You are an informed eldercare consumer when…

This is the first generation that has such a wide and varied selection of aging services and supports. Many of the current services, supports, and products did not even exist a generation ago such as assisted living, long term care insurance, medical advocacy, geriatric care management, professional organizers, remodeling/universal designers to help individuals age in place, and senior housing search services to name just some. Federal and state aging and disability programs have changed and are continuing to change to accommodate the unprecedented growth of aging and disabled Americans. Even aging and disability service specialists are struggling to stay current. Please visit CCAL’s ELDERCARE AND DISABILITY RESOURCES section on the website regularly to help keep abreast of the most current information. Go ahead and take the quiz.

• You know where to get information about eldercare and disability topics when you need them.
• You know what home and community-based services (HCBS) means.
• You know that falls are the leading cause of injury death among people age 65 and older.
• You know what a geriatrician and a geriatric care manager are and how to locate them.
• You know the difference between Medicaid and Medicare and what each provides.
• You know about the different senior living options.
• You know that many elders are prescribed new medications without an assessment of the medications they are already taking.

Eldercare & Disability Topics

Becoming an informed consumer is both on-going and personalized; a learning process most often motivated by health and life circumstances. So the information that is needed can change over time. The following resources are offered as broad starting points in your on-going quest for information that is relevant at a specific time for a specific reason and for a specific person:

The network of professionals working at Area Agencies on Aging (AAA) around the country are an important resource to turn to for finding information and resources for older adult home and community-based services. For the AAA online search directory, visit AAAS/TITLE VI AGENCIES

In many states, the scope of the AAA network has been expanded to serve older adults and individuals with disabilities, and are called Aging and Disability Resource Centers (ADRC). ADRCs serve as a single coordinated entry point into the long term support and service system to better assist consumers and families with information and access to the resources and services they need.

The Eldercare Locator, another public service of the U.S. Administration on Aging (AOA), is a nationwide service that connects older Americans and their caregivers with information. You can speak with an information specialist Mon-Fri 9 am 8 pm ET at (800) 677-1116 or search online at Eldercare Locator.

Disability.Gov also provides an extensive array of information and resources on programs, services, and life topics to assist people to lead full inclusive lives in their communities.

Home and Community-Based Services (HCBS)

Many older adults wish to remain in their own homes as they age, but require some assistance and support services to do so safely. Home and community-based service (HCBS) providers offer a diverse array of services and care support for older adults living at home. Depending upon the person’s individual needs, home-delivered meals, companion and personal care services, home healthcare, adult day services and respite services for family caregivers are some examples of the options intended to assist older adults to remain living at home safely and comfortably. Contact your local Area Agency on Aging (AAA) to learn what services are available in your community. To find the AAA in your community, check the online search directory at AAAS/TITLE VI AGENCIES

Falls Among Older Adults

According to statistics from the Centers for Disease Control and Prevention’s National Center for Injury Prevention and Control (NCIPC), each year one in every three adults age 65 and older falls. Among those age 65 and older, falls are the leading cause of injury death. They are also the most common cause of nonfatal injuries and hospital admissions for trauma.

Falls can lead to moderate to severe injuries, such as hip fractures and head traumas, and can even increase the risk of early death. Fortunately, falls are a public health problem that is largely preventable.

Fall Prevention: Older adults can take several steps to protect their independence and reduce their chances of falling. They can:

• Exercise regularly. It’s important that the exercises focus on increasing leg strength and improving balance. Tai Chi programs are especially good.
• Ask their doctor or pharmacist to review their medicines—both prescription and over-the counter—to reduce side effects and interactions that may cause dizziness or drowsiness.
• Have their eyes checked by an eye doctor at least once a year and update their eyeglasses to maximize their vision.
• Make their homes safer by reducing tripping hazards, adding grab bars and railings, and improving the lighting in their homes.

Additional ways to lower hip fracture risk include:

• Getting adequate calcium and vitamin D in your diet.
• Undertaking a program of weight bearing exercise.
• Getting screened and treated for osteoporosis.

For additional information, fact sheets, and other resources on fall prevention, visit CDC’s site at CDC: Falls Among Older Adults: An Overview

Difference between a Geriatrician and a Geriatric Care Manager

It is very important to understand the difference between these two professionals because, while their title may sound similar, they practice very different roles in and responsibilities for the health and well-being of an older adult.

A Geriatrician is a physician with specialized training in the aging process and the diseases and clinical problems specific to the elderly. As pediatricians are experts in the care of children, geriatricians are experts in the care of elders.

A Geriatric Care Manager is a health and human services specialist (typically a nurse or social worker) who provides consulting expertise related to aging and disability services and supports. The Geriatric Care Manager is trained and experienced in many facets of care management including but not limited to nursing, gerontology, social work, or psychology. For additional information on professional geriatric care managers and how to locate one near you, visit the site of the National Association of Professional Geriatric Care Managers at National Association of Professional Geriatric Care Managers.

Difference between Medicaid and Medicare

While Medicaid and Medicare sound similar, they are in fact very different programs. One of the biggest differences is Medicaid is a state governed program and Medicare is a federal governed program. The following are some other differences:

Medicaid serves people with low incomes including:

• Pregnant women
• Children under the age of 19
• People 65 and over
• People who are blind
• People who are disabled
• People who need nursing home care

Application for Medicaid is made at the States Medicaid agency

Medicare serves people:

• Age 65 and over
• Of any age who have kidney failure or long term kidney disease
• Who are permanently disabled and cannot work

Medicare is applied for at the local Social Security office.

Some people qualify for both Medicaid and Medicare. People who qualify for both programs are called dual eligible. To learn more about Medicaid eligibility and guidelines, visit the Centers for Medicare and Medicaid Services site at Centers for Medicare & Medicaid Services: Overview.

To learn more about Medicare basics and for a complete resource locator, visit the official Medicare site of the US government at Medicare.gov.

Senior Living Options

There are many housing options for older adults. Options include remaining in their current residence, sharing a residence with others or moving in with family, moving to a retirement community, or a congregate living facility such as assisted living. Individuals with mobility and health limitations may consider options offering personal care services such as continuing care retirement and assisted living facilities. A choice within these basic options depends upon one’s income, health status, and family situation.

While 80% of adults age 55 to 74 own their homes, the percentage of older adults living in their home declines with age and health status (Source: AoA Aging Information Notes).

An extensive on-line resource manual has been created by the National Association of State Units on Aging and Disability (NASUAD) to enable consumers to find additional information on senior living options, including federally funded senior housing, accessible housing, and home modification options. To learn more about senior living options, visit Developing Aging Competency Chapter 16: Senior Housing Options

Medication Assessment and Monitoring

Taking numerous medications (known as polypharmacy) is particularly common among older adults who are more likely to need medications to manage an array of chronic conditions. Many elders are being prescribed medications by a number of different physicians and specialists for their various conditions often without the physician(s) assessing all of the medications the elder is currently taking. Frequent changes in medication and/or dosages resulting from a doctor’s visit or hospitalization add to the potential for medication errors. Lack of complete medication monitoring and communication among all healthcare providers may increase the person’s risk of harmful drug-drug interactions; in fact, 28% of all hospital admissions among older adults are medication-related.

Consumers need to understand the importance of having older adults assessed and monitored for safe and effective medication administration: 1) to ensure the avoidance of potentially dangerous drug interactions and complications; and 2) to confirm that the person is complying with a safe medication regimen. This is especially important for older adults taking large numbers of medications to address chronic illnesses and multiple diseases.

The Institute for Safe Medication Practices (ISMP)—the nations only nonprofit organization of pharmacists, nurses, and doctors devoted entirely to safe medication practices – provides helpful online information. Preventing medication errors is no longer just a responsibility for health professionals—consumers, like you, also play a vital role Consumermedsafety.org.