Jewish Ledger | 7-1-11

As with many other cultural and social phenomena, options for the older adult are largely being shaped by the needs and preferences of the Baby Boomers.
“When our grandparents were aging, there were some options available, but they were not as formalized as they are now,” says Kate Collette, administrator of Hebrew Health Visiting Nurse Agency, based in West Hartford. “For example, when my grandfather was living home alone, we had a ‘housekeeper’ who would also make sure he got his meals. But you had to find these people on your own, through word of mouth, because there were no registries or agencies. Many older adults who could no longer stay at home went straight into a skilled nursing facility.”
Collette says that many Baby Boomers exploring options for their own impending eldercare won’t consider a skilled nursing facility unless and until they’ve exhausted all other possibilities. And with the breadth of services and support available, many won’t have to.
The key is to learn about the options and get help navigating them – preferably ahead of time, rather than in an emergency situation.
In Connecticut, all Jewish Family Service agencies and Jewish Family Services offer a range of support for older adults living at home.
Jewish Family Services of Greenwich Older Adult Services include luncheon programs, grocery shopping, case management, friendly visiting, counseling, discussion groups, telephone consultations, and referrals. Contact: Lisa-Loraine Smith, (203) 622-1881 / LLsmith@jfsgreenwich.org
JFS at Home, LLC, is a fee-for-service homecare agency and affiliate of Jewish Family Services of Greater Hartford. Contact: Patricia Kiely, (860) 233-4470 / info@jfscareathome.org
Jewish Family Service, based in Stamford and serving mid- and lower Fairfield County, offers a Comprehensive Geriatric Care Program, with the longest-running home-companion training and placement program in the state, as well as personal care services, case management, and volunteer services. Contact: Isrella Knopf, (203) 921-4161 / isrellak@ctjfs.org
The Jewish Family Service of The Jewish Federation of Greater Danbury, CT & Putnam County, NY offers counseling services, referrals, and programs for aging parents. Contact: (203) 792-6353
Jewish Family Service of Connecticut, based in Bridgeport, offers case-management and referral services. Contact: Harvey Paris, (203) 366-5438 / info@jfsct.org
Jewish Family Service of New Haven Services for Older Adults offers in-home and in-office counseling and assessment. Contact: (203) 389-5599 / contact@jfsnh.org
Brownstein Jewish Family Service in Southbury provides referral services. Contact: Debby Horowitz, (203) 267-3177, ext. 105 / dhorowitz@jfed.net
The Jewish Home for the Elderly in Fairfield’s Senior Choice at Home is the only continuing-care-at-home program in southern Connecticut, and offers a “life care” plan of personalized healthcare coordination and a comprehensive package of home care and long-term care services. Contact: Gail Bromer, (203) 365-6491 / gbromer@jhe.org. Upcoming info sessions: Wednesdays, July 6 & 27, 10 a.m., The Jewish Home Kurianski Pavilion, 175 Jefferson St., Fairfield.
West Hartford-based Hebrew Health Care’s licensed and certified home-health agency, Hebrew Health Visiting Nurses, provides skilled in-home care to those recovering from an illness, recent surgery, or hospitalization, or who have a chronic medical condition. Contact: Kate Collette, (860) 523-3888 / kcollette@hebrewhealthcare.org

Plan ahead for healthy aging

A healthy transition to older adulthood can seem like a daunting task, with many considerations and moving parts. Projections indicate that, by 2030, 20 percent of the U.S. population will be 65 and older.
“With people living longer, chances are that many of us will have some care needs,” says Isrella Knopf, MSW, director of Geriatric Care Services at Jewish Family Service in Stamford.
And many of us wish to age in our own homes. Nearly 80 percent of respondents in  “Connecticut Long-Term Care Needs Assessment,” a survey conducted in 2007 by University of Connecticut Health Center, expressed as much.
The question then becomes, what resources and supports are necessary for healthy aging at home? One thing everyone seems to agree on: don’t wait until a crisis arises. Have a family conversation, and make a plan reflecting how and where you want to age.
“As an older adult, first, look at yourself,” says Knopf. “Have a doctor give you a good medical assessment and look to see: are you able to take care of your personal hygiene and do your laundry? is your house clean and can you prepare your own meals? Do you have mobility issues, memory issues, increased confusion? Are you remembering to take medications and follow up with a doctor’s orders?”
Or, start with a consultation, says Ann Leabman, geriatric care manager at Jewish Family Services of Greater Hartford, and care coordinator at JFS Care at Home, LLC. “As a concept, ‘aging in place’ is important because it’s acknowledging that older adults should have a choice in how and where to age,” she says. “But they need a plan that is a permanent solution, not a stepping stone to another place, like a nursing home, for example.”
That plan must include a current living will and advance directives for end-of-life care. Children of older adults can help start the conversation, Leabman says, and should do so as soon as possible. An assessment of financial assets and resources, as well as what are the finances? Maybe see an eldercare attorney to discuss becoming power of attorney for your parent, or at least understand what the rules are.
“Discuss the really important issues, like what would the parent wish to have happen when he or she can no longer make decisions?” she says. “If the parent seems reluctant to talk about these things, the child can tell the parent, ‘I’m thinking about these things for myself and would like to discuss them with you. Maybe we can problem-solve together.'”
It’s important to understand how well the parent is managing right now and what his or her resources are for current and future use, Leabman says, both financial and in terms of a support system. Sometimes, it’s enough for an adult child to be prepared with information and step in when necessary.
The biggest confusion seniors face is around funding issues, says Isrella Knopf. “Many think that Medicare will take care of everything, and that’s not necessarily the case. It’s true with something acute, but with a chronic illness or situation, the payments won’t continue indefinitely, and then what?”
That’s where a consultation with a Jewish Family Services agency can help. Leabman also refers clients to resources like the Veterans Administration, or CHOICES, the State’s “program for health insurance, assistance, outreach, information and referral, counseling, eligibility, screening,” or Connecticut Community Care, Inc. (CCCI), which helps people of all income levels access at-home care.
“Aging in place means setting up a situation in which the older adult is successful in remaining where they are, or are considering the next step to assisted living or skilled-nursing facility,” Leabman says. “The goal is to remain as independent as possible as safely as possible, with the best care available.”