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www.BusinessWomanPA.com BUSINESSWoman CAREGIVER SOLUTIONS 2013 3

PUBLISHER

Donna K. Anderson

EDITORIAL

Vice -President & Managing Editor

Christianne Rupp

Editor

Megan Joyce

CONTRIBUTING WRITERS

Barbara Trainin BlankRichard Cheu

Claire Yezbak FaddenMarielle Hazen

Stephanie Kalina-MetzgerDr. Linda Rhodes

ART DEPARTMENT

Production Coordinator

Renee McWilliams

Production Artist

Janys Cuffe

SALES

Account Executives

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Valerie KissingerDoug Kline

Ranee Shaub MillerSue Rugh

Sales & Event Coordinator

Eileen Culp

ADMINISTRATION

Business Manager

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Project Coordinator

Loren Gochnauer

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CAREGIVERSOLUTIONS

2013

Dear Readers,

4 Working Families:Setting RealisticExpectations

6 Improving theMental Health ofChronically IllPatients

8 Paying for NursingHome Care

11 The PennsylvaniaCaregiver SupportProgram

12 UnderstandingHospice Care: Whatit Is and What it Isn’t

14 Easing theDiscomfort inAlzheimer’s Patients

18 Reducing the Risk ofFalls in the Elderly

21 Simple Solutions

22 Federal and StateWaivers andPrograms

24 Frequently AskedQuestions byCaregivers

28 Resources

29 Directory of Housing& Care Providers

33 Directory ofAncillary Services

34 Support andInformation

Throughout this past year, a number of my friends have become more involved in thecare of a parent. It’s carried out with love and compassion and the desire to ensure theirloved one’s comfort and safety. They’ve had to deal with money matters, safety concerns,and health issues. And I have seen the consequences of them trying to keep up with theircareers, their family affairs, their new caregiving responsibilities, and, lastly, themselves.

As the saying goes, “You don’t know what you don’t know.” This edition of CaregiverSolutions, includes information that can help caregivers make more informed decisionsand become aware of programs and services that are available in their community.

Many caregivers find that they have had to sacrifice advancement opportunities intheir careers. We have included an article that talks about options you may want toconsider the next time a career opportunity arises so you can realistically consider it.

You have frequently asked questions. Caregiver Solutions has answers to thosequestions, with information about waivers and programs that may benefit your lovedone, information about the Caregiver Support Program, an article that broaches thetopic of how to pay for nursing-home care, and other relevant topics.

An important feature in Caregiver Solutions is the Directory of Providers andServices. Whether you’re considering a move or some type of care or assistance for yourloved one, please check it out. The organizations included are eager to discuss how theirservices can help in your caregiving responsibilities.

Your situation is unique to you, but you don’t have to be alone in your journey. Lookto your local Office of Aging; they have a wide range of people and programs to assistyou. Join a support group; hear from other people whose experiences are similar toyours. Read what you can, whether it’s in print or online (use only reliable sources,though).

And most importantly, don’t forget to take care of yourself and your needs.

Christianne Rupp, Editor

Contents 2013

4 6 18 21

BUSINESSWoman CAREGIVER SOLUTIONS 2013 www.BusinessWomanPA.com4

One major cultural shift we haven’t talked about is the impactthat women in the workforce have on how families provide care.

This matters because the majority of caregivers are women,many of whom are thrown into a juggling act that they simplycan’t withstand. Raising kids, sustaining a marriage, andmaintaining a career is enough for anyone’s plate, but add caringfor one or two aging parents (which, on average, consumes about20 hours a week), and you can expect the juggling act to end witha crash.

Men, too, are increasingly becoming caregivers, but themajority are in their mid-70s and are caring for an ailing spouse.

Most baby boomers providing care to parents are working,and their employers report that their work productivity islessened by nearly 20 percent; they also suffer from higher levelsof stress, depression, and health problems than their colleagueswho don’t have parents needing care.

If you are a working caregiver, you might have had or areconsidering a number of alternatives to help you balance yourfamily life with your job. Some of these might be the following:

• Letting go of advancement or promotion opportunities• Reducing hours to part time• Asking for or finding a less demanding job• Passing up extra shifts that would earn more money• Turning down new training opportunities that require traveling

out of town

• Expending all your personal leave, sick days, and vacation daysto provide care

• Taking unpaid leave (Family Medical Leave Act)• Resigning from your job

Because of the 2008 economic downturn, many workers arereluctant to take time off work to provide caregiving becausethey are afraid of losing their jobs, or they can’t afford to lose thewages. On the flipside, some families are taking an extra job justto pay for the out-of-pocket costs associated with providing care.

In any event, before you take drastic steps, especially quittinga job, be aware that women who leave a job during their workingyears to provide full-time caregiving are 2.5 times more likely tolive in poverty once they reach retirement age than women whoremained in the workforce.

These women can expect to lose an estimated $659,000 inwages, Social Security, and pension contributions, as well as lostcoverage for healthcare insurance over her lifetime (source:AARP Policy Institute).

My guess is that your parents certainly don’t want this for yourfuture, so consider taking these steps to achieve balance betweenyour job and caregiving:

1. Talk to your supervisor about your situation. If you employerhas an employee assistance program, explore your options.Because of the huge numbers of workers faced with caregiving,companies are offering more assistance to their employees.

Working Families:Setting RealisticExpectationsBy DR. LINDA RHODES


2. Explore whether you can complete any of your work at homeinstead of at the office (telecommuting).

3. Ask how you can use the Family Medical Leave Act and howit can best complement the days you have accumulated forvacation and personal leave.

4. Research opportunities at work, such as splitting yourresponsibilities with another coworker (job sharing) in a similarsituation or devising a more flexible schedule (flex time).

5. Ask your human resources department whether it offers anyinformation and referral services to help you track downbenefits and resources to care for your aging parent. Humanresources also might provide the services of a geriatric caremanager to help you create a caregiving plan.

6. Look into the option of using an adult day center that offerstherapeutic and social activities for your parent while you are atwork.

7. If you have siblings, create a Caregiving Resource Assessmentworksheet showing how this impacts your job (for example,days you’ve been off work, lost vacation days, and so on).

Discuss how they can help. For example, you all mightcontribute to covering a nonmedical senior care aid to assist orpay for adult day center services.

It’s best to explore all your options at work before you walkaway from your own economic security, so necessary for yourolder years. Don’t wait for your work performance to startslipping before you approach your supervisor.

Excerpted from Dr. Linda Rhodes’ new book, The Essential Guide toCaring for Aging Parents. Please see a review of her book on page 28.

Dr. Linda Rhodes, a former secretary of aging for the state ofPennsylvania, is a Patriot-News columnist, gerontologist, and author ofFinding Your Way and The Essential Guide to Caring for Aging Parents(Penguin Group 2012). Go to www.lindarhodescaregiving.com to learnmore about her book and receive free resources and videos.

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By RICHARD CHEU

A diagnosis of chronic illness unleashesmany negative emotions in the patient:fear, anxiety, despair, anger, and grief.

If these negative emotions are notaddressed and dealt with when they firstappear, the patient may become focusedon the past and grieve for what has beenlost: a better job, a child’s graduation, aspecial vacation, or retirement.

It is important to control, reduce, andeliminate this emotional baggage before itimmobilizes the patient and prevents

them from moving forward to ameaningful and fulfilling life.

The caregiver is at the core of apatient’s care. She/he often knows moreabout the personality, habits, and lifestyleof the patient than anyone else. Thecaregiver can encourage the patient totake responsibility for her/his mental,physical, and spiritual health.

When confronted with a seriousproblem, most people instinctively knowthe best solution to the problem. They arefaced with three possible actions: “do it,”“don’t do it,” or “I’ll think about it.”

Many patients will prefer the lastoption and choose to procrastinate until itbecomes too late to achieve the bestpossible results. If the patient, however, isgiven an opportunity to express anddiscuss the problem and alternativesolutions, she/he often will choose to dowhat is right no matter how distasteful itmay seem.

The caregiver can be the means bywhich the patient confronts and conquersthe negative emotions that are preventingher/him from moving forward withtreatment and achieving a greater quality

Improving the Mental Health ofChronically Ill Patients


of life. The caregiver does this bybecoming an active listener.

The usual conversation between twopeople, especially at cocktail parties,consists of two people talking “at eachother,” each trying to tell her/his storywithout really understanding or, perhaps,not caring about the other person’s story.

Active listening is a method oflistening in which the listener focuses onwhat the speaker is saying, tries todevelop an understanding of the meaningof what has been said, and responds tothe speaker through encouraging bodylanguage, such as a nod of the head orsmile.

This encourages the speaker tocontinue talking openly about importantor troubling issues. The listener does nottell her/his own story, does not make anyjudgments about what the speaker says,and concentrates on helping the speakerto express her/his most importantfeelings and thoughts.

In other words, the listener engages themind and disengages the tongue.

Five Tips for Helping Caregivers toBecome Active Listeners

• Avoid an environment with distractionssuch as a window onto a busy street,noise, or frequent interruptions. Sitclose to the speaker and look directly ather/him. This body language tells the

speaker that you are interested in whatshe/he is saying. If the speaker is in bed, don’t sit on thebed. Sit in a chair beside the bed, situpright, and lean toward the patient;these are signs of attentiveness to whatthe speaker is saying.

• Take mental notes. As the speakerspeaks, try to summarize what is beingsaid. Pause the conversationperiodically to review with the patientwhat has been said. Keep mental notesof where the discussion began, is now,and how it ends. At each pause, say something that asksthe speaker if you understand what hasbeen said thus far. “I think you aresaying …” or “Do you mean that …?”

• Begin the conversation by asking aboutsome aspect of the patient’s life beforechronic illness. “What was it like when…?” “What did you do before youretired?” Allow the patient to direct theconversation to topics and concerns ofgreatest interest.

• Use silence to the patient’s advantage.Most people are afraid of a lull in aconversation; five seconds seems likefive hours. Be patient and wait for thespeaker to resume speaking. Look forsigns that the speaker is thinking hardabout what to say or how to say

something very important. Use bodylanguage to show that you continue tobe interested and are not in any hurry,such as a nod or smile. The speaker will let you know when theconversation is over. Like a 911 call, “Bethe last one to hang up.”

• Know yourself. Are you an extrovert orintrovert? Either personality type canbecome an effective active listener if thelistener is aware of the barriers to goodlistening associated with her/hispersonality type. Extroverts have no problem talking. Infact, they often talk too much and don’tpay enough attention to what the otherperson is saying.

Introverts, on the other hand, don’t liketo speak until they are certain that whatthey will say is correct. Silence is not aproblem for an introvert. The biggestchallenge for an introvert can bestarting a conversation or keeping itgoing when the speaker is also anintrovert.

Richard Cheu, author of Living Well withChronic Illness a Practical and Spiritual Guide,is a Catholic hospital chaplain, a caregiver forhis chronically ill wife, and was aneurophysiologist and an EMT.

Please see a review of Richard Cheu’s book onpage 28.

~


Admitting a loved one into a nursinghome is stressful and emotionallydraining. Compounding the stress andheartbreak is the daunting task faced bythe spouse and family members:navigating the complicated maze ofMedicare, Medicaid, and private insurancerules associated with paying for nursinghome care.

The costs of long term-care can befinancially devastating. Getting competentplanning advice from an experiencedattorney as early in the process as possibleis very important to protect your rightsand ensure that you access all availablepublic and private benefits.

It is a common misconception that anyplanning to protect resources for thespouse or other family members must bedone five years before admission into thenursing home. This is simply inaccurate.In most cases, even after admission intothe nursing home, it is not too late to doplanning to protect resources for thespouse or family members of the nursing-home resident.

Many people mistakenly believe thatMedicare will cover the cost of nursing-home care. Medicare coverage fornursing-home care is actually verylimited. Medicare is a federal healthinsurance program for individuals 65years of age or older, certain younger

individuals with disabilities, andindividuals with end-stage renal disease.

Medicare is not a means-testedprogram. Generally, you are eligible forMedicare if you or your spouse worked forat least 10 years in Medicare-coveredemployment.

Medicare Part A benefits covernursing-home costs when both thefollowing limited conditions are met:

1. There must have been a three-dayhospital stay within 30 days of beingadmitted into the nursing home.

2. You must require skilled care, whichmeans you need skilled nursing orrehabilitation staff to treat, manage,observe, and evaluate your care.

If you meet the criteria for Medicarecoverage of your nursing-home stay, thebenefits will be limited to 100 days ofcoverage. Under Original Medicare, aslong as you continue to meet thequalifications, the full cost of care will becovered for the first 20 days, and then fordays 21-100 there will be a copayment.

For 2013, the daily co-pay amount is$148 per day. Many supplementalinsurance plans cover this copayment.After 100 days, Medicare coverage ends.Note that for people with Medicare

Advantage Plans, the costs may bedifferent.

It is a common misconception thatupon admission into the nursing home, allassets have to be turned over to thenursing home. This is not the case.

Rather, after exhausting any Medicareand private insurance benefits, you arerequired to pay privately from yourincome and resources until you qualify forMedicaid. Unlike Medicare, Medicaid is astate and federal program that will paynursing-home costs for people withlimited income and assets.

In Pennsylvania, the Medicaid programis administered by the Department ofPublic Welfare. In order to qualify, youmust meet all of the followingrequirements:

• U.S. citizen/resident alien• Resident of Pennsylvania • 65 years of age or disabled or blind• Require nursing-facility care• Meet financial-eligibility requirementsoutlined below

For single individuals, financiallyqualifying for Medicaid means assets havebeen depleted to between $2,000 and

Paying forNursing Home CareBy MARIELLE HAZEN

Continued on page 10


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$8,000. Most assets are countable forMedicaid purposes, including, but notlimited to: property, bank accounts,investment accounts, retirement accounts,deferred annuities, and the cash value oflife-insurance policies.

Up to $536,000 in equity in the primaryresidence of a single nursing-homeresident can be excluded if the nursing-home resident intends to return home.This is not a way of protecting theresidence, however, because when thenursing-home resident dies, depending onhow the property is titled, it may have tobe sold and the proceeds used to repayMedicaid benefits through the EstateRecovery Program. Estate Recovery isdescribed in more detail below.

For married couples, the financial-qualification rules are more complicated.

The spouse of a nursing-home resident(the “community spouse”) is entitled tokeep certain excluded resources, includingthe residence, one automobile, tangiblepersonal property, and his or her qualifiedretirement accounts. Most other resourcesare considered available resources.

In addition to the excluded resources,the community spouse is entitled to keepone-half of the available resources,provided one-half doesn’t exceed amaximum number, which is currently$115,920.

For example, if the total availableresources is $50,000, the share for thecommunity spouse will be $25,000. If thetotal available resources is $500,000, theshare for the community spouse will be$115,920 because that is the maximum.This maximum number is subject to

change every year.After the death of a Medicaid recipient,

the Department of Public Welfare willseek to recover benefits paid out from theestate of the Medicaid recipient. Thisprogram is called Estate Recovery, and itapplies to individuals who were 55 yearsor older at the time assistance wasreceived. In certain hardship situations,DPW will waive the recovery claim.

Pennsylvania’s Estate RecoveryProgram currently applies only to assetsowned solely by the Medicaid recipient atthe time of his or her death. As mentionedabove, a home owned by a Medicaidrecipient at the time of his or her deathwould be subject to Medicaid EstateRecovery.

However, if the home is owned jointlyby the Medicaid recipient and acommunity spouse as tenants by theentireties, and if the Medicaid recipientdies first, under current law the homewould not be subject to Estate Recovery,even after the death of the communityspouse.

In this same situation, if thecommunity spouse dies first, the homewould become an available asset of theMedicaid recipient and would be exposedto nursing-home costs and EstateRecovery.

The importance of comprehensiveplanning with an experienced attorney toprotect resources for your family andminimize exposure to Estate Recoverycannot be overemphasized.

There are many exceptions andexclusions in the Medicaid rules that allowresources to be protected for a communityspouse and other family members. Gettingadvice from an experienced attorney asearly in the process as possible is veryimportant to protect your rights and thefinancial security of your family.

Marielle Hazen is a Certified Elder LawAttorney and owner of Hazen Elder Law, anestate planning, elder law, and special-needsplanning law firm. More information can befound at www.HazenElderLaw.com.


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Paying for Nursing Home CareContinued from page 8

~

Caregiver must reside in the samehousehold as care receiver.

Caregiver must be related to the carereceiver.

Household income of care receiver isused to determine eligibility.

Care receiver must require assistancewith two or more ADLs.

Maximum amount of monthlyreimbursement for caregiverexpenses (depending onreimbursement rate chart) is:

Maximum amount ofreimbursement for homemodification/assistive devices(depending on reimbursementrate/cost-sharing chart andavailability of funding) is:

Information to caregivers includesadvice on how to access: individualcounseling, locations of localsupport groups, and caregivertraining to assist caregivers inmaking decisions to solve problemsrelated to their caregiving role.

Caregiver must provide daily hands-on caregiving to care receiver.

*A primary caregiver is the “one identified adult familymember or other individual who has assumed theprimary responsibility for the provision of care needed tomaintain the physical or mental health of a care receiverand who does not receive financial compensation for thecare provided.”

For specific program information, please contact yourlocal Area Agency on Aging.

• Assessment of caregiver and care recipient needs

• Counseling on coping skills

• Respite care

• Training in caregiving skills

• Home chore caregiving skills

• Financial assistance to purchase supplies or services

• One-time grant for home adaptations

• Benefits and counseling on services available throughlocal, state, and federal programs

• Referrals to family support or disease-specificorganizations such as Children of Aging Parents or theAlzheimer’s Disease & Related Disorders Association

• Assistance in completing benefits and insurance forms

Benefits & Services for Caregivers

Eligibility

State FederalNo** No

No No

Yes Yes

No (1) Yes (2)

$200 $300

$2,000 $2,000

Yes Yes

Yes Yes

Assessment Criteria(Federal and State)

If you are age 18 or older and the primary caregiver* ofa functionally dependent person who is age 60 or older,you may be eligible for assistance.

If you are age 18 or older and the primary caregiver* ofa relative who is age 18 to 59 with dementia, you may beeligible for assistance.

If you are age 55 or older and the primary caregiver* ofa relative who is age 18 or younger and lives with you, youmay be eligible for assistance.

There are approximately 52 million Americans serving as caregivers ofolder adults. Adult family caregivers caring for someone 50+ years of agenumber 43.5 million, and 14.9 million care for someone who hasAlzheimer’s disease or other dementia.

Americans are living longer, and as the population ages, the number ofcaregivers will also continue to rise in the coming years.

Caregivers are an essential element in our healthcare system,accounting for about $450 billion worth of unpaid labor in the U.S. in 2009.

Caregiving already has become the new norm for many, as we findourselves helping loved ones who are disabled, frail, or suffering fromAlzheimer’s disease, Parkinson’s disease, and kidney and liver diseases,

which have been on the rise. Daughters are more likely to provide basic care (i.e., help with dressing,

feeding, and bathing), while sons are more likely to provide financialassistance. A number of studies have shown that women caregivers aremore likely than men to suffer from high stress due to caregiving.

The major focus of the Pennsylvania Caregiver Support Program is toreinforce the care being given to people over the age of 60 or adults withchronic dementia. To determine what your particular needs are, both thecaregiver and receiver, the package of benefits begins with an assessment.

You could also take advantage of other benefits available such ascounseling, education, and financial information.

The Pennsylvania Caregiver Support Program


**Unless care receiver is 19-59 years of age with dementia or other disability.

By CLAIRE YEZBAK FADDEN

I was at the medical center near myhome when the administrator of mymother’s board and care introduced theword “hospice” to me.

In her gentle way, she was getting meacquainted with the term. I had heard theword before. It was used for situations thatwouldn’t have a positive outcome. Justhearing her say hospice made me afraid.She and I were in the doctor’s office withmy mom.

For some 10 years, my mother hadsuffered from Alzheimer’s disease. Shewas in the late stages of the disease.

That’s when Mom’s doctor told us“everything that could be done medicallywas being done. The truth is,” the doctorsaid, gesturing toward my 89-year-oldmother, “we are moving in the direction ofcomfort care.”

Since that meeting, I have learned a lotabout hospice care. The most importantlesson is that having hospice interventionfor my mom didn’t mean that I had given

up on her. It meant employing a level ofcare designed to improve her quality oflife, even at its end. It meant that Isought optimal physical and emotionalcomfort for her in a way that minimizedher pain.

In fact, due in part to the efforts ofthe hospice care workers during the next16 months, my mother’s quality of lifeimproved. I believe their care extendedher life.

What is HospiceHospice dates back to medieval times

when travelers, the sick, wounded, or

dying would seek a place for rest andcomfort. Today, hospice offers acomprehensive program of care topatients and families facing a life-limitingillness. Hospice is primarily a concept ofcare, not a specific place of care.Hospice emphasizes palliative rather thancurative treatment, quality rather thanquantity of life. Its goal is to relieve andsoothe the symptoms of a disease ordisorder without affecting a cure.

Who’s InvolvedHospice care involves teamwork

between the caregivers and the family.Working with the patient and the patient’sfamily, a care plan is outlined. Emotional,spiritual, and practical support are givenbased on the patient’s wishes and family’sneeds.

The hospice physician, nurses, aides,social workers, clergy, volunteers, andother professionals work together to easethe difficulties and uncertainties of thedying process.

How to DecideAt any time during a life-limiting


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illness, it’s appropriate to discuss all of apatient’s care options, including hospice.By law, the decision belongs to the patient.If your loved one is unable to makemedical decisions, a relative or friendmust have a durable power of attorney forhealthcare issues to be able to authorizeany medical-related services.

The requirements to be hospice-appropriate include:• The patient must be diagnosed with a

terminal illness by a physician.• Because of the illness, the patient is

considered to have a life expectancy ofsix months or fewer, if the disease runs itnormal course.

• The patient must sign a statementacknowledging that they choose hospice

treatment over curative treatment fortheir terminal illness.

Understandably, most people areuncomfortable with the idea of stoppingaggressive efforts to “beat” the disease.Hospice staff members are highly sensitiveto these concerns and always available todiscuss them with the patient and family.A patient who needs hospice careexceeding six months can remain in theprogram.

Is Hospice Care Covered by Insurance?

Hospice coverage is widely available. Itis provided by the Medicare HospiceBenefit (under Medicare Part A, orhospital insurance) and by most privateinsurance providers.

To be sure of coverage, check with youremployer or health-insurance provider. Itcovers medical services, medications,durable medical equipment, supplies, andtreatments related to managing your life-limiting illness and approved as part ofyour individual care plan as stated above.

It’s comforting to know that hospiceaffirms life and regards dying as a normalprocess. Its goal is to neither hasten norpostpone death. For more information onlocal hospice services, and to determine ifyour loved one is “hospice appropriate,”contact your healthcare provider and yourinsurance carrier.

Claire Yezbak Fadden, a freelance writer, iscomforted by the team of hospice workers whoprovided comfort care for her mother.

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By BARBARA TRAININ BLANK

At present, Alzheimer’s isunpreventable and incurable. But thatdoesn’t mean the situation is hopeless.

New approaches to individualssuffering from the disease and other formsof dementia can make their lives morefulfilling and help caregivers reach out tothem more effectively.

Sounds of MusicIt’s long been known that music

therapy offers benefits to individuals withchallenges by addressing their physical,emotional, cognitive, and social needs

through music. It has also been observedthat people with dementia seem torespond to music, often rememberinglyrics despite memory limitations.

At Messiah Lifeways (formerly MessiahVillage), a community for seniors over 55,the Asper Unit for individuals in advancedstages of dementia has implemented amusic program with a twist.

The unit has provided iPods to each ofits 53 residents so they can listen to themusic they like and might soothe thembest. The staff turns on the iPods, but theycan be clipped onto the shirts of residents,who have access to the handset.

The iPods were purchased in the fall

through a special fundraising drive,according Krystal Robinson-Bert, aneighborhood enrichment specialist atMessiah Liveways. The response has beenenthusiastic.

“No one doesn’t enjoy the earphones,”Robinson-Bert said.

With the help of family members andstaff, residents can personalize playlists,which gives them a sense of autonomy andthe chance to listen to music they’refamiliar with and holds pleasantmemories for them. They can make themusic louder or softer at will.

The staff at Asper has learned to be intouch with the “signals” of residents to

Easing the Discomfortin Alzheimer’s PatientsEasing the Discomfortin Alzheimer’s Patients

Esther Cohick, an Asper Unitteam member, enjoys a momentwith her mother, Anna. A residentof Messiah Lifeways’ Asper Unit,Anna enjoys her music.


recognize when music will be helpful,said Robinson-Bert.

Esther Cohick, an Asper Unit teammember, has seen an enormous change inresidents since the program waslaunched—including her mother. Cohickhas seen her mother’s “whole life”changed by having an iPod.

“This has been a wonderful thing, verytherapeutic,” Cohick said. “My motherhas anxiety and trouble with transitions.If she has that perplexed look, or if she’sbored or restless and wants to listen tomusic, she can play the iPod. My momlikes patriotic songs and hymns, and

she’ll start to sing all the verses of themusic.”

The iPods don’t take the place of groupmusic programs common to seniorcommunities. But during downtimes inthe schedule, they allow residents to“initiate” listening and change theirplaylists at will.

Moreover, group settings may notprovide the opportunity for teammembers to draw out the individualmusical tastes and preferences ofresidents.

As Cohick knows, family involvementin the program is “really key,” because

their loved ones know what the residentslike to listen to.

“I see that when I visit her and she’slistening to music that she’s happy,” shesaid. “I can even hear her singing before Icome in. Sometimes she dances. Musicbreaks up the boredom and relievesanxiety, and it stirs memories.”

The iPod program was initiatedbecause of family members, in fact; somehad seen media coverage of a similarprogram at Bethany Village.

Improving CommunicationDementia residents may become

New approaches to individuals suffering from Alzheimer’sand other forms of dementia can make their lives more

fulfilling and help caregivers reach out to them more effectively.

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depressed, agitated, and hostile whenthey realize their cognitive impairmentsand try to hide them. They may haveonce been active socially but now spendmore time alone and decline socialinvitations.

“They have feelings and needs theycan’t express,” said Ashley Uhler,executive director of program strategyfor Country Meadows RetirementCommunities, which assists residentswith memory deficits in a variety ofsettings through their ConnectionsMemory Support Services program.

“If we intervene earlier, we can helpthese residents function better longerand not withdraw from life as much.”

Family members are also saddenedand frustrated by what they see as the“irrationality” of the Alzheimer’s ordementia resident and the loss of theperson he or she was before. They mayblame themselves for not being able todo more.

One way to enhance communicationbetween residents and their familymembers or caregivers is throughvalidation therapy.

Developed specifically for patientswith cognitive impairment, validationtherapy is based on respectfulcommunication—hearing andacknowledging the other person’sopinions, regardless of whether or notthe listener agrees with them or findsthem rational.

“Validation therapy means acceptingthe person where he or she is, notnecessarily that you’re expected toexperience his or her sense of reality,”Uhler explained. “It’s frustrating anddegrading for the resident to be told heor she is wrong. It always ends in


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Chaplain James Daytalks with a dementiaresident during avalidation therapy sessionat Country Meadows.

confrontation, and at the end of the day,does it really matter? The caregiver hasto pick battles.”

For example, if a resident startsspeaking about his or her mother asthough she were still alive, validationtherapy would suggest that the staffmember shouldn’t play along but not tryto correct the person, either. Instead, thestaff member can say, “Tell me aboutyour mother,” which could stimulateseveral minutes of positive feelings in theresident.

Staff at Country Meadows receivestraining in this method to help keeparguments to a minimum and preserveresidents’ dignity. Family members andcaregivers can also request training.

“It’s not counseling, and it’s notcomplicated,” said Uhler. “We want thetherapy to be user friendly.”

Validation therapy builds trust withdementia patients, she adds. Despitetheir memory issues, they’re often veryperceptive.

“You can’t provide care if they don’ttrust you. Validation therapy teaches youhow to respond and how not to.”

The therapy also helps residents sharefeelings, even if it’s nonverbally.

“It’s not about making them feel betternecessarily, but about allowing them tofeel they’re being listened to,” Uhler said.“It’s not sympathy, which can bedismissive.”

Validation therapy is not the end-all-and-be-all but only one of the “tools” inthe caregiver’s toolbag, she added. But itis effective in helping family memberslearn to “enjoy the moment”—to realizethere is beauty and humor even in thesesituations when a loved one hasdementia.


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Health & Wellness Programs


By STEPHANIE KALINA-METZGER

Statistics from a York County coroner’s report show that 54residents aged 65 and older died due to accidents in 2012, with 49of those deaths attributable to falls.

According to the Centers for Disease Control, one in threeadults age 65 and older falls each year. Of those who fall, 20 to 30percent suffer moderate to severe injuries that make it hard forthem to get around or live independently. Older adults arehospitalized five times more often for fall-related injuries than forinjuries from other causes.

The statistics are sobering, but with a little knowledge,

caregivers can take steps to increase the chances that their lovedones remain fall free throughout their lives.

One of the first steps, according to Melissa Graham,information specialist for the York County Area Agency on Aging,is to make sure that the home is safe.

“Caregivers can evaluate a person’s home and take steps toreduce tripping hazards and improve lighting. If stairs have onlyone railing, add a second one. We also suggest that caregiversinstall grab bars both inside and outside of their tubs and showersand next to the toilet,” she said, adding that home assessments areoften available for those who are in rehab. “They can arrange tohave their home evaluated prior to being discharged.”

Reducing the Risk of Fallsin the Elderly


Graham suggests taking the health ofthe individual into account as well.

“All the evidence shows that falls arenot a normal part of aging. Those whohave fallen really need to talk with theirdoctor as to which direction they shouldgo. They may need a professional skillsassessment to determine if physicaltherapy is needed or if an underlyinghealth problem is going unaddressed,” shesaid.

Caregivers should meet with thepatient and the doctor to discuss bothprescription and over-the-countermedications.

“Drug interactions can cause dizzinessor drowsiness, placing individuals at riskfor falling. It’s also important to make surethey have their eyes tested regularly,”Graham said.

Exercise is another important activitythat combats the effects of aging and aidsin preventing falls.

“You should encourage them toexercise regularly to increase leg strengthand improve balance. The exercises don’thave to be aerobic. Many can be sittingdown in a chair or standing behind a chairand can improve not only balance, butstrength, flexibility, and endurance,” saidGraham.

Exercise Programs Geared TowardSeniors

A Matter of BalanceStudies show that seniors benefit from

socialization, so it may be helpful tosuggest a class designed to improve theirbalance and decrease their potential forfalls.

The Agency on Aging sponsors aprogram called A Matter of Balance.Developed through Boston University andMainHealth’s Partnership for HealthyAging, it’s designed to help reduce the fearof falling and increase activity levels of

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older adults who have concerns aboutfalling. It consists of eight two-hourclasses.

“During this time, they learn to viewfalls and the fear of falling ascontrollable. They also learn to setrealistic goals for increasing activity,while improving strength and balance,”said Graham.

The classes are conducted by twovolunteer coaches who are trained by theAgency on Aging, and the program isevidenced based, meaning it wasdeveloped, tested, and proven to reducefalls.

Healthy Steps for Older AdultsFor seniors who don’t want to commit

to eight two-hour classes, they can enrollin a shorter program through the

Pennsylvania Department of Agingcalled Healthy Steps for Older Adults.

“This program has recently gonethrough the evidenced-based process andis offered at some local senior centers. It’sthe same type of concept as A Matter ofBalance, but it’s done in two two-hourworkshops,” said Graham, who addedthat there’s also a follow-up programcalled Healthy Steps in Motion, whichincorporates exercise.

Silver Sneakers ProgramThe Silver Sneakers Program is

designed especially for seniors and offersgroup exercises ranging from cardio, toyoga, to classes designed to improvemuscular strength and range ofmovement.

“A lot of insurance companies will payfor this program,” said Graham. Go tosilversneakers.com to locate a class nearyou and remember to contact yourinsurance company to determinecoverage.

Falls Free York Coalition Takes Steps toReduce Risks

The Falls Free York Coalition wasstarted in 2010 and is part of a nationalfalls-free coalition to reduce the numberof falls and fall-related injuries amongolder adults. It is comprised of healthcareproviders, community service providers,community leaders, and older adults tocombat the problem of falls in the elderly.

“The mission is to reduce the risk offalls through partnerships, education,and awareness. Our hope is that olderadults will have fewer falls and fall-related injuries, thereby maximizing theirindependence and quality of life,” saidGraham.

“So much is being done now tocombat this very serious problem amongour elderly, and we want to keep thatmomentum going,” she added.


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Caregivers can takesteps to increase the

chances that theirloved ones remainfall free throughout

their lives. (

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Waivers offer an array of services andbenefits such as choice of qualifiedproviders, due process, and health andsafety assurances.

The name waiver comes from the factthat the federal government “waives”Medical Assistance/Medicaid rules forinstitutional care in order forPennsylvania to use the same funds toprovide supports and services for peoplecloser to home in their own communities.

In Pennsylvania, the Department ofPublic Welfare administers multipleMedical Assistance/Medicaid waivers.Each waiver has its own unique set ofeligibility requirements and services.

AIDS WaiverOffice of Medical Assistance Programs717.772.2525

For people diagnosed as having AIDSor Symptomatic HIV; not enrolled in amanaged care organization, healthinsurance organization, or hospiceprogram; no age limit; requires a level ofcare provided in hospital, skilled nursingfacility, or intermediate care facility; and isnot residing in an institution or inpatientsetting.

COMMCARE WaiverOffice of Social Programs717.783.8182

For people diagnosed with a traumaticbrain injury; are age 21 or older; needspecial rehabilitation level of care; notdependent on mechanical ventilatorsupports; and the disability results in atleast three substantial functionallimitations.

Michael Dallas Waiver Program forTechnology-Dependent IndividualsOffice of Medical Assistance Programs 717.772.2525

For people in need of nursing facilitylevel of care as certified by a physician; noage limit; technology dependent due tophysical disabilities.

Home and Community-Based WaiverProgram for Attendant Care Services(OSP/AC Waiver)Office of Social Programs717.705.5060

For people ages 18 through 59; requiresassistance with activities of daily living dueto a medically determined physical

impairment that can be expected to last fora continuous period of not less than 12months; mentally alert and capable ofselecting, supervising, and, if needed,firing an attendant; able to manage theirown financial and legal affairs; and befound in need of a basic service.

Independence WaiverOffice of Social Programs717.772.2094

For people with physical disabilities;disability results in at least threesubstantial functional limitations;disability is expected to continueindefinitely; age 18 or older; notdependent on mechanical ventilatorsupports; and requires nursing facilitylevel of care.

LIFE (Living Independence for theElderly)Lancaster County717.381.4320Lebanon County717.376.1133York County717.757.5433

LIFE is a managed care program forelderly recipients who have beendetermined to need “nursing facility levelof care” but wish to remain in their homeand community as long as possible. Theprogram is known nationally as theProgram of All-inclusive Care for theElderly (PACE). All PACE providers inPennsylvania have the name “LIFE” intheir name. Please note: This federalprogram is not the PACE prescriptiondrug program for Pennsylvanians.

OBRA WaiverOffice of Social Programs717.772.2094


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For people with developmentalphysical disabilities; disability results in atleast three substantial functionallimitations; disability manifested prior toage 22; disability is expected to continueindefinitely; requires intermediate carefacility for people with other relatedconditions level of care.

Nursing Home Transition (NHT)ProgramCumberland County Area Agency onAging888.697.0371Dauphin County Area Agency on Aging800.328.0058Lancaster County Office of Aging800.801.3070Lebanon County Area Agency on Aging717.273.9262York County Area Agency on Aging800.632.9073

The NHT Program assists consumerswho want to move from a nursing facilityback to a home of their choice in thecommunity. Families or caregivers arefully informed of all long-term livingoptions, including the full range of home-and community-based services, andreceive the guidance and support neededto make an informed choice about theirlong-term living services.

OPTIONS ProgramCumberland County Area Agency onAging888. 697.0371Dauphin County Area Agency on Aging800.328.0058Lancaster County Office of Aging800.801.3070Lebanon County Area Agency on Aging717.273.9262

York County Area Agency on Aging800.632.9073

The OPTIONS Program provides anintensive assessment of consumers,generally 60 years or older, and isadministered by staff from the AreaAgency on Aging (AAA). Combinedwith additional information obtainedfrom the consumer’s primary carephysician, care alternatives are identifiedand discussed with the consumer.Services range from those outside thehome, such as nursing facility or

personal care home, to a wide array ofservices in the consumer’s home, such ashome health, respite, environmentalmodifications, etc.

Pennsylvania Department of AgingWaiverDepartment of Aging717.787.6207

For people 60 or older; must meetnursing facility level of care criteria; andwish to be treated in own home or othercommunity setting.

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At Juniper Village we believe that quality is knowing an individual and being attentive totheir needs and wishes!

We offer services that provide flexibility and individuality in defining quality of life.

• Simple lease agreement for all levels of care, with no high up-front costs• Respite care, relieving caregiver stress and providing social interaction and care for the resident• Long-term residency, with our vibrant connections activities program and consistent care

From the first call and tour, to setting up a personalized schedule of activities the week you move in, to communicatingwith your family monthly, as a resident of Juniper Village you will become part of a family that cares for you.

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What is the waiver program offeredthrough the Pennsylvania Departmentof Aging?

There are several waivers availablethrough the Pennsylvania Departments ofAging for people aged 60 and older whomeet the eligibility requirements andincome limits.

Under the program, home- andcommunity-based long-term care servicescan be provided as alternatives to nursingcare. Services are funded through a specialwaiver of certain Medicaid restrictions,allowing payments typically used fornursing-home care to be used for home-

care services.The consumer is able to choose which

local organization or company/agency willprovide the services. All service providersare certified by the PennsylvaniaDepartment of Public Welfare to ensurethat they meet Medicaid standards.

Some services/benefits that individualscan be approved for are:• Adult daily living services (adult daycare)• Attendant care (personal care)• Community transition services (moving

assistance)• Companion services (escort)

Frequently Asked Questionsby Caregivers

?

• Counseling• Environmental accessibility

modifications (home and/or vehicle)• Financial management services • Home health services • Home medical equipment and supplies • Meal delivery (hot or prepared)• Non-medical transportation• Personal emergency response (PER)

system • Respite care services (temporarycaregiver relief)

See page 22 to see an overview ofwaivers and programs offered.

What is respite care?Respite care provides relief from your

caregiving responsibilities on a short-termbasis, which could be for a day or two oreven up to a month. Care may range frompersonal to nursing care.

Respite care may be offered through alocal retirement community, throughhome care services, and through a state-funded program, such as adult daycareprograms. Respite care offers you theability to rest, relax, and regroup,confident that your loved one is the handsof trained and qualified professionals.

What are my obligations as a caregiver?As the caregiver, you should make sure

your loved one is in a safe and healthyenvironment, whether that is their home,your home, or a nursing home. He or sheshould be protected from any type ofabuse—physical, mental, or financial.Some documents that you should have inplace are listed below.What are some of the most importantdocuments a caregiver should have inplace?

The most common legal documentsthat every caregiver should have are:

A Will – It should say what your loved onewants to do with his or her property,including how and when the assets will bedistributed.Advanced Health Care Directive – Thisoffers the assurance that your loved one’sdecisions regarding his or her futuremedical care will reflect their values andwishes.Durable Power of Attorney forHealthcare – This gives you, the caregiver,the right to make healthcare decisions. Ittakes effect when a loved one becomesmentally incapacitated and is unable to

make his/her own healthcare decisions.Your agent must act consistently with yourdesires as stated in the document.Durable Power of Attorney for Finances– This allows a caregiver to manage theirloved one’s finances and takes effect whena loved one becomes incapacitated and nolonger able to pay the bills, file tax returns,manage investments, and make otherimportant financial decisions. HIPAA authorization – The HealthInformation Portability andAccountability Act (HIPAA) keeps healthinformation and records private. Your


Call 717.866.3553 for information.

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??

? ?

loved one must authorize in writing thatyou may receive their health information.Otherwise, their doctors aren’t obligatedto share any details about their health withyou, the caregiver.

You will need to have a copy from eachdoctor’s office. Sign it at the office andthen keep a copy for yourself and theperson you’re caring for. Of course, thedoctor’s office will also have a copy. What services are available fromPennsylvania Area Agencies on Aging?

Area Agencies on Aging, county- ormulti-county-based agencies that partnerwith the Department of Aging, provide awide range of services, such as assessmentof need, care management, in-homeservices, transportation, protectiveservices, adult daycare, legal services,healthcare counseling, and senior centers.

Services may vary from county tocounty, so it is wise to call your local AAAfor particular services or programs.Is there someplace I can get help withdrug bills for someone in my care?

Many senior citizens with low incomes

are eligible for assistance with payment fortheir prescribed medications throughPACE/PACENET programs.

Who is eligible for PACE?To be eligible for PACE, you must be 65

years of age or older and a Pennsylvaniaresident for at least 90 consecutive daysprior to the date of application.

For a single person, your total incomemust be $14,500 or less. For a marriedcouple, your combined total income mustbe $17,700 or less.

Prescriptions: co-pay for generic, $6;co-pay for single-source brand, $9.

Who is eligible for PACENET?To be eligible for PACENET, the

qualifications are the same as PACE.However, the total income for a single

person can be between $14,500 and$23,500. A couple’s combined totalincome can be between $17,700 and$31,500.

Prescriptions: co-pay for generic, $8;co-pay for single-source brand, $15.Monthly $40 deductible.

Call your local Area on Aging office forforms or more information.

What is PACE Plus Medicare?Under PACE Plus Medicare,

PACE/PACENET coverage issupplemented by federal Medicare Part Dprescription coverage—offering olderPennsylvanians the best benefits of bothprograms. Older adults continue toreceive the same prescription benefitswhile, in many cases, saving more money. What is the APPRISE Program andwhere can I get more information?

The APPRISE Program is a freeprogram operated by the Area Agencieson Aging to provide health-insurancecounseling and assistance toPennsylvanians age 60 and over. They canhelp you understand Medicare benefits byexplaining Medicare, MedicareSupplemental Insurance, Medicaid, andlong-term care insurance.

They can explain the Medicare appealsprocess, help you select a Medigapinsurance policy, explain the Medicareprescription Part D benefit, and explainfinancial assistance programs. Call800.783.7067 or your local Area Agencyon Aging for more information. Theservices are free of charge.I heard that communities must now belicensed as a personal care home or anassisted living residence. Is that true?

Yes, that is correct. At the beginning of2011, personal care and assisted living canno longer be interchangeable terms.Specific requirements must be met, andcommunities (including retirementcommunities and CCRCs that offer thoseservices) must be licensed as one or theother, although they can meetrequirements and be licensed for both.


At Spring Creek, our team of skilled healthcare professionals iscommitted to meeting your loved one’s skilled nursing needs in abeautiful home-like environment. Our short-term and sub-acuterehabilitation programs deliver resident-centered care to maximizefull potential. We offer a full array of exemplary services to include:

Physical, speech, and occupational therapyRespiratory services, including ventilator and tracheostomy careNutritional services Secure Alzheimer’s communityWound care clinic

Come see us for yourself. Tours given daily.717-565-7000

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ErrandsShoppingLightHousekeepingFriendlyCompanionshipMeal PreparationFlexible HourlyCareRespite Care forFamilies

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RN-OWNED & OPERATED104 Carlisle St. Ste. 1, Hanover, PA 17331 717-630-0067202 Butler Ave. Ste. 302, Lancaster, PA 17601 717-393-34501840 E. Market St. York, PA 17402 717-751-2488www.visitingangels.com

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Do home care agencies needlicenses too?

Yes, home care agencies (HCAs) andhome care registries (HCRs) must now belicensed by the Department of Health toprovide home care services, medical andnonmedical. Are there caregiving tax breaks Ican take advantage of?

You may be able to claim your lovedone as a dependent on your tax return.To qualify for dependency, you must payfor more than 50 percent of yourqualifying relative’s support costs for theyear.

With changes occurring in thehealthcare laws, it is advisable to checkwith your tax preparer to find out whatyou qualify for, such as medicaldeductions and a dependant-care credit. What is the Pennsylvania CaregiverSupport Program?

Previously called The Family CaregiverSupport Program, the PennsylvaniaCaregiver Support Program’s major focusis to reinforce the care being given topeople over the age of 60 or adults withchronic dementia.

The package of benefits begins with anassessment to determine what benefitsbest meet your needs and the needs of theperson receiving care. Then you willchoose an option from availablesupportive services. Other benefits couldalso include counseling, education, andfinancial information.Are there any other online sourcesfor additional information?

Yes. Visit www.heretohelp.pa.gov.There is an abundance of information tobe found at Here to Help on the PAGovernment Portal.

Chester County610.344.6350

Cumberland County717.240.6110

Dauphin County717.780.6130

Lancaster County717.299.7979

Lebanon County717.273.9262

York County717.771.9610

Responding to the Needs ofAmericans 60 and Over

w w w . p 4 a . o r g

Responding to the Needs ofAmericans 60 and Over

Contact your local agency for assistance

ADVOCACY. ACTION. ANSWERS ON AGING.

Resources


Balancing Work and Caregiving for Children,Adults, and EldersBy Margaret B. Neal, Arthur C. Emlen, Nancy J.Chapman, Berit Ingersoll-Daytonwww.sagepub.com

Exploring how caregivers juggletheir responsibilities of work andfamily, the authors suggest thatdependant care needs to beaddressed as a corporate, family,and community concern. They

present the stress factors experienced byworkers caught between the conflictingdemands of these two roles. Policies, benefits,and services reviewed range from approachesthat intervene in the caregiving process to thosethat change the world of work with suchalternatives as flexible working hours, child-carefacilities, and tax credits for dependants.

The Boomer Burden: Dealing with YourParents’ Lifetime Accumulation of StuffBy Julie Hallwww.theboomerburden.com

Professional estate liquidatorJulie Hall walks baby boomersthrough the often painfulchallenge of dividing the wealthand property of their parents’lifetime accumulation of stuff.

From preparation while the parent is still livingthrough compassionately helping them emptythe family home, The Estate Lady® givesinvaluable tips on negotiating the inevitabledisputes, avoiding exploitation from scamartists, and eventually closing the chapter oftheir lives in a way that preserves relationshipsand maximizes value of assets.

I Will Never ForgetElaine C. Pereirawww.iuniverse.com

In her touching memoir, I WillNever Forget, Pereira shares thesometimes heartbreaking andoccasionally humorous story ofher mother’s journey throughdementia, as seen through the

eyes of her little girl. I Will Never Forget shares apowerful, emotional story that can help peopleaffected by dementia take comfort in knowingthat they are not alone.

“If I Should Die Before My Dog—” Joe and Cathy Connollywww.amazon.com

What would happen if youcould no longer care for your dog?If he/she outlived you? Would thenew caretakers know about yourdog’s needs? Joe and CathyConnolly have witnessed several

pets lose their human guardians and saw howdifficult it was for those pets to adjust. If IShould Die Before My Dog is a beautifullywritten prompted journal that enables you toshare everything you would want a newguardian to know about your beloved pet in theevent you were no longer able to take care ofhim or her.

Ice Cream in the Cupboard A True Story of Early Onset Alzheimer’sBy Pat Moffettwww.patmoffett.com

In his moving memoir, IceCream in the Cupboard, PatMoffett chronicles not only hiswife Carmen’s struggle as she slipsaway, but also his own struggle ashe navigates his new role as

caregiver. Thanks to his experience withCarmen, Pat believes Ice Cream in the Cupboardcan be an educational tool for those who alreadycare for someone with Alzheimer’s disease. Itwill make you reevaluate and renew yourappreciation for the people you love.

The Essential Guide to Caring for AgingParentsBy Dr. Linda Rhodeswww.penguin.com

Written by an expert on agingwho cared for her own parentsand in-laws, The Essential Guideto Caring for Aging Parents leadsyou through the elder care maze.Learn how to spot signs that a

loved one requires special attention, get adviceon ways to talk to your parents about theirhealth, help arrange for their care, and addresstheir needs and wishes. All aspects of elder careare also discussed, including living options,insurance, legal matters, and how to becomeyour parent’s medical and financial advocate.

The Emotional Survival Guide for Caregivers:Looking After Yourself and Your FamilyWhile Helping an Aging ParentBy Barry J. Jacobs, PsyDwww.emotionalsurvivalguide.com

The Emotional Survival Guidefor Caregivers helps familymembers navigate toughdecisions and make the most oftheir time together as they carefor an aging parent. The author

urges readers to be honest about the level ofcommitment and emphasizes the need for clearcommunication within the family. Whileacknowledging their guilt, stress, and fatigue, hehelps caregivers reaffirm emotional connectionsworn thin by the routine of daily care. Thiscompassionate book will help familieseverywhere avoid burnout and preserve bondsduring one of life’s most difficult passages.

Living Well with Chronic Illness:A Practical and Spiritual GuideBy Richard Cheuwww.chroniclivingwell.com

Author, neurophysiologist, andpastoral counselor Richard Cheutackles the impact of thissurprisingly widespread problemin his new book, Living Well withChronic Illness: a Practical and

Spiritual Guide (April 2013). Cheu is intimatelyfamiliar with the care of the chronically ill. Fornine years, he has been caring for his wife whohas a progressive neurological disease. Drawingon his knowledge and experiences inneurophysiology, counseling, and patient care,he has been able to help her maintain a positiveattitude and good health through physical andsocial activities.


DIRECTORY OF HOUSING & CARE PROVIDERS

INDEPENDENT RESIDENCES

ASSISTED LIVING RESIDENCEPERSONAL CARE HOME

DEMENTIA UNITSNURSING CARE COMMUNITY

RESPITEADULT DAY CENTERHOME CARE SERVICESHOSPICE CARE

REHABILITATION FACILITY

COLOR KEY FOR DIRECTORY OF CAREGIVING PROVIDERS

Avenues Eldercare Adult Day Center 717.832.38541200 Grubb Road [email protected], PA 17078 www.avenuesofpa.org

Avenues Eldercare is a community-based program thatencourages older adults to live as independently as possible intheir own homes.

Bayada Home Health Care 717.652.11304807 Jonestown Road, Suite 254 [email protected], PA 17109 www.bayada.com

Bayada Home Health Care provides home health aide andR.N./L.P.N. nursing services for adults in their own homes tohelp maintain independence. Shifts consist of three to 24 hours.

Bethany Village at Home 717.591.83325225 Wilson Lane [email protected], PA 17055 www.bethanyvillageathome.org

We provide quality in-home care services for adults 55+ inMechanicsburg, Pa., and surrounding areas. Services arecustomized to the needs of each client. Private pay/LTCinsurance.

The Campus of the Jewish Home 717.657.0700of Greater Harrisburg [email protected] Linglestown Road www.jewishhomeharrisburg.orgHarrisburg, PA 17112See ad page 16

Central Penn Nursing Care, Inc. 717.569.04511910 Fruitville Pike, Suite 1 [email protected], PA 17601 www.cpnc.com

Providing cost-effective homecare to clients in homes,hospitals, and retirement communities. All levels —homemaker-companions, personal care aides, CNAs, RNs,and LPNs. Free nursing assessment.See ad page 20

ComForcare Senior Services

Harrisburg 717.545.60512330 Vartan Way [email protected], PA 17110 www.harrisburgpa.comforcare.comLancaster 717.824.3643150 Farmington Lane [email protected], PA 17601 www.lancaster.comforcare.comYork 717.718.9393140 East Market Street [email protected], PA 17401 www.yorkpa.comforcare.com

Providing compassionate, non-medical care in the home by fullylicensed, insured, and trained caregivers. ComForcare hassupported independence, dignity, and quality of life since 1996.See ad page 7

Comfort Keepers 717.920.98987A North Clover Lane [email protected], PA 17112 www.comfortkeepers.com

Cross Keys Village – 717.624.5350The Brethren Home Community [email protected] Carlisle Pike www.crosskeysvillage.orgNew Oxford, PA 17350

You will not find a stronger continuum of care or a campus withmore services. Come discover our blend of values and value.See ad page 9

Elm Spring Residence 717.840.7676118 Pleasant Acres Road [email protected], PA 17402

Griswold Home Care 717.975.05406 West Main Street www.griswoldhomecare.comShiremanstown, PA 17011

RN-owned and operated. Serving Cumberland County for 25years by providing personal care, homemaking, friendlycompanionship, and transport 24/7. Home Care Plus Awardrecipient 2013.

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Homeland Center 717.221.79021901 North Fifth Street [email protected], PA 17102 www.homelandcenter.org

Homeland Center, a continuing care retirement community,offers beautiful personal care suites, skilled nursing, hospice,rehabilitation, and dementia care, all delivered by highlycompetent and compassionate staff.See ad page 13

Homeland Hospice 717.221.78902300 Vartan Way, Suite 115 [email protected], PA 17110 www.homelandhospice.org

Homeland Hospice, a service of Homeland Center, provides thehighest level of care and support at the end stages of life whileserving as a compassionate resource for families.See ad page 13

Hospice & Community Care 717.295.3900(founded as Hospice of Lancaster County) www.hospicecommunity.orgLancaster685 Good Drive, P.O. Box 4125Lancaster, PA 17604York224 St. Charles Way, Suite 200York, PA 17402

Compassionate serious illness and end-of-life care andbereavement support for patients and families. Medical,emotional, and spiritual care at home, in nursing homes,hospitals, and our Hospice Inpatient Centers. Lancaster andsurrounding counties and York and Adams counties.See ad page 12

Juniper Village at Lebanon 717.272.87821125 Birch Road [email protected], PA 17042 www.junipercommunities.com

At Juniper Village, we believe that maintaining and promotingan active body, an engaged mind, and a fulfilled spirit are keysto healthy aging.See ad page 24

Juniper Village at Mount Joy 717.492.9692607 Hearthstone Lane [email protected] Joy, PA 17552 www.junipercommunities.com

Personal care is quality care. At Juniper Village, we believethat quality is knowing an individual and being attentive totheir needs and wishes.See ad page 24

Life Time Adult Day Care 717.975.97623 Crossgate Drive [email protected], PA 17050 www.cparc.org

Compassionate daytime care for older adults and support totheir caregivers. Over 30 years of experience. Nowconveniently located in Mechanicsburg.See ad page 21

Lutheran Retirement Village 717.637.0633at Utz Terrace [email protected] Utz Terrace www.lutheranscp.orgHanover, PA 17331See ad page 19

Lutheran Social Services 717.854.3971South Central Pennsylvania [email protected] Pennsylvania Avenue www.lutheranscp.orgYork, PA 17404

For 60 years, Lutheran Social Services has been providingseniors throughout York, Adams, and Franklin counties withhomes and services designed to meet their needs. See our adand listings for locations and contact information.See ad page 19

Magnolias of Lancaster 717.560.11001870 Rohrerstown Road [email protected], PA 17601 www.integracare.com

We provide care for residents with memory-impairing diseases.Our specialized program caters to residents’ specific needs.Enhanced care services available for those requiring higherlevels of assistance.See ad page 2









Messiah Lifeways 717.790.8201100 Mount Allen Drive [email protected], PA 17055 www.messiahlifeways.org

Messiah Lifeways offers more options for caregivers andeveryone 55+, including: coaching, enrichment, communitysupport, and resident communities.See ad page 15

Riddle Village 610.891.37001048 West Baltimore Pike www.riddlevillage.orgMedia, PA 19063

Comprehensive Lifecare program with ideal Main Linelocation adjacent to Riddle Memorial Hospital. Multiple diningvenues, expansive fitness area with indoor pool, andunderground parking garage.

Senior Helpers 717.920.07073806 Market Street, Suite 3 [email protected] Hill, PA 17011 www.seniorhelpers.com

Positive solutions for aging in place with dignity.Companionship, personal care, and our specialized dementiacare allows us to provide non-medical, in-home care.See ad page 17

SeniorLIFE York 717.757.54331500 Memory Lane Ext. www.seniorlifeyork.comYork, PA 17402

SeniorLIFE is an all-inclusive care, non-residential program.Services include transportation, physician and nursing services,and much more. Call for complete service listing and eligibilityrequirements.See ad on the back page

Shrewsbury Lutheran Retirement Village 717.235.5737800 Bollinger Drive [email protected], PA 17361 www.lutheranscp.orgSee ad page 19

Specialty Home Care 717.533.44001251 East Chocolate Avenue [email protected]. Box 362 www.specialtyhomecare.comHershey, PA 17033

Hershey’s premier home care company! Homemaker,transportation, and personal care services. Free, in-homeassessment, no obligation. Veteran benefit experts!

Spring Creek Rehabilitation & 717.565.7050Healthcare Center [email protected] South 28th Street www.springcreekcares.comHarrisburg, PA 17111

Spring Creek offers a full array of exemplary services, includingphysical, speech, occupational, and respiratory therapies. Asecure dementia unit, wound care clinic, ventilator, andtracheostomy care.See ad page 26

StoneRidge Retirement Living 717.866.3200440 East Lincoln Avenue [email protected], PA 17067 www.stoneridgeretirement.com

StoneRidge is a full-service CCRC in Myerstown, Pa. Since1924, we’ve been providing quality senior care just a short drivefrom Reading, Lebanon, and Hershey.See ad page 25

Surrey Services for Seniors 610.647.984028 Bridge Avenue [email protected], PA 19312 www.surreyservices.orgSee ad page 17

Synergy HomeCare of Mid Penn 717.243.5473453 Lincoln Street, Suite 110 [email protected], PA 17013 www.synergyhomecare.com/midpenn

Synergy HomeCare offers customized in-home care for seniorsand those limited by Alzheimer’s disease or dementia, patientsrecovering from surgery — even new mothers. Our teamspecializes in providing a care plan that works for you.

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Tel Hai Retirement Community 610.273.93331200 Tel Hai Circle [email protected], PA 19344 www.telhai.org

The Village at Kelly Drive 717.854.5010750 Kelly Drive [email protected], PA 17404 www.lutheranscp.orgSee ad page 19

The Village at Sprenkle Drive 717.764.99941802 Folkemer Circle [email protected], PA 17404 www.lutheranscp.orgSee ad page 19

Visiting Angels Living Assistance Services

Hanover 717.630.0067104 Carlisle Street, Suite 1 [email protected], PA 17331 www.visitingangels.comLancaster 717.393.3450202 Butler Avenue, Suite 302 [email protected], PA 17601 www.visitingangels.comYork 717.751.24881840 East Market Street [email protected], PA 17402 www.visitingangels.comSee ad page 27

Visiting Angels 717.652.88999A North Progress Avenue 717.737.8899Harrisburg, PA 17109 www.visitingangels.com

VNA of Central PA/ 717.233.1035Crossings Hospice of the VNA 800.995.82073315 Derry Street www.vnacentralpa.comHarrisburg, PA 17111

The Woods at Cedar Run 717.737.3373824 Lisburn Road [email protected] Hill, PA 17011 www.integracare.com

We offer three lifestyle choices: Independent living encouragesresidents to thrive. Senior living adds the security ofprofessional assistance. Memory care embraces state-of-the-artpractices for memory loss.See ad page 2


INDEPENDENT RESIDENCESPERSONAL CARE HOMEASSISTED LIVING RESIDENCEDEMENTIA UNITS

NURSING CARE COMMUNITY

REHABILITATION FACILITYRESPITE

ADULT DAY CENTERHOME CARE SERVICESHOSPICE CARE

COLOR KEY FOR DIRECTORY OFCAREGIVING PROVIDERS

• Active adult and residential living

• Independent and retirement living communities

• Assisted living /personal care residences

• Nursing and healthcare services

• Home health, companions, and hospice care providers

• Easy-to-read format

Call for your free copy today! (717) 285-1350

In print. Online: onlinepub.com

17th Edition Now Available!

Have a lifestyle change on the horizon?Let this be your guide.

Have a lifestyle change on the horizon?Let this be your guide.


GERIATRIC CARE SERVICES MOVING & RELATED SERVICES

Transition Solutions for Seniors, LLC 717.615.65071075 Hunters Path [email protected], PA 17601

Move organizing and implementation: sorting, packing,disposal of unwanted items, unpacking, resettling, homestaging, cleaning, and selling (through Prudential HSG), workwith estates.See ad page 5

PET SERVICES

Angel Pet Cremation Services 717.921.2117Serving South Central PA www.angelpets.org

“Helping pets and their people any way we can.”Low-cost spay/neuter. Loans of live traps, cages. Free ID tags.Pet cremation services, too.

TRANSPORTATION SERVICES

Access Bus and Van Sales 717.932.6060629 Wyndamere Road [email protected], PA 17319 www.accessbusandvan.comSee ad page 35

Need A Lift Accessible Van Rentals 717.932.6060629 Wyndamere Road [email protected], PA 17319 www.wheelersvanrentals.com

Wheelchair-accessible van rentals to meet your transportationneeds by the day, week, or month. Get online – get a quote –make your reservation today.See ad page 35

Red Rose Transit Authority 717.291.124345 Erick Road [email protected], PA 17601 www.redrosetransit.com

Offering transportation solutions for those 65 and older. Seniorsride free on our bus routes or at a discounted rate on our shared-ride service.

AREA AGENCIES ON AGING

Chester County Area Agency on Aging 610.344.6350

Cumberland County Aging andCommunity Services 717.240.6110

Dauphin County Area Agency on Aging 717.780.6130Lancaster County Office of Aging 717.299.7979Lebanon County Area Agency on Aging 717.273.9262York County Area Agency on Aging 717.771.9610

www.p4a.org

Your local offices of aging act as advocates for Pennsylvania’sseniors—promoting their continued physical, social, andeconomic self-sufficiency.

Elder Healthcare Solutions, LLC 717.825.8828211 Pauline Drive #315 [email protected], PA 17402 www.ehs-pa.com

Elder Healthcare Solutions assists with navigating healthcare,lifestyle, and living options. From geriatric care management toassessments, care coordination, and transitional support —know your options!See ad page 23

Senior Caregiving Solutions 717.228.8067Serving Lebanon, [email protected], Dauphin, and www.seniorcaregive.comeastern Cumberland counties

Licensed, clinical social worker (15 years as geriatric caremanager) advises and guides families. Conducts assessment,then makes recommendations, including options withincommunity. Specialty – dementia.

HEALTH

Advanced Hearing Aid Center 610.781.9001Six Locations Serving www.advancedhearingaidcenter.orgSoutheastern PA

Free hearing exams! Sales, service, and repairs on all hearingaids. House calls at no charge. Servicing local independent,assisted living, and personal care facilities. Locally owned andoperated.See ad page 9

Cumberland/Perry Health Education 717.497.7002Resource Center www.cpherc.org306 Fairview StreetCarlisle, PA 17015

Kilmore Eye Associates 717.697.1414890 Century Drive www.kilmoreeye.comMechanicsburg, PA 17055See ad page 10

INSURANCE

AmeriHealth VIP Care – Lancaster County 866.533.5490www.amerihealthvipcare.com

Keystone VIP Choice – Chester County 800.450.1166www.keystonevipchoice.com

[email protected] ad page 35

Long Term Care Consultants 717.394.4287Marcille Crossland, LUTCF, CLTC [email protected] Lititz Pike, Suite 4 www.integratedbusinessconsultantsinc.comLancaster, PA 17601See ad page 22


Support and Information

All About Visionwww.allaboutvision.org

Alzheimer’s Disease Education andReferral Center

800.438.4380www.alzheimers.org

American Cancer Society Response Line800.227.2345www.cancer.org

American Diabetes Association800.254.9255www.diabetes.org

American Speech Language-HearingAssociation

800.638.8255www.asha.org

American Urological Association800.828.7866www.auanet.org

Arthritis Foundation Information800.283.7800www.arthritis.org

BenefitsCheckUpwww.benefitscheckup.org

CareCentralwww.carecentral.com

Caregiver Action Network800.896.3650www.caregiveraction.org

Caregiver Media Group800.829.2734www.caregiver.com

Children of Aging Parents800.227.7294www.caps4caregivers.org

Christopher & Dana ReeveParalysis Foundation

800.225.0292www.christopherreeve.org

Crohn’s and Colitis Foundationof America, Inc.

800.932.2423www.ccfa.org

Eldercare Locator800.677.1116www.eldercare.gov

Epilepsy Foundation of America800.332.1000www.epilepsyfoundation.org

EyeCare America877.887.6327www.eyecareamerica.com

Family Caregiver Alliance800.445.8106www.caregiver.org

Guide Dog Foundation for the Blind800.548.4337www.guidedog.org

Medicare & Medicaid Services800.633.4227www.cms.hhs.gov

Medicare Rights800.333.4114www.medicarerights.org

Medicare Telephone Hotline800.633.4227www.medicare.gov

National Alliance for Caregivingwww.caregiving.org

National Council on Alcoholism &Drug Dependence, Inc.

800.622.2255www.ncadd.org

National Health Information Center800.336.4797www.health.gov/nhic

National Institute on AgingInformation Center

800.222.2225www.nia.nih.gov

National Institute of Mental HealthInformation Line

800.647.2642www.nimh.nih.gov

National Insurance Institute Helpline212.346.5500www.cancerandcareers.org/resources

National Library Service for the Blind& Physically Handicapped

800.424.8567www.loc.gov/nls

National Parkinson Foundation, Inc.800.327.4545www.parkinson.org

Needy Medswww.needymeds.org

Office of Minority Health Resource Center800.444.6472www.omhrc.gov

PACE/PACENET800.225.7223www.aging.state.pa.us/aging

Pennsylvania Department of Public Welfare800.692.7462www.dpw.state.pa.us

Rural Information Center Health Service800.633.7701www.nal.usda.gov/ric

RxAssist401.729.3284www.rxassist.org

Shriners Hospital Referral Line800.237.5055www.shrinershq.org

Simon Foundation for Continence800.237.4666www.simonfoundation.org


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Sales of New and Pre-OwnedSpecialty TransportationVehiclesBuses: • Up to 45-passenger seating• Wheelchair Accessible • Varied Floor Plans Vans: • Full-sized or Mini Vans• Side or Rear-Entry • Wheelchair Accessible

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Call 1-877-679-1261 (TTY 1-855-241-3649) | 7 days a week, 8:00 a.m. to 8:00 p.m.www.amerihealthvipcare.com

AmeriHealth VIP Care is a Medicare Advantage organization with a Medicare contract and a contract with the Pennsylvania Medicaid program. This plan is available to anyone who has both Medical Assistance from the State and Medicare. AmeriHealth VIP Care is available in Lancaster, Lehigh and Northampton counties.

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On average, those caring for their aging parents spend about 20 hours a week with those caregiver duties. Combined with a full time job, children, and day to day life, the stress can be overwhelming.

There is a solution. Senior LIFE has compiled tips and solutions for caregivers in a brochure entitled: “Find the Balance: What’s Best for Them, and For You.” Call today for your complimentary copy, and stop the stress.

Stop the stress and learn how to

Stress of being a caregiver can take as much as10 years off of your life.

Senior LIFE York1500 Memory Lane Extension717-757-5433www.seniorlifeyork.com

caregiver solutions 2013

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