Wednesday, July 22, 2009

Elderly Care Waiver Program

Elderly Care Waiver Program helps seniors get help and services to remain in their own homes or community. Each state may have a different name for it but many refer to it as the "Waiver Program for Elderly Care".

The Elderly Waiver (EW) program funds home and community-based services for people age 65 and older who are eligible for Medical Assistance (MA) and require the level of medical care provided in a nursing home, but choose to reside in the community. Counties administer the program as part of the federal waiver program.

What is the Elder Care Waiver Program? Each state has their own program and requirements. The waiver care program can include visits by a skilled nurse, home health care aides, personal care assistant, adult day care, supplies and equipment, certified community residential services (assisted living, residential care)

Who is eligible?
• Those eligible for the EW program are 65 or older, eligible for Medical Assistance, and need nursing home level of care as determined by the Long-Term Care Consultation process.
• The EW service cost for an individual cannot be greater than the estimated nursing home cost for that same individual.

Medicaid State Waiver Program - General Information is a website set up to locate your state's link for further information. Another source for getting further information would be to contact your state's Department of Human Services.

Honoring Caregivers

I was my mother's primary care-giver for over 10 years. I believe that family care-giving is an important story that needs to be told to the rest of the nation. One way to tell the story is the proposed US postage stamp campaign honoring caregivers. The objective of the campaign is to bring awareness of the issues facing family caregivers to the general public, healthcare professionals and public policy officials.

"Currently there are more than 52 million family caregivers (approximately 17% of the population) in the United States. A family caregiver is a relative or friend taking care of a loved one who is chronically ill, disabled, or living with the frailties of old age and no longer able to care for themselves. The services provided by family caregivers represent approximately 80% of all home care services and are conservatively valued at more than $375 billion in 2007."

The U.S. Citizen's Stamp Advisory Committee is considering a U.S. postage stamp honoring family caregivers. There is currently a petition to have a US stamp created to honor family caregivers. If you would like to sign the petition, click on the blue word petition. This will take you to the National Family Caregivers website.

Sunday, July 19, 2009

Impact of a Quiet Question

I have been attending the Montana Writers Project this summer. One of the personal pieces that I have been working on is "Impact of a Quiet Question". As my mother's primary care giver I struggled with many decisions when 9/11 happened. I think all care-givers go through similar struggles as we try to maintain balance between the various demands on our life.

Impact of a Quiet Question

I couldn’t sleep. I kept waking up: 2345, 0045… 0445, 0545 I still needed just a little more sleep and then I finally woke up at 0645. I was late! I started getting dressed; then went to finish putting myself together in the living room. The TV was still on, there was no closed captioning. The sound was still off! I could see the Twin Towers on the screen; smoke coming from one of the towers and a clear blue sky in the background. In my muddled brain I didn’t think about turning up the sound. I tried to think about what movie they were hawking – what movie was getting so much air time?
As I put on my socks my mind wanders back to that June afternoon. I recalled the cracker box room. On the dresser were the new cell phones, my military dog tags, the car keys, and our wallets, and thrown into Dan’s cap was the motel key. A few short hours carved from work and the chaos of home – care givers, responsibility, and the commotion that is always present. I exchange the din for private time with my soul mate. Time away from the mother I cherish. The mother I am losing.
When Dan gave me that cell phone in March, I first thought it was kind of silly. Then I experienced its freedom. I could go, do something, and not worry about finding pay phones to check on Mom. I could go and could still be in contact. Freedom.
As I scan the room I am glad the furnishings do not tell everyone’s story. Like a voyeur I watch the replay – me scootching across the crinkled sheets. The raspy whine of the air conditioner as it spurts out cold air. Up against Dan I snuggle and take shelter in his arms. The bedside clock ticks away our time together. Reality reasserts itself like the sunlight filtering through the drawn curtains.
Out loud I review my to do list that is in the olive green notebook.
• Polish combat boots
• Sew on new patches
• Gather up training manual
• Double check and confirm the times with Mom’s caregiver
• Layout Mom’s pills

I gripe and grumble about what needs to be accomplished this weekend. I bitch about the decisions the higher ups have made. He listens. Now he quietly asks:”Why are you still there if you aren’t happy?” Time stops -1445.
“What do you mean? I’m ok once I get there. I like the people, I just dread the BS. I hate the goat ropes.”
Stroking my hand he repeats: “Why are you still there if you’re not happy?”
I hadn’t thought of happy. Duty, service, responsibility, family and country – yes. But happiness?
I grappled with my decision for the next couple of months. Pondering my choices, I kept feeling it’s time. Impulsively - I talk with my CO (Commander). She asked me: "What will you do?”
Yes, what will I do? Who will I become? Dan’s quiet inquiry echoes in my head “Why are you still there if you’re not happy?” For 24 years I have been a citizen soldier, a member of the Montana National Guard. One question triggers such major changes in my life. I sign the papers requesting retirement on 28 August 2001.

I kiss Mom’s forehead as I watch her sleep. Her caregiver is late today.
I come through the front door of school to an unusual greeting by Natalie, our usually sunny secretary. “Do you have rabbit ears?”
“Not here. I have some at home do you want me to go get them?”
“No. No. It should work in the hall. I am confused. I walk down the hall wondering what that was all about. I need to get to my room and get started processing the books. Tuesday morning I work on automating our library.
Shortly though I am back at the office. The TV is set up in the hall and that stupid film clip is still on. That‘s not right! Finally I ask,” what is happening”? I learn a plane has hit the Twin Towers. The time difference between NY and Montana adds to the surrealism. Viewers watch as a second crash is reported. My mind replays the decision I have recently made, knowing that retirements will be frozen.
With two crashes I know it is not an accident. I head for my room to call my unit and report in. When I ask for a status report I am told nothing has come down. My sister calls; she is on her way to Colorado for her work. What do I know? When will she need to get Mom? What paperwork does she need to complete for Mom’s care? I tell her what I know and proceed making calls to set up care for Mom when I deploy.
I am humbled by Rita’s love for Mom and me. In May 1999 I was sent to Germany for a 30 day deployment. Mother had been diagnosed with moderate advanced Alzheimer’s in 1998. Those 30 days were a difficult sentence for both Rita and Mom. She was belligerent and antagonistic because she was out of her comfort zone and was trying to find her way home.
In order to keep her safe Rita & her young family wired the gates shut, put deadbolts at the top of exterior doors. They tried every means possible to stall my mother’s escape plans. Mother, like any good soldier held against her will valiantly followed the Military Code of Conduct (Section III)
a. If I am captured I will continue to resist by all means available. I will make every effort to escape and aid others to escape. I will accept neither parole nor special favors from the enemy.
b. The duty of a member of the armed forces to use all means available to resist the enemy is not lessened by the misfortune of captivity.
Mother was a valiant soldier. She never passed up an opportunity to try and escape.

I learn if Mom goes to Wyoming with Rita, the cost of her care is only covered for 30 days. Rita and I talk again. We now make plans for 24 hour care here in Montana. I continue to check in with the unit. No one has been given any intelligence. I am frustrated but continue to make contingency plans for my probable deployment and the care of my mother.
Dan calls me. The Pentagon has been hit. We are talking when the line goes dead. My friend Bernie is at the Pentagon. I am worried and try to reach her. Of course I don’t get through. I think of her and have a sense of peace. Later that night I get through to her. She was scheduled to be at a meeting in the section where the plane crashed. But she had “use- it- or -lose –it- leave” and so was home. She watched the plane flying low over their street just before it crashed into the Pentagon. She is grieving the loss of good friends. I am relieved that she and her husband, Ron are safe.
As I am seeing the news coverage unfold, I continued thinking back to the day that had triggered my decision to retire from the guard, 15 days before 9/11. Yet even as I made that decision the world shifted on its axis and intersected mine.

A part of me was relived that my retirement papers were in the pipeline. I also knew that all of my training was for just this sort of moment. The third and most critical concern is my mother's care. She started living with me just before being diagnosed with Alzheimer's in 1998. I am juggling a full time job (teaching/library); being her primary care giver; and my career in the Montana National Guard. My internal struggle is which call to follow.

Days go by and still my unit is not called up. I learn that my paperwork has been pushed through even though there is a freeze on retirements. I second guess myself trying to decide if I’ve made the right decision. I know that eventually my unit will be activated. I consider pulling my papers.
Dan and I discuss my options. I fidget with my dog tags as he quietly reminds me that I have served my country for 24 years and that my family needs me now. In my heart I know that he is right. If I go, Mom will not be here when I return. I am haunted because I do not want to make that sacrifice.
In the bible Jacob wrestles with “an angel of the Lord” all night and doesn’t stop until the angel agrees to bless Jacob and his family. My struggle feels more like wrestling demons for a part of my soul. I am truly blessed because I have the freedom to make this decision - the freedom that I so revere. I continue to grapple with the formidable questions: Who am I? Who will I become? And will I be happy?
I read later that my former unit was called up.

Sunday, July 12, 2009

Connection between Alzheimer's & Nitrates

"A new study by researchers at Rhode Island Hospital have found a substantial link between increased levels of nitrates in our environment and food, with increased deaths from diseases, including Alzheimer's, diabetes mellitus and Parkinson's. The study was published in the Journal of Alzheimer's Disease (Volume 17:3 July 2009)."

According to the article Researchers Find Possible Environmental Causes For Alzheimer's, Diabetes Researchers have found a parallel between the nitrates in our processed food, soil, ground water and fertilizer and deaths from Alzheimer's, Parkinson's, diabetes and other insulin-resistant diseases.

Oh my! The article said these diseases are pandemic.

In my mind this finding offers hope for some new leads in combating these diseases with medicine. But, maybe more importantly through changing our eating habits on a personal level. This article also shocked me as I took a mental inventory of what I have been eating. Lets just say if nitrates came in the form of a salt shaker, you wouldn't have tasted anything else.

Much of what I have been reading lately speaks to the hope that a diet similar to that eaten in the Mediterranean may be optimal for our health. That is proving quite a challenge for me as I am addicted to so many processed foods.

The second research findings that caught my eye was the connection that these diseases are insulin-resistant. In other articles I have read they have drawn a connection between belly fat as an increased risk factor for developing Alzheimer's. I have had a weight problem most of my life. Recent findings on that front also recommend a Mediterranean diet for achieving weight loss and a healthier lifestyle. It scares me that there is a connection between my belly fat and a greater risk of developing Alzheimer's.

Monday, July 6, 2009

Keeping the Brain Sharp

Please read the full article at the Alzheimer's Research website on brain health.

10 Tips for Keeping the Brain Sharp Into 2009

One piece of excellent news in the past year was that brain health seems to be improving among older Americans. A large national survey from the University of Michigan found that over a 10-year-period ending in 2002, memory loss and thinking problems were down significantly among seniors aged 70 and up, from 12.2 percent to 8.7 percent. That’s a change that translates into hundreds of thousands of men and women, though Alzheimer’s is still a top concern for millions worldwide.

Here’s a roundup of's Wellness and Prevention stories from the past year that may help set the tone for a brain-healthy new year:

1. Stay Mentally Challenged.

2. Practice Good Waist Management.

3. Work It.

4. Stay in School.

5. Maintain an Active Social Life.

6. Walk for the Brain.

7. Keep Cholesterol in Check.

8. Control Blood Pressure.

9. Pass the Fish.

10. Surf the Web.

Click here to get detail info on this article

Sunday, July 5, 2009

Tools for the Care Givers Toolbox

One of the resources that I love is the free quarterly magazine care ADvantage. I still subscribe to it to keep up on Alzheimers and to marvel at what other people have accomplished. It is a free publication of the Alzheimer's Foundation of America.

When I first started caring for my mother I met a young woman in my National Guard unit who told me about "Validation Therapy" that was developed by Naomi Feil. Shortly after that I had the privilege to attend a AD conference where Naomi was the featured presenter. What an awesome experience. It truly helped me begin to fill my caregiver's toolbox.

I was pleased to learn that the website fore "care Advantage" has archived copies of past articles on Validation Therapy. The Fall 2008 edition has the article "The Validation Method at Work". I hope this resource becomes as valuable to you as it is to me.

Friday, July 3, 2009

Leeza's Place

Leeza Gibbons has written a book titled "Take Your Oxygen First". After reading some of the reviews it's going on my list of books to read soon! It sounds compelling.

Leeza Gibbons has developed a great website. It has great resources for caregivers and their loved ones. It blew me away. The site deals with solving today's problems as well as helping fund research for a cure. Her mother said, "Tell my story and make it count." Leeza has surely done that.