Georgia is the statewide association of over 150 key not-for-profit and
other mission-focused organizations dedicated to providing quality
housing, health care, community-based and other related services for
older Georgians. The mission of LeadingAge Georgia is to represent and
promote the common interests of its members through leadership,
advocacy, education and other services in order to enhance each
member's ability to serve older Georgians.
Conversations with Ginny
"If everyone is moving forward together, then success takes care of itself." --Henry Ford
Great news – Katie Smith Sloan, president of LeadingAge will join us for our business meeting on December 6th so please mark your calendar and come spend time with our dynamic leader! Katie is a visionary whose talent and passion is propelling public policy initiatives on the federal level and we can expect to see great outcomes from these efforts. In late July, Katie testified before the United Nations on behalf of the Global Ageing Network. She put the need for palliative care on the map – the global map! According to one study, 80% of the world's population lack adequate access to medication needed for palliative care. "The great variability from country to country is largely due to lack of medical knowledge on the part of health care professionals and access to medication. That said, there is a great opportunity for increased education and training so that no one has to live with pain if that is their choice. Palliative care has been proven to work. More should have the opportunity to live out their later years pain free," said Katie.
It is invigorating to see the great work that Katie and her team are doing in public policy with efforts to shore up affordable housing, improve the nursing home survey and certification process, promote long-term services and supports financing reform and improve the Medicare post-acute programs. She and her team truly listen to LeadingAge members and then formulate policy that is sound and they take the lead where changes need to be made. They also reach out to engage state affiliates and members across the nation so that we can use our collective voices to engage Congress.
It is exciting to know, that here in Georgia, we're in synch with efforts on the national level. We're hosting the Culture Change Network Summit on Palliative Care. If you haven't signed up yet, please click here to register. Together we'll do our part to make palliative care more available to those we serve.
If you haven't seen it yet, take a look at the new LeadingAge Learning Hub. The beauty of the hub is that it is web based so your team can access education when and where it's convenient. Click here for more information. The topics are in-line with what our members have voiced an interest in – but if there's a topic you need and you don't see it on the hub, let me know and I'll pass it along to national.
I hope you take advantage of upcoming educational opportunities and that you join in our two events coming up that support our efforts – the 23rd Annual Center for Positive Aging Golf Tournament coming up on October 8th and the Profiles of Positive Aging coming up on November 4th. Click here for more information on the golf tournament. See below for information on Profiles of Positive Aging.
I hope you too feel excited that we are moving forward together!
2018 Profiles of Positive Aging Honoree Entry Form
You're invited to experience an inspiring event with your colleagues and community heroes & heroines for the sixth annual Profiles of Positive Aging Awards Gala. This event is intended to unveil the beautiful truths about aging. On November 4, 2018 (3:00 pm – 5:00 pm), we'll pay tribute to Elders who have changed our lives, achieved a positive aging lifestyle, and continue to give of their tremendous talents and wisdom across our great state and nation.
The Profiles of Positive Aging Gala is designed to support the educational arm of LeadingAge Georgia, the Georgia Institute on Aging. The purpose of the Institute is to provide affordable, quality professional development for individuals working in the field of aging. Currently, the Institute provides education to over 1300 professionals, via 25-30 events each year, who are dedicated to providing the best care and services to older Georgians.
Positive Aging Profile 2018 Entry Form
A Profile of Positive Aging honors someone who is currently making a difference in your community, your organization, and/or our state/society. It is the gift of legacy. By recognizing someone who exemplifies Positive Aging, you honor those who are standing on the shoulders of years of wisdom and positive aging experiences, who have lived life to the fullest and inspire us by their examples.
Deadline: Profiles submitted by August 31, 2018 to the Association office will be evaluated.
Honorees will participate in this special Awards Gala to be held in their honor on November 5, 2018 at the annual "Profiles of Positive Aging Gala". Elders will be featured along with the 2018 Icon in Positive Aging.
Register your honoree by downloading the entry form or complete the nomination by submitting a brief profile of the individual at: https://form.jotform.com/21493468894166
Profiles in Positive Aging Debuts at the Center for Civil and Human Rights
The public is invited to attend an inspiring exhibition honoring 22 unsung community heroes and heroines at the inaugural Profiles in Positive Aging Exhibition to Re-frame Aging in partnership with the Center for Civil and Human Rights in Atlanta. The exhibit will feature older adults in Georgia, nationally, and globally, who have multiple life lessons to share as learners, innovators, and teachers. Experience the living gallery of Georgia's elders engaged in positive aging. Invite your family, friends, and colleagues to attend this wonderful exhibition honoring exemplary people who are living positive and influential lives while embracing aging as they continue to learn and grow well past retirement age.
The Center for Civil and Human Rights museum will now become home to the storyboards about these individuals to reach the broader public as we work collectively to overcome ageism in our society—one story at a time. In addition, Story Corps is lending their support and technology to help us record the oral history of the elders featured during the Exhibit. Please join us for this unprecedented moment at the Center for Civil and Human Rights museum on Sept. 25th. The exhibit is opened from 10 am - 2 pm.
Click here for tickets at the special rate of $14 each.
The 23rd Annual Center for Positive Aging Golf Tournament
The competition will be a scramble format, with prizes awarded to the top three teams, both men and ladies. The 1st place team is awarded custodianship of the trophy for a year (won by Lenbrook-Atlanta CCRC). Additionally, there are numerous prizes for longest drives, closest to the hole, and oldest and youngest participant.
2018 Tournament Itinerary
Columbus Day: Mon., Oct. 8th
8:15 am: Registration | Practice Range
9:00 am: Shotgun Start
11:30 am: Lunch on the Fairway
2:30 pm: Presentation of Prizes
Tournament Hosted at RiverPines Golf Club
Enjoy the many attributes of RiverPines. Designed by nature and enhanced by man, this 18-hole Championship Course and Par-3 Course will challenge you with woods, ravines, creeks and ponds. Lush Bermuda grass fairways and carefully-cultivated bentgrass greens will inspire you to play your best as you wind your way through this picturesque Chattahoochee River setting—a short drive from downtown Atlanta.
Ways To Support:
- Hole Sponsorship
- Closest to the Hole Sponsorship
- Register a Foursome
- Register a Twosome
- Donate Golf Balls
- Donate Door Prizes
Click HERE for registration brochure
By Ginny Helms
The Oaks Resident Advocacy Group (TORAG), made up of residents from Clairmont Oaks and Briarcliff Oaks, delivered a coup recently when the legislative issue they pitched to the Coalition of Advocates for Georgia's Elderly (COAGE) was chosen as the issue that COAGE will focus on when the Georgia legislature convenes in January. Each year, COAGE members are invited to propose legislative issues for the coalition to work on for the upcoming session. The best issues are then presented at the July COAGE meeting and members have until August 31st to vote on issues. This year, with carry-over issues from last year, COAGE members were only allowed to choose one new issue and out of all of the issues pitched, COAGE members chose the one presented by TORAG.
The Oaks Resident Advocacy Group recognized that it is common for affordable housing residents to have to choose between medical care and groceries. So, they crafted a legislative proposal to increase the income limit for Medicaid so that older adults who need medical care have a better chance of getting the care they need and are still able to eat.
LeadingAge is leading the charge to shore up Medicare for the same reasons that TORAG is carrying the torch for Medicaid in Georgia -- because seniors should not have to choose between medical care and eating. I am so proud of The Oaks Resident Advocacy Group and look forward to a great advocacy battle in January.
What if There Were Alternatives to Pain and Suffering? By Ginny Helms
Pain is pain and suffering is suffering. Individuals we serve with dementia commonly suffer from anxiety and agitation. It's what led to the overuse of antipsychotics. In fact, nurses said that the number one reason a person in nursing home gets put on an antipsychotic is due to agitation and resistance of care at bath time. Our members have made great strides in decreasing agitation through person centered staff training and implementation of models like the Eden Alternative --- but what if there is more help for alleviating anxiety and agitation?
A large number of the older adults we serve suffer from chronic pain. Whether it is back pain, arthritis pain, stiffness from Parkinson's disease, neuropathy or other conditions, the pain is impacting quality of life. When physical pain exists, anxiety, depression, sleeplessness and withdrawal from favorite activities are common. What if there were options for treatment of pain that were less harmful than opioids? What if less pain led to individuals in long-term care leaving their rooms and engaging in meaningful activities again?
What if decreasing agitation among persons with dementia made not just for a better quality of life for the person living with dementia, but made for less distress for family members worn down from watching the suffering? What if the decrease in agitation made for a better job experience for staff working in long-term care?
LeadingAge national has rolled out a new program that I think is fabulous. It's called Aging Unmasked and is a new podcast where "we normalize, humanize, and unmask taboos and aging". Their very first podcast features how medical marijuana is being used legally by residents in the Hebrew Home of Riverdale in New York. Take a few minutes and listen to this podcast and learn how residents are getting relief from pain and suffering: https://soundcloud.com/user-285270443. Then, let's have some dialogue about a healthy way to consider making medical marijuana available for older adults we serve here in Georgia. While we haven't had clinical trials in the US due to marijuana being a Schedule 1 drug, there have been trials and studies regarding the effectiveness of medical marijuana in Europe and Canada. Other states including our neighbor Florida have legalized dispensing of medical marijuana and there is momentum to legalize it nationwide – even in Georgia. In other states where it's been legalized, we're hearing there are great outcomes but it is only used by a fraction of individuals who could benefit from it. If it is legalized here in Georgia, it would great for us to have some clinical trials which could increase comfort levels with this alternative to anxiety, agitation and pain. Whatever approach we take, we'll do it legally, member driven and the older adults we serve will be at the forefront of our efforts.
Sysco and US Foods for Thought
LeadingAge Georgia members can now buy from Sysco and US Foods through Value First group purchasing organization.
We understand that food and dining expenses are often second only to salaries—which is why we encourage members to have cost studies done in this very important spend category. A cost study is a comparison of what you are currently paying, retail or through a different GPO, to Value First GPO pricing. This is a free membership benefit.
Food cost studies include line-item price comparisons, drop-size discounts, rebates, and other data to let members see if there are potential savings by purchasing through Value First.
If you'd like to request a food cost study for your community, simply click HERE to submit your request. For more details call Vanessa Ceasar at 404-421-3956.
Value First, an affiliate of Vizient/Provista, is a group purchasing organization owned by LeadingAge national and twenty-five state associations, including LeadingAge Georgia. Value First is designed to leverage the buying power of thousands of senior service providers across the country to get the best pricing on a comprehensive array of products and services. This is your GPO
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Georgia Security Associates, LLC
269 Market Place Blvd. 200
Cartersville, GA 30121
Celebrating A Much Deserved Award
By Ginny Helms
Alliant Health Solutions, Inc. is the Quality Improvement Organization for nursing homes, hospitals and other medical entities in Georgia through a CMS contract. Alliant has led the way on numerous quality improvement initiatives in nursing homes including reducing antipsychotics, falls, decubitus ulcers, restraints and infections. They've also been progressive in helping to reduce unnecessary hospitalizations, they introduced palliative care programs and well-being at the end of life in nursing homes. They're a founding member of the Culture Change Network of Georgia and they have provided funding to LeadingAge Georgia for quality improvement educational programs like Eden and our leadership programs. They have also brought Mental First Aid training and scholarships for the training to Georgia. They have incredible leaders including Dennis White, their CEO, Adrienne Mims, MD their chief medical director and Linda Kluge, their executive director of QIO-QIN.
Linda Kluge was named the 2018 Champion of Quality by the American Health Care Association and National Center for Assisted Living. Linda is well deserving of this award. She has incredible talent, she knows the nursing home world, she values the staff who run the homes, leads with inclusiveness, and brings the right individuals to the table for developing improvement initiatives. She has built relationships with surveyors, agency heads and policy leaders in Georgia and across the nation and works with them to orchestrate efforts to improve quality care in long-term care. We are fortunate to have a partnership with Alliant Health Solutions, to have their great leadership, to have Linda Kluge leading quality improvement initiatives in nursing homes in Georgia and we celebrate Linda! If Alliant Health Solutions is not on your radar, it should be – so be sure to take advantage of any quality improvement/training programs that Alliant is involved in. You'll see why Linda Kluge is so deserving of this award!
assist with planning, we are sharing information
holidays and observances for each month
2 months early.
This month we are sending you information for October
October 1 International Day for the Elderly
October 4 Feast of St Francis of Assisi
October 16 Boss's Day
October 24 United Nations Day
October 31 Halloween
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LeadingAge Georgia Public Policy Report
By Tom Bauer, LeadingAge Georgia Policy Advisor
Since most eyes were following the primary runoffs in late July, the past month remained somewhat slow in pace for public policy. As most LeadingAge Georgia members know by now the November elections will pit Republicans Brian Kemp and Geoff Duncan against Democrats Stacey Abrams and Sarah Riggs Amico for governor and lieutenant governor, respectively. With regard to public policy, LeadingAge Georgia's board recently accepted the agenda contained in last month's report. In addition, the Coalition of Advocates for Georgia's elderly (CO-AGE) has selected its new legislative issue to pursue at the 2019 General Assembly
Public Policy Agenda
As noted the LeadingAge Georgia board accepted the public policy agenda proposed by the LeadingAge Georgia Public Policy Committee, which is listed below. Based upon board discussion and probably coalition partners, the issues most likely to take prominence are listed in bold.
LeadingAge Georgia 2018-2019 Public Policy Issues
Position and Involvement:
- Adult Day Services
- Cost Studies
- Medicaid Non-Emergency Transportation (NET)
- Physical and Behavioral Health Needs: Aging in Place
- Medicaid Funded Assisted Living Communities
- Life Plan Communities/CCRCs
- Implementation of SB 406 (Fingerprint check)
Position and Monitor:
- Home and Community-Based Services: CMS Rules
- Community Care Services Program (CCSP)/Service Options Using Resources (SOURCE)
- Proxy Caregiver Rules
- CCRCs/ Department of Insurance
- Property Tax Issues concerning Not-for-Profit Organizations
Position and Involvement:
- Home and Community-Based Services Medicaid (CCSP) and Non-Medicaid
- Adult Day Center Reimbursement Rates
- Financial Resources/Loan Forgiveness for Gerontology Education/Aging Services Professionals
- Health Coaches
- Funding for Increased Staffing in Nursing Homes
Position and Monitor:
- Nursing Home Provider Tax
- Use of Civil Monetary Penalty Funds
As noted, the CO-AGE selected a new legislative issue, "Medicaid Coverage for More Georgia Seniors," This new issue joins the carryover issues. The entire CO-AGE agenda is:
- Funding for Home and Community Based Services
- Funding for Aging and Disability Resource Connection
- Medicaid Funded Assisted Living
- Personal Care Home Requirements
- Medicaid Coverage for More Georgia Seniors
Members and staff of LeadingAge Georgia will be participating in various work groups developing these issues.
Fair Housing & Ethics Symposia
Fair Housing and Ethics Symposium provided essential information to keep you current as an operator in the senior living and services arena. Kathi Williams and Leslie Tucker with Williams & Edelstein opened our eyes with Fair Housing case examples in which they have litigated to help our member mitigate these encounters in the future. James Wells with Canterbury Court engaged attendees with thought provoking concepts to inform leaders around ethical decision making practices. In addition, we touched on the new cyber security breach epidemic and Will Hosea with Pointe North Insurance Group shared ways to protect your business and residents/clients information in the new era of cyber security.
Leadership Academy Fourth Event
August 15, 2018
Maintenance Professionals Forum
August 29, 2018
Dementia & Mental Health Symposium
September 13, 2018
Profiles in Positive Aging Exhibit Debut
Center for Civil & Human Rights
September 25, 2018
Click here for tickets
Culture Change Summit
September 27, 2018
Engage at Every Age Expo
October 3, 2018
Information coming soon
Center for Positive Aging Golf Tournament Fundraiser
October 8, 2018
Leadership Academy Fifth Event
October 10, 2018
Adult Day Services Symposium
October 19, 2018
Registration coming soon
LeadingAge National Conference
October 28-31, 20018
Philadelphia Convention Center
Georgia Night Dinner at the LeadingAge National Conference
October 28, 2018
Profiles of Positive Aging Gala
November 4, 2018
Information coming soon
Technology & Aging Summit
November 15, 2018
Information coming soon
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Engage at Every Age Expo 2018
Engage at every age is a multi-cultural expo for the greatest generations of our time — to connect, inspire, become informed, empowered, and sample the rich heritage of our collective communities! Join LeadingAge Georgia and other proud partners for a spectacular experience to include Senior Idol and Top Chefs! Your residents and clients will have a marvelous opportunity to access the following galleries:
- Wellness & Well-being "Healthy Living"Gallery
- Forever Young Gallery
- Cultural Arts | Theatre | Entertainment Gallery
- BizHub & Financial Gallery
- Social Engagement | Tech Savvy Square
- and so much more...
This event is free and open to the public. LeadingAge Georgia members are serving as judges for Senior Idol and Top Chefs. Be Engaged. Be Inspired.
Click here for more information.
More MARTA Atlanta
We want to hear from you!
Your input has helped us develop the More MARTA Atlanta program from the beginning. Now we need your feedback on the proposed project list.
Visit itsmarta.com/moremarta to:
- Take the survey
- Learn more about the program and projects
- Check out the outreach calendar and visit us at an upcoming event
Engage at Every Age
My message is simple this month…
Engage at Every Age!
Click here to watch video
Wesley Shelby, Jr., participant of JUST WALK! a Walk with a Doc program
Carolyn received her Health Coach certificate from Emory University. She is a 2016 recipient of the LeadingAge Georgia Profiles in Positive Aging Award, representing AARP. She is a National Senior Games (NSG) Athlete earning numerous gold and silver medals; she is featured in the 2017 National Senior Games Non-Ambulatory Athlete Exercise Videos; featured on the TV News Magazine for Baby Boomers 50Plus Prime; she was featured in the Atlanta Journal Constitution (AJC) newspaper; the cover story for the GirlFriends Lifestyle - A Women's Guide to Healthy Living Magazine, Special Edition for the White House Conference on Aging; and interviewed for various other media outlets. She is the founder of Hartfield's Hikers, Older People with Active Lifestyles (OPALs), Atlanta African American Baby Boomers and the Walk Outdoors for Wellness! (WOW!) program. For more information visit www.CarolynHartfield.com or send Carolyn an email at CH@CarolynHartfield.com
Minimizing Falls Within The Homes Of Seniorsby Cassie Steele
Did you know that falls are the leading cause of unintentional injury amongst seniors in the USA? Every year more than 3 million seniors are treated in emergency rooms across the country for fall-related injuries according to the CDC. While there are a number of falls that do occur while out and about, more than 75% of falls take place in or directly outside the home. With older adults being especially prone to falling and getting injured as a result, it is of vital importance to take every precaution possible to ensure that falls are prevented. There are a number of steps, such as the following, that can be taken to make a senior's place of living as safe as possible.
In the bedroom
Always ensure that there is a light source near the bed that can be turned on at night. Make sure that the room is clutter free and that there is a safe, unobstructed route from the bedroom to the bathroom. Motion-sensor lights can be extremely useful as they will automatically switch on as you make your way out of the room. Installing a bed rail can provide much-needed support when climbing in and out of bed and can help you steady yourself when you change position that may leave you feeling dizzy or disorientated.
In the kitchen
It is estimated that as much as 18.25% of all falls involving older adults occur in the kitchen, which is why it is so important to make it as safe as possible. Try to keep the items you use most often within easy reach and refrain from standing on step ladders and chairs to reach items on shelves. Remove all scatter rugs from the kitchen as they pose a great tripping danger. If you are more comfortable having a mat in front of your wash-up area or stove opt for one with a rubber backing that does not have any upturned corners. If something is spilled on the floor, make sure it is cleaned up immediately. Oily substances on a floor can cause you to slip and fall, injuring yourself badly. You can furthermore increase your safety by investing in a range of emergency warning systems such as smoke detectors that will notify both you and your loved ones should anything go awry within your home.
In the bathroom
The bathroom can be of great danger to a senior in terms of slips and falls. Install a grab rail next to the toilet as well as in the shower and bathtub. Put non-slip rubber mats in both the shower and bathtub to prevent you from slipping when you step on the damp surfaces. Having motion sensor lights in the bathroom is also a good idea, especially for seniors that are prone to going to the bathroom during the night.
Outside the home
Ensure that all pathways leading to and from your home are in good condition and kept free of leaves and moss that can become dangerously slippery. Inspect your steps and replace or repair any that are broken, damaged or loose. Adequate garden lighting is essential, especially to illuminate dark-colored cobblestones or tarmac. Always wear non-slip shoes when venturing outside and carry your mobile phone or emergency alert device with you should you fall and need to call for assistance.
Due to the increased vulnerability of seniors, it is imperative to take whatever steps are necessary to ensure that they are safe at all times, especially within their own homes. Despite one's best efforts, however, it still may not be possible to prevent all slips and falls in and around the house. It is for this reason that it is of vital importance to have effective care strategies in place should a beloved senior suffer an injury from a slip or fall.
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2018 Annual Culture Change Network of Georgia Summit
Person-Centered Palliatie Care: A Key to Well-Being
Older adults often experience pain associated with chronic conditions and acute illnesses. When the pain is not managed, the quality of life for the person diminishes and the person suffers from pain, isolation and depression along fatigue, loss of appetite, difficulty sleeping, and any a host of other symptoms that diminish well-being.
We're calling on all individuals who work with older adults to join us for this important summit on palliative care, to learn best practices and to help ensure that older adult who need palliative care receive it.
We will talk about what palliative care is, how it's different than hospice care, and how it is the key person-centered approach to providing relief from the symptoms and stress of chronic and acute illnesses.
It is all about improving quality of life and well-being for the individual who is experiencing the illness as well as their family/care partners. Palliative Care is not just about treating pain. It also treats depression, It helps give people the strength they need to carry on with daily life.
Research shows that once people know what palliative care is and what it can do, 92% want palliative care for themselves and those they love. We will discuss how we can come together as a community of caring to advance awareness and access to palliative care in Georgia.
Click HERE to register
The Eden Alternative Training
CMP Funds Continue to Support Transformative Culture Change Education to Georgia Nursing Homes Via The Eden Alternative® in Six Locations Throughout The State: Project Space Is Limited
RISE UP for Person-Directed Care in Georgia is a powerful, new grant opportunity that will help nursing homes improve quality of care and quality of life for their residents and advance their culture change journey. Thanks to the Georgia Department of Community Health, grant funds will make it possible for up to six people from each organization to experience the three-day in-person Certified Eden Associate Training, a power-packed culture change certification from The Eden Alternative®. The Culture Change Network of Georgia partnered with The Eden Alternative to bring this opportunity to Georgia.
Click HERE for more information.
2018 CCNG Advisory Group Meeting Dates & Update
Friday, August 24, 2018 | 9:30am – noon | Location: TBA
Friday, October 12, 2018 | 9:30am – noon | Location: TBA
Adult Day Services Symposium: SAVE THE DATE
October 19, 2018
Information coming soon
2018 GADSA Leadership Team
President: Claire Russell, The Homeplace
Vice-Presidents Public Policy: Ned Morgens, Skylark Senior Care;
Aysha Cooper, SarahCare of Snellville
Vice-Presidents of Members: Carla Jones, Rosswoods; Peggy Padgett, Georgia Infirmary Adult Day Health
GAAP Symposium This year's summer symposium was extraordinary with our first experience with a Graphic Recorder (Gabby Melnick) facilitated by the GAAP Leadership Team. See the photos and images of the experience as we continue to pave the way to Person Centered/Person Directed engagement and wellbeing for all residents/clients served in LeadingAge Georgia member communities:
2018 GAAP Leadership Team
President: Scott Bassett (Philips Tower, Decatur) email@example.com
Vice-President: Amanda Bennett (Campbell-Stone Sandy Springs; Atlanta) firstname.lastname@example.org
Program/Education: Liana Sisco (Lutheran Towers; Atlanta) email@example.com
So much of the success of activities professionals depends on the networking and ideas shared by those of us "in the trenches." Opportunities for collaboration with peers, in addition to the vendors and speakers helps to expand our knowledge, our inspiration, and our personal emotional investments in our communities. Every community is different. To be able to attend events that encourage the sharing of our success stories and positive experiences is vital for the industry as a whole.
- Amanda Bennett, Campbell-Stone Sandy Springs
Can Furniture Improve Quality of Life for Memory Care Residents?
By Bryan Durkis, Hekman Contract
We all know the data. By 2030, 20% of the U.S. population will be 65 or older and the number of Americans over the age of 85 will more than double between 2020 and 2040.
- 1 in 8 people over age 65 in the United States has Alzheimer's disease, and nearly 50% over age 85
- 64% of people aged 65 or older in nursing homes have Alzheimer's disease or another dementia
- With 5.3 million people in the US living with Alzheimer's disease it is the most common dementia accounting for 70% of all Dementia cases
- 1 in 6 women and 1 in 11 men will develop Alzheimer's disease in their lifetime
Despite billions of dollars spent on research, a cure remains out of reach. In fact, earlier this year Pfizer announced it has halted research into treatment of Alzheimer's altogether.
While a cure remains elusive, we have learned much in recent years about the daily challenges faced by someone struggling with dementia and how to care for them. We know, for example, that people suffering from dementia are often confused, embarrassed and anxious as everyday activities become more difficult. Having too many choices can quickly lead to frustration.
So, how can furniture improve the lives of those with dementia?
Companies like HEKMAN CONTRACT have developed furniture specifically for Memory Care residents. One example is Reveal bedroom furniture featuring "look through" door and drawer fronts on wardrobes, bedside cabinets and dressers. Being able to see what is in a drawer can help reduce confusion and provide a greater sense of autonomy. In the wardrobe, a full-length window allows care providers to stage clothing for the next day, thereby reducing the number of choices and allowing the resident to see where their clothes are. A skylight in the wardrobe provides ambient light thus making the contents easier to see while the white interior reduces the "cave effect" often associated with dark spaces.
Made of moisture resistant Thermoshield material, Reveal withstands harsh cleaners and is durable enough to stand up to impact from wheelchairs, walkers and other hard surfaces.
Optional features like motion sensitive lighting can aid in fall prevention and contoured edges and corners help prevent injuries should a resident bump into the furniture.
Until a cure is found, we will work to provide the best possible quality of life for those suffering from dementia as well as for those who provide care.
But the history of population health management predates fee for service payments or the American colonies and contributes significantly to the story of modern day medicine. It is a fact that for all the attention that is generated with the advent of new drug therapies or invasive procedures for the health-related maladies that plague mankind today the greatest reductions in deaths from diseases throughout written history are largely due to our collective ability to identify and document the cause of the congenital or acquired conditions and, where possible, mount society supported efforts to eliminate or eradicate them. The mobilization of the communities of Europe during the bubonic plague of the 1300s, the use of Variolation in Africa in the 1700s to provide immunity from smallpox, the eradication of the London Cholera epidemic of 1854, the 1860 publication of The etiology, concept and prophylaxis of childbed fever by Ignaz Semmelweis which led to the widespread practice of routine handwashing by physicians, iodization of salt in 1924 to reduce thyroid disease, the fortification of bread with niacin in 1934 to reduce pellagra, the enrichment of milk with Vitamin D in the 1930s to reduce rickets, the addition of fluoride to community water supplies in 1945 to reduce tooth decay, the vaccines for polio, German measles, diphtheria, and influenza, the Framingham heart study, the eradication of blindness from guinea worm infestations, safety belts for automobiles, the detection and removal of colon polyps to reduce colon cancers and the distribution of clean needles and condoms to reduce the spread of HIV. None of these advancements would have been possible in the absence of the collection, aggregation, analysis, reporting and utilization of data on populations of afflicted individuals in conjunction with a perception of the benefit to society at large from the reduction of illness from these conditions. The importance of this element of the transformation of medicine is critical. First because all of these are examples of primary and secondary prevention-based interventions versus treatment for an individual. Of equal importance, no direct transactional benefit is accrued to the individuals allocating the resources to support them. These advancements are not possible without first understanding the cause of the condition and then designing, developing and deploying resources first for the benefit of those at greatest risk for acquiring the affliction and, as is often the case, on reducing the burden of illness on those in the earliest stages of affliction. Many of these interventions have their origins in the military. Most of them required a level of organizational structure, processes and outcome monitoring and management beyond the singular scope of even the best practitioners of their day. All of them were aided by the marshalling of the resources of society either through civic, non-profit or governmental support for the benefit of the community at large.
The true origin of population health management, then, lies here; in the understanding that even as we have evolved newer methodologies to treat and cure diseases it is our society-funded advancements in prevention and early detection that have led to the greatest decreases in human suffering. Regardless of your political proclivities the evidence here suggests that it takes a village to eradicate or control the greatest health threats to a population. The one patient at a time business model of fee for service medicine evolved alongside and benefitted from the collective wisdom gained from managing community health issues. The aggregation and management of victims of tuberculosis led to the specialty of thoracic surgery, the treatment of injuries in the theater of war led to the field of trauma surgery, the development of antibiotics and the use of helicopter transport for emergency medical services. But with each new diagnostic and therapeutic modality the cost of health care escalated to the point where the expense incurred from the treatment of one individual with a severe illness could exhaust the generational wealth of an entire middle class family. The desire to reduce the risk of financial ruin from catastrophic illness was, in part, the genesis of employee sponsored health insurance. The subsequent belief as a nation that American seniors should be protected from destitution related to the cost of medical care led to the establishment of the single-payer, national social insurance program known as Medicare.
The introduction of Medicare Part A and Part B in 1966 were game-changers for low-income seniors in communities around America and, frankly, for the hospitals and providers that had served them for years without compensation. Prior to the establishment of this citizen-funded, government-managed health insurance option many of these seniors had been turned away from some hospitals or impoverished due to the cost of treatment for a catastrophic illness. But as beneficial as Medicare was its Fee for Service model led to misaligned incentives by compensating for the treatment of illness and not the prevention of disease. The predictable consequence spawned the medical industrial complex, with the design and development of larger brick and mortar medical treatment infrastructures, the buying up of providers of care and the arms-race-like acquisition of health centered technologies to attract and retain this new revenue stream. Early on it became evident that the system as implemented provided little supervision with regard to over-utilization of diagnostic and therapeutic resources, showed disregard for site of service as a variable in care delivery and rewarded poor performance by paying for complications and their resultant prolonged hospitalizations. The financial impact was so great that many of the medical groups, hospitals and drug manufacturers that were opposed to the passage of Medicare in the beginning became less vocal in their protestation of "government intervention in health care" as they began to reap the benefits of more patients with the ability to pay for the increasing cost for their services. By 1973 Congress and the President were enacting legislation in an attempt to manage the rising costs of government funded health care. But despite the best efforts of the executive and legislative branches U.S. healthcare costs as a percentage of Gross Domestic Product continued to grow at non-sustainable rates. This backdrop sets the stage for the tectonic shift in the U.S. healthcare landscape euphemistically known as managed care.
The epochal shift in the health care terrain is being driven by the convergence of three distinct but related factors in managed care: 1) the lack of personal accountability of a large segment of society for their health and well-being, 2) the realization that the fee for service employer-based and government sponsored insurance models reward the treatment of disease vs the prevention or reduction of illness and has led to the current medical industrial complex and 3) that the cost of primary or even secondary prevention of illness is cheaper than treatment by orders of magnitude for most conditions. Health policy in the United States for the last 45 years has been shaped around the second and third of these factors. We have not focused on the first because as a society we lack the desire or the capacity to hold individuals accountable for the modifiable risk factors that drive the majority of preventable deaths in this country. It is a fact that diet, sedentary lifestyle, obesity, smoking and alcohol are the cause of the majority of premature deaths in this country. We have decided as a nation to hold the providers and underwriters of health care costs accountable for increasing the engagement, education and empowerment of individuals with regard to their health.
All substantive health policy in the U.S. since the Health Maintenance Organization Act of 1973 has attempted to shape U.S. health care based on these two premises. The legislative solutions have attempted to catalyze the collaboration of payers, providers and high performing integrated care delivery system by ratcheting down the pool of inflation adjusted per capita dollars available for total cost of care. The architects of these social engineering policies are aware that the current state individual provider's practice, designed for optimization of the fee for service model, lacks to tactics, the team and the tools to successfully meet the performance and quality benchmarks to be competitive in this new environment. One recent study observed that for the average primary care provider with a panel of 2300 members it would take 21 hours a day for them to provide all of the annual acute, chronic and preventive care functions necessary for their membership3. Health policy architects are counting on market forces to drive the evolution of new symbiotic relationships while eliminating non-competitive models and rewarding those that lower costs, improve quality and enhance the experience of the member receiving care. The most sweeping and recent of these solutions is the Affordable Care Act and the Health Care and Education Reconciliation Act of 2010. The stated intend of the legislation is to improve access, increase quality and lower the cost of health care through (among other mechanisms) moving the majority of government sponsored health payments to value-based compensation and away from volume based fee for service compensation. As could be expected all major commercial health plans have quickly followed this trend.
So while the Fee for Service based health care delivery industry has invested time, talent and resources toward maximizing profits in a volume-based, unit-cost maximizing, specialist incentivizing, complication rewarding treatment of disease-based business model the payers of health care are economically catalyzing an antithetical care management model that rewards prevention, health maintenance and reduced utilization of services. As in the case of the ice shipping service and refrigeration these two models could co-exist together for a time. But in the same way that the Industrial Revolution gave the refrigeration proponents a competitive advantage over the ice shippers, the Information Revolution that the electronic age as spawned will provide opportunities to change health care delivery in ways that have yet to be imagined. And those changes are not 100 years into the future but are happening today.
Simply stated health care providers today are first and foremost in the information management business. The successful emerging health care organizations will be the ones that collect, store, analyze, report and utilize health information in a manner that delivers the most value to health care consumers and payers. The tactics for doing so and the importance of population health in achieving this goal are the topic of the next installment in this series.
3Annals of Family Medicine; www.annfammed.org; VOL. 10, NO. 5; SEPT/OCT 2012 396
By: Michael Vincent Smith, MD
News Throughout the Spectrum of Aging Services
Federally Assisted Housing (HUD-Subsidized)
New Venture for HUD Homes
The Atlanta Regional Commission is partnering with LeadingAge Georgia on a pilot project to provide mental health coaches in HUD senior living developments. The coach will work with service coordinators and will coach residents who need assistance with accessing mental health services. The coach model has reportedly worked well in the Atlanta Housing Authority homes and is becoming nationally recognized as a model of helping to improve well-being for residents with mental health concerns. In addition to coaching to enhance well-being, the coaches assist in making mental health appointments and accompany the residents to the appointments. The pilot is for homes in Cobb and Gwinnett Counties and if it goes well, we'll pursue funding to expand to other counties. If your HUD home is in Cobb or Gwinett and you are interested in participating in the pilot, please contact Ginny Helms firstname.lastname@example.org
Home and Community Based Services
Simulation Program Helps Recruit, Train Next Generation of Home Care Nurses
The United States is projected to experience a serious shortage of nurses, one that is only expected to intensify as baby boomers age and more frequently become in need of home health services. To recruit and prepare aspiring nurses, many of whom are millennials, nursing schools are launching innovative training programs specifically targeting in-home care.
House Bill to Support Hospice Training Moves Closer to Vote
Legislation aimed at raising awareness and increasing the quality of hospice and
palliative care is steadily finding its way through Capitol Hill. U.S. Rep. Tom Reed (R-New York) announced on Tuesday that the Palliative Care and Hospice Education and Training Act (PCHETA) has made it out of the House Energy and Commerce Health Subcommittee and is now advancing to the full committee for a vote.
LeadingAge Urges Increased Funding for HCBS Programs in 2019
The House Labor/HHS Appropriations Subcommittee drafted the fiscal 2019 bill with an allocation allowing for no increases in total spending on the programs within the subcommittee's jurisdiction over the levels provided for 2018. LeadingAge joined other members of the Leadership Council of Aging Organizations in a letter to appropriators pointing out the importance of Older Americans Act and other supportive services programs as a means of enabling thousands of elders to remain in home- and community-based settings. The letter urges Congress to increase funding for these programs in line with the rising population of people in need of services.
Life Plan Community/CCRC
Legislation for Name Change
When the LeadingAge NameStorm task force recommended a name change from Continuing Care Retirement Community to Life Plan Community, they provided a launch kit to help with the undertaking. The kit included a whitepaper to share with leadership and key stakeholders, a communications audit with a checklist of all of the places to add the Life Plan Community name, an internal roll out program with suggestions for rolling out the name changes within your organization, your residents and their families. They also included an external communications plan with suggestions for ways to introduce Life Plan Community to your local media and leads with a sample release, emails and social media posts. Our members all rose to the challenge and made the change with grace. At the time of the launch, the NameStorm task force told us that name "Life Plan Community" allows "planning" and "living" and the name tested positively with consumers who felt that it centered around them, their needs, was easy to remember and made them want to learn more. They also told us that we needed to use the term Life Plan Community in tandem with "CCRC" initially. We recently sought guidance from our national office about the possibility of working with the legislature in the next session to change the name in the state statutes to align with the name change. Our national office advised that it is appropriate and our public policy committee and board has agreed to move forward with legislation to make the change. At this point, we intend for the statute to indicate the change to the name Life Plan Community but will provide language such as "also known as Continuing Care Retirement Communities" in case any of our members have language in documents and need the protection. If you have any comments, suggestions or concerns regarding the legislation, please contact Ginny Helms at ghelms@LeadingAgeGa.org.
A Simple Fix for Low Occupancy
I cringe every time I remember the day several years ago when I unveiled my latest home improvement project to my wife. Frankly, I thought this one was one of my best. I'd given it a lot of thought. I'd devoted a ton of time to making sure it would be perfect. I loved it. I was sure she would love it too.
And then came the moment of truth. I gleefully shouted, "Ta-da!" She paused.
I waited for my pat on the back. And then she gave me a look that
implied—although she would never say it—that the project wasn't exactly the worst thing I'd ever done around the house. But, clearly, it wasn't my best work either.
That scene came to mind recently when I read an analysis of occupancy rates by the National Investment Center for Seniors Housing & Care (NIC). The best thing that NIC could say about our sector was that occupancy rates during the first quarter of 2018 were "not the lowest on record."
Not stellar. Not even that good. Just not the lowest.
How SNFs are Cutting Costs without Cutting Back on Care
As if managing the health of patients wasn't difficult and time-consuming enough, skilled nursing facilities now have to do more to manage their increasingly complex businesses as well. Why? To begin, revenue isn't rising at the same rate as expenses. A large percentage of this swelling cost is related to staffing, which already represents about 60% to 65% of a facility's operating costs, according to a report about the industry's need to adapt.
RUSH Act Seeks to Improve Opportunities for Telehealth Services for SNFs
The Reducing Unnecessary Senior Hospitalization Act (RUSH) Act of 2018, (H.R. 6502), introduced by Reps. Adrian Smith (R-NE) and Diane Black (R-TN), seeks to reduce unnecessary hospitalizations by allowing for the use of technology in SNFs, to treat patients in place rather than transferring them to the hospital. Specifically, the legislation allows the Medicare program to selectively enter into value-based arrangements with qualified physician group practices furnishing a combination of telehealth and on-site first responders. With a telehealth connection to an emergency physician, an on-site first responder equipped with mobile diagnostics would coordinate treatment for patients with acute care needs. The Department of Health and Human Services would also have the authority to determine the reimbursement level for these services. The anticipated savings will be shared between the physician group practice, Medicare, and SNFs.
Aging Services' Fiscal 2019 Funding Moving in Congress
To facilitate timely passage of 2019 spending bills and avoid a government shutdown when the new fiscal year begins on October 1, House and Senate appropriators are combining multiple individual spending bills into larger legislative packages.
Aging services programs involved in this process include senior housing and home- and community-based services under the Older Americans Act and other human services programs. Medicare and Medicaid are not subject to the annual appropriations process and so are unaffected.
The Senate is adding its version of the Transportation/Housing and Urban Development appropriation to an Interior Department spending bill, H.R. 6147, already passed by the House. Both the House and Senate HUD appropriations bills would fund Section 202 housing at a total of $679 million, the amount provided for fiscal 2018. This funding would be sufficient to renew all existing Section 202 contracts. In addition, the Senate bill provides $51 million for new Section 202 homes.
Administrator - Calvin Court
See full job description at: http://leadingagega.org/jobmart/public/job/213/
Chief Operating Officer (COO) - Canterbury Court
See full job description at: http://leadingagega.org/jobmart/public/job/228/
Cook - Saint Anne's Terrace
See full job description at: http://leadingagega.org/jobmart/public/job/227/
Dining Room/Catering Manager - Carlyle Place
See full job description at: http://leadingagega.org/jobmart/public/job/229/
Facility Operations Manager - Clairmont Oaks
See full job description at: http://leadingagega.org/jobmart/public/job/223/
Home Services Director of Nursing - Lanier Village Estates
See full job description at: http://leadingagega.org/jobmart/public/job/210/
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Check Out the New LeadingAge Learning Hub
"Develop a passion for learning. If you do, you will never cease to grow.
-- Anthony J. D'Angelo
LeadingAge launched a new on-line Learning Hub giving our members plenty of options for learning. The online learning platform enables anyone to access education content from any location using any internet-connected device any time. Content is developed in partnership with LeadingAge members, experienced speakers and experts from various academic and professional disciplines and is designed to address the diverse professional development and education needs of individuals working across the entire spectrum of aging. Whether you would like "QuickCasts which include narrated Power Point presentations providing an overview of a specific trend impacting LeadingAge members and lasting 10 to 20 minutes or "Deep Dives" which provide an in-depth look at topics or webinars or sessions, you'll find The Learning Hub has a lot of formats and topics to choose from – day or night. Click here and find a topic that fits your need.
Navigating Unchartered Waters: New Power Models and Change
While our world is changing from the outside in, it is also changing from the inside out. We are navigating uncharted waters with payment reform, technology, partnerships, emerging competition, and a consumer population with expectations and preferences that we have not previously experienced. We are also experiencing new power models, as described by Jeremy Heimans and Henry Timms in their recent book, "New Power: How Power Works in Our Hyperconnected World--and How to Make It Work for You."
"Old power models ask of us only that we comply (pay your taxes, do your homework) or consume. New power models demand and allow for more: that we share ideas, create new content (as on YouTube) or assets (as in Etsy), even shape a community…The future will be a battle over mobilization. The everyday people, leaders, and organizations who flourish will be those best able to channel the participatory energy of those around them—for the good, the bad, and for the trivial."
The focus on participation, cooperation, collaboration, and sharing should not be overlooked. "Our world is a little more Yelp and a little less Frommers". This fact alone has enormous implications for the work we do and how we do it. How do we engage a public beyond just those we serve? How do we mobilize those in our sphere for partnerships, action, support, donations, and more? What do our organizations look like when the walls or boundaries are porous rather than protective? How do we ensure that our content is not just consumed, but is shared and spread, often sideways, and becomes contagious? How do we engage the public to better understand what we do?
In the realm of aging services, we are challenged every day to connect with more people and organizations in new and different ways…partnering with hospice, hospitals, physician groups, or the local community colleges. Advocating for jobs in aging services before the Workforce Investment Board, tapping evidence-based practices to ensure we are being the best that we can be, and extending missions to serve underserved populations, including younger individuals with disabilities and perhaps even children and families.
Increasingly, LeadingAge members are community-based organizations serving families with a particular focus, in most (but not all) cases, on older adults. We are essential to the people we serve, those we employ, and those who we will serve in the future. Yet, we are constrained by old power models, defined by regulatory structures, attitudes, traditions, and assumptions about quality, aging, care, older adults, and much more.
In the fall, LeadingAge published "A New Vision for Long-Term Services and Supports," our vision for an integrated service delivery model. The premise is simple: older adults are at the center—their needs and preferences drive the services they receive. The success of the model is dependent on participation, cooperation, collaboration, and sharing by all the stakeholders—family, care coordinator, service providers—and is a system that facilitates collaboration among all those parties and more.
Many LeadingAge members have already embraced this puzzle—they are person-driven, have thorough and thoughtful care coordination, and operate a multitude of services. If technology allows, they share information among all parties to advance the best interests of the individual.
The individual must be at the center of this model, driving preferences, articulating needs, and getting access when and if needs arise. This model would represent a new power model. The key ingredient that is missing is funding constraints: what's covered and under what circumstances and by whom. Imagine the experience for the individual if he or she did not have to navigate various funding sources depending on the services accessed.
As it is, form follows finance and, as a result, we have the system we have…for now.
As new power models become more widespread as the drivers of our economy and the essence of the consumer experience, I imagine the value placed on participation, cooperation, and transparency will strongly influence how we, as community-based organizations serving families with a particular emphasis on older adults, operate, communicate, and participate with the community at large.
"New power models, at their best, reinforce the human instinct to cooperate by rewarding those who share their own assets or ideas, spread those of others, and build on existing idea to make them better."
As nonprofits with deep roots in your communities, this is not a bridge too far, but a natural evolution of where you have been and where you are going.
I look forward to navigating uncharted waters with you as we build the links to the new power world.
Katie Sloan, CEO