Commitment to care

Chautauqua County’s senior population is growing, and so is the need for resources that delay institutional care.

The Center for Governmental Research’s Options for the Future of the Chautauqua County Nursing Home, released in August, reports that while the county’s overall population is expected to decline, the 65-and-over population is projected to increase by 2030. The increase in the number of elderly residents in the county will have significant implications for an array of long-term-care services for older citizens going forward, the report states.

“Why you’re seeing such a shift now with Medicare change is because people were almost driven into facilities in order to get care because they weren’t paying for it in the community,” said Mary Ann Spanos, Office for the Aging director.

The CGR’s report also states that research and federal and state policies suggest that there will be increased demands for community-based services to support the concept of residents wishing to age in place, delaying institutional care as long as possible. This suggests that there will be a growing need for expanding such community resources as assisted living, home care, personal care, Meals on Wheels, case management and adult day care programs.

“We have this aging population that there is no way we can afford, and we’ve downsized all of our facilities, so we don’t have places for these people to go,” said Spanos. “So, we need to work on developing community supports and services in order to meet that need of the aging population.”

Yet, Spanos feels positive about the ability of resources such as Office for the Aging and NY Connects, a helpline that provides access to information on long-term care, to find the members of the aging community the support that they need.

“The whole focus of the Office for the Aging is keeping people independent and in the community for as long as is safe to do so,” said Spanos. “That doesn’t mean that there aren’t going to be people who need facilities. But, there are many people, who with just a little bit of help, can stay in their homes. And, why that’s so important is not only the cost to the client, but to the government because people who can stay in their home are not going to spend all their money and go on Medicaid. It really makes economic sense because we have about 300 people in our home-care program, and it costs us roughly $1,000 per person for the year. Even our highest level of care is about $10,000 per year, as opposed to $100,000 for a nursing home, or $50,000 to 60,000 for assisted living, and these people’s characteristics are very similar to those living in nursing homes.”

In 2011, the Chautauqua County Long Term Care Council released The Chautauqua Model for Long Term Services and Supports – 2011-2013. The plan focuses on the establishment of an effective integrated continuum of care, including such services as home care, palliative care, assisted living, adult homes, medical and social day care, case management, and referral and skilled-nursing facilities. One of the objectives of the plan is to promote awareness of the NY Connects program.

“The Office for the Aging is the main way, besides Medicaid, that people have as help to pay for services, but we’re still dealing with 2007 funding levels,” said Spanos. “But, I think on a federal and state level they are starting to understand that we need more investment in these services, and Jason Helgerson, the new state Medicaid director, has asked for reinvestment of some of the Medicaid savings into our NY Connects program. The program is the first place that people should call to find out what is available. Whether you’re on Medicaid or not, need a medical service or a community service, we keep a database of all the services to try to council people on what is available to help. The Federal Administration on Aging’s research shows that if you got one service through the Office for the Aging, it delayed nursing home placement by 12 months; if you got three, it delayed it by 30 months.”

MAKING PREPARATIONS

To meet the needs of the individuals entering the 60-and-over range, there are several levels of care available in Chautauqua County.

According to Janell Sluga, Senior Life Matters and geriatric care manager for Lutheran, one level of care focuses on allowing seniors the choice of living at home, with assistance. But, what Sluga has found is that there is no one way to do things, she said.

“Everyone who ages, ages differently and needs to have a guide,” said Sluga. “So, what I try to do is bring people advice, a wealth of information and experience to help guide them through the process of aging.”

The first step to remaining independent is to take into consideration the Activities of Daily Living and Instrumental Activities of Daily Living, Sluga said. These terms refer to daily self-care activities that are the tools utilized when determining which level of care is appropriate for individuals.

ADLs include activities such as walking, dressing, bathing, eating, transferring from bed and toileting. IADLs include preparing meals, grocery shopping, using the telephone, taking medicine and managing money. Once the needs of an individual are assessed, a geriatric care manager such as Sluga can recommend the appropriate level of care and help determine what services an individual qualifies for based on age.

“Most people want to stay at home,” said Sluga. “But, it also makes sense to plan by looking at the criteria that will determine if you’re still safe at home. I love it when seniors reach out for information before they need it, because then they’re not in a crisis. There are choices at every stage, and depending on whether you plan or don’t plan, it affects how much time you’ll have to make those choices.”

Another step is to ensure a safe environment at home by signing up for an emergency response system, which is meant to provide individuals with peace of mind while living independently. When an individual needs assistance, they press a button that connects them to an emergency response center.

In the event of an emergency, Venture Forthe’s service coordinator Kelly Beers recommends considering taking advantage of up to 24 hours of care through the Home and Community Based Services Medicaid Waiver, Nursing Home Transition and Diversion. The program allows a personal care aide who can provide up to 24 hours of care, oversight and supervision, housekeeping, meal preparation, and more. Call 870-8857 or visit ventureforthe.com for more information.

According to Spanos, one of the most important aspects to staying healthy while aging is being active. One way to do so is by continuing to work even after retirement. There are many part-time jobs specifically geared toward seniors that are available through the Senior Employment Program by calling 753-4856.

“Both work and volunteering keep your mind active, and when you’re mentally and physically stimulated it’s very helpful,” said Spanos. “The Senior Employment Program is geared toward people who either have retired and can’t make ends meet, or those who are at the age of retirement and can’t find a job because of their skills. It’s really a training-to-work program for people ages 55 and over that places them in government and nonprofit agencies at minimum wage for 20 hours a week for up to three years. The goal is to learn skills and build a resume to help them find an unsubsidized job.”

Nutrition is also an important aspect to remaining healthy and independent, said Spanos. Those who cannot work or who need further assistance have the option of signing up for food stamps, Meals on Wheels and the Dining Out Program. Spanos said that everyone who qualifies for food stamps should sign up for them. In addition to providing an extra level of assistance, the program brings federal dollars to Chautauqua County, she said.

Spanos also recommends considering signing up for the Chautauqua Cares Health Care Proxy Registry. The proxy acts as a legal document that allows an individual to designate a friend or family member to make health-care decisions for them should they become unable to communicate. The service is free, and anyone 18 and over can sign up by calling 338-0010 or by visiting the Chautauqua County Health Network website at cchn.net.

“The sooner you connect people with services, rather than waiting until there is a crisis, the more apt that people are to be aging in place and staying in their homes for as long as possible,” said Spanos.

For more information, call the NY Connects helpline at 753-4582 or the Office for the Aging at 661-8940. A full list of senior services is available online by visiting www.co.chautauqua.ny.us, clicking on “Departments & Agencies,” and then following the link for Office for the Aging.