Vol. 4, No. 11, November 2007
RSS Feeds
Senior Service
The need for advance planning and information about services for New Jersey seniors has never been greater
On a spectacularly sunny, unseasonably warm day in early October, the Jewish Community Center in Margate was bustling with activity.
Excited people scurried among approximately 75 booths, where representatives from such wide-ranging companies and organizations as banks, mortgage services, universities and health care agencies held forth.
Interestingly, the majority of this sprightly, enthusiastic throng were aged 65 and older, and were here to attend the Senior Expo 2007, presented by AtlantiCare, a not-for-profit health care organization serving southeastern New Jersey.
But they weren’t your granddaddy’s granddaddies (or grandmas, for that matter).
They were members of the fastest-growing segment of the country’s population—a population that is living longer and, in many cases, stronger than at any previous time in history.
In recent times, the first members of the omnipresent baby boom generation (those born between 1945 and 1960) officially reached the age of 60. Thus, many now find themselves caring for elderly parents and other loved ones. Meanwhile, fewer of today’s older folks require full-time residency in nursing homes. Yet, someone has to look after Mom, Pop, Uncle Joe or even Grandma.
While this presents wide-ranging challenges for virtually anyone, it can be especially daunting for casino workers and others in the hospitality industry.
Due to shift work, late hours on the job, rigid absenteeism and personal time regulations, scheduling their lives to accommodate elder loved ones’ medical appointments, simple day-to-day tasks such as grocery shopping and laundry, finding outside care options and social activities can be very complicated for these workers. Those with limited incomes face even greater challenges. And Medicare doesn’t cover everything.
But the good news is there’s plenty of support in Atlantic County to help smooth the way.
One-Stop for Mom and Pop
A great place to start is Intergenerational Services, a division of the Department of Human Services headquartered in Northfield. Founded in 1973 with federal Older American Act funds, this provides referrals and resources covering a wide array of issues and needs, for children to seniors. These range from home and personal care (light housekeeping, for example) to social activities, adult daycare, Medicare counseling and legal services referrals, among many others.
While the agency does offer resources and information about the region’s nursing homes, “We help to keep people out of nursing homes; most people are happier at home,” Division Director Marilu Gagnon explains.
According to U.S. Census Bureau figures for 2006, 13.5 percent of the total population of 271,620 in Atlantic County is aged 65 or older. “The highest growth rate in the county is among people 85 and older,” Gagnon points out. “At the casinos, there’s shift work, and it’s difficult to get time off (to care for loved ones).”
That’s why the agency’s toll-free 211 number comes in very handy. You can call 24/7 to locate resources for the Senior Health Insurance Program and the Aging and Disabilities Resource Connection, among other essential services.
The latter helps callers locate resources for and information on adult daycare, home-delivered meals, transportation, legal services, caregiver assistance, homecare services and more. ADRC also screens Medicaid-qualified applicants to determine the level of care required, which may render them eligible for community-based services as opposed to nursing home placement.
There’s also a Care-giver Assistance Program, a Community Care for the Elderly and Disabled program that provides in-home services to those at risk of nursing home placement, a low-income dental care program and others.
“We don’t provide the services, but we connect people to them,” Gagnon explains.
As there are more active, relatively independent seniors than ever, outside activities are vital to their existence. To that end, the county’s numerous senior centers and other agencies host a bevy of activities for anyone over 60, with a $1 donation for meals.
“These are free, and operate Monday through Friday from 9 a.m. to 2 p.m.,” Gagnon says. “They offer bingo, self-defense classes, line-dancing. Guest speakers come in. There are special trips, weekly grocery shopping and other services.”
Institutions such as the aforementioned Jewish Community Center and Shore Memorial Hospital in Somers Point also host a bunch of activities, from mah-jongg and computer classes for seniors to health maintenance lectures presented by physicians, financial planning and smoking cessation seminars.
The most recent development in this area was the September opening of the Stockton Center on Successful Aging at Richard Stockton State College in Pomona. There are three focus areas here: research, education and services. The center offers older adult educational programs such as lectures on art, music and history, to encourage intellectual stimulation.
“This started due to Stockton’s wonderful certification program to train people to work with older adults; since 1978, 200 students have earned certification,” explains David Burdick, Ph.D, the center’s director. “We’ve often done things in the community (geared toward older adults). We started this because Stockton is a citizen of the community.”
The center also offers caregiver support groups; the “Brown Bag” series, a program of lectures on the latest aging research, and the CMS and You TV program cover topics related to Medicare, Medicaid and Social Security, airing on Comcast Cable Channel 13 Thursdays at noon and 8 p.m.
There’s No Place Like Home
There also are many resources for elderly who don’t need 24-hour care, but still require supervision, support and/or home aid.
For instance, the Division of Intergenerational Services offers a Fix-It program. “This is a residential maintenance program designed to help seniors live safely,” Gagnon says. “They will put in window units, and do minor plumbing and electrical work. There is a very big need for this among our senior population.”
Another popular option is adult daycare. But this involves more than just “babysitting.” In an effort to foster vitality in seniors, agencies such as Atlantic Adult Day Healthcare, whose services are covered 100 percent by Medicaid, offer door-to-door transportation, meals, hairdresser and manicure services, field trips, parties, exercise, medical education classes, movies, physical therapy and other wide-ranging services.
In addition, there are caregiver support programs.
“We have a huge demand for home care aides; there’s a waiting list,” Gagnon says. “So, we now have a contract with the Family Service Association whereby the Alzheimer’s Association South Jersey chapter trains volunteers. Caregivers need as much support as they can get.”
But what about those who require more in-home care, or supervision in the evenings?
Diane Ott, director of marketing development for Atlantic Adult Day Care, says, “We are looking into extending our hours for 24-hour shifts.” But at the moment, there are no such services available in this area.
“This is a serious workforce issue, especially if you’re single and the only one in the household, and you have to work at night,” David Burdick says.
That’s why caregivers may opt for home care workers, either hired through agencies or privately. Needs may include everything from companionship provided by a worker who helps with personal care (light housekeeping to running errands) to home health aides for the more dependent elderly and hospice services for the seriously ill. This may encompass visits of a mere few hours a week to round-the-clock, live-in care.
One agency that can help sort out the confusion is Bayada Nurses, a nationwide home health care provider headquartered in Moorestown, with branches in Atlantic and Cape May counties. This is one of the few area agencies of its kind that is covered by Medicare.
“We link families to the right resources,” says Bayada Atlantic and Cape May Director Maryanne Prudhomme. “Many times, people will think they need a nurse, but don’t. So the first thing we do is to find out what the need is and put together a plan. We may refer people who need live-ins to non-medical companies. Mom may have Medicare, which provides intermittent care if she breaks her hip.
“But once the skilled need is gone, the home health aide services stop; Medicare doesn’t cover custodial care. But that doesn’t mean Mom doesn’t need help in the morning. Medicare doesn’t provide that. Home care is very confusing. People need to know what they will need—before they need it.”
So, it’s crucial that one is prepared, as opposed to waiting for an emergency to seek care. For one, determine if a parent or other elderly loved one has long-term care coverage, and what their financial issues are.
Moreover, when hiring aides or nurses through an agency, there are critical questions that you must ask. How are employees selected? Are employees bonded and insured? Are employees subjected to background and criminal checks? How is insurance and billing handled?
“You need to ask whether the agency is the employer, or if the family is the employer,” Prudhomme adds. “Does the employer (agency) pay taxes and insurance, or is the family responsible for this? Does the agency provide personal protective equipment, such as surgical gloves? Is there worker’s comp? Is there supervision? Does a nurse come out and do an assessment?”
You also must bear in mind that you are inviting a complete stranger into your home, and entrusting the care of a loved one to them. If you do decide to hire someone privately, it’s best to do so through the state Board of Nurses.
Prudhomme points out that, in certain circumstances, hospice care is an excellent option.
“This is also Medicare-covered,” she says. “People may go to this as a last resort, but it’s one of the most under-utilized programs. This is a team approach that helps patients and their families deal with life-limiting illnesses.”
Be Prepared
While many relatives of the elderly may avoid facing the inevitable due to the emotional impact of the prospect, it’s important to maintain a sense of pragmatism when planning for their future care. (And your own, for that matter.)
That’s why one must anticipate issues and prepare in advance, before there is a crisis.
Preparing for the future financially and in terms of retirement funds, wills, living wills, long-term care and the like are critical. Michael D. Weinraub, P.C., a Ventnor attorney who specializes in elder law, Medicaid planning and estate planning, urges families and caretakers to take steps to avoid leaving the handling of a loved one’s affairs up to the courts.
Among the most important subjects to address are the signing of a durable power of attorney for business and legal matters, a health care directive and living will for medical decision-making. There are many other confusing issues, such as how one can assure their financial security as they age, how and when to distribute assets, tax concerns, how to provide for one’s family, housing, long-term care insurance and so much more.
Thus, Weinraub urges everyone with older loved ones to do a “legal” checkup consisting of a review of estate planning, as well as reviews of legal documents, tax implications, liquidity planning and disabilities planning.
Those who can’t afford an attorney may, once again, refer to Intergenerational Services for information about South Jersey Legal Services, Inc., a non-profit agency that provides free advocacy and representation to low-income people.
While it may be far more difficult for casino and hospitality workers to care for elderly and infirm loved ones, there are plenty of resources and support.
As David Burdick says, “If the casinos want to hire and keep good workers, these services are very important.”
RESOURCES FOR SENIORS
2-1-1, 24-hour toll-free number to call all county Human Services AtlantiCare, 888-569-1000, www.atlanticare.org
AtlantiCare Hospice, Doughty Road, Egg Harbor Twp. 609-272-2424
Atlantic County Division of Intergenerational Services Shoreview Building, 101 S. Shore Road, Northfield 609-645-7700, www.aclink.org
Atlantic Adult Day Health Care, Tilton Plaza, 331 Tilton Road, Suite 2, Northfield 609-383-3313 www.atlanticadult.com
Bayada Nurses, 35 Central Square, Linwood, 609-926-4600, www.bayada.com
Milton and Betty Katz Jewish Community Center, 501 N. Jerome Ave., Margate, 609-822-1167
www.jccatlantic.org
Shore Memorial Hospital, 1 East New York Ave., Somers Point, 609-653-3500, www.shorememorial.org
