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

Also in This Issue: ■ Care Management

Services for Seniors■ A Look at AAAs

Around Michigan

Depression

GenerationsTMSpring 2004Michigan

NewLightA

on

2 Michigan Generations

SPRING 2004 Published quarterlythrough a cooperative effort ofMichigan’s Area Agencies on Aging.

For information contact:Jenny Jarvis248-262-9202jjarvis@aaa1b.com

Editorial Project Development:JAM Communications, Atlanta, GA

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

On the Cover:Today, depression among seniors is ahighly treatable illness. For a detailedlook at symptoms, diagnoses andtreatment, turn to page 4.

GenerationsMichigan

Spring 2004, Volume 1, #4 © 2004 by the MichiganArea Agencies on Aging. The information con-tained 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 Americansage 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

3B3A

3C4

1B

MAP

PHO

TOG

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 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

Spring 2004 3

CAREGIVINGNews&Notes

Surfing the NetEach issue of Michigan Generations offers several websites of inter-est to older adults and their caregivers … right at your fingertips.

www.cornellcares.com offers information on emotionaland mental health among older adults.The site was developed by

the geriatrics division at Cornell University’sMedical College.

www.healthcarecoach.comis a “how-to” resource for caregivers

that offers guidelines on subjects such ashow to choose a doctor, questions

to ask a surgeon and how to han-dle disputes with insurancecompanies.

Look for more helpful websitesin the next issue of Michigan

Generations.

Test your knowledge of good exercise habitswith this true/false quiz:1. Recommended levels of activity decreasefor individuals as they age.2. Even with regular exercise, it is not possible for older adults to be as fit asyoung people.3. A long, brisk walk each day is enough tostay healthy.4. Before beginning an exercise program,you should consult your doctor.

1. False. Recommendations do not vary by age. Everyone who can should aim for moderate exercise daily and vigorous activityat least once a week.2. False. If you stay fit, your body can per-form even better than someone youngerwho is unfit.3. False.Walking is good aerobic exercise,but research indicates you also needstrength training and stretching to stay fit.4. True.Your doctor should examine the stateof your health and check for any limitations.

Smoking is strongly associated with colon cancer, according to a

study reported in the Journal of the American Medical Association.

Inadequate intake of vitamin D and of dietary fiber is also linked

to the disease. The study involved over 3,000 individuals age 50

to 75. Current smokers were at double the risk compared to

non-smokers. On the positive side, factors that reduce the

chance of colon cancer included having a diet rich in fiber and

vitamin D.

The Risks of Colon Cancer

Here’s good news for older adults who feel thejob market always favors younger employees:

A recent study shows that more U.S. companies wantolder workers.

Challenger, Gray & Christmas, an outplacementconsulting firm, reports that an increasing number offirms are hiring older adults because they have valu-able experience, a mastery of certain skills and agood work ethic. Older workers accounted for about77 percent of net employment growth in October2003, according to the study. Opportunities werenoted in fields such as accounting, education, secu-rity and business administration.

Job Opportunities forSeniorsAre you faced with a legal problem, but you’re intimidated by the thoughtof hiring a lawyer? If you find yourself in this situation, use this check-list of basic questions to determine which lawyer is right for you:

1. What is your experience in this field?2. Have you handled matters like mine?3. What are the possible outcomes of my case?4. What are my alternatives in resolving the matter?5. Approximately how long will it take to resolve?6. Do you recommend mediation or arbitration?7. What are your rates and how often will you bill me?8. What is a ballpark figure for the total bill, including fees

and expenses?9. How will you keep me informed of progress?10. Can junior attorneys or paralegals in the office handle some

of the administrative work at a lower rate?

10QUESTIONSTO ASK A

Lawyer

Exercise facts fictionVS

4 Michigan Generations

The roots of Florence’sdepression were nothard to trace. The St.Joseph woman hadcared for a successionof loved ones, includingher sister, sister-in-lawand husband, only towatch them pass away.High blood pressureand hip problemsplagued her physicalhealth. And the apart-

ment building where she was living burned to the groundas Florence watched.

While such tragedies would certainly bring anyonedown, Florence was not able to shake her anxiety and list-lessness. “I was so nervous, I could hardly handle it,” saidFlorence. “I’ve lost all my family, and I just felt so alone.Many times I just wished the good Lord would take me.”

Happily for Florence, she was referred to a psychia-trist, who put her on an antidepressant, and a counselor,who helped her work through her feelings. Though she

still feels nervous at times, she claims to be happier thesedays. “I try to keep busy and do things to help others,”she said. “And no, I no longer think I want to die.”

Like Florence, many seniors find their golden yearstarnished by depression. Indeed, aging brings many chal-lenges that can lead to depression — loss of loved ones,functional limitations, chronic illnesses and waning inde-pendence, to name a few.

The good news is that depression is a highly treatableillness. About 90 percent of those who suffer from depres-sion get better with medication and/or therapy. The badnews is only about 10 percent of seniors get the treatmentthey need. Seniors either don’t recognize what they areexperiencing as depression, hide it as a shameful weaknessor simply believe turning gray and feeling blue go hand inhand. The latter attitude is too often shared by their care-givers and physicians.

“People think, ‘Well, you’re old, of course you’redepressed,’ ” said Dr. Suzann Ogland-Hand, director ofthe Center for Senior Care at Pine Rest Christian MentalHealth Services in Grand Rapids. “But it’s like the story ofthe 81-year-old man who goes to his doctor with a soreleft knee. The doctor listens to the man’s complaints and

a NEW

A YEAR AGO, 76-YEAR-OLD

Florence was plagued with anxi-

ety and panic attacks. She lost

her appetite, rarely ventured

from her apartment and lost

interest in activities she used to

enjoy. Though at the time she did

not realize it, all of these symp-

toms stemmed from depression.

DepressionBy Martha Nolan McKenzie

LIGHTon

then says, ‘You know, you’re 81. You haveto expect some aches and pains.’ Thepatient replies, ‘Well, my right knee is81, too, and it feels fine.’

“Depression is not normal at any age,”continued Ogland-Hand. “The fact is,most seniors feel satisfied with their lives.And those who do suffer from depressioncan feel better with treatment.”

Factors in depressionDespite the serious consequences,

depression in seniors often goes unde-tected and untreated. One reason is thatseniors rarely identify depression as aproblem. “Someone under 65 will comein and say, ‘I’m feeling depressed andsad,’ ” said Sandra Plumer-Dickens, pro-gram director of geropsychiatry at Bots-ford Hospital in Farmington Hills. “Butan elderly person will hardly ever comein with that complaint. Instead, theirsymptoms are typically aches and pains,sleep problems and generally not feelinggood. So they go to their family doctor,who treats the physical problems but maynot recognize the underlying depression.”

Fortunately, that situation is changing.More and more doctors are recognizingdepression for what it is — a seriousmedical problem that can be attributed tomany factors, including:

LOSSES. Old age inevitably bringslosses. Loved ones move away or die.Careers are left behind, along with one’ssense of identity and social status. Activi-ties that used to be possible are now outof reach. It’s easy to feel trapped in anever-narrowing circle of isolation andlimitations.

Our society doesn’t make it any easierto cope with these losses. “We are sogeared up for everything to happenquickly,” said Ogland-Hand. “It used tobe, if you lost a spouse, you wore blackmourning clothes for a year. Now ifyou’re still feeling blue after six months,people think you’re not coping.”

MEDICAL PROBLEMS. Aging alsooften brings health problems, many ofwhich can cause depressive symptoms.Menopause, hypothyroidism (low thy-roid), heart disease, stroke, cancer, arthri-tis, Alzheimer’s and Parkinson’s diseaseare often associated with depression.While having a chronic illness is certainly

reason enough to feel depressed, in somecases the connection is even more direct.

“Conditions such as diabetes, highblood pressure and elevated cholesterolaffect the blood flow,” said Dr. PeterLichtenberg, director of the Institute ofGerontology at Wayne State University inDetroit. “They may be causing microvas-cular changes in the brain, which areproducing mood disturbances. There is afair amount of evidence to support this.”

Often, seniors with chronic conditionsconsider depression the least of theirworries. “They really are not focused onwhether they have depression or not,”said Lichtenberg. “They are too con-sumed with their health problems. Butdepression is an integral factor in theirwhole health.”

Shirley, a 72-year-old retired school-teacher in Vicksburg, suffered fromdepression brought on by chronic diges-tive tract problems and severe pain in herlegs. Any time the slightest thing wentwrong — a scheduling snafu, a disappoint-ing lab result, a doctor’s negative tone ofvoice — she would cry uncontrollably.

Her husband urged her to get treat-ment for depression, but she balked. “Iwas dealing with so many other things —battling the insurance company, goingthrough all these tests and having severepain,” said Shirley. “I told him I couldn’tdeal with the depression until I wasn’thurting so badly.”

Today, Shirley is feeling much better.Treatments relieved her leg pain anddigestive problems, and psychotherapyand an antidepressant lifted her mood.“I’m feeling pretty great right now, forthe first time in a long time,” she said.

MEDICATIONS. Seniors these daystypically take a myriad of medications.While these drugs are a godsend forkeeping heart disease at bay and arthritispain checked, they can also bring anunwanted side effect — depression.Drugs used to treat high blood pressure,arthritis and thyroid problems, for exam-ple, can bring on depressive symptoms.And even if a drug is not associated withdepression, it may react with other med-ications the senior is taking.

“It’s very difficult to predict the effectswhen people are taking four to five med-ications a day, and some seniors are taking

Spring 2004 5

Most people think of depression

only as sadness or “the blues,”

but clinical depression is a far

more serious condition. While every-

one gets down now and then, those

who suffer from clinical depression can-

not shake their empty, sad mood and/or

lost interest in the activities they used

to love. Other symptoms include:

• Sleep disturbance — insomnia or

wanting to sleep all the time

• Reduced appetite and weight loss

or increased appetite and weight gain

• Restlessness or irritability

• Persistent physical symptoms that

don’t respond to treatment, such as

headaches, chronic pain, constipation or

digestive disorders

• Difficulty concentrating, remember-

ing or making decisions

• Fatigue or loss of energy

• Feelings of guilt, hopelessness or

worthlessness

• Crying easily or for no reason

• Thoughts of death or suicide

Of the 35 million Americans over

65 years old, 2 million suffer from a

depressive illness, and another 5 million

have depressive symptoms that fall

short of meeting the medical criteria

for a disorder, according to the

National Institute of Mental Health.

“There is nothing minor about minor

depression,” said Dr. Lichtenberg. “Any

degree of depression can interfere with

someone’s life, adversely affect health,

delay recovery from an illness or injury

and, in the worse case, lead to suicide.”

A common —and dangerous— problem

many more than that,” said Mick Pries, PhD, an elder specialist atRiverwood Center, a mental health center in Benton Harbor. “Theresult of all these drug interactions may be unforeseen.”

Treating depressionWhen many of today’s seniors were growing up, there were few

effective treatments for depression. Antidepressants came along inthe 1950s, but they often brought on severe side effects. Psychother-apy was available, but the field of geropsychology was unknown.

Today, depression may be the most treatable problem a sen-ior has. The most common treatments are psychotherapy and/orantidepressant medications. Other treatments have also proveneffective. Here is a look at the treatments:

ANTIDEPRESSANT MEDICATIONS. Though they cannot curedepression, antidepressants help people feel better by control-ling their symptoms. They work by restoring the chemical bal-ance in the brain to improve mood, sleep, appetite, energy levelsand concentration. They are not habit forming and do notchange a person’s personality.

The newer antidepressants have fewer and milder sideeffects than their predecessors. Most commonly prescribed arethe serotonin selective reuptake inhibitors (SSRIs), whichinclude Prozak, Zoloft and Paxil.

Some people need to try several different medications beforethey find the one that works for them, and some may need to beon more than one at a time. “The medications that are out noware very good and can play a critical role in controlling depres-sive symptoms,” said Plumer-Dickens.

PSYCHOTHERAPY. Many seniors who take a plethora of dailymedications already are reluctant to add another pill to theirarsenal. And those with mild to moderate depression may notneed to. Psychotherapy — therapeutic discussions with a psychi-atrist, psychologist, social worker, trained nurse or licensedcounselor — can be just as effective as medications for manyindividuals.

Through psychotherapy, seniors can change their pessimisticideas, unrealistic expectations and critical self-image. They candevelop better coping skills and work on resolving relationship

conflicts. And simply having a caring, sympathetic counselor tolisten to them can lift feelings of isolation and hopelessness.

“Sometimes just having someone sit down and talk to themcan make all the difference in the world,” said Dr. Ralph Hutchi-son, a clinical psychologist with Caring Alternatives in Monroe.He recently visited a retired farmer who suffers from Alzheimer’sand lives in a nursing home. The old man had been giving thenurses a lot of trouble, and they were at their wits’ end trying todeal with him. “I sat down and talked to him for a long timeabout farming,” said Hutchison. “I reminded him of the thingshe had done well in his life, like running a successful farm. Ialso talked to the nurses about giving him a job or somethinguseful he could do so he could feel he was still able to make acontribution. You could see him start to feel better about himselfand brighten up.”

A big part of any therapy is to help people learn how tochange the things they can and accept the things they can’t. Thelosses seniors experience can’t be reversed. Loved ones cannotcome back. Abilities won’t reappear. But seniors can change howthey perceive these losses.

“First, you have to help the person acknowledge and verbal-ize the losses,” said Jim Loomis, a certified social worker andowner of Counseling at Home in Portage. “Then I try to normal-ize it. Point out that this is the normal course of life. But thatdoesn’t mean they have to give up everything.”

6 Michigan Generations

Help for Caregivers

While depression among seniors is a serious con-dition, it can be an equally serious problemamong the loved ones who care for them.

About half of all caregivers will experience an episode ofmajor depressive disorder, according to Dr. Ogland-Hand.She estimates as many as 90 percent may suffer minordepressive symptoms.

It’s easy to see why caregivers are at risk. They are typi-cally watching a loved one deteriorate and they feel helplessto halt the decline. They may be juggling the demands ofwork, children and a spouse with their caregiving duties. Andcaregiving may place a strain on their finances and their ownphysical health.

“Caregiving is a very stressful situation,” said Plumer-Dickens. “It’s like taking on another full-time job — one that’sfilled with worry.”

It’s critical that caregivers take care of themselves, or theywon’t be able to care for their loved ones. If a caregiverbegins to feel overwhelmed and depressed, he or she shouldcontact a physician or a mental health counselor. The sametreatments that can help a depressed senior can bring reliefto the caregiver. Support groups can also help a caregiverrecognize he or she is not alone and provide a safe place toshare mutual concerns and frustrations.

Antidepressant medications

PsychotherapySocial supportElectroconvulsive (shock)

therapy (ECT)Bibliotherapy.Light therapyExercise therapy

TREATINGDEPRESSION

TREATINGDEPRESSION

For example, Loomis worked with one woman who washaving a hard time with her children taking over control ofthings in her life, such as her finances and house maintenance.While she was out one day, her daughter, without asking her,painted one of her kitchen cabinets brown while the otherswere white.

“I worked with her to help her see that she needed theirhelp with her finances and house maintenance to enable her tostay in her home,” said Loomis. “But I also helped to empowerher to stand up for herself and tell her children that decisionslike painting her cabinets are hers to make, not theirs.”

SOCIAL SUPPORT. Sometimes getting help with daily tasksgoes a long way in combating depression. If a senior is feelingdown because she can no longer keep her house as clean as sheused to or is having trouble dressing and undressing herself,arrangements can be made for someone to come in to help cleanor dress. It sounds like a small thing, but it can make a big dif-ference in the person’s outlook.

Connecting with other seniors can also help. “Just gettingsomeone out of the house and to the senior center can make ahuge difference,” said Hutchison. “Finding a role for them attheir church, providing activities that get them out of the house,getting them together with another senior to talk — all of thesethings can be very effective.”

ELECTROCONVULSIVE (SHOCK) THERAPY. While themajority of depression sufferers find relief with antidepressantsand/or psychotherapy, some with severe depression don’trespond to either. For these people, electroconvulsive therapy(ECT) can be an effective treatment.

With ECT, a patient is put under general anesthesia and alow, carefully monitored electrical current is delivered to thebrain. Like antidepressants, ECT restores the brain’s mood-regulating chemical balance. The patient generally wakes up inrecovery five to 10 minutes after the procedure. ECT does notinduce a seizure or render a patient catatonic.

“ECT went through a period of bad press in the ’80s and’90s — the whole One Flew Over the Cuckoo’s Nest Jack Nichol-son thing,” said Loomis. “But that barbaric image of the movie isnot the case at all. ECT is considered safe and quite effective forpeople with severe depression who don’t respond to other thera-pies. It can make for long-lasting changes.”

ALTERNATIVE THERAPIES. Several therapies outside themainstream have proven effective with some patients, eitherused in conjunction with antidepressants and/or psychotherapyor as stand-alone treatments. Among them:

Bibliotherapy. In reading therapy, a person reads self-helpbooks to address depression. While therapists have long encour-aged patients to read motivational books in between therapies tospeed up recovery, the effectiveness of stand-alone bibliotherapywas demonstrated in the mid-’90s by a series of studies at theUniversity of Alabama. The researchers had groups of mildly andmoderately depressed seniors read one of two books — FeelingGood by Dr. David Burns or Control Your Depression by Dr.Peter Lewinsohn. At the end of four weeks, two-thirds of theseniors no longer met the criteria for depression, and three yearslater, these people had not had a relapse of depression.

Light therapy. For some seniors, lack of sunlight brings onthe blues. Seasonal Affect Disorder (SAD) is a specific type ofdepression induced by periods of reduced sunlight, such asMichigan’s long winter months. A special light box can deliver ameasured amount of balanced spectrum light equivalent tostanding outdoors on a clear Spring day. This therapy helps reg-ulate the body clock and can elevate the mood.

Exercise therapy. For many seniors, exercise can provide thesame relief as other treatment for depression. A study by theNational Institute of Mental Health found 30 minutes of aerobicexercise three times a week was as effective as antidepressantmedication for some seniors with a major depressive disorder. Inaddition, researchers found improvement in cognitive function inthe group who did the exercise therapy, leading the researchersto speculate that exercise might be able to offset some of themental declines often associated with aging.

Brightening seniors’ tomorrowsThe world can be a challenging place for today’s seniors.

They’ve witnessed mind-boggling changes during their lifetimes.They are living longer than they ever expected to. And they haveno road map for what this new period of their lives should look like.

“People are living so much longer,” said Pries. “A hundredyears ago, life expectancy was about 45. Now it’s almost doublethat. We don’t really have models about how to be this old, sothere is no clear path for today’s seniors. People start tuning in towhat’s going wrong and the losses they’ve suffered. But it doesn’thave to be that way. Many seniors are still busy living their lives.”

With today’s highly effective treatment options, many seniorscan leave their depression behind and put the shine back intotheir golden years. MI

For information about or help with depression, contact the following:

National Alliance for the Mentally Ill1-800-950-6264 or www.nami.org

The National Institute of Mental HealthCall or write for free brochures. 1-800-421-4211 orwww.nimh.nih.gov/publicat/depressionmenu.cfm.

The National Institutes of Health’s National Institute on Aging For a free brochure, “Depression: A Serious but Treatable Illness,” call 1-800-222-2225.

National Mental Health Association Call 1-800-969-NMHA or visit www.nmha.org. To order brochures on depression, call 1-800-228-1114. To take a free confidential screening for depression, visit www.depressionscreening.org. To contact NMHA of Michigan, call 248-647-1711 or visit www.mha-mi.org.

AARPCall 1-888-OUR-AARP or visit www.aarp.org.

Resources

Spring 2004 7

On January 21, PBS ran a wonderful documentary aboutAlzheimer’s disease titled The Forgetting. I felt privi-leged to be part of a large team of volunteers who

answered phones from viewers who were watching the show andwanting more information. Alzheimer’s disease has increased 10-fold from 500,000 to 5,000,000 in the United States duringthe past 15 years, and this includes over 200,000 Michigan citi-zens. Over the next 20 years the prevalence of Alzheimer’s dis-ease will again double and include over 10 million citizens of ourcountry. The average out-of-pocket cost per family to care forsomeone with Alzheimer’s disease is $25,000/year. The Forgettingfollowed three different families and victims of Alzheimer’s dis-ease across many years. The show also followed two researchleaders whose discoveries are crucial to unraveling the mysteryof Alzheimer’s disease. Despite its many strengths, there aresome important points that the show did not address at all.

In Michigan we are fortunate to have a Michigan DementiaCoalition, which brings together concerned consumers, universityeducators, state government officials and major geriatric-orientedhealth centers to work on Michigan’s priorities for dementia. Inthe Fall of 2003 the Michigan Dementia Plan, a strategic three-year plan for dementia, was published after 18 months of hearingsand hard work by experts across the state. This plan detailed somecritical aspects about dementia that were omitted by The Forgetting.

FAMILY CAREGIVING PROGRAMS WORK: The Forgetting failedto include the progress that has been made in supporting familycaregivers. Fifteen years ago there was no menu of options toassist family caregivers in trying to keep their loved ones athome. Real progress has been made in identifying the types ofcommunity support and programs that assist family membersand other informal caregivers to keep their loved ones in the

community — the residence of choice for most of us. Supportgroups, learning to partner with health professionals, respite

care options, home and community-based dementiasupport case management, estate planning and edu-cational information about dementia are some of themajor tools we have to help caregivers.

DEMENTIA IS A CHRONIC CONDITION AND REQUIRES

A PUBLIC HEALTH APPROACH: The Forgetting quotedan expert saying that he believes the “cure” forAlzheimer’s disease is only five to 10 years away.This quote is reminiscent of what was said aboutcancer 20 years ago. Only this year did cancerexperts state that the best approach to understanding

cancer is a chronic disease model. Cancers cannot all be cured,but people can live long and fulfilling lives with treatment forthe condition. Dementia is the same. I highly doubt Alzheimer’sdisease will be cured in the next decade or two, but treatmentsare available and I believe the effectiveness of these treatmentswill only increase. The keys to effective treatments of chronicconditions are early detection, aggressive medical management,caregiver support and planning and an increase in options foraccess to the best care and medicines. All citizens need to knowthe “10 Warning Signs of Alzheimer’s Disease,” published by theAlzheimer’s Association. Call 1-800-272-3900 or visitwww.alz.org.

There are many factors that can modify risk for gettingAlzheimer’s disease: Risks for chronic diseases need to beviewed from the more global to the more individual. Examplesof more global risks include increased pollutions and environ-mental hazards from ozone loss, etc. Examples of personal risksinclude poorer health functioning of Michiganders (i.e. increasedweight problems and chronic diseases such as high blood pres-sure, diabetes and high cholesterol). Reducing our risks for diseases such as Alzheimer’s is critical to our society’s copingwith this growing epidemic. MI

DR. PETER LICHTENBERG is the Director of the Institute ofGerontology and a Professor of Psychology at Wayne State University.He has authored many articles on dementia detection and evaluation.

In 2003 Dr. Lichtenberg was the lead editor on the book Handbook of Demen-tia: Psychological, Neurological and Psychiatric Perspectives (John Wiley &Sons, Inc.). He is the current chair of the Michigan Dementia Coalition and canbe reached at 313-577-2297 or email p.lichtenberg@wayne.edu.

A copy of The Forgetting can be pur-chased by calling Warner Home Video at1-800-364-6928. The cost is $19.95 plusshipping and handling.

8 Michigan Generations

By Dr. Peter Lichtenberg

MissingPieces

Filling inSome

GUESTClose-Up

A L Z H E I M E R ’ S D I S E A S E

“I’m calling about my mother. Sheneeds help at home, and I am won-dering what’s available for her.”For those of us who respond to calls at theArea Agency on Aging, this is an all-too-familiar question. Many family caregiverscall when a crisis occurs. They are oftenunsure about what to do and don’t knowhow to go about getting the help they need.

Working with your local Area Agencyon Aging is beneficial because you can findthe information you need to make decisionsabout care options, and the agency can alsohelp direct the care you receive through itsCare Management Program.

What is care management?CARE MANAGEMENT IS A PROGRAM ofpersonal consultation to help people knowand understand what choices are availablewhen an older loved one has difficulty living independently. The program enablesindividuals to receive long-term care intheir home rather than in a nursing homeby providing realistic options.

Through a team of qualified professionals,care management will provide assistanceto help an older adult or their caregivernavigate through an array of services andprograms available in the community,

including those offered through the AreaAgency on Aging.

Who is eligible for care management?AS PROVIDED BY THE AREA AGENCIES

on Aging, care management is intended toassist those older adults, 60-plus, who areexperiencing limitations of daily living thatplace them at risk of entering a nursinghome. They usually require a moderate tohigh level of help with their personal andhome care needs. Nursing home residentsassessed as being able to return home ifsupportive services are available are alsoeligible for care management.

What is the first step?CALL YOUR LOCAL AREA AGENCY ON AGING.All persons referred to care managementreceive a telephone interview to determinewhether they meet the eligibility require-ments for the program. When it appearsthat an individual qualifies, a registerednurse and social worker visit the client’shome for an in-depth needs assessment.

What can I expect from anassessment?THE COMPREHENSIVE ASSESSMENT,performed by a nurse and social worker, isan evaluation of the older adult’s livingenvironment, including health, emotionaland social status. The assessment alsoreviews safety issues, support from familyand the financial situation to determinehow services will be paid.

What follows the evaluation?THE NURSE AND SOCIAL WORKER WILL WORK

with the older adult and their family todevelop a plan of care. This plan mayinclude services such as meals, personalcare, medication monitoring and lighthousekeeping. Respite care for the primarycaregiver can also be arranged if required.The nurse and social worker become thecare managers of the older adult.

Families may accept or refuse all or anypart of the plan, and can work with the caremanager to determine what will best meettheir individual needs and budget.

Who will pay for the services?DEPENDING ON THE INDIVIDUAL’Scircumstances, services may be paid for ina number of ways as appropriate, includ-ing Medicare, private insurance, commu-nity programs, Medicaid or private pay. Allpersons eligible for the program areinformed about the cost of the assistanceand requested to make a contributionaccording to their financial ability.

What happens to the informationthat is provided?AREA AGENCIES ON AGING ARE REQUIRED

by law to maintain client confidentiality.Therefore, all information is kept confi-dential and will not be released withoutwritten permission from the client or theircaregiver.

What happens if care needs change?YOUR NEEDS ARE MONITORED BY THE CARE

manager through periodic in-home visitsand telephone contacts. The plan of care isreviewed and adjusted as needed.

Will care management result innursing home placement?SINCE THE CARE MANAGEMENT PROGRAM

is voluntary, it’s your choice as to whereyou receive long-term care services. Theprogram is designed to allow you to remainin your own home and to assist you to liveas independently and as safely as possible.

To find out more information, contact yourlocal Area Agency on Aging by referring topages 10 to 19 of this publication.

ASKtheExpert Audrey North

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;

jjarvis@aaa1b.com.We will make every

effort to answer your question in an

upcoming issue of Michigan Generations.

Care Management

Provides Help

AUDREY NORTH is the Care Manage-ment Clinical Operations Supervisor for theRegion IV Area Agency on Aging.

Spring 2004 9

Transportation services areextremely important to older

adults who can no longer drive. Burn-ham Brook Region IIIB has been pro-viding transportation services tosenior citizens for 10 years. It startedwith a small bus and volunteer driversand has developed into a full-time pro-gram with a full-time director, threepart-time drivers and a part-time assis-tant. The program currently servesabout 250 seniors a year. Transporta-tion is available Monday through Fridayfrom 8:00 a.m. to 4:30 p.m.

The transportation program is offeredto Calhoun County residents age 60 andover. Transportation is provided for med-ical appointments; ongoing medical treat-

ments; volunteeractivities; personalerrands such asgrocery shopping,banking and hairappointments; andsocial events. Indi-viduals going tomedical appoint-ments are given toppriority. There is nocost to the clientsfor the service,although donations are appreciated.

“Burnham Brook’s transportationprogram enables seniors to maintainsocial contacts and continue importanthealth care,” says Jolene English, direc-

tor of SupportServices. “Theprogram not only helps thesenior citizen involved butalso supports family mem-bers who might otherwisehave to take off work toprovide transportation.”

Eleanor Kipp uses Burnham Brook’s trans-portation three times aweek from her home inMarshall to SouthwestMichigan Rehab in BattleCreek. She says, “I don’tknow what I’d do withoutBurnham Brook’s trans-

portation. I am very grateful for thisservice.”

For more information, call 269-966-2540 or visit our website atwww.burnhambrook.com.

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 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

10 Michigan Generations

Burnham Brook Region IIIBServing Barry and Calhoun counties in Southwest Michigan

Transportation Program Helps Seniors Retain Independence

Burnham Brook driver Rick Hirle-mann delivers Eleanor Kipp to amedical appointment in Battle Creek.

Spring 2004 11

How many of you know of some-one who is living in a nursing

home simply because they need helpsuch as bathing, cooking and house-cleaning?

If you know of someone in that situ-ation, ask yourself this: If they had achoice, would they rather live in thecomfort of their own home or remainin the nursing home?

Now seniors living in a nursinghome because they need assistancewith activities ofdaily living dohave a choice, andit’s called theNursing FacilityTransition Initia-tive, or NFTI. TheDetroit AreaAgency on Agingwas awarded theNursing FacilityTransition Initia-tive Grant fromthe U.S. Depart-ment of Healthand Human Services/Center forMedicare and Medicaid Services. Ourcollaborative partners on the projectare Citizens for Better Care, Neighbor-hood Services Organization, Legal Aidand Defender Association, Inc. and PatLake and Associates.

The goal of NFTI is to transition 12clients from nursing homes back intothe community between September2003 and December 2004. Nursinghome residents who are able to livesafely and independently are eligible forthe program. The program also pro-vides assistance in obtaining suitablehousing, household goods, arrangingnecessary supportive services and man-aging the clients’ ongoing care.

NFTI is open to seniors who are

currently living in a nursing home andwould like to move back into a com-munity within Wayne County. After aninitial interview to assess the client’s

eligibility for the program, NFTI work-ers will develop a person-centered planwith input from the client, their familymembers and/or caregiver.

After the client has been assessedand deemed eligible for the program,NFTI workers will assist the client inlocating suitable living arrangements.

Clients can move in with family mem-bers or friends,or they may liveindependently.

Once housing hasbeen secured andthe client has beenmoved into the set-ting, support servicesare implementedbased on the client’sneeds. These ser-vices include long-term care optionslike MI Choice, acost-effective, long-term option forMedicaid-eligible seniors and disabled

adults. This program has allowed manypeople to stay in the comfort of theirown homes while receiving home careservices — similar to those providedby nursing homes.

“This program is very empoweringto the senior and the senior’s family,”says Paul Bridgewater, executive direc-tor of the Detroit Area Agency onAging. “Through each step of the tran-sitional process out of the nursing

facility and back into the community, thesenior and the senior’s family membersare making the decisions regarding theircase management. We are just there toprovide support and assistance.”

For more information on the NFTI program, call 313-446-4444 or visit ourwebsite at DAAA1A.org.

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

Seniors Transition from Nursing Homes Back into the Community

This program has allowed many people to stay in the comfort of their own homes while receiving home care services — similar to those provided by nursing homes.

NFTI helpstransition clientsback to moreindependent living.

Larry O’Mara believes in miracles,and one of them is the Rapid

Response Short Term Program devel-oped by the Area Agency on Aging 1-B. This innovative program can pro-vide quick access to short-term homecare services for older adults or per-sons with disabilities.

At the end of October 2002,O’Mara was just months into a newjob when he fell at work, severelyinjuring his back. After several monthsof treatment, O’Mara wasn’t better.The next step was surgery — aneight-hour procedure where doctorsfused discs and added rods, pins, platesand screws to his back.

Following surgery, the hospital dis-charge planner recommended thatO’Mara, who lost his wife to cancerseveral years ago, go to a nursinghome for recovery, since he had noone to help him at home. But withoutinsurance, a nursing home stay wasn’tan option, so the 61-year-old went tolive with his friend in a mobile home.

O’Mara made one vital contact thathas made all the difference in hisrecovery. He says, “I talked withAudrey Smith, care manager at the

AAA 1-B Macomboffice, and she setthe wheels inmotion for me.Within a day, shehad been out tovisit me andarranged forsomeone to comein and help mewith personal careand homemakingtasks.” Meals onWheels brought hima hot meal eachday. And soon hewas struggling backon the road torecovery, letting nothing get in the wayof his goal to get better.

That recovery couldn’t happenwithout physical therapy, and again,Smith was able to assist. DespiteO’Mara’s lack of insurance, Smitharranged therapy services for him withPeter Kovack at the First Choice Physical Therapy Clinic. “Larry was somotivated to get better that he got hisdoctor’s permission to drive the shortdistance to the clinic,” Smith says.

Now, three days a week, O’Maraworks with his therapist, graduallybuilding up his strength. He’s so deter-mined to get back to his normal activities that he’s already scheduled atee time for a game of golf. “But noneof this would have happened withoutthe AAA 1-B’s help and that of myphysical therapy team,” says O’Mara.

The Area Agency on Aging 1-Boffers two Rapid Response programs:Rapid Response Short Term and RapidResponse Respite. Rapid ResponseShort Term is designed for individualsage 60 and older who need immedi-ate short-term homemaking or per-sonal care services for four to sixweeks, but no longer than 12 weeks.Many times the need for this care fol-lows a hospital stay. Other times afamily crisis may mean that a clientneeds some outside help. Manypatients don’t meet the criteria forskilled care in a nursing home, butcan’t manage for themselves — forexample, after breaking an arm or aleg. Sometimes there is no family toprovide support, and often the

Everyday Miracles: The AAA 1-B’s Rapid Response Program

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

AreaAgencyon Aging 1-B

Help is a Phone Call AwayThe Area Agency on Aging 1-B is the first resource for older adults, care-

givers and persons with disabilities to call when looking to resolve problemsor locate the resources they need to improve the quality of their life.

When individuals call the toll-free Information and Assistance (I&A) service at 1-800-852-7795, they speak with a certified Information andReferral Specialist to determine what theirneeds are and the services and assistanceavailable to address those needs. Once theneeds are determined, the specialist accesses the I&A database of over 2,000community agencies and mails the individual a complete listing of relevantservices and providers in their local community.

Call us. We can help.

1-800-852-7795

12 Michigan Generations

Larry O’Mara with Audrey Smith, care manager (right), and Peter Kovack,physical therapist (left).

The Detroit Pistons honored TheSenior Alliance for its work with

seniors and caregivers. The ceremonytook place at halftime of the PistonsFebruary 18th home game against theMilwaukee Bucks, played at the Palace inAuburn Hills. While both teams warmedup prior to the second half, The SeniorAlliance board members and staffwalked to center court and were intro-duced to the sellout crowd.

“We are very pleased to recognizean organization that provides so muchto the community and to seniors asThe Senior Alliance,” states PalaceSports & Entertainment Group SalesRepresentative, Jaclyn Immel. “Wehope that by placing attention on The

Senior Alliance, we may be able toalert caregivers where to find help ifthey need it, and if people want tocontact The Senior Alliance to make acontribution supporting senior pro-grams, well, that’s okay too.”

For the 2003-2004 NBA season,the Detroit Pistons along with TheSenior Alliance coordinated a series of“Senior Nights at the Palace,” fourevening basketball games with dis-counted ticket prices for lower bowland upper bowl seating and a free Pistons’ visor for all seniors 60 orolder along with their friends and fam-ily, regardless of age.

After the NBA seasoncompletes, Palace Sports& Entertainment plans to provide sen-iors with discounted packages toattend women’s basketball games fea-turing the WNBA World Champions,the Detroit Shock.

“We are honored to be partnerswith the Palace on this special pro-gram for seniors,” states SeniorAlliance Executive Director MikeSimowski. “Sports provides a greatopportunity for families to get out andenjoy themselves.”

The Area Agency on Aging 1-B willbe holding several community

forums on the new Medicare Prescrip-tion Drug Benefit. These forums arefree to the public and will address theinterim prescription drug card, howthe new program will work, enroll-ment in the benefit, how much thenew benefit will help with prescriptioncosts and other changes to Medicare.

The dates and locations of thecommunity forums are listed below.Please call the Area Agency on Aging1-B for more information.

Livingston CountyLivingston Education Services Agency,1425 West Grand River, Howell; Friday,May 14, 2004, 2 p.m to 4 p.m.

Macomb CountyMacomb Department of Senior CitizenServices,Verkuilen Building Auditorium,21885 Dunham Road, Clinton Town-ship; Wednesday, May 19, 2004, 10 a.m.to 12 p.m.

Monroe CountyMonroe County Intermediate SchoolDistrict, 1101 S. Raisinville Road,Monroe; Tuesday, May 25, 2004, 10 a.m.to 12 p.m.

Oakland CountyOlder Person’s Commission, 650 Letica Drive, Rochester; Monday, May10, 2004, 10 a.m. to 12 p.m.

Costick Center — Shannon Hall,28600 Eleven Mile Road, FarmingtonHills; Tuesday, May 18, 2004, 10 a.m. to12 p.m.

St. Clair CountyThe Council on Aging, Inc., serving St.Clair County, 600 Grand River, PortHuron; Tuesday, June 8, 2004, 10 a.m.to 12 p.m.

Washtenaw CountyTurner Resource Clinic, 2401 Plymouth Road,Ann Arbor; Tuesday,May 4, 2004, 1 p.m. to 3 p.m.

Questions About the New Medicare Benefit?individual can’t afford to pay the fullcost of private care. Older adultsreceiving Rapid Response Short Termservices are informed about the costof the assistance provided andrequested to make a contributionaccording to their financial ability.

The AAA 1-B offers a second RapidResponse program — Rapid ResponseRespite. This program is designed toprovide short-term relief for individu-als who are long-term caregivers forindividuals age 60 or older or foradults age 18 or older with a disability.Services consist of in-home respite,out-of-home respite and adult dayservices. Individuals receiving RapidResponse Respite are required to paya percentage of the cost for theirservices received according to theirfinancial ability.

For more information on the Rapid Response programs and services,contact the Area Agency on Aging 1-B at1-800-852-7795 and ask to speak withthe Rapid Response Nurse for yourcounty.

The Senior AllianceServing caregivers and seniors in the 34 communities of southern and western Wayne County

Detroit Pistons Honor The Senior Alliance

The Senior Alliance board and staff are honored by Detroit Pistons.

Spring 2004 13

The Jackson County Departmenton Aging and LifeWays received a

grant from the Department of Com-munity Health to provide supportservices to older adults living in Jack-son and Hillsdale counties. The pro-gram was developed to address themental health needs of seniors in ourcommunity. The Region 2 Area Agencyon Aging has formed a partnership thisyear with the Department on Aging tooffer these services to clients who arepart of the Home-Based CommunityWaiver Program that the agency pro-vides in the tri-county area.

The SEARCH program providesservices that are free to those whoare 60 and older or disabled. Theservices are:

■ Screening services for memory,depression and substance abuse

■ Homebound supportive coun-seling for seniors living alone or theircaregivers

■ Intensive elder case management■ Community education through

a training called “Partners inHealth” — informing seniors onhow to develop a partnership withtheir physician, which helps toimprove care.

Often seniors may be experiencing

problems and think that depressionor memory loss is a normal part ofthe aging process; therefore, theydon’t address their concerns withtheir primary physician. This program

provides the opportunity for seniorsto meet with a social worker in theirhome or at the Department’s officeto address their concerns.

For more information about the aboveservices, please call Ginny Wood-Bailey at1-800-335-7881.

Why is it that many caregiversfeel guilty about taking a break

from the constant care a loved oneneeds? Perhaps it’s because so many ofus hold on to the myth that says it’sour personal duty to always be there.

The truth is, we all need a breakfrom our everyday routines, especiallyif someone is a caregiver. Although weknow that the care we give our lovedones cannot be duplicated, there aremany competent volunteer and paid

caregivers who can give us a neededbreak on a regular basis so we can

recharge. Research indi-cates that without thesebreaks, sooner or laterour physical and emo-tional health will be

affected.The service of in-home respite care isprovided by everyhome care agency inthe county. Trainedaides can stay withyour loved one for aslittle as two hours orovernight. The Region3A Area Agency onAging provides fundingfor two local agenciesthat give priority to

persons who need financial assistance(see box at left).

Contact the AAA 3A at 269-373-5147or the Caregiver Resource Center at 269-978-0085 for information on other in-home respite care agencies, adult dayprograms or overnight respite care facilities.

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

Covering Kalamazoo County and its 24 municipalities

SEARCH: Serving Elders At-Risk in the Home

Senior Services, Inc. . . . . . . . . . . 269-382-0515ADL Home Care, Inc. . . . . . . . . . 269-373-5444

14 Michigan Generations

Kalamazoo Cty. Human Services Dept.Region3A

The SEARCH program is free to those over 60. It provides the opportunity for seniors to meet with a social worker intheir home to address their concerns.

Taking a Break: In-Home Respite Care

Caregivers need a break from their daily responsibilities.

In recent years, studies have producedwelcome news for older adults: Mod-

erate physical exercise, including briskwalking, can improve overall health andincrease energy levels.

The “Walkie Talkies” exercise groupin St. Joseph County has been feelingthe healing effects of abrisk walk for the pastyear. At HealthTRAC (arecreation/athletic centerlocated in Three Rivers),this group of 20 men and

women walk or cycle for an hourtwice per week. The safety and secu-rity of walking indoors and having pro-fessionals available for assistance arewhat keeps them going. Also, thecamaraderie of old and new friendsexercising in this type of group has

them, as they say,“looking out for one another.” Overthe past year, the group has seen anincrease in energy as well as muscletone, and some have even seen a fewpounds melt away.

The St. Joseph County Commissionon Aging was able to negotiate a specialrate with HealthTRAC to accommodatethe group, and it has proven to be agreat business partnership for eachorganization. As one member com-ments, “We’ll be doing this until thegroup gets so big the track can’t hold us— come on over and join us!”

For further information, please contactthe Branch-St. Joseph Area Agency onAging (IIIC) at 517-279-9561 or toll-free at1-888-615-8009. You may also visit ourwebsite at www.bhsj.org.

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

The Healing Power of a Brisk “Walkie Talkie”

The Tri-County Office on Aging(TCOA) is one of five sites in

Michigan chosen to administer a grantthrough the Family IndependenceAgency to assist senior refugees in ourtri-county area. The goal of the grantis to link senior refugees to existingsenior services. TCOA’s brochure hasbeen translated into the five languagesprevalent in this community’s seniorrefugee populations.

TCOA has identified isolation as anarea of concern and has held socialgatherings for the Cuban and Viet-namese elder communities. TCOA hasalso linked with Catholic Social Ser-vices/Refugee Services to do commu-

nity outreach to find senior refugeesin need of assistance. TCOA hasalready helped 37 senior refugeesobtain services and items that wereotherwise unavailable to them. One

Haitian refugeewas helped with an orthopedicbed because her back had beendamaged when she was tor-tured in her home country.Other assistance has includedsuch services as transportation,interpretation, help in payingmedical bills, purchase of house-hold items such as beds andfurniture, assistance in payingimmigration costs and the pur-chase of clothing.

To be eligible for assistance,the client must be a refugee, 60years of age or older, and there

must be no other available source offunding to cover the need.

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

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

Senior RefugeesReceive Help

Geraldine Tase uses “ExerStrider”poles to assist her as she circles

the track. In the background,Twila Jones and Maxine Milhahn

keep up the pace.Spring 2004 15

Refugees enjoy a social gathering and other outreachprograms.

Through a grant provided by BlueCross/Blue Shield of Michigan, the

Valley Area Agency on Aging (VAAA)has been able to assist approximately50 seniors by providing safety equip-ment such as grab bars, handrails andnonskid strips. VAAA has also pro-vided home modifications such asremoving clutter and tacking downcarpets that provide a fall risk. Fallsaccount for 87% of all fractures forpersons age 65 and over, and of thosewho fall, 20 to 30% suffer moderate tosevere injuries that reduce mobilityand independence, and increase therisk of premature death.

As seniors grow older it is impor-

tant to look at their homes and seewhat can be done to prevent falls.This task is often difficult for seniorsthemselves, because they do not pos-sess the expertise to determine whatneeds to be done and often lack theresources needed to implement thechanges. The Blue Cross/Blue Shieldgrant has made it possible for VAAAsocial workers to assess seniors’homes for fall prevention and pur-chase safety equipment when needed.

Seniors often face giving up activitiesdue to functional limitations; however, itis important to encourage them to con-tinue as many activities as possible in asafe manner. Many seniors, for instance,

have reported giving upbathing in the tub orshower for fear of falling. Once VAAAequipped their bathrooms with grabbars and shower benches, they feltmore secure and resumed bathing safely.

You can obtain a home safety check-list for seniors at Miseniors.net, or callVAAA at 810-239-7671 ext. 243.

Blue Cross/Blue Shield — Partnering to Prevent Falls

Tips for reducing falls■ Maintain a regular exercise program.■ Make living areas safer by removing tripping hazards and usingnonslip mats and grab bars in thebathroom.■ Have doctors review all of yourmedications.■ Have your vision checked annually.

Computer training for seniors isone of the services offered by

the Area Agency on Aging. The South-west Michigan SeniorNet LearningCenter is a nonprofit computer class-room for adults 50 years of age andolder. The age requirement applies tothe volunteer teachers and coaches aswell as the students.

Courses currently offered at theLearning Center include: BeginningComputers, Intermediate Computers,Word Processing, Graphics, Genealogy,Spreadsheets, Windows and your PC,and Introduction to the Internet. Eachof the two-hour classes meets onceper week for eight weeks.

The classroom accommodates 12 students, and classes are “hands-on.”A video projection system displays the

instructor’s screen for all to see. Senior-Net is designed to be a low-pressure,enjoyable learning environment. Bestof all … there are no tests.

Our training center features theWindows XP operating system on

all computers and has a high-speed Internet connection.

The Learning Center islocated at 211 HilltopRoad in the old Heath/Zenith building in St. Joseph.The Area Agency on Aging

provides the classroom andall of the equipment.

To find out about classes orbecoming a volunteer, call the

Learning Center at 269-983-4232 orsend an e-mail to snlc@qtm.net. Ourwebsite is at www.swmisnlc.org.

Region IVArea Agency on Aging

ValleyAreaAgencyonAgingServing Genesee, Lapeer and Shiawassee counties

SeniorNet Learning Center Offers Computer Classes

Covering Michigan’s Great Southwest including Berrien, Cass and Van Buren counties

SeniorNet coordinator and instructor Dennis Bowenworks at his computer.

16 Michigan Generations

Prescription drugs can be a miracleof modern medicine when taken

properly, but a health hazard whennot. To help make sure seniors aretaking their drugs as prescribed, theArea Agency on Aging of WesternMichigan funds a Medication Manage-ment Program in Kent, Mason, Lakeand Newaygo counties. “Studies showthat older adults account for morethan half of all drug reactions that leadto hospitalization,” says Tom Czerwin-ski, director of the Area Agency onAging of Western Michigan. “With justa little oversight, they can take themsafely and remain at home.”

The Medication Management Pro-gram helps a variety of people, includ-ing those who are blind, those with

dementia and those with little or nohelp from family. “We have foundolder adults may run out ofmedicine or they may takedouble doses,” saysCharlotte Nickelsonof Gentiva HealthServices, which pro-vides the nurses inKent County. “Westart out withweekly visits to setup the meds, then grad-ually drop down to once permonth. Our goal is to teach themor a family member or friend to prop-erly dispense the drugs. We try to getin, get out, but give as much help asthey need while we’re there.” Some

clients, however, mayneed to remain on theprogram indefinitely.

During the time someone is in theMedication Management Program, an

RN or LPN will do a completehealth check on the person.

“We do a health assessmentevery time we go to the

home. We look at thewhole person andwhether the person is

eating properly. We willdo quick, skilled checks

like blood pressure tests,”says Nickelson. If the nurse

sees something else the clientmay need, she will refer them on toother programs.

For more information, call the AreaAgency on Aging of Western Michigan at1-888-456-5664.

How often have we heard some-one say, “I just want to be home

and be able to sleep in my own bed?”Most seniors prefer to receive serv-ices and care in the comfort of theirown homes. Region VII AAA fundsprograms to help seniors receive careand maintain their independence whileremaining at home.

In-home services such as home-delivered meals, personal care, respitecare and homemaking are key sup-ports for seniors. The MI Choice Medicaid Waiver program offers assis-tance to seniors who meet both medical and financial eligibility.

Region VII also supports programs

that modify the senior’shome to make it safer.Adding grab bars, providing a tubtransfer bench, changing doorknobsto lever-style handles or replacingshelves with drawers in kitchen basecabinets can make everyday tasks easier. Lift chairs save caregivers fromback strain and help the care receiverto be more mobile. Making homemodifications and obtaining helpfulequipment may be just the answer forseniors who wish to maintain theirindependence and safely remain intheir own homes.

For further information, contact theRegion VII Area Agency on Aging, 1615South Euclid Avenue, Bay City, MI 48706,or call toll-free at 1-800-858-1637. Abrief overview of services is available onour website at region7aaa.org.

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

Medication Management

Services and Home ModificationsEncourage Independence

Helpful Region VII staff — Elaine, Mary and Wendy— waiting to take your call.

Spring 2004 17

As a person’s health declines, theyneed to start looking at care

options. This was the case for NaomiThompson. Naomi has a heart condi-tion and until recently had remainedindependent. Naomi was used to lead-ing an active life. She worked at thelocal hospital for many years and thenowned her own real estate companyfor 12 years. Once her health becameworse, she found herself unable to dosome things she used to handle easily.She turned to the MI Choice Program.

The MI Choice Program helps theelderly and disabled at risk of nursinghome placement remain in theirhomes. Once a referral is received, aCare Management team conducts anin-home assessment, develops a care

plan, arranges for services and pro-vides follow-up with periodic reassess-ments. Services under MI Choiceinclude homemaking, respite, adult daycare, private duty nursing, home-deliv-ered meals, personal care supervision,personal emergency response systems,chore service, counseling, home modi-fications, medical supplies/equipmentand some training.

Prior to his death, Naomi’s husbandwas receiving help through NEMCSA’sMI Choice Program. It was an easytransition for Naomi to seek assis-tance since she was familiar with thecaregivers and services available.Although Naomi’s six children help outas much as possible, more assistancewas needed. The children live out of

state or not conveniently close by —a situation similar to many families.With MI Choice, Naomi receives helpwith homemaking, bathing and mealpreparation. Naomi still likes to do asmuch on her own as possible — suchas managing her own finances, medica-tions and so on. The physical tasks aremost challenging, as she is on oxygenand not able to walk great distances.

If you or someone you know needshelp but is reluctant to ask, Naomioffers this bit of wisdom: “You’re notgiving up your life; you’re simply mak-ing your life easier.”

For more information, call NEMCSA at1-800-219-2273 ext. 231.

The innovative “Dining Out” Pro-gram in Region 10, which debuted

in November 1999, has maintained itssuccess over the past four years, pro-viding senior citizens with more flexi-bility in dining times and mealselections. The program is a service ofthe Area Agency on Aging of North-west Michigan (AAANM) and severalCommissions on Aging in Region 10, incooperation with area restaurants.The restaurant voucher program hashelped to provide seniors who do notlive near a traditional congregate mealsite the option of receiving a nutritiousmeal that meets the meal standards ofthe Senior Nutrition Program.

Seniors pick up “Dining Out”

vouchers at AAANM and participatingCommissions on Aging, which exposesthem to valuable information on availability of additional services. A

suggested donation of $2.00per voucher is appreciatedbut not required.Vouchers are currently limited to fourper month per participant to insure program continua-tion throughout the entire fiscal year.

Dale Millward, a long-timeparticipant, says the program“promotes people to get outof the house and meet peo-ple” and that it fills “not somuch a physical need, butrather an emotional need.”

To learn more about “Dining Out,”contact AAANM at 1-800-442-1713.

NEMCSA Region9 Area Agencyon AgingCovering 12 counties of Northeast Michigan

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

Seniors Are “Dining Out” at Local Restaurants

MI Choice Makes a Difference

18 Michigan Generations

Dale and Evelyn Millward of Traverse City enjoy dining at theCottage Café, the first restaurant to participate in the “DiningOut” Program.

UPCAP Services, Inc., is a multi-pur-pose, 501(c)3 nonprofit organiza-

tion. In addition to its role as an AreaAgency on Aging, UPCAP also adminis-ters a number of other programs thatbenefit the senior citizens of the UpperPeninsula. One rather unlikely programis the West-Central Regional Commu-nity Corrections Program.

The Community Corrections Pro-gram provides safe, alternative sentenc-ing options to judges for nonviolentoffenders in our local communities.These options allow the offender toremain in the community while servinghis or her sentence, instead of beingplaced in jail or prison.

How does a Corrections Program

benefit seniors? The Corrections Pro-gram offers local nonprofit organiza-tions assistance with any number ofdifferent jobs or activities through itsCommunity Services Work Crew Pro-gram. Within UPCAP’s six-county program area, the three local Commu-nity Action Agencies take advantage ofthe program and utilize the work crewsto assist with the monthly and quarterlydistribution of commodities — unload-ing bulk supplies and packing them intosmaller packets for actual distribution tolow-income families and seniors.

Senior centers and congregate mealsites also take advantage of the pro-gram for assistance with preparationand the serving of meals. In one

instance, a senior centerhad all of its computers upgraded andprograms developed to meet monthlyreporting requirements by a programparticipant with extensive computertraining.

UPCAP’s Care Management Pro-gram uses the Community Correc-tions Program too, utilizing workcrews during the summer to helpmaintain the lawns of seniors and inthe winter to keep sidewalks anddriveways shoveled. Work crews havealso been used to caulk and repair orput up and take down storm windowsat the homes of seniors.

During FY 2003, over 4,700 hoursof service, with a monetary value inexcess of $60,000, was generated bythe program for the benefit of seniors.

For more information on this program,contact Sue Young at 906-789-0511.

There are many reasons why olderadults need home-delivered meals.

Some may not have enough money topay bills, buy medications and buy gro-ceries. Home-delivered meals can helpstretch dollars with one or two nutri-tious meals a day.

Maybe someone has a short-termmedical need — like Rose in Holland,who says: “I really enjoy your meals.Since I cannot cook for myself for awhile [due to a hip replacement], thisreally helps a lot and they are so nutri-tious.” Or maybe someone has a dis-ability — like Clare in Hart, who isnearly blind and asked her driver,“What was that I had yesterday for

lunch?” Her driver explained it wasquiche, and Clare said, “It was verytasty and a nice change.”

In Muskegon, William takes care ofhis wife, who has Alzheimer’s. He says,“I just can’t seem to keep up with

everything; it is so helpfulto know we have thismeal taken care of each day.” AndKatherine lives alone in Spring Lakewhile her family lives out of state. Herfamily says, “It is such a relief to knowsomeone is checking on Mom every-day. The meals and visit mean so muchto her and us.”

Whatever the reason, Meals onWheels is a program of NutritionalServices that truly impacts the qualityof life for older citizens in our threecounties. Volunteers and staff deliverhot meals, cold meals, special diets,frozen meals and liquid supplements.

To find out about Meals on Wheelsand other programs for seniors in thisarea, call 231-755-0434 or 1-800-442-6769, or visit www.nutritionalservices.org.

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

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

Community Corrections ProgramBenefits Seniors

Meals on Wheels: A Helping Hand forthe Homebound and Their Families!

Spring 2004 19

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

personalized home care 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.

Visiting PhysiciansProviding compassionate, high quality medical care in thehome. 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.

Whirlpool CorporationWhirlpool Corp., the global leader in home appliances,proudly serves and sponsors agencies that help people livetheir lives to the fullest.

SPONSORS

1. Are you basically satisfied with your life?

2. Have you dropped many of your activities and interests?

3. Do you feel that your life is empty?

4. Do you often get bored?

5. Are you bothered by thoughts you can’tget out of your head?

6. Are you in good spirits most of the time?

7. Are you afraid that something bad is goingto happen to you?

8. Do you often feel helpless?

9. Do you often get restless and fidgety?

10. Do you prefer to stay at home rather thango out and do things?

11. Do you frequently worry about thefuture?

12. Do you feel you have more problems withmemory than most?

13. Do you feel downhearted and blue?

14. Do you feel pretty worthless the way youare now?

15. Do you worry a lot about the past?

16. Do you find life very exciting?

17. Is it hard for you to get started on newprojects?

18. Do you feel full of energy?

19. Do you think that most people are betteroff than you are?

20. Do you frequently get upset over littlethings?

21. Do you frequently feel like crying?

22. Do you have trouble concentrating?

23. Do you enjoy getting up in the morning?

24. Do you prefer to avoid social occasions?

25. Is it easy for you to make decisions?

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 .

Here is a sampling ofquestions that have beenused extensively todetermine depressionamong seniors. While theGDS is a useful screeningtool, it is not a substitutefor a diagnostic interviewby mental health profes-sionals.

* The Geriatric DepressionScale was created by Dr.Jerome Yesavage, director ofthe Aging Clinical ResearchCenter at Stanford UniversitySchool of Medicine.

Geriatric Depression Scale (GDS)*