeing offered. And the future holds even more promise for improved diag-nosis, treatments and, perhaps one day, a cure.

Dementia

Residents of Our PlaceCares in Greenville enjoy

participating in dailyactivities such as baking

and cooking.

ComesHelpHope

By Martha Nolan McKenzie

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“I am very hopeful because of the tremendousadvances I’ve seen recently,” says Peter A. Lichten-berg, PhD, director of the Institute of Gerontology,Wayne State University in Detroit and chairman ofthe Michigan Dementia Coalition. The coalition isa collaboration between consumers, communitygroups, universities and state agencies chargedwith improving the lives of people with dementiaand their families. “When I started in this field,there were no treatments for people with dementia.Now we have some good treatments for symptoms,and I think we’ll see more improvements. In thefuture, I think we will see significant delay ofdementia, earlier detection, better treatments andbetter quality of life.”

Dementia definedDementia is a group of symptoms including mem-

ory loss and impaired thinking. It’s much more thanmisplacing your keys or forgetting a name, and it’s nota natural part of the aging process, experts point out.

“Real memory loss and cognitive impairment arenot a part of normal aging,” says Dr. Chris Hough, ageriatrician and medical director of the Mid Michi-gan Physicians Group in Midland. “There are somechanges in the way your brain works as you age. Itmay take you longer to recall something than it didbefore, and learning new things may be more diffi-cult. That’s really benign. People with dementia forget more things more often and don’t rememberthem later on.”

Specific symptoms may include asking the samequestions repeatedly, becoming lost in familiarplaces, being unable to follow directions andneglecting personal safety, hygiene and nutrition.

Another hallmark of dementia is denial. “If youare worried about your memory loss, you probablydon’t have anything to worry about,” says Hough.“It’s the people who are not worried about it at allwho are more apt to have dementia. They don’tnotice it, but their family does.”

More than 80 conditions can lead to dementia,the most common of which is Alzheimer’s disease,accounting for 50 to 70 percent of all incidences.Multi-infarct disease (mini strokes) and Lewy bodydementia (characterized by abnormal brain cellscalled Lewy bodies) are the next most commonconditions causing dementia. Other causes includeLou Gehrig’s disease, Huntington’s disease, Parkin-son’s disease, brain injury, brain tumors, HIV/AIDS,alcohol and drug abuse, and vitamin B1 deficiency.

In multi-infarct dementia, a series of smallstrokes may result in the death of brain tissue. The location in the brain where the small strokesoccur determines the seriousness of the problemand the symptoms that result. Symptoms that begin

suddenly may be a sign of this kind of dementia.People with multi-infarct dementia are likely toshow signs of improvement or remain stable forlong periods of time, then quickly develop newsymptoms if more strokes occur. In many peoplewith multi-infarct dementia, high blood pressure isto blame.

Dementia with Lewy bodies (DLB) is not quiteAlzheimer’s and not quite Parkinson’s, although itshares characteristics with both. As with Alzheimer’sdisease, DLB can only be diagnosed with certaintyby an autopsy of the brain after death to search forthe presence of Lewy bodies, which are small,round inclusions that are found within nerve cells.Lewy bodies are a characteristic feature of Parkin-son’s disease, but they appear in different areas ofthe brain in each disease. DLB is also characterizedby one of the hallmarks of Alzheimer’s — plaques

Our Place Cares OffersUnique Alternative Living

T he house, with its vinyl siding, large front porch and neatly keptlawn, looks like many of the others that line the quiet suburbanstreet in Greenville. But 10710 Roy Drive is a unique sort of resi-

dence. I t is home to 11 seniors with Alzheimer’s disease or relateddementia.

As an adult foster care facility, the Roy Drive house, named “Our PlaceCares,” provides an alternative to nursing homes for people in the moder-ate to severe stages of Alzheimer’s. Co-owners Dianne Weaver and ChrisSimons had both worked in nursing homes before founding Our PlaceCares in 1996.

“We both saw first-hand that institutional settings were not optimal forpeople with Alzheimer’s,” says Weaver. “We wanted to offer a smaller,more residential, more personal setting.”

And they have. An open kitchen, living room and dining room provides ahomey gathering place for residents. Shared bedrooms offer a place to getaway, but alleviate the fear of being alone that tends to come with the dis-ease. A screened porch and a planned fenced garden area allow patients toenjoy the outdoors.

“We provide a lot of help with daily activities, we serve meals and med-ications and offer activities throughout the day,” says Weaver. “But we tryto give the residents as much freedom as we can. They can wake up andgo to bed whenever they want. They can get a snack whenever they want.They can participate in any activities they want.”

Weaver is pleased with the service Our Place Cares provides. “We reallyfocus on the individual,” she says. “We go out of our way to keep theminvolved. Our cook always gets residents involved in meal preparations.Even residents who do not communicate anymore will chop vegetables ormix cookie batter. And some of our less cognitively impaired residentshave started a social hour where they drink coffee and chat. There isalways a lot of laughter. And on Halloween, the residents helped hand outcandy to the neighborhood children. They loved that.”

Winter 2005 5

In Michigan, theestimated costof caring forpeople withAlzheimer’s andother forms ofdementia is $5 billion per year.

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Dementia looms larger on thenation’s public health horizon thanperhaps any other threat. Since

the biggest risk factor for dementia is age,the number of people who suffer from it isexpected to explode in the coming years.

Policy makers and health officials inMichigan recognized demen-tia’s growing menace nearlytwo decades ago and tookaction. In 1985, the Gover-nor appointed a dementiatask force composed of con-sumers, community groups,universities and state agen-cies. The task force, whichgrew into the Michigan Dementia Coalition,developed various public health dementiaprograms statewide.

In 2003, the coalition released the Michigan Dementia Plan, outlining the beststrategies for reducing the burden ofdementia in Michigan. “This plan was reallydeveloped in response to communityneeds,” says Dr. Judith L. Heidebrink, the

plan’s co-chair and co-investigator with theMichigan Alzheimer’s Disease ResearchCenter at the University of Michigan. “Wetried to identify the pressing needs on vari-ous levels — for the state as a whole, forpatients, for physicians. We synthesized ourfindings into five goals.”

These five goals are:1. Increase support for family

members who provide care for persons with dementia at home.

2. Promote a public health,disease management approach todementia care in primary care practice that makes full use of bestdementia care practices.

3. Increase the dementia competency ofhealth care professionals.

4. Improve the choices for residence andcare of persons with dementia.

5. Increase early intervention by increas-ing public awareness of the caregiver roleand the early warning signs of dementia.

Though the plan does not provide anyfunding, work has already begun in many

areas to reach these goals. The stateOffice of Services to the Aging, for exam-ple, has developed a joint work group withseveral major associations to map out allavailable sources for families. “This infor-mation has never been centralized, cata-logued and available to patients andcaregivers,” says Peter A. Lichtenberg, PhD,director of the Institute of Gerontology,Wayne State University in Detroit andchairman of the Michigan Dementia Coalition. “Now this information will begiven to physicians so they can provide itto their patients.”

The plan also led to the creation of aPrimary Care Physicians’ Network, which isworking with primary care physicians toenhance their ability to diagnose and treatdementia. “The network has identified 15practices and has started working withthem, and it will roll it out from there,”says Lichtenberg.

“Our five goals are coming to fruition,even without a lot of funding,” says Heide-brink. “We’ve all been pleasantly surprised.”


More thanseven out of 10 people withAlzheimer’s liveat home,wherefamily andfriends providealmost 75percent of their care. Theremainder is“paid care”costing anaverage of$12,500 peryear.

in the brain tissue. Symptoms may also mimicAlzheimer’s and Parkinson’s. People with DLB may suffer short-term memory problems and language problems, as with Alzheimer’s, as well asthe resting tremors, rigidity and reduced facialexpression of Parkinson’s.

Since Alzheimer’s is far and away the biggestculprit, the remainder of this article will deal specif-ically with this disease, unless otherwise noted.

The long good-byeAlzheimer’s disease is an irreversible, fatal con-

dition. Researchers understand the process of thedisease — protein plaques and tangles accumulatein the brain, causing brain cells to die. Scientistsdon’t know, however, what causes this deadlyprocess to begin.

Age clearly plays a key role. One in 10 peopleover age 65 have Alzheimer’s, but nearly half of allpeople over 85 have it. “Scientists are starting tothink that if you live long enough, you will eventu-ally get Alzheimer’s,” says Dr. Kevin T. Foley, medical director of the Hauenstein Alzheimer’s Disease and Memory Disorders Program at St.Mary’s Health Care in Grand Rapids.

Alzheimer’s is progressive, and patients passthrough three stages: mild, moderate and severe. In

the mild stage, someone might have trouble findingthe right words or might get lost in a familiar place.In the severe stage, someone might not recognizeloved ones, forget how to walk and become inconti-nent. Most patients live an average of eight yearsafter they are diagnosed, but they can live as long as20 years. That’s why Alzheimer’s is often called “thelong good-bye.”

Diagnosing Alzheimer’s Diagnosis, particularly in the mild stage, can be

tricky. Since the only truly definitive confirmatorytest is a brain autopsy, physicians must rely oninterviews with the patient and loved ones, memorytests and a physical exam. Physicians typically doseveral lab tests, mostly to rule out other, perhapsreversible, causes of dementia, such as vitamin defi-ciency or anemia. They may do brain scans to lookfor evidence of strokes, tumors or head injury. Theymay also do a psychological evaluation to rule outmajor depression.

“If a patient has a heart attack, you can do a testand know instantly what the problem is,” says Foley.“That’s not the case with Alzheimer’s. On top ofthat, general practitioners are not adequatelytrained in diagnosing it, and they don’t have verygood screening tools at their disposal. As a result,

Michigan Dementia Coalition Outlines Strategies

two-thirds of people who are diagnosed withAlzheimer’s are not diagnosed until they are in themoderate or severe stage of the disease.”

Roger Markell knows how difficult it can be toget a physician to make a diagnosis. Roger, now78, noticed his wife, June, also 78, was becomingforgetful at least 15 years ago. Then the Midlandsenior watched hiswife’s personalitygradually changefrom outgoing andgregarious to anxiousand reclusive.

During an officevisit in 1996, Rogertold his wife’s doctorthat she had a prob-lem. The doctor dis-missed his concern,saying it was justage. Over the nextyear, June’s symp-toms worsened, andat the next visit Roger insisted that something bedone. The physician performed a battery of testsand finally diagnosed June with Alzheimer’s.

Effective treatments availableA delay in diagnosis can be tragic, because

early intervention can slow the progress of the dis-ease. Indeed, four medications have beenapproved by the FDA to treat mild to moderatesymptoms of Alzheimer’s. They are Cognex, Ari-cept, Exelon and Reminyl. The drugs can’t stop orreverse the course of the disease, but they canslow the development of symptoms. “So instead ofgoing down a really steep slope, you go down agradual one,” says Denlinger. “If you catch it earlyand start treatment early, you can stay in a muchmore functional, higher quality of life positionmuch longer. But if you wait until the disease has progressed, the medications can’t get back lost abilities.”

The problem is that in the very early mild stage, it’s difficult to tell if a patient actually hasAlzheimer’s or not. “I have patients who have gone both ways,” says Denlinger. “Even thoughwe’re not positive if they have Alzheimer’s, somewill start taking the medication, just in case. Others decide to wait and see if their memorydeclines further.”

By the time she was diagnosed, June Markellhad already progressed to the moderate stage.Though she still lives at home, she is confined to awheelchair and no longer recognizes Roger, herhusband of 61 years.

“The only reason we’re surviving is that Junegoes to day care at the senior center every day, and I have someone who comes in our home for afew hours on Saturday and Sunday so I can doerrands and go to church,” says Roger. “Fortunately,my health is pretty good. Otherwise, we’d be in real trouble.”

Beyond medications, any kind of mental stimu-lation can be helpful, particularly in the mild stage.“Reading, working a puzzle — anything to get

Continued on page 19

Winter 2005 7

Support for Caregivers

Providing care for a loved one with a chronic illness is never easy, butcaring for someone with Alzheimer’s disease is perhaps the mostchallenging task of all. “It’s hard to overstate how difficult it can be,”

says Kim DeHart Walsh, program director of the Alzheimer’s AssociationMichigan Great Lakes Chapter in Ann Arbor. “Due to the progressivenature of the disease, as soon as the caregiver gets a handle on one phaseof the disease, the loved one gets worse and the caregiver has to adapt to

a new set of challenges.”The most difficult aspect, how-

ever, is the gradual stripping awayof the loved one’s personality.“The person they care for nowmay not seem like the person theyhave known and loved all theseyears,” says Walsh. “It’s hard to putall your love and care into assistingsomeone who is not able to saythank you and who is not able torelate to you in the way youremember.”

It’s critical for caregivers to reachout for help early in the process andset up a support system. “There is alot of help out there, so you don’tneed to do this alone,” says Walsh.“You just have to reach out.”

The best place to start is theAlzheimer’s Association. You can call

the association’s statewide helpline at 1-800-337-3827 seven days a week,24 hours a day. You will always get a live person. Through the helpline, youcan access care consultation. A staff member will meet with you one-on-one to assess your needs and develop an action plan. You can also find outabout support groups, education programs and support services through-out the state.

In addition, the Alzheimer’s Association offers a national registry calledSafe Return. You can get an ID bracelet for your loved one and register himinto the national databank. Then if he wanders off and becomes lost, he canbe identified and safely returned to his home.

Another good place to look for help is your local Area Agency on Aging.Each agency maintains a list of local services, programs and support avail-able for people who suffer from dementia. “With Alzheimer’s, you’re notjust dealing with the person who has the disease,” says Pat Phillips, exec-utive director of Senior Services at the Midland County Council onAging. “It’s just as big a deal for the caregiver and the family of the care-giver. So services and support need to be family-centered.”

Caring and comfort are top priorities at Seasons Adult Day Services in Midland County.

What will Powers, Michigan, in the Upper Peninsula andRedford Township, a west side suburb of Detroit, have in

common in 2005? The answer is that Pinecrest Medical CareFacility in Powers and Presbyterian Villages of Michigan in Red-ford will be buildingthe first GreenHouses in Michigan.

The GreenHouse Project™ isthe newest conceptfor frail seniors whoneed 24-hourlicensed skillednursing care butwant a home-likeenvironment. Con-ceived by Dr.William H. Thomas,creator of the Eden Alternative™ (a model for culturalchange within nursing homes), each Green House will offer 10private rooms with their own bathrooms, a large communityroom, meals cooked right in the home — where residents cansee the cooking and smell the meal they are going to eat — andmuch, much more. Everything from the size of the home to theinterior design, staffing patterns and delivery of professionalservices is different from other nursing homes.

Each elder (a term Dr. Thomas prefers to “seniors”) enjoys aprivate room and bath, which they can decorate with their ownbelongings. Each house has a large living room with fireplace, anopen kitchen and dining area, an outdoor garden and a patio.The dining room table is large enough for residents, staff andresidents’ guests to dine together. The elders decide what timeto get up or go to bed, when they are going to eat and howmuch time they would like to take for their meals. Also, resi-

dents are free to use the kitchen to make a cup of tea or preparesnacks for themselves or their guests.

The “Shahbaz,” or elder assistant, is the direct care providerwho prepares the meals, washes the clothes, assists residents andso forth. “Shahbazim” are certified nursing assistants withadvanced training who work as a self-managed team. They arecoached by a “guide,” usually the administrator, and advised by a“sage,” who is a Green House resident. Doctors and nurses visitthe house to provide skilled nursing and therapy as needed.

This extraordinary service is possible because the increase incosts for direct care workers with advanced training is offset by areduction in the costs related to operating a large institution.

In order for an organization to duplicate the Green Housemodel, several factors must be considered, including state regu-lations, reimbursement rates, financial goals and project scope.

The first Green Houses in the United States are located atthe Mississippi Methodist Senior Services’ Tupelo, Mississippi,campus. They plan on building a total of 12 Green Houses,replacing their current 140-bed nursing home.

Pinecrest Medical Care Facility is a 174-bed nursing home owned by Delta, Dickin-son and Menominee counties in the UpperPeninsula. Pinecrest is planning to buildfive Green Houses. Presbyterian Villages ofMichigan has over a dozen senior livingcommunities serving 2,000 elders and planson building its first Green Houses on theirRedford campus, with plans to build morethroughout Michigan. Both Michigan GreenHouse projects have been designated asRobert Wood Johnson Pilot Projects.

For more information on the new GreenHouses in Michigan, contact Gerald Bet-ters, Administrator at Pinecrest MedicalCare Facility, at 906-497-5244 or MariellenDavis, Regional Vice President and Execu-

tive Director at the Village of Redford Senior Living Community,at 313-533-0146. Information is also available at the followingWeb sites: www.thegreenhouseproject.com and www.pvm.org.

The Green House Project has beenfunded by grants from the RobertWood Johnson Foundation, the FanFox and Leslie R. Samuels Foundation,Inc. and the Hulda B. and Maurice L.Rothschild Foundation. MI

KAY J. MILLER, MSW, is the Vice President of Marketing and Communica-tions for Presbyterian Villages of Michigan Senior Living Communities.


GUESTClose-Up

By Kay J. Miller

A typical evening meal in a Green House in Mississippi.

S K I L L E D N U R S I N G C A R E

Home-likeCreating a

Environment

I am often tempted to make lesshealthy food choices. What can I doto make my diet healthier?MAKING CHANGES IN YOUR EATING HABITS

can help you not only to eat healthier butto save time in your daily routine. Keephealthy foods on hand, storing them visi-bly in clear containers and cutting theminto bite-size, ready-to-eat pieces. Preparefoods ahead of meals, or freeze meals forextra-busy days. Fill a bowl with fresh sea-sonal fruit to brighten your kitchen, and cutfavorite veggies for a tempting snack. Keepmeats, cheeses and vegetables available tostuff into pitas or tortillas or to serve as fin-ger food for a quick bite.

My mother has lived alone since myfather passed away, and I worry abouther eating too many meals alone.SOCIALIZATION IS AN IMPORTANT PART

OF HEALTHY LIVING, so take time to get toknow the variety of resources in the agingnetwork that can benefit your mother. Mostcommunities offer a congregate meal pro-gram during the lunch hour. Or have yourmother schedule a date with a friend toexplore the local community senior center.There are many older adults who sharesimilar experiences and can be of supportin times of need.

My father recently got quite ill aftereating some cheese at my house. Noone else in the family was affected.Are seniors more vulnerable tocertain types of foods? FOR SENIORS, CERTAIN FOODS may posea significant health hazard because of thelevel of bacteria present in the product’suncooked state. In some cases, older adultshave mistakenly self-diagnosed a food-borne illness as “the flu.”

The U.S. Food and Drug Administrationwarns that seniors should avoid these products: • Raw fish and shellfish • Raw or unpasteurized milk or cheese • Soft cheeses such as Brie, Camembert,

blue-veined and Mexican-style cheese • Raw or lightly cooked egg or egg

products • Raw meat or poultry • Raw alfalfa sprouts • Unpasteurized or untreated fruit or

vegetable juices

When should I refrigerate cookedleftovers? My mother traditionallywaited until they were somewhatcool before putting them in the fridge.REFRIGERATE LEFTOVERS IMMEDIATELY.Divide large amounts of food into severalshallow containers so that they will coolquickly in the refrigerator. If food is not con-sumed later that day, label each containerwith a date. Most often harmful bacteriacannot be smelled, tasted or otherwisedetected. But the consequences, which caninclude abdominal cramping, diarrhea,fever, headache, nausea, vomiting and evendeath, are all too apparent.

Are food supplements beneficial? IT’S THE OFFICIAL POSITION OF THE

AMERICAN DIETETIC ASSOCIATION thatmost healthy people can get all the nutri-ents they need from food in a well-planneddiet. Consult with your physician or a registered dietitian about supplements

before using them. Consumers need to paya great deal of attention and do someresearch before buying supplements. TheFood and Drug Administration does notregulate supplements as it does prescription and over-the-counter medica-tions. There are no government regulationsthat require warning labels about potentialside effects or dangers. To help you spotquestionable practices and avoid supple-ments that may not be safe, beware of sup-plements that:

• Promote quick fixes or guaranteedcures.

• Tout “all-natural” aspects. Many harm-ful compounds are “all-natural.”

• Lack research to support productclaims.

• Attempt to impress you by using hard-to-understand medical terminology.

• Announce special deals or products thatare available for a limited time only.

• Make unrealistic claims.

I am on a special diet and find itdifficult to follow my diet wheneating out, so I have been avoiding going out with my friends. DON’T HESITATE TO ASK YOUR SERVER

or the grocer how meals are prepared whendining or taking out. Many restaurants andsenior nutrition programs will accommo-date requests to prepare foods to your liking — using less salt, fat or sugar oradjusting portions. If a restaurant menu orfood container is not descriptive and youhave a question, inquire about specificingredients. Often sharing a meal from arestaurant can cut portions to the size youneed, and you can add variety with a salad,soup or appetizer selection. MI

KAREN JACKSON is a registered dieti-tian for the AAA 1-B and a fellow in theAmerican Dietetic Association.

ASKtheExpert Karen Jackson

Do you have acaregiving question?Write or email your question to our

“Expert” at: Jenny Jarvis,Area Agency

on Aging 1-B, 29100 Northwestern

Highway, Suite 400, Southfield, MI 48034;

[email protected] will make every

effort to answer your question in an

upcoming issue of Michigan Generations.

Healthy Food Habits for the New Year

Winter 2005 9

REGIONALNews

In communities

across the U.S.,

Area Agencies on

Aging (AAAs) serve

as gateways to local

resources, planning

efforts and services

that help older adults

remain independent.

Here are the

programs and

services offered by

Michigan’s AAAs.

SPOTLIGHT ON…

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7

5

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2

8

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6

3B3A

3C4

1B

6 Tri-County Office on Aging

7 Region VII Area Agency on Aging

8 Area Agency on Aging of Western Michigan

9 NEMCSA Region 9 Area Agency on Aging

10 Area Agency onAging of NorthwestMichigan

11 Upper Peninsula Area Agency on Aging

14 Senior Resources of West Michigan

1A Detroit Area Agency on Aging

1B Area Agency on Aging 1-B

1C The Senior Alliance

2 Region 2 Area Agency on Aging

3A Kalamazoo Cty.Human Services Dept.Region 3A

3B Burnham-Brook Region IIIB

3C Branch-St.Joseph Area Agency on Aging IIIC

4 Region IV Area Agency on Aging

5 Valley AreaAgency on Aging

There’s no place like home. Period.But for many individuals and fami-

lies, the challenges of aging in placeand caregiving at home require thatother care options be pursued toensure total well-being and peace ofmind. An important piece of the carestrategy may be adult day care.

Adult day center programs offercaregivers respite from the 24-hour-a-day mental and physical responsibili-

ties of home care. According to Web-ster’s dictionary, respite (pronounced“ress-pit”) is “a short time of rest orrelief.” But there’s a lot more goingon at adult day centers than what thisdefinition tells us.

The primary benefit of respite is animproved quality of life for participantsand their caregivers. Whether it be fora few short hours once a week or dailycare, participants are provided numer-ous venues in which to improve their functional abilities, nutritional habits,physical activity and psychosocial skills.As a result, participants may experience

reduced health care costs,easier medical manage-ment and fewer barriers that tradition-ally hamper personal care.

The atmosphere created at adultday centers provides opportunities forsocialization and camaraderie. Thus,there are opportunities to increaseself-esteem and to minimize reactionssuch as inappropriate anger, combative-ness and wandering. New andrenewed friendships take on greaterpossibilities, and isolation and loneli-ness are bid adieu.

To learn if adult day care is a realis-tic option for your family, visit a centernear you. If cost is a concern, askabout scholarships and grant funding.

For more information, contact yourlocal Area Agency on Aging or the AreaAgency on Aging of Northwest Michiganat 1-800-442-1713.

AreaAgency on Aging of Northwest MichiganOffering information and funding senior services in the 10-county area of Northwest Lower Michigan

Day Centers Improve Quality of Life

Daughter Donna states,“DayBreak (Cadillac) hasbeen a great way for Mom (Shirley) to get out andbe with other people. The warm, caringenvironment makes her feel special.”

Michigan Generations

Imagine being alone for the holidays.Now imagine being alone and hun-

gry. For many seniors, this is their real-ity — a holiday without family, friends,food or cheer. Fortunately, there is aholiday meal delivery programdesigned specifically for these at-riskseniors. The Detroit Area Agency onAging’s Holiday Meals on Wheels is avolunteer-based program that providesdelicious meals prepared from scratchto thousands of homebound seniors inthe metropolitan Detroit area.

Holiday Cards was developed tosupport the Holiday Meals on Wheelsprogram. Holiday Cards is a fundraiserthrough which specially-designed holi-day cards are sold for five dollarseach. Each card sale allows for thepurchase of one hot, nutritious meal.Holiday Cards is a unique and com-passionate way for an individual ororganization to show support tohomebound, at-risk seniors.

“Far too many seniors spend theirholidays in isolation and without anutritious meal,” says Paul Bridgewa-ter, executive director of the DetroitArea Agency on Aging. “Holiday Cardsis a way for people to support ourHoliday Meals on Wheels programand provide these seniors with a deli-cious Thanksgiving and Christmasmeal, along with a beautiful holi-day card signed by thedonor.”

This year, with goals sethigher than ever, specialevents and strategieswere planned to supportthis worthwhile annualeffort. A lavish kickoffevent was held at The

Roostertail in Detroit during earlyNovember, where supporters came tocollect cards to sell while theyenjoyed a strolling supper, cocktailsand music. The cost for guests toattend the event was a commitmentto sell as many cards as possible.

Last year, HMOWwas able to delivernearly 90,000 meals tofrail, at-risk homeboundseniors. HMOW aug-ments Meals onWheels’ regular Mon-day through Friday mealdeliveries. Homeboundseniors who wouldotherwise not receive ameal on a holiday orweekend will receivethese specially preparedholiday meals. Theseindividuals are:

• Homebound sen-iors age 60 and over

• Lonely and iso-lated persons: Two out of three sen-iors live alone.

• Seniors who are low-income• The very old: Many seniors are

well over 75 years of age.Detroit Meals on

Wheels provides mealsdaily to homebound

seniors residing inthe cities of

Detroit, Ham-tramck, High-land Park,GrossePointe,

GrossePointe Woods,

Grosse PointeFarms, GrossePointe Shores,Grosse Pointe

Park and Harper Woods.The DAAA’s goal is tomaintain and increase the servicesprovided to the elderly; improve thequality of life of the senior population;and increase the level of communitysupport and awareness of the seniorpopulation. Since 2000, more than halfa million dollars have been raisedfrom the Holiday Cards program. In

the fiscal year 2003/2004, over 64,000meals were delivered to clients of thisprogram.

“The dire need for Meals onWheels and Holiday Meals on Wheelsstems from three factors: the highpoverty rate among older adults, thelack of awareness within the generalpopulation of the crisis in our seniorcommunity and, most of all, the lackof resources available to combat theunique needs that develop as peopleage,” says Bridgewater. “Unfortunately,because of the scope of our servicesand the lack of supportive funding,Meals on Wheels and Holiday Mealson Wheels must continuously rely ongenerous donations from communityand corporate entities.”

For more information on Holiday Cards,please call the Detroit Area Agency onAging at 313-446-4444.

Detroit Area Agencyon AgingServing Detroit, Highland Park, Hamtramck, Harper Woods and the five Grosse Pointes in Wayne County

Brightening Seniors’ Holidays

John Steigelman and Dameon Wilburn from DAAA are prepared to sellholiday cards at the Holiday Cards Kickoff.

Donna Burke from SBC presentsPaul Bridgewater of DAAA acheck for $10,000 to supportHoliday Cards.

Winter 2005 11

The Area Agency on Aging 1-B(AAA 1-B) is reaching out to

refugees to inform them about servicesavailable to help improve their qualityof life. Many older adults are eligible forservices in the aging network, regard-less of their country of birth. The AAA1-B service region has the highest pop-ulation of older adult refugees in thestate of Michigan. This outreach hasbeen very positively received by therefugee population and would not havebeen possible without funding providedby the Michigan Family IndependenceAgency Refugee Assistance Programand the Office of Services for theAging. The program targets Russian,Bosnian,Asian, Iraqi,Vietnamese andHmong refugee groups.

In August 2004 the AAA 1-Bcosponsored an Outreach Fair withthe Chaldean American Ladies ofCharity. Over 100 Chaldean olderadults attended and were providedinformation on transportation, nutri-tion, community care management andolder adult employment opportunities.Translators were at the event to inter-pret presentations and facilitate com-munication of valuable informationbetween the refugee attendees andthe various service groups. Otherevents have been held to provideinformation to Asian,Vietnamese andHmong older adults. In Spring 2005the AAA 1-B will be hosting a fair forAsian-Indian older adults.

According to Tina Abbate Marzolf,director of Contracted and DSP Ser-vices at the AAA 1-B, who overseesthe refugee program,“One of thegreatest barriers aging networkproviders face when working with theolder adult refugee population is com-munication.The ability to communicatewith individuals who do not speakEnglish is crucial. We have developed

several mechanisms for providers todo this.We will continue to work toaddress these and other barriers to

ensure that older adult refugees accessmuch-needed aging network services.”

To help further address the com-munication barrier, the AAA 1-B has also implemented a Language Line service that, with the assistanceof a translator, enables staff at theagency to talk on the telephone with

individuals who do not speak English.Additionally, information on care man-agement, public assistance, legal serv-

ices, nutrition and transportation hasbeen translated into Bosnian,Arabic,Vietnamese, Spanish and Russian.

For more information on upcomingrefugee events, to find out about avail-able services or to receive translatedmaterials, please call the AAA 1-B at 1-800-852-7795.

Reaching Out to Older Adult Refugees

Serving the counties of Livingston, Macomb, Monroe, Oakland, St. Clair and Washtenaw

AreaAgencyon Aging 1-B

Recently the Area Agency on Aging1-B (AAA 1-B) Advisory Council

completed a study on long-term careinsurance and determined that con-sumers will benefit from a betterunderstanding of the advantages anddrawbacks of long-term care insurancepolicies. Long-term care insurance

(LTCI) is a way to pay for long-termcare in a nursing home, one’s ownhome or assisted-living facilities. LTCIis not appropriate for everyone, andthere are a number of factors to con-sider when thinking about purchasing apolicy, including your financial ability topay for the monthly premium, your

Consumer Tips on PurchasingLong-Term Care Insurance

Chaldean older adults participate in a workshop on using local transportation services at the outreach eventcosponsored by the AAA 1-B and the Chaldean American Ladies of Charity.


Winter 2005 13

total assets and how you wish thoseto be utilized for long-term care orother purposes, your health status andyour age.

If you are considering purchasing aLTCI policy for yourself or someoneelse in your family, below are somepoints to keep in mind as you shop forlong-term care insurance in Michigan:

ASK QUESTIONS If you have ques-tions or concerns about LTCI, anagent, an insurance company or a pol-icy, there are a variety of resources toturn to:

• The AAA 1-B’s Medicare Medic-aid Assistance Program has trained vol-unteers that can answer generalquestions and provide an informationpacket about LTCI at 1-800-803-7174.

• Michigan’s Office of Financial &Insurance Services (OFIS) can providevarious information, including the latestrate information filed by any companymarketing long-term care products in

Michigan, at 1-877-999-6442 orwww.michigan.gov/ofis.

PICK A REPUTABLE AGENT Manyprofessions may be licensed to sellLTCI, including attorneys, financial plan-ners and insurance agents. Get a busi-ness card and call the company tomake sure that person is employedthere and licensed to sell insurance.

SHOP AROUND Check with severalinsurance companies and agents beforemaking a decision.

CHECK THE COMPANY’S FINANCIAL

STABILITY The following companiesrate insurance companies:—A.M. Best Company,

908-439-2200, www.ambest.com.—Demotech, Inc., 614-761-8602,

www.demotech.com.—Fitch, Inc., 1-800-753-4824,

www.fitchratings.com.—Moody’s Investors Service,

212-553-1653, www.moodys.com.—Standard & Poor’s, 212-208-1527,

www.standardandpoors.com.—Weiss Research, Inc., 1-800-289-

9222, www.weissratings.com.NEVER PAY IN CASH To avoid fraud,

your payment should be a check ormoney order made out to the com-pany, not to the agent.

READ THE POLICY CAREFULLY

When you receive your policy in themail, make sure it is what you thoughtyou were buying. In Michigan all long-term care policies have a 30-day “freelook” period. If you decide that youdo not want the policy, you are underno obligation and will receive a totalrefund of any premiums already paid ifwithin the “free look” period.

Remember that the Area Agency onAging 1-B can provide you with non-biased information on long-term careinsurance to help you make a decisionif this insurance is appropriate for youor someone else in your family. Youmay speak with a trained counselor at1-800-803-7174, Monday through Fri-day, between 8:00 a.m. and 5:00 p.m.

For general questions, contact the AAA 1-B at 1-800-852-7795.

In late August the HillsdaleCounty Sheriff ’s Depart-

ment, Hillsdale TRIAD, KurtzFuneral Home, HillsdaleCounty Senior Center andRegion 2 Area Agency onAging provided an all-dayconference on senior safetyat the Hillsdale CountySenior Center. This was thethird safety seminar for Hills-dale County and had anattendance of more than100 persons.

Presentations were givenon identity theft, living willsand trusts, fire and home safety, griefand recovery, senior abuse andexploitation and Internet safety.

The Hillsdale County Sheriff ’sDepartment provided a wonderfulcontinental breakfast, and lunch wasprovided with a grant from the

Michigan Sheriffs Association. Hills-dale Senior Center staff donatedtheir time for meal planning andservice.

Local merchants and providersdonated wonderful gifts for a draw-ing, and seniors went home withhelpful information about how to besafe, sound and secure in theircounty.

In October two other senior sem-inars are planned for Lenawee andJackson counties.The two countieswill use the same format and willinclude speakers from the AttorneyGeneral’s Office.

For more information on the confer-ence, contact Ginny Wood-Bailey at Region2 AAA, 1-800-335-7881.

Region 2 Area Agency on AgingServing Hillsdale, Jackson and Lenawee counties

Seniors Learn About Scams and Identity Theft

All-day conference focuses on senior safety.

Continued from previous page

The Region 3A AAA received agrant from the Access to Benefits

Coalition to help Medicare beneficiar-ies and/or their caregivers to deter-mine what Medicare-approvedprescription drug discount card orother prescription assistance programwould be most helpful in loweringtheir drug costs.

Working through a local Coalition,the AAA 3A has trained volunteeradvisors and paid outreach workers toassist people by utilizing a computerprogram that searches over 300potential programs that could savepeople money. This in-depth analysiscan reassure many beneficiaries whoare confused about which program or

card will work best for them.The Coalition is targeting Medicare

beneficiaries who qualify for the $600extra assistance avail-able through theMedicare certifiedcards, disabled

personsunder 65 and rural,African-American andHispanic elders. Coor-dination with theMedicare/ MedicaidAssistance Program(MMAP) results inassistance for more complex situations.

For assistance, callABC project manager,Peggy Sattler, at 269-373-5173. Information is

also available for people who wish to usetheir own computers for the research.

Covering Kalamazoo County and its 24 municipalities

Burnham Brook Region IIIB wasselected as one of three AAAs in

the state to participate in the MichiganDepartment of Community Healthdemonstration project Cash and Coun-seling. DCH was awarded funding fromthe Robert Wood Johnson Foundation.

This effort will bring a newapproach to our various care manage-ment programs, as it involves support-ing clients to direct their own carewithin a set authorized budget. Thiswill create an alternative care manage-ment model for all Medicaid Waiveragents to replicate.

The Cash and Counseling modelempowers participants to act as theprimary causal agent in planning and

directing their own care by managing anindividualized budget to address serviceand support needs. The program willoffer participants a flexible allowance topurchase needed services and willinclude direction to their chosen per-sonal care workers as well as providingcounseling and fiscal assistance to sup-port participants in managing theirallowance. Consumers may designaterepresentatives, such as family members,to make decisions on their behalf. Thisfeature makes the model adaptable to abroad spectrum of consumers, regard-less of age or type of impairment.

In addition to increased personalcontrol over one’s life, implementingthe model should increase opportuni-

ties for the Waiver par-ticipant and their familyin planning and purchasing neededlong-term care supports, increase thelevel of comfort in receiving care byallowing more control over the selec-tion of workers, and strengthen thesupport of families and individuals,which could further delay institutional-ization.

The model is based on the valuethat it is more appropriate for individ-uals, not agencies, to make decisionsabout their own care. Empoweringand supporting participants will facili-tate quality of life, as consumers andtheir families take charge of their careand make choices based on their pref-erences and values.

For more information on the program,call 269-966-8136 or visit our Web siteat www.burnhambrook.com.

Burnham Brook Region IIIBServing Barry and Calhoun counties in Southwest Michigan

Information and Assistance. . . . . . . . . . . . 269-373-5173MMAP . . . . . . . . . . . . . . . . . . . . . . . . . 1-800-803-7174


Access to Benefits Coalition advisors are ready to offer assistance.

Kalamazoo Cty. Human Services Dept.Region3A

Cash and Counseling DemonstrationProject Promotes Self-Determination

Grant Helps Medicare BeneficiariesDetermine Prescription Drug Assistance

Pines Senior Respite Services hasbeen operating in Branch County

since 1997. Since then, grant fundingfrom Region IIIC AAA has helped support the program, and their compassionate staff hasworked with over 90 families.Pictured here (from left) areNancy and Mike Stevens,Nancy’s mother, Agnes Cate-rina, and Julie Hurley, directorof Pines Senior Respite Ser-vices. The Stevens family sharesa few thoughts to enlightenreaders about “when to ask for help.”

Seek out services that are availablein your community, they suggest,including home health aides andrespite care.You may find yourself get-ting angry, frustrated or resentful and

this can be a sign thatyou need help.

Consider safety issues, living alone,falling, confusion and cooking as youcare for a person with dementia. If yourloved one is diagnosed with dementia,look into adult day services. Adult dayprograms offer a safe, secure and enjoy-able environment outside the home toallow caregivers a needed break.

Mike states, “Without a respite pro-gram it would be impossible for me toeven accomplish simple outdoorchores such as mowing the lawn. PinesRespite has been a prayer answered.Their staff is caring and just can’t bebeat. Without them I couldn’t havemade it through this past year.”

For more information on respite programs, call the Branch-St. Joseph Area Agency on Aging at 517-279-9561ext. 137 or toll-free at 1-888-615-8009.

Branch–St.JosephAreaAgencyonAging IIIC

Winter 2005 15

In Berrien County, the Falls Preven-tion Task Force was formed by key

organizations serving older persons tostop the alarming incidence of falls inthe community.

Local data has shown that falls arethe single most likely event to send

older persons to the emergency room,often followed by an epidemic of hipinjuries, hospitalizations, subsequentdisabilities and even death. So the taskforce decided to do something to helpstop the painful and costly conse-

quences of falls by older people.A packet of information was cre-

ated with self-administering guidelinesand checklists to make older personsand their caregivers aware of the risksof falls, to give doctors tools to dis-tribute, to provide information about

improving strengthand balance and tomake homes safer.

Included are aflyer and tearsheet listing fall

risk factors such as age, medical con-ditions and medication use. Sincemost falls happen at home, a HomeSafety Assessment assists in evaluat-ing home safety. And, because main-taining strength and flexibility is key

to fall prevention,there’s a list of healthclubs, exercise classes and walkingclubs for people to take advantage of.

The information has been widelydistributed through physicians’ offices,pharmacies, senior centers and partici-

pating agencies, and is being circulatedthroughout the region.

For more information, call the SeniorInfo-Line at 1-800-654-2810.

Region IVArea Agency on AgingCovering Michigan’s Great Southwest including Berrien, Cass and Van Buren counties

Are You at Risk of Falling?

Data has shown that falls are the single most likely event to send older persons tothe emergency room.

When to Ask for Caregiving Help

Serving a two-county area surrounding Sturgis, Three Rivers, Coldwater and Quincy

The Stevens family offers advice for caregivers.

The Valley Area Agency on AgingRegion 5 receives grant money

from the Department of CommunityHealth for the purpose of Alzheimer’scaregiver education.

Alzheimer’s disease is the most com-mon cause of dementia, affecting asmany as 4.5 million Americans. Cur-rently in Genesee County alone, thereare over 9,000 individuals diagnosedwith this disease. In partnership with theAlzheimer’s Association’s Greater Michi-gan Chapter, the East Central Regionprovides educational programs and sup-port services to those living in Genesee,Shiawassee and Lapeer counties.

The East Central Region providesHelpline services during regular busi-ness hours (8:30 a.m. to 4:30 p.m.), but

individuals calling after these hours canaccess the National Contact Center bycalling 1-800-272-3900. By calling thistoll-free number, the caller will speakdirectly to a person who can assistwith any questions or concerns.

The office conducts community pre-sentations and educational workshopsfor family members (including the person with Alzheimer’s disease), profes-sionals and the general public. Recenteducational workshops included “Getting Through the Holidays” atDevonshire Retirement Village in Lapeer,“An Overview of Alzheimer’s Disease”at Shiawassee Medical Care Facility inCorunna and “Partnering with YourDoctor” at Lapeer County Medical CareFacility. In addition to these presenta-

tions, the East Central Regional officemaintains a resource lending library.

Safe Return is a national programdesigned to identify, locate and safelyreturn individuals who wander. This pro-gram is offered in Genesee County atno additional charge. Recently the EastCentral Region received a grant fromHealthPlus of Michigan that provides alimited number of scholarships for theregistration cost of this program. Finally,through the Respite Care program,they can offer caregivers $500 over a 12-month period to bring in a respitecare worker, so the caregivers can havea much-needed break from their duties.

For additional information regardingthese programs, please contact our officeat 810-720-2791 or 1-800-337-3827.

ValleyAreaAgencyonAgingServing Genesee, Lapeer and Shiawassee counties


The Tri-County Office on Aging(TCOA) places a very high prior-

ity on consumer choice.This has beenespecially true over the years withregard to in-home services: personalcare, homemaker and in-home respite.

TCOA was one of the first AreaAgencies on Aging to switch from oneannual contractor per county for thethree in-home services to a directpurchase of service system (DPOS).Most of the home health care agenciesin Clinton, Eaton and Ingham countiesparticipate in this process. DPOSagreements lock an agency into a unitcost for a year but do not commitTCOA to use any particular agency.With this change, clients are able tochoose a home care agency.

Using the DPOS agreements allowsconsumers to choose and/or changedirect care workers (DCW). It alsoallows them the important choice ofthe time of day when the service isprovided.

For the nextphase in consumerchoice for home andcommunity-basedservices,TCOA willbe participating in a“Cash and Counsel-ing” grant throughthe Michigan Department of Commu-nity Health from the Robert WoodJohnson Foundation. Consumers whowish to participate will receive educa-tion and information on how to

choose, train and super-vise DCW that providein-home services. DCW will receivesupport and training.The consumer willhave the opportunity to choose theirlevel of involvement in arranging forcare. TCOA is pleased to be a pioneerin home and community-based servicesand a partner with the Michigan

Department of Community Health inthis change in service delivery.

For further information, contact Tri-County Office on Aging at 517-887-1440or 1-800-405-9141.

Tri-County Office on AgingA consortium of Clinton, Eaton and Ingham counties and the cities of Lansing and East Lansing

Consumer Choice: In-Home Services

Helpful Resources for Alzheimer’s Caregivers

COA was one of the first Area Agencies onAging to switch from one annual contractorper county for the three in-home services toa direct purchase of service system (DPOS).

Caring for a family member orfriend at home, with its rewards

and trials, can be a 24-7 job — leavinga caregiver with very little time orenergy. The burnout that often resultsis the bane of family caregiving.“Because we recognize that familycaregivers face unique challenges, weare going to expand our caregiverrespite certificate program to all WestMichigan counties we serve,” explainsBarbara Nelson, rural counties con-tract coordinator at the Area Agencyon Aging of Western Michigan(AAAWM). “Our goal is to help familycaregivers get the breaks they need toavoid burnout,” she says. “A familycaregiver can cash in the certificate forone day of in-home, on-site or

overnight respite. It can be used at anyof our contracted respite careproviders.” Already established in Kentand Mason counties, the caregiverrespite certificates will now be avail-able in Allegan, Ionia, Lake, Mecosta,Montcalm, Newaygo and Osceolacounties.

Family caregivers in West Michiganwill also have new opportunities tolearn about caregiver education andsupport. The Caregiver Resource Net-work (CRN), a collaboration of elderservice providers established in KentCounty in 2001, is expanding to allthe nine counties served by AAAWM.“We know that family caregivers areoften very isolated, particularly inrural counties. The hardest thing is

being alone,” says Nora Barkey,contract coordinator at AAAWM.

CRN members have developed factsheets for each county, which includeinformation about adult day services,respite, support, a nurse support lineand family caregiver resources. Eachcounty will host a traveling displaythat includes books, articles, informa-tion on medical and legal issues, andmany other caregiver resources. “Thisshould reach a lot of people who’veoften said, ‘We wish we had heard ofyou sooner,’” says Barkey.

For more information on the CaregiverResource Network and respite certificates,call the Area Agency on Aging of WesternMichigan at 1-888-456-5664.

Are you providing care for or wor-rying about an elderly family

member? Would you like assistanceduring the day? Do you need time andspace to remain an effective caregiver?Seasons Adult Day Services may bethe answer. Seasons is a state-of-the-art adult day care center in Midland.The Midland County Council on Aging,also known as Senior Services, is com-mitted to a comprehensive program toserve those who cannot stay at homeby themselves.

Family members are encouraged tovisit (an appointment is suggested) andobserve a typical day at Seasons.Scheduled daily activities include exer-cise, discussion groups and specialinterests and hobbies. Music, dancing,

gardening, current events and arts andcrafts motivate seniors and increasetheir self-esteem. Holiday festivitiesand birthday celebrations turn ordi-nary days into special occasions. Socialstimulation helps your loved one main-tain his or her memory and ability tofunction. A supportive environment

celebrates individual achieve-ments and abilities.

Comfort, safety and secur-ity are a top priority.Well-balanced meals and snacks areincluded as well as dignifiedassistance with feeding, bathing,dressing and grooming. Theconvenient hours are Mondaythrough Friday, from 6:00 a.m.to 5:30 p.m. Safe door-to-doortransportation is available for

Midland County residents.For further information, contact

Region VII at 1615 South Euclid Avenue,Bay City, MI 48706 or call us toll-free at 1-800-858-1637.The Midland Council onAging’s toll-free number is 1-800-638-2058 or 989-633-3700.

RegionVII Area Agency on AgingServing Bay, Clare, Gladwin, Gratiot, Huron, Isabella, Midland, Saginaw, Sanilac and Tuscola counties

Area Agency on Agingof Western MichiganServing Allegan, Ionia, Kent, Lake, Mason, Mecosta, Montcalm, Newaygo and Osceola counties

Respite and Resources for Caregivers

Winter 2005 17

Caring for Your Loved One, Caring for Yourself

Seniors thrive in the supportive environment of SeasonsAdult Day Services.

Aprimary role of all Area Agencieson Aging is the provision of infor-

mation and assistance to address theneeds of seniors and their families andcaregivers. To this end, the U.P. AAA hasestablished a toll-free telephone numberknown as the “Senior Help Line.”

The Senior Help Line is supportedby trained information and assistancespecialists who have a comprehensive

database with information about agen-cies and services across the UpperPeninsula.

The database contains informationfrom over 500 agencies and nearly1,000 programs. Most calls received sofar have been inquiries concerninghealth-related and medical problemsthat involve Medicare and Medicaidbenefits, prescription drug coverage andthe AAA’s Care Management Program.Currently the Senior Help Line isstaffed by trained MMAP (Medicare/Medicaid Assistance Program) counselors.

The U.P. Senior Help Line is avail-able Monday through Friday from 8:00a.m. to 4:30 p.m. Carolyn Young is one

of the primary AAAemployees responsiblefor staffing the Senior Help Line.Carolyn says that the calls shereceives most frequently are requestsfor information on Medigap policy,Medicare-approved discount cards orlow-cost or free prescription drugs.Carolyn knows the information shegives callers is helpful, because she hasreceived many thank-you notes andmany repeat callers.

In addition to information aboutservices in the Upper Peninsula, theSenior Help Line can also link callersto information about services outsidethe Upper Peninsula through its mem-bership with the National EldercareLocator Network.

To access the U.P. Senior Help Lineand talk to an information specialist, call1-800-33-UPCAP (1-800-338-7227).

Upper Peninsula Area Agencyon AgingServing all 15 counties of Michigan’s Upper Peninsula

The Upper Peninsula’s Senior Help Line

Carolyn King staffs the Senior Help Line.

The Greater Michigan Alzheimer’sAssociation Chapter covers the

Northeastern Region with their officesin Alpena and Midland. The Northeast-ern Regional Alzheimer’s office covers11 counties of AAA Region 9’s area,with Mid-Michigan Alzheimer’s staffassisting persons in Arenac County.Families dealing with Alzheimer’s andrelated dementias benefit from sup-port groups, educational workshopsfor caregivers and professionals andscholarship offerings for Adult DayServices respite and the Safe Returnprogram.Working with the AreaAgency on Aging and various Councilsor Commissions on Aging, theAlzheimer’s Association has becomethe source for information, education

and referralto dementiaservices inNortheasternMichigan.

Caregiversupportgroups areheld in coop-eration withIosco, Otsego,Arenac, Oscoda and Roscommoncounties’ Councils or Commissions onAging. All AAA Region 9 counties havesupport group meetings coordinatingwith various agencies and organiza-tions. Please call the Alzheimer’s officeat 1-800-337-3827 to learn where yourlocal caregiver support group meets.

Educationalmaterial andsupport serv-ices for familiesdealing withthe decline ofcognitive abili-ties of a lovedone are avail-able at allCOA and sen-

ior centers. COA and senior staff areready, willing and able to help familieswith questions and concerns regardingall types of dementia.

To learn more about this excitingopportunity or for more information,contact your local ombudsman at 1-866-485-9393 or 989-356-3474 ext. 230.

NEMCSA Region9 Area Agencyon AgingCovering 12 counties of Northeast Michigan

Alzheimer’s Association regional staff were on hand for theIosco County Memory Walk, one of six events held in theAAA Region 9 area. Proceeds from all the Walks in our areago toward education and support services for familiesthroughout Northeastern Michigan.

Alzheimer’s Support and Education

Michigan Generations

Winter 2005 19

Acaregiver is anyone who isresponsible for helping someone

manage daily life. Fifty-six percent ofcaregivers experience stress and anxi-ety; another 54 percent are concernedabout their ability to provide qualitycaregiving. Today family caregivers aresupporting our entire health care system by providing more than 80 per-cent of all home care services, accord-ing to the National Family CaregiversAssociation. Caregivers can get helpthrough this stressful time.

The Caregiver Support Line, a serv-ice of Gerontology Network, focuseson you, the caregiver, and your needsby asking, “How are you doing? Whatare you going to do today?”

Any caregiver over the age of 60 or

anyone caring for someone over 60years old is eligible to call with ques-tions and concerns. You don’t need tobe a member of any group or pro-gram. You don’t have to be using anyof Gerontology Network’s other pro-grams or services. All you need tohave is a question or a concern.

A registered nurse will conduct an assessment of you based on yourneeds. This assessment covers topicssuch as your health, stress levels andquestions about caring for your loved one.

Do you take enough time for your-self? The nurse will work with you tocreate a care plan. Here you will iden-tify things to do to ensure your ownhealth. Together you and the nurse

will create a callback schedule to pro-vide ongoing support toward meetingyour goals.

Call the Caregiver Support Line at 616-771-9714 or 1-800-730-6135ext. 714, twenty-four hours a day,seven days a week, 365 days a year.Your message should include a con-venient time for the registered nurseto return your call. Please allow 48hours for the return call. Any care-giver living in Kent, Osceola, Allegan,Ionia, Lake, Mason, Mecosta, Montcalm,Muskegon, Newaygo, Oceana orOttawa counties may call.

For further information, contact Senior Resources of West Michigan at231-739-5858 or 1-800-442-0054.

Senior Resourcesof West MichiganLocated on the shores of Lake Michigan, serving the three counties of Muskegon, Oceana and Ottawa

Caregiving... It’s About You, Too

them to think can help,” says Denlinger.“It’s like flexing your muscles. Exercisingyour brain is important.”

Beatrice LaPorte knew this intu-itively. Her husband, Rodrigue, 77, beganhaving slight memory problems about 10

years ago, which progressed graduallybut were never diagnosed. When thecouple moved to Midland from NorthCarolina last April, Rodrigue’s new doctor put him on two anti-dementiamedications — Arasapt and Amenda.

While Beatrice, 75, thinks the drugshave helped Rodrigue, she does her partas well. “I play a guessing game with himto try to shore up his memory,” she says.“I’ll say, ‘Do you remember this?’ and‘Do you remember that?’ I’ve gotten him

playing cards again — we used to play alot. And he’s interested in model rail-roading, so we’re going to set up a tracksoon. I just try to keep his brain engagedand working.”

Since researchers don’t know exactlywhat causes Alzheimer’s, they can’tadvise how to prevent it. Several studies,though not conclusive, have suggested alargely vegetarian diet high in betacaro-

tene and vitamins Eand C may lower aperson’s risk ofdementia. Othershave shown, againinconclusively, that

active hobbies, such as ballroom dancing,can provide some protection.

“Basically, it’s all the things yourmother told you that you should do —eat right, exercise and live a healthylifestyle,” says Dr. Judith L. Heidebrink,co-chair of the Michigan Dementia PlanCommittee and co-investigator with theMichigan Alzheimer’s Disease ResearchCenter at the University of Michigan.“And we know that not smoking and eat-ing a low-fat diet reduces your risk for

cardiovascular disease. Habits such asusing seat belts and wearing helmets canreduce the risk of head injury. Both car-diovascular disease and head injury canlead to dementia. So, in general, leadinga safe, healthy lifestyle will probablyimprove your chances of avoidingAlzheimer’s and other dementia.”

Hopeful outlookThe future holds promise for those

suffering with Alzheimer’s. Researchersare studying new medications that workin an entirely different way from currentdrugs on the market. They have also hadsuccess in animal trials with a vaccinethat actually reverses the damage to thebrain cells. Human trials have alreadybegun. And researchers at the Universityof Michigan are studying the use of PETscans as a way to identify the earlieststages of the disease.

“In the next five to 10 years, I thinkwe are going to see tremendous stridesnot only in improving patients’ function-ing, but perhaps in actually arresting orreversing the disease,” says Hough. “Ithink we are in a very hopeful time.” MI

DementiaContinued from page 7

Alzheimer’s disease is the third most expensivedisease to treat,behind heart disease and cancer.

Gentiva Health ServicesServing clients in Lansing, Jackson, Flint,Saginaw, Grand Rapids, Kalamazoo, Muskegonand Southfield. Call today to set up your

personalized homecare services. 1-800-322-7111.

Health & Home Services Unlimited, Inc.Care, companionship and peace of mind. In-home or wherever your residence may be!

We specialize in meeting your needs — from personal care to home maintenance. Insured and bonded. 1-800-314-8718.

Presbyterian Villages of Michigan Senior Living Communities

Celebrating 60 years of serving seniors of all faiths throughoutMichigan. To find out more, visit our website, www.pvm.org,or call 1-313-537-0000 for a brochure describing the variety of

housing and services Presbyterian Villages of Michigan offers.

Visiting PhysiciansProviding compassionate, high-quality medical care in the home. We serve communities across Michigan, Ohio, Chicago, Atlanta and Milwaukee. Services are covered by

Medicare and most other insurances. Call 1-877-HOUSE-CALL or visitwww.visitingphysicians.com.

SPONSORS

Thanks to these companies and organizations for their generous support. For more information on becoming a sponsor of Michigan Generations, please call Jenny Jarvis at 248-262-9202 .

MEMORY LOSS. While it’s normal to forget appointments, names ortelephone numbers, those with dementia will forget such things moreoften and not remember them later.

DIFFICULTY PERFORMING FAMILIAR TASKS. People with dementiaoften find it hard to complete everyday tasks that are so familiar weusually do not think about how to do them. They may forget thesteps for preparing a meal or using a household appliance.

PROBLEMS WITH LANGUAGE. Most people sometimes have troublefinding the right word. People with dementia often cannot remem-ber simple words and instead use inappropriate fillers, making it dif-ficult to understand their sentences.

DISORIENTATION TO TIME AND PLACE. It’s normal to occasionallyforget the day of the week or where you are going. People withdementia can become lost on their own street, forget where theyare and how they got there and not know how to get back home.

POOR OR DECREASED JUDGMENT. People with dementia may some-times wear totally inappropriate clothes, such as a bathrobe whileshopping or several blouses on a hot day. They may give away largeamounts of money to telemarketers or pay for home repairs theydon’t need.

PROBLEMS WITH ABSTRACT THINKING. Balancing a checkbookcan be challenging for anyone. People with dementia could for-get completely what the numbers are and what needs to bedone with them.

MISPLACING THINGS. Anyone can temporarily misplace a wal-let or the keys. A person with dementia may put things in com-pletely inappropriate places — an iron in the freezer or a watchin the sugar bowl.

CHANGES IN MOOD OR BEHAVIOR. Everyone has mood swingsfrom time to time. Someone with dementia can have rapidmood swings — from calm to anger — for no apparent reason.

CHANGES IN PERSONALITY. People’s personalities commonlychange a little with age. The personality of a person withdementia can change dramatically. About 15 to 20 percent ofpeople with Alzheimer’s become anxious, suspicious or fearful.

LOSS OF INITIATIVE. People with dementia may become verypassive, sitting in front of the TV for hours, sleeping more thanusual or not wanting to do usual activities.

Source: Alzheimer’s Association

Ten Warning Signs of Dementia

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