MIG06Su PPrf ALL r3

RaisingGrandchildren

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

GenerationsTMSummer 2006Michigan

Also in This Issue: ■ Ask the Expert About

Inflammation and Pain■ A Look at Area Agencies

Around Our State

HOMECARE

A Boon forCaregivers

Leo and Merelyn Sullivan ofPetoskey, Michigan

SUMMER 2006 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

Cover and feature photography:Green Frog Photography,Grand Rapids, MI

On the Cover: Leo Sullivan callshome-health care “a blessing” in offer-ing help with his wife, Merelyn. TheSullivans are part of a growing trend,as caregivers throughout Michigan turnto a broad range of home services andassistance. See story, page 4.

GenerationsMichigan

Summer 2006, Volume 4, #1 © 2006 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 8 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

3B3A

3C4

1B

MAP

PHOT

OG

RAPH

YCO

URTE

SYTR

AVEL

MIC

HIG

AN

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 Co.Health & CommunityServices 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

Visit the AAA’s state website at www.mi-seniors.net

AAAs—Gateways to Community Resources

Prostate

CAREGIVINGNews&Notes

Surfing the NetEach issue of Michigan Generations offers several websites of

interest to older adults and their care-givers … right at your fingertips.www.medicinenet.com offers

A to Z lists of diseases and conditions, symptoms, proce-

dures and tests, news and tips for healthy living, all written by physicians andhealth professionals.

www.wellspouse.org showcases Well Spouse Association,a national nonprofit that gives support to wives, husbands, andpartners of the chronically ill and/or disabled.

Look for more helpful websites in the next issue of Michigan Generations.

Summer 2006 3

Promising NewsOn

TreatmentIF YOU KNOW SOMEONE who has been diagnosed with prostatecancer, you’ll be interested to learn that some doctors are startingto use minimally invasive laparoscopic surgery to remove theprostate. Early research indicates this form of surgery may lead toless pain and shorter recovery times than conventional surgery.

Other noteworthy news: A study in the journal Urology foundthat men with slow-growing prostate cancer who stuck to a vege-tarian diet and exercised regularly actually lowered their PSAscores. However, the study only followed the men for one year, soadditional follow-up is needed to determine long-term results.

It is surprising how many seniors or caregivers worry about “avoid-

ing probate.” In many cases, that concern is not justified — and it is often based on a misunderstanding of what “probate” means.

Often, the process of probating an estate is relativelyquick and inexpensive. Unfortunately, for several yearsthere have been efforts to portray the probate process asslow and expensive. Often the people who make theseclaims are trying to convince the listener to hire them tocreate a so-called “living trust.”

Although trust agreements are often a good way forseniors to plan their estates, they are not always necessaryand usually involve higher fees up front. Individualsshould always be concerned if the person trying to “sellthem a trust” uses scare tactics about probate. This isespecially true when the person selling the legal docu-ments is not an attorney. The decision of whether a trustor will is appropriate should be something that is decidedafter consulting with a qualified attorney.

Courtesy Douglas G. Chalgian, certified elderlaw attorney, and Amy R. Tripp, attorney at law.

Caregivers are often faced with the task ofdiscussing a difficult situation with an older

adult. Here are tips for communicating better:■ Hold discussions in a quiet setting at a time of day that is

best for the elder.■ Listen to the older adult and acknowledge his or her

opinions.■ Stay positive. Use constructive suggestions instead of

blanket statements.■ Provide accurate information. Don’t tell “half-truths.”■ Allow the older adult plenty of time to process the

information.■ Supplement your words with nonverbal cues and support-

ive body language.

6 Steps to Better Communication !

!

About

A GoodNight’sSleep

Half of all older adultssleep fewer than seven

hours a night, and a quarterof them say they have a sleepproblem, according to arecent Gallup survey.

If you are the caregiver fora person who has troublesleeping, here are severalhealth conditions that could becontributing to the problem:

• Sleep apnea, an obstruc-tion of the airway, which cancause a person to stopbreathing repeatedly,

• Restless legs syndrome(RLS), which can cause leg“tingles,”

• REM behavior disorder,which can cause dream dis-turbances,

• Urinary problems, result-ing in frequent trips to thebathroom,

• Medications such as anti-depressants, decongestants orhigh blood pressure drugs,which can have a stimulatingeffect on the brain.

Review these conditionswith a doctor. He or she willbe able to provide guidelinesfor getting a better night’ssleep, such as getting on anew routine, changing theperson’s diet or exercise pattern, restricting caffeineclose to bedtime or trying amild prescription sleep drug.

ProbateWORRYING

EO SULLIVAN COULD CARE FOR HIS WIFE, MERELYN, BYhimself, but he prefers to have help. So anaide comes to Sullivan’s home in Petoskeyevery morning to help Merelyn (who suffers

from dementia) get bathed, dressed and ready forher day.

Twice a year, Sullivan takes a golfing trip withsome buddies. Although his daughter comes andstays with Merelyn while he’s gone, Sullivanincreases the aide’s visits to twice a day — twohours in the morning and t0wo hours in theevening to get Merelyn ready for bed — to givehis daughter additional assistance during that time.

“I’m in excellent condition, and I could doeverything myself,” says Sullivan, 78. “But then Iwould run out of steam. Having an aide come inand help out makes it a lot easier on me. Thehome-health aide has been a blessing.”

If you are a caregiver who, like Sullivan,needs extra help at home, you’re not alone. Sulli-van is part of an important and growing trend.Caregivers throughout Michigan and across thenation are turning to a broad range of home serv-ices and assistance available in every community.

In addition, seniors who years ago may haveended up in an assisted-living facility or a nursinghome are able to remain in their own homes withthe help of aides, nurses and therapists who makeregular visits. Broadly called “home care,” thisindustry encompasses all health and social serv-

ices delivered in a private residence. These serv-ices can range from personal services, such ascompanionship visits, help with activities of dailyliving (dressing, bathing, etc.), housekeeping,meal preparation and shopping, to health andskilled nursing services, such as medication man-agement, physical therapy, injections and intra-venous therapy.

“Sometimes just a little bit of help in thehome makes the difference between being able tolive independently or going to a nursing home,”says Anne Zemlick, RN, program manager for theCare Management Program at the AAA Region3A in Kalamazoo County. “So often it is minimalsupport, and it doesn’t even have to be daily, butit can make a huge difference in their lives.”

The need for such services has swelled withthe aging population. Ali Ucar has witnessed theboom firsthand. The vice president and CFO ofSignature Home Care in Southfield has watchedthe number of clients his company serves jumpfrom about 80 at the end of 2002 to upwards of300 today. “Most of our growth has come in theareas of personal services and medication assis-tance,” says Ucar. “We expect continued stronggrowth as the population ages. I think families willdo whatever they can to keep Mom and Dad outof a nursing home setting, so they will fuel thedemand for personal services in the coming years,and for more technical nursing services as well.”

4 Michigan Generations

By Martha Nolan McKenzie

L

A Boon forCaregivers

Care:Home

Home-health aide Angela Prince, right, offers caringsupport to Leo Sullivan and his wife, Merelyn.

Types of home careThe types of services provided by home-care

agencies can be divided into two areas: medical orhome-health and social or personal.

MEDICAL OR HOME-HEALTH SERVICES might includeinjections, intravenous therapy, wound care, medica-tion management and physical therapy. These serv-ices are usually provided by registered nurses (RN)or licensed practical nurses (LPN), physical thera-pists, occupational therapists and speech languagepathologists.

Two types of home-health agencies generally provide skilled nursing care — Medicare-certifiedhome-health agencies and private-duty agencies. Thelion’s share of skilled nursing care in the home ispaid for by Medicare. But there is a catch. “Medicarewill only cover home skilled care for one hundreddays post hospitalization, and the hospitalization hasto qualify,” says Zemlick. “There is also the MIChoice Medicaid waiver program to help pay forservices for low-income individuals, but to qualifyyou must be eligible for a nursing home level ofcare, your income level can be no higher than $1,809a month and you cannot have assets over $2,000.”

Private-duty agencies can offer skilled nursingservices on a longer-term basis, but the client typi-cally pays for these services out of pocket. The costcan run as high as about $40 an hour for an RN.

SOCIAL OR PERSONAL SERVICES include assistance withactivities of daily living, such as getting in and out ofbed, bathing and dressing. They can also includecompanionship visits, transportation and help withhousehold tasks and errands.

“Very often, a son or daughter has been doingthese things for their parent, but it’s either justbecome too much for them to do every single day orthey simply want some extra help,” says Susan Mole-naar, assistant administrator and director of marketingfor United Nursing Service in Kalamazoo. “Manytimes their parent just needs a little help getting upand getting going in the morning and then a little bitof help getting ready for bed.”

Personal services are generally provided by home-care aides, home-health aides, homemakers and vol-unteers. Medicare-certified home-care agencies andprivate-duty agencies typically offer these services, asdo homemaker and home-care aide agencies.

(See Accreditation Pull-Out at end of main article.) Often a private-duty agency will team up with a

Medicare-certified agency to provide the entire arrayof home-care services. Consider Care Solutions Net-work in Southfield. Founded by several home-careprofessionals, Care Solutions Network is a consor-tium including a private-duty agency, a Medicare-certified agency, physicians, pharmacies and medicalequipment manufacturers.

“It’s common for a client to need some ofthe services a private-duty agency offers andsome that a Medicare-certified agencyoffers, and perhaps some others,” saysUcar of Signature Home Care, the pri-vate duty component of Care Solu-tions Network. “We created anetwork of all the home servicessomeone might need, so the familymember just has to call one numberand we’ll coordinate the services withthe various agencies, whether it’s med-ical monitoring, nursing, physical therapy,physician’s services or personal assistance.”

New directions in home care

As the home-care industry has grown, theservices offered have become more compre-hensive and sophisticated. Here’s a look atsome noteworthy home-care offerings:

LIVE-IN SERVICES. Some seniors needmore than a visit or two a day. Theyneed an aide available 24/7, but theydon’t want to go to a nursing home.That’s where live-in services comein. A caregiver will stay in thepatient’s home 24 hours a day, help-ing with cooking, cleaning, personalcare and errands. If the patientrequires live-in care seven days a week,the agency will typically rotate two or threecaregivers in the home.

The bonds formed between the patient and care-giver can be quite strong in such an arrangement.“It’s amazing to watch how close they become after atime,” says Jeff Alisch, CEO of Home Care Assis-tance in Grand Rapids. “We’ve even had our care-givers go on vacation with their clients.”

The cost for such care, however, is steep. “Ouraverage is about $150 a day,” says Linda Coffell,administrator of Leelin Home Health Care in WestBranch. “But it could go above that, depending onwhat the patient needs to have done. Live-in care isgenerally an out-of-pocket expense, although somelong-term care policies will cover it.”

TELEMONITORING. A growing array of gadgets thatallow patients to electronically transmit vital data,such as weight, blood sugar and oxygen levels, to dis-tant hospitals, doctors and nurses has led to a newangle in home care — telemonitoring. Other telemon-itoring includes “Virtually There Care” and medica-tion monitoring.

“We currently have five clients who are usinghome monitoring equipment,” says Rosemary Mayes,director of professional health services for Metro

Summer 2006 5

Home Health Care Services in Dearborn. “We can remotelymonitor their weight, blood pressure and blood sugars, so weonly have to make a home visit twice a week instead of threeto four times a week. Since we are able to get immediate infor-mation from the client, we can alert a doctor right away if a

problem starts to show up, which cuts down onhospital re-admissions. The patients are able

to stay in their homes, which is wherethey want to be.”

PSYCHIATRIC HOME CARE. Somepatients are homebound not becauseof physical limitations but from psy-chiatric ones — either their illnessrenders them unable to leave theirhome safely unattended or it mani-

fests by a refusal to leave their home.Metro Home Health Care Services

offers specialized home-care services forsuch situations.“People with psychiatric illnesses, such as

bipolar disorder, depression and schizophrenia, oftenare not good at complying with their medication regimen,”says Mayes. “We have a psychiatric nurse specialist who cangive injections, draw blood to monitor medication levels,evaluate drug side effects and intervene in a crisis. Our goalis to educate and support the family andallow the patient to remain in his ownhome.”

BOOKKEEPING. Many times seniors needhelp with more than dressing and takingtheir medications — they need a littlehelp with the checkbook. And the bills.And their taxes. Michelle Masta, presidentof Home & Health Services Unlimited in Jonesville, sawthat need and added bookkeeping services to the company’sroster of home-care offerings. “If we see that our clientsneed something, we try to find a way to provide it,” saysMasta. “And we saw that some clients were not able tomaintain their checkbooks. They were not paying their billscorrectly. So now we have staff who have bookkeeping andfinance management backgrounds to provide in-home book-keeping services.”

LEGAL SERVICES. Another unmet need Masta discovered waslegal services. She saw clients who needed wills, wanted toset up trusts or establish advanced directives. So Masta hireda health-care attorney (who happened to be her daughter),Megan Stiverson.

“In the event a client with dementia starts mismanagingtheir funds, for example, we can help the family seek power ofattorney or guardianship over the parent,” says Masta. “Wehave worked with clients who were the victims of phone scamsto try to recoup their losses. We try to be a one-stop shop.”

How to find a home-care providerBefore you start to look for a home-care provider, you

need to determine what types of services you need. If youare not sure — and many caregivers aren’t — you can callyour local Area Agency on Aging. “We have a registerednurse and social worker team go out to the home and do athorough assessment,” says Evelyn Richardson, Care Con-nections supervisor at the AAA of Northwest Michigan. “Welook at their medical, psychosocial and financial needs to geta full picture of their environment, their caregivers and thesupports they have in place. Then we work with them to fillin the gaps so they can stay safely in their home.”

Your local AAA is also a good place to get names of home-care providers in your area. “Before we contract with a

home-care agency, we make sure all theirpolicies and procedures are in place andthat they meet our service standards,” saysKathy Bogl, vendor quality assurance man-ager at AAA 1-B in Southfield. “We meetwith our vendors twice a year to keep thelines of communication open, and we dotraining for our vendors and health care

workers. We recently conducted a training session on home-care code of conduct in which we discussed professionalismand behavior in the workplace.”

To find the AAA office nearest you, look in the regionalsection (pages 8–15) of this publication.

Your physician or hospital discharge planner can also helpyou find home-care providers in your area. If you are lookingfor a Medicare-certified home-care agency, you can go toMedicare’s Home Health Compare website to get informa-

tion about home-health agencies, includingareas they serve and their quality of care com-pared to others in the state. Go towww.medicare.gov/hhcompare/home.asp.

In addition, the National Association forHome Care & Hospice (NAH) website offers alocator service by zip code. Visit www.nahc.org.

Finding the right home-care agency couldbe the answer to caregivers’ prayers. “Many ofthe people we serve would either be living withtheir children or in a nursing home if they didn’t have home-care services,” says Richard-son. “Giving them the ability to remain in theirhomes certainly adds to their quality of life.” MI

What Does “Accreditation” Mean?While a Medicare-certified agency has to be approved by Medicare, there is

no state licensure for the types of private agencies listed in this article. Such

agencies can elect to become accredited by a group, such as the Commu-

nity Health Accreditation Program or Joint Commission Accreditation.

“Getting accredited is a cost to the agency, so many don’t do it,” says Val

Bauer, vice president of Borgess Home Care in Portage.“But since there are

no licensing requirements in Michigan, accreditation is the only way you can

know that a company has met a certain standard in providing care.”


For helpful tips on selecting a home-care provider,turn to page 16.

Inflammation: Why is it a growingconcern?A NUMBER OF RECENT STUDIES HAVEshown the direct relationship that inflam-mation has not only with pain (in the formof arthritis and other joint-related pain)but with various forms of cancer and car-diovascular disease as well.

What causes inflammation?INFLAMMATION OCCURS WHEN CHEM-icals from the body’s white blood cellsare released into the blood or affectedtissues to protect the body from foreign substances. This release ofchemicals increases blood flow to thearea of injury or infection and mayresult in redness and warmth. Some ofthe chemicals cause a leak of fluid intothe tissues, resulting in swelling. Thisprotective process may stimulatenerves and cause pain.

What are signs of inflammation?ONE MAY EXPERIENCE REDNESS,swollen joints that are warm to touch,joint pain, joint stiffness and loss ofjoint function.

Why did you develop a nutritionalsystem to reduce inflammation?A FEW YEARS AGO, I HAD CUT BACK ONmy running due to inflammation in myhip associated with arthritis. In 2002,

I decided to run the Detroit Marathon.I attempted to conquer my hip pain ina natural fashion without the use ofdrugs. I developed a nutritional pro-gram to protect my joints and to prevent musculoskeletal pain. I ran therace to completion and, in April 2005,I accomplished a lifetime goal of running the Boston Marathon.

How did you develop your nutritionalprogram? FIRST, I CREATED A REGIMEN THATworked for me — intensifying my pro-gram of diet, vitamins and other sup-plements. I then completed extensivesecondary research to thoroughly edu-cate myself on the topic of inflamma-tion and the relationship to pain.

What can be done to counter theeffects of inflammation?THERE ARE A NUMBER OF SIMPLEand affordable lifestyle changes peoplecan make to reduce their “index ofinflammation” and live healthier asthey grow older.• Fish oil — Take five grams of fishoil per day. Make sure to get a brandthat is high in EPA and DHA.• Minimize dairy except for yogurt— It provides bacteria that helps breakdown food in your digestive system,reducing food allergies that can con-tribute to arthritis and headaches. • Avoid red meat — You can get mostof your protein from chicken andseafood, as well as the new eggs withhigh Omega-three oils that are nowavailable in grocery stores.• Increase fiber — Incorporatingfiber into your diet will reduce the riskof colon cancer and heart disease bybinding the cholesterol in your stooland preventing reabsorption in thesmall intestine. Take Metamucil atleast once a day.

• One alcoholic beverage a day — Alittle bit of alcohol each day is good foryour cholesterol, but no more than onedrink a day is recommended.• Green tea — Drink green tea insteadof coffee. Green tea helps unlock yourmetabolism. It’s recommended to drinkat least four cups per day.• Soy milk — Drink two glasses a day.Silk-brand vanilla flavor is tastiest andavailable at all grocery stores.• Seven helpings of fruits and veg-etables a day — Fruits and vegetablesare high in antioxidants, which helprelieve inflammation. Apples, berriesand dark greens like spinach are verybeneficial.• Low-glycemic diet — We know thatinsulin causes inflammation. Try to eatjust high-quality protein like chickenand seafood with fruits and vegetables,avoiding bread, pasta, white rice andpotatoes. Nuts, beans and whole grainsare excellent. Eating a handful of nutstwice a week reduces your risk of heartdisease by about 40%.• Herb turmeric — Season your foodliberally with turmeric, which is a yel-low spice found in mustard. It has anearthy flavor like cumin and is used incurry, an Indian spice mixture. It haspotent anti-inflammatory qualities.• Glucosamin sulfate — Take 1,500mg of this supplement per day for jointprotection.• Walk/exercise — Walk at least twomiles per day. You may never run amarathon, but you will feel better.

MARK GOSTINE, M.D., is a nationallyrecognized pain management specialistand co-founder of Michigan Pain Con-sultants, a comprehensive interdiscipli-nary pain management program. Forinformation, call 616-940-2662 or 1-800-281-3237, or visit www.michiganpain.com.

ASKtheExpert Mark Gostine, M.D.

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.

Inflammation and PainCountering the Effects

Summer 2006 7

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…

11

10 9

7

5

1A1C

2

8

14

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 Co.Health &Community 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 Area Agency on Aging


Area Agency on Aging Region 9 isfortunate to be a part of the

Northeast Michigan Community Ser-vices Agency (NEMCSA). NEMCSAbrings together federal and state grantfunds as well as dollars from local,private and public sources. Theseresources are thendirected into pro-grams that aid thepoor and otherwisedisadvantaged throughout the agespectrum.

NEMCSA has a variety of servicesthat include food assistance programs,Low-Income Weatherization and CrisisPrevention Programs — namely Home-less Prevention and Utility Assistance.

The childhood education programs

through NEMCSA are Early HeadStart, Head Start Services (available in21 counties), the Michigan SchoolReadiness program, and a School Suc-cess partnership. Compass Youth andFamily Guidance provides free crisisintervention and counseling services to

youth and/ortheir families.

NEMCSA’sCommunity

Development Division provides techni-cal assistance and training to countyhousing agencies. A matched savingsprogram helps low-income familiesacquire assets to obtain housing.

The aging programs include theLong-Term Care Ombudsman and the Medicaid/Medicare Assistance

Program, as well as fund-ing for In-Home Servicesand Congregate Meals. Health care-related services include CareManagement, MI Choice Waiver andMichigan Enrolls. Foster Grandparent,Senior Companion and Retired andSenior Volunteer programs round out the community-based care andvolunteer programs.

NEMCSA maintains the contractfor Michigan Works! offices in 14counties. Workforce Investment Act(WIA) Adult and Dislocated Workers,Welfare Reform and the Michigan NoWrong Door System are some of thefocuses of Michigan Works!

The Area Agency on Aging is happyto be the referral source within theNEMCSA organization.

For more information on these programs, call 989-356-3474.

NEMCSA Region9 Area Agencyon AgingCovering 12 counties of Northeast Michigan

Taking a Close Look at NEMCSA

It seems that “Ask and you shallreceive” is becoming a standard

practice for Detroit Meals on Wheelssolicitors. Although there is still a longway to go, more and more Detroitarea do-gooders are supporting thisworthy cause.

This Spring, the Detroit AreaAgency on Aging (DAAA) put forthextra effort to ensure that home-bound seniors receive nutritioushome-delivered meals on holidays andweekends as well as every day of theweek. For the Easter holiday delivery,various new programs were estab-lished, including a beautiful new greet-ing card that was sold by individuals,corporations and organizations.

The new card, which highlighted apicture of a beautiful yellow tulip, soldvery well. Several area churches tookup exclusive collections. Communitygroups and businesses initiated specialpromotional efforts, and some compa-nies made significant donations.

“The most important thing we cando for the citizens of Detroit is toimprove their health, and our goal isto improve the health status in thiscommunity and the people we serve,”explains Diane Byrd-Johnson, managerof community affairs for MolinaHealthcare of Michigan, an EasterMeals on Wheels sponsor that hasalways shown strong support toDAAA and its causes.

DTE Energy far exceeded their$1,000 goal to raise money for

Detroit Meals on Wheelswhen they offered staff mem-bers a chance to win a nightin the company’s privatesuite for a Detroit Tigersgame by simply donating aminimum of $10.

“I am so thrilled withthe outcome and supportmy fellow employees areshowing,” says KatherineHill, who organizesMeals on Wheels sup-port efforts at DTE.

Through theDAAA home-deliv-ered meal program,which is federallyand state-funded,meals are delivered toseniors five days a week. Unfortu-nately, there are no public funds tofeed seniors during weekends and holi-days. It was because of the dire needto expand the existing program that, in

1988, DAAA created the DetroitMeals on Wheels —Holiday Meals onWheels program.

HMOW is prima-rily supportedthrough private and

community funds. Currently, the Holi-day Meals on Wheels program pro-vides hot nutritious meals onThanksgiving, Christmas, Easter andLabor Day. Weekend meals and break-fast boxes are also delivered whenfunds permit.

As one of sixteen Area Agencies onAging in Michigan, DAAA plans, coordi-nates and develops numerous servicesfor the elderly, offers some directservices, and funds and monitorsnearly 40 community agencies, which

provide most of the direct elder careservices in our area.

DAAA services an area consistingof almost 150,000 older adults residingin Detroit, Hamtramck, Harper Woods,Highland Park and the five GrossePointes.

Holiday Meals on Wheels is fundedprimarily by DAAA’s annual golf out-ing and by the Holiday Card Program.The holiday greeting cards sell for $5 each, which covers the cost of thedelivery of a meal to a homeboundsenior. But one card and one mealhardly make a dent in the thousandsof seniors who go without companyand without food every single holiday.Some don’t even see or talk to any-one other than the volunteers whodeliver the meals.

For more information on HolidayMeals on Wheels or the Holiday CardProgram, call Beth Wheland, DAAAresource development manager, at 313-446-4444, ext. 5853.

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

Summer 2006 9

The new greeting card, which highlighteda picture of a beautiful yellow tulip, soldvery well. Several area churches took upexclusive collections.

Feeding Homebound Seniors on Easter:Mission Accomplished!

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

AreaAgencyon Aging 1-B

Program Provides Short-Term Assistance for Older Adults or Caregivers

This Fall, the AreaAgency on Aging

1-B (AAA 1-B) will behosting two freeevents for caregivers ofolder adults.

• The 2nd annualSt. Clair CountyCaregiver Fair willbe held on Saturday,September 30, 2006, atthe Thomas Edison Innin Port Huron from9:00 a.m. to 1:00 p.m.

• The 7th annualSolutions for FamilyCaregivers Fair will beheld on Saturday, October 21, 2006, atthe Best Western Sterling Inn Banquetand Conference Center, located at34911 Van Dyke Avenue in Sterling

Heights, from 9:00 a.m. to 2:00 p.m.These annual fairs will benefit peo-

ple who provide care for elderly ordisabled family members or friends.

The programswill includeexpert presenta-tions on a vari-ety of topicssuch as homehealth careoptions, thespectrum of localservices available,guardianship,Medicare andMedicaid. Exhibi-tors will also beon-site to pro-vide information,products and

services for seniors, caregivers and per-sons with disabilities.

For information, visit www.aaa1b.comor call us at 1-800-852-7795.

Don’t Miss These Events! Fairs Provide Valuable Information for Caregivers

AAA 1-B Resource Specialist Vikki Rochester assists a caregiver at the St. Clair County Caregiver Fair.

The Rapid Response Program pro-vided by the AAA 1-B can offer

quick access to short-term home careservices for older adults or immediatehelp with caregiver relief for olderadults or persons with disabilities.There are two Rapid Response Pro-grams available: Rapid Response Short-Term and Rapid Response Respite.

Rapid Response Short-Termprovides immediate short-term home-making or personal care service dueto an emergency situation, such as dis-charge from a hospital, or during afamily crisis, for four to six weeks andno longer than 12 weeks. This pro-gram is available for adults 60 yearsand older. Seniors receiving assistancethrough Rapid Response Short-Term

are informed about the cost of theassistance provided and are asked tomake an appropriate contributionaccording to their financial ability.

Rapid Response Respite is avail-able for adults 18 years and older witha disability or adults age 60 and overwho need short-term or long-termcaregiver relief. The program servicesinclude in-home respite, out-of-homerespite and Adult Day Services. Individ-uals receiving Rapid Response Respiteare required to pay a percentage ofthe cost for the services receivedaccording to their financial ability.

For more information on these twoprograms, please call the AAA 1-B at 1-800-852-7795 and speak with aresource specialist.

AAA 1-B Care Manager Barbara Sims, RN, does anassessment with an AAA 1-B client.


In March 2005 the Lenawee UnitedWay and Volunteer Center decided

that they could no longer coordinatethe ramp program and asked whetherthe Lenawee Department on Agingwould accept that responsibility. Know-ing how important the program is, andwith the knowledge that Project Rampcomes with no funding attached, weagreed. We took on the responsibilitywith the understanding that we woulddo our best to build ramps not justfor those who are 60-plus but for per-sons of all ages. As soon as ProjectRamp became ours, the requestsbegan pouring in. That’s when we real-ized that building ramps could be verychallenging. Our plan was to find vol-unteer builders who would be willing

to design and build the ramps and tofind funding on a ramp-by-ramp basis.Well … that is easier said than done!

Building a ramp involves measuringthe homeowner’s property; having aperson with a builder’s license submita design that meets code to the build-ing inspector; having the plan approv-ed; and finding funding to pay formaterials, which cost about $1,000.

Finding builders who have time tobuild ramps proved to be nearlyimpossible. We found two who agreedto help, but neither followed through.Fortunately, we live near Holy CrossChildren’s Services; they have beenbuilding ramps for years, and theyoffered their assistance.

The outcome was that we had 32

requests, and we com-pleted nine and repairedthree others. Of the 32 requests, 21were for older adults.

Now that we have a year’s experi-ence, we expect to be much moresuccessful in 2006.Already, Holy Crosshas committed to pay for and build 10ramps; the Adrian Rotary Club will payfor and build one; Lenawee Commu-nity Mental Health has committed upto $5,000 for ramp materials to aidclients referred by CMH staff; and theDepartment on Aging has made their$5,000 an annual commitment.

Our goal is to meet every requestwithin a reasonable amount of time.We know it will take persistence anddiligence, but the rewards will be great!

For more information, contact Ginny Wood-Bailey at the Region 2 AAA,1-800-335-7881 or 1-517-467-1909.

Just for Fun: Five Ways to Improve Brain Fitness

Serving Hillsdale, Jackson and Lenawee counties

We Tackle Project Ramp!

Region 2 Area Agency on Aging

Summer 2006 11

Help Is a PhoneCall Away

1. Exercise gets the blood pump-ing, and that means better creativity,retention and reaction time. Studiesshow a 20% to 30% increase in mentalability with regular exercise.

2. Give your mind a workout.Finish a crossword puzzle; play cha-rades; take uptyping, dancing,swimming or amusical instru-ment, or learna foreign lan-guage; balancea checkbookor estimateyour grocerybill before paying.Visit a mental fitnessgym at www.mybraintrainer.com for astimulating workout.

3. Take up mediation. A recentstudy found that mediation thickenedparts of the brain in those who engaged

in this activity 45 minutes a day, six daysa week. Mediation can improve bloodpressure, memory loss and relieve stress.

4. Listen to Mozart. Music perksup your creativity through the forma-tion of neural pathways in the brain. Italso trains your mind for higher forms

of thinking likeinventing andpainting.

5. Enjoy aro-matherapy. Stim-ulate your brainwith essential oilsof lemon, pepper-mint, cinnamon,eucalyptus, tea

tree and cypress. Kick back and relaxwith lavender, chamomile, frankincense,jasmine and rose. Just place a coupledrops into a cotton ball, and inhale forimmediate results. Feed your mindpositive messages for an added perk.

1-800-852-7795

The Area Agency on Aging 1-B isthe first resource for older adults,caregivers and persons with disabilities to call when looking to resolve problems or locate theresources they need to improvethe quality of their life.

When individuals call the toll-free service at 1-800-852-7795,they speak with a certifiedResource Specialist who accessesa database of over 2,000 commu-nity agencies and mails the indi-vidual a complete listing of rele-vant services and providers.

Call us.We can help.

Although every elder’s situation isunique, callers to the Kalamazoo

County Area Agency on Aging Region3A are often encountering the olderadult service system for the first time.A caller may be thinking about movingto a new kind of senior housing, ormay have questions about the finerlegal points of how to appoint some-one who can make important medicaldecisions if they are not able to.

The next most frequent informationrequest is for any of a number of serv-ices that can enable an older person toremain safely and comfortably in their

home and“age inplace.” Thismay initially involve having someonehelp with the yard, shopping or otherchores, and may go on to assistancewith personal care or setting up med-ications, and Meals on Wheels. Trans-portation is perhaps the number-onerequested service after in-home care.

Often a call for information is pre-cipitated by a health crisis, when anadult child begins to think about howbest to support the parent as theyrecover. If this is their first encounter

with the elderservice system, theymay not be awareof the range of

services that can help,and may feel over-

whelmed. The information specialistcan be a great help in suggesting notonly possible solutions and services tai-lored to each family, but also theimportant questions to ask to findcapable, qualified service providers.

The AAA 3A’s Information and Assis-tance Service is your connection toinformation and community supports.The coordinator of the service, PeggySattler, MSW, has recently passed theCertification for Information and Refer-ral Specialist for Aging (CIRS-A) exami-nation, offered by the Alliance forInformation and Referral Systems. Themission of AIRS is to advance the capac-ity of information and referral programsto better serve their communities.

For more information, call the numberslisted at the left.

Are you caring for an older ordisabled adult and need a

break? The Branch County Com-mission on Aging/H. & C. BurnsideSenior Center has just announced aspecial opportunity for caregiversto receive a grant-funded stipend to help:

• Take a short vacation• Attend a wedding out of town• Tackle a large project• Or just take time for yourselfContact the Branch County

Commission on Aging to see if youmay qualify for their OvernightRespite Care Program.You can call517-279-6565 and ask for Liz atextension 28. Some cost sharing mayapply, depending on family income.

Funding is only available for a limited time.

One of the best ways tocare for your loved one is tocare for yourself!

The Branch-St. Joseph AreaAgency on Aging’s mission is to provide an array of high-quality services, programs andopportunities that support the independence and dignityof older adults and family caregivers across Branch andSt. Joseph counties.

For additional information onsupports and services in yourarea, please call us toll-free at 1-888-615-8009.

Branch–St.JosephAreaAgencyonAging IIICServing a two-county area surrounding Sturgis, Three Rivers, Coldwater and Quincy


Region 3ACovering Kalamazoo County and its 24 municipalities

Kalamazoo Co. Health & Community Services Dept.

Caregiver Resource Center . . . . . . . . . . . 269-978-00853A AAA Information & Assistance. . . . . . . 269-373-5173

Attention, Branch County Caregivers!

The Best Elder Care Questions

To celebrate Older AmericansMonth and Mothers Day in May,

The Region IV AAA held a “Moms inthe Middle” contest.Almost half of allwomen between 45 and 55 are caringfor both a child and an older adult.This dual role usually leaves little timefor “mom” to spend time on herself.

The AAA gave husbands, sons,daughters or friends a chance tohonor that special “mom” who alwaysseems to be giving to others.To lether know how much she is appreci-ated, applicants submitted nominationsin the form of essays highlighting theadmirable work that “mom” doesevery day.

As part of the celebration, the AAAalso ran ads in local newspapers to

serve as apublic aware-ness and edu-cation campaignabout caregiving.The ads providedpractical tips forcaregivers, such as:“Ask for and AcceptHelp,” “ManageYour Time” and“Learn AboutCommunity Services.”

One “Mom in the Middle” wasselected and received the winningprize, a gift basket worth $500. Thebasket consisted primarily of gift certifi-cates from local merchants, which thewinner could use to pamper

herself with various goodsand services. Along with the

contest, the AAA will continue tolet those special “Moms in the Mid-

dle” know more about local support-ive services that they can access tomake their caregiving role a bit easierand to take care of themselves.The original “Moms in the Middle”

public awareness campaign waslaunched a few years back by theEldercare Locator (1-800-677-1116 or www.eldercare.gov), a nationwide public service that provides connec-tions to local resources and informa-tion about caregiver supports.

For more information on Area Agencyon Aging services, call the Senior Info-Lineat 1-800-654-2810.

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

Region IV Honors “Moms in the Middle”

Summer 2006 13

Good nutritioncan help

lessen the effects ofdiseases prevalentamong older peo-ple, or improve thequality of life inpeople who havesuch diseases —including osteo-porosis, obesity,high blood pres-sure, diabetes, heartdisease, certain cancers, gastrointesti-nal problems and chronic malnutrition.

Studies show that a good diet inlater years helps both in reducing therisk of these diseases and in managingthe diseases’ symptoms. This con-

tributes to a higherquality of life,enabling older peo-ple to maintaintheir independenceby continuing toperform basic dailyactivities such asbathing, dressingand eating. Inade-quate nutrition, onthe other hand, canprolong recovery

from illness, increase the cost and inci-dence of institutionalization and leadto a poorer quality of life.

The Valley Area Agency on Aging(VAAA) and the Genesee CountyCommunity Action Resource Depart-

ment (GCCARD) co-sponsored the first “BigWheels Deliver Meals” event in May2005 in Genesee County. The purposeof the event was to raise public aware-ness about senior nutrition issues.Fifteen elected officials from GeneseeCounty participated in the event bydelivering 40 home-delivered meals toarea seniors.

The first “Big Wheels DeliverMeals” event was such a success thatVAAA is expanding the event toLapeer and Shiawassee counties in2006. VAAA is committed to increas-ing the public’s knowledge of the life-long value of good nutrition.

For more information on the “BigWheels Deliver Meals” event, contact the Valley Area Agency on Aging at 810-239-7671 or 1-800-978-6275.

Judy Garza and Ben Mata, both members ofthe VAAA Board of Directors, shared in thesuccessful “Big Wheels Deliver Meals” eventby bringing meals to area seniors.

ValleyAreaAgencyonAgingServing Genesee, Lapeer and Shiawassee counties

“Big Wheels Deliver Meals”


In all 10 counties of Region VII, thehome-delivered meal program is a

great service to our seniors. Theseseniors are homebound for variousreasons and are unable to travel tothe congregate center, so the mealsare delivered right to their doors.Sometimes the home-delivered serviceis only temporary until the senior isable to once again enjoy the meal,activities and social interaction at thecongregate center.

At the Farwell Senior Center, the daybegins at 7:00 a.m. for the loving handsof the preparation crew. The meals arecarefully regulated for content and tem-perature, then attractively assembledand packed for transport. The meals are

personally delivered Monday throughFriday, with frozen entrees provided forthe weekend.

The drivers and delivery people pro-vide much more than meal transport.

They are the “eyes andears” of the home baseAging Council, Commission or Divisionin their respective county. If the driveror delivery person notices that the sen-ior is not well or has a special concern,he or she is able to report this findingfor further follow-up.A meal is neverleft if the senior does not personallyreceive it. Thank-you notes are routinelysent by grateful family members whoappreciate having their loved onereceive a good meal along with dailypersonal contact. Everyone who con-tributes to the success of the home-delivered and congregate meal programis greatly valued!

For additional information on programsand services, contact the Region VII AreaAgency on Aging, 1615 S. Euclid Ave, BayCity, MI 48706, 1-800-858-1637, or visitour website at www.region7aaa.org.

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

Volunteer Mary Eisele presents a meal to VirginiaWillard.Now that Mary is retired, she provides toothers the service that her mother received duringthe years when Mary was working.

The Tri-County Officeon Aging has part-

nered with AARP to pro-vide the Tax AssistanceProgram for seniors in thetri-county area for over 25years. For the 2006 taxseason, 30 trained volun-teers were available amongfive tax assistance sites,all working under theleadership of JoyceLaFleur. Joyce has been the instructorand coordinator of the Tax AssistanceProgram for six years, and previouslyshe was a volunteer tax counselor forthe program. With the aid of the pro-gram, 2,703 older adults received tax

assistance in 2006. Vol-unteers were able tovisit 518 seniors intheir homes to com-plete their tax forms.The five assistancesites are located at theTri-County Office onAging and in Okemos,Mason, East Lansingand Charlotte.

All seniors servedby the AARP Tax Assistance Programhave also been helped in applying forthe MI Property Tax and Home Heat-ing Rebates. An average HomesteadProperty Tax Credit for individuals was$700–$800.The program helped local

senior citizens to receiveover two million dollarsin credits/rebates. Many seniorsdepend on these rebates to pay fortheir property taxes for the presentyear.

With the exception of Detroit, thisAARP Tax Assistance Program com-pletes the highest number of taxreturns and has the lowest rate oferrors in the state. On average,approximately 26 older adults wereassisted per day at the Tri-CountyOffice on Aging during the months ofJanuary through April. Nearly all taxreturns were filed electronically, so therecipients received their refundsand/or rebates very quickly.

For more information about the AARP Tax Assistance Program partneringwith the Tri-County Office on Aging, call 517-887-1440.

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

Tri-County/AARP Partnership Offers Tax Assistance

Meals on Wheels Are Rolling in Clare County

Instructor Joyce LaFleur.

On the heels of an overwhelm-ingly positive reception to their

first-ever Senior EmPower Day, whichconvened last October in TraverseCity, the Area Agency on Aging ofNorthwest Michigan (AAANM) Boardof Advisors (BOA) is preparing tooffer an even bigger and better eventthis Fall. The intention of SeniorEmPower Day is to educate seniorsand their caregivers about key issuesthat impact the lives of older adults.

The BOA is currently seekinghigh-caliber speakers and securing alocation to accommodate moreguests for Senior EmPower Day2006. They are also narrowing downthe list of “hot topics” to be

addressed at theevent, selectingissues that theybelieve challengeolder adults. SeniorEmPower Day willagain be designed tooffer guests accurateinformation and critical insight, tostimulate discussion and to empowerthem to make informed decisionsabout important issues in their lives.

In addition to seeing great presen-ters, attendees will have the opportu-nity to visit with a variety of businessexhibits from around NorthwestLower Michigan, as well as trainedcounselors from the Medicare/

Medicaid Assis-tance Program.

Thanks togenerous spon-sorship fromlocal businesseslast year, therewas no cost toparticipate in

Senior EmPower Day 2005.The BOAis soliciting financial support againthis year and anticipates that spon-sors will enthusiastically agree to setup displays and provide informationbooths.

For more information about SeniorEmPower Day, contact AAANM at 1-800-442-1713 or 231-947-8920.

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

Summer 2006 15

In January 2005, the Department ofCommunity Health added a new

service option for the MI ChoiceWaiver Program, operated by the U.P.AAA. The service is called “NursingFacility Transition Initiative” (NFT) andis designed to assist current nursingfacility residents to move back into thecommunity.

Frequently, individuals need the levelof care and expertise offered by nurs-ing facilities to address health issuesfollowing hospitalization or anothermedical crisis. Sometimes rehabilita-tion is short-term and the individual isable to return home to resume his orher previous lifestyle. Unfortunately,rehabilitation does not always follow

precise timetables, and by the time theperson is ready to return home, manybarriers have popped up, making dis-charge very difficult.

Through NFT, MI Choice care man-agers work with nursing home resi-dents and discharge planning staff toidentify the barriers that are prevent-ing an individual from returning home,and then set forth to resolve them.Sometimes the issue is identifyinghousing or modifying housing toaccommodate the person’s disability.NFT resources can be used to accessnecessary household goods and appli-ances, address installation fees andservice charges for utilities and phoneservice, or to simply install adaptive

items such as grab bars.In 2005, the Depart-

ment of Community Health issuedspecific standards and policies to assistin making as many transitions as possi-ble a reality. While a basic guideline isthat a person must be a resident of anursing facility for six months, MIChoice care managers can begin work-ing with residents at any time. In addi-tion, the person is not required tobecome a MI Choice participant.

The U.P.AAA has teamed up withthe Superior Alliance for IndependentLiving (SAIL) to facilitate as many U.P.residents wishing to return to thecommunity as possible.

For more information on the NFT program or to make a referral, contactSAIL at 1-800-379-7245 or the U.P.Senior Help Line at 1-800-388-7227, orsimply dial 2-1-1.

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

Nursing Facility Transition AssistanceAvailable Through AAA

Board of Advisors Gears Up for 2nd Annual Senior EmPower Day

Last year’s speakers were (at left) Dr. Donald L.Fraser,D.O., Medical Director of Hospice andPalliative Care, Munson Medical Center, andRobert Simpson, District Manager at the SocialSecurity Administration,Traverse City.

Chalgian & Tripp Law Offices PLLC• Elder Law• Estate Planning• Special Needs Planning Offices in East Lansing, Jackson and Ithaca.1-888-956-9600.

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.

Porter Hills Retirement Communities & Services

Nine communities throughout West Michigan offeringResidential & Assisted Living, Alzheimer’s/Dementia Care,Skilled Nursing and Affordable Housing. Porter Hills

Services provides Home Health Care, Private Duty and Rehabilitation. To learn more, visit www.porterhills.org or call 616-949-4975.

Presbyterian Villages of Michigan Senior Living Communities

Serving seniors of all faiths since 1945. To find out more, visit our website, www.pvm.org, or call 248-281-2020 for a brochure describing the variety of housing and services

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SPONSORSThanks 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 .

How to Select a Home-Care Provider

A re you worried about hiring astranger to come into your

home — or the home of your elderlyrelative — and help with medicalneeds or personal tasks? For manycaregivers or seniors, the idea is down-right scary.

“We live in an age where you can’tbe too careful when you are havingsomeone come into your home,” saysVal Bauer, vice president of BorgessHome Care in Portage.“You need toknow and trust the company you aredealing with.”

The National Association for HomeCare & Hospice suggests asking home-care agencies the following questions:

• How long has this provider beenserving the community?

• What kinds of services does thisprovider offer?

• What procedures does thisprovider have in place to handle emer-gencies?

• Are caregivers available 24 hours aday, 7 days a week?

• How does the provider select andsupervise staff?

• Does the provider bill directly tothird-party payers?

• Is the provider accredited by aquality review organization?

• Are references available?• If this is a Medicare provider, how

does its quality compare to others onthe Medicare Home Health Comparewebsite?

• Does it protect its employees withwritten personnel policies, benefitspackages and malpractice insurance?


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