Lexington Fire Department and Lexington Lodge of Elks Install Smoke Alarms

Firefighter Paramedic Shawn Ormiston Installs a smoke dectector.

The Fire Department with support from the Lexington Lodge of Elks #2204 installed smoke alarms in several homes of seniors living in Lexington at no cost to them this past Saturday. “Funding for the program was received by a grant of the Benevolent and Protective Order of Elks of the U.S. designed to have local Lodges impact the community they serve,” stated Christopher Cavanaugh, President of the Lexington Lodge.

This pilot program supplied new battery-operated smoke alarms and carbon monoxide detectors to seniors. Lt. Tremblay, Fire Prevention Inspector along with Charlotte Rodgers, Director of Human Services coordinated the program each deemed it a success. “In almost all the homes visited this Saturday smoke alarms were either missing batteries, incorrect type or out-of-date or installed incorrectly,” said Lt. Tremblay. “Members of the fire department S.A.F.E fire safety educators team helped to install the detectors,” Lt Tremblay went on to say.

Having a properly operating and maintained smoke alarm in your home reduces the chancing of being injured or dying in a fire by nearly 90% – however nearly half the homes in the United States do not have smoke alarms or they are not properly maintained (missing or dead batteries for example). National statistics have shown older adults have a much higher risk of being injured or dying in a fire.

All residents are encouraged to look around your home and make sure you have smoke alarms and carbon monoxide detectors located on each level of your home. Press the test button either with your finger or the end of a mop handle to see if it sounds at least monthly. Change the batteries in the smoke alarms and carbon monoxide detectors annually. A good reminder is when we change our clocks in the spring or fall.

If you’re a resident over the age of 60 and would like to be part of this program, we encourage you to call Gwen Jefferson, at the Senior Center 781-861-0194 to sign up.

Senior Center Summer Trips

Maine Lobster Bake
Thursday, June 21
9AM – 5:30PM

We will stop at the Nubble Light and York Village before we go to Foster’s for an authentic Lobster Bake. After our meal, choice of lobster or chicken, there will be time to walk to the beach to view the Annual Sand Sculpture show.

Tall Ships 2012

Tuesday, July 3
8:30AM – 5PM

On arrival in Boston, we will board the Provincetown Cruise vessel for a one and one-half hour narrated Harbor Cruise to view the world’s largest and grandest sailing ships. After the harbor sail, we will go to Quincy Market to have lunch (on your own) and browse the shops before heading home.

Tanglewood Overnight

Sun, Mon., July 29-30
Sun., 8AM – Mon., 5-5:30PM
$345-double; $385 single

Emanuel Ax will be the featured pianist at the Sunday afternoon performance of the Boston Symphony Orchestra, when he plays Beethoven’s Piano Concerto No.3. Tchaikovsky’s Symphony No. 5 is the other feature on the program. The overnight stay at the William’s Inn in Williamstown includes a complete dinner and breakfast. On Monday, we will visit the Clark Art Museum, noted for its Impressionist collection. Lunch on your own at the museum.

Park at the Lexington High School, Worthen Rd. Lot. Deposit of $25 required; balance due July 2.
If you have questions, please contact Phyllis Rand at the Senior Center at 781-861-0194.


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Living All the Way

By Sandy Simon  |

Why does there seem to be an increased fascination with the experience of growing older? I think it is safe to assume it is because the baby boomers have come of age. On January 1, 2011, the first baby boomers turned 65 years old. The US Census Bureau defines baby boomers as those born between January 1, 1946 and December 31, 1964. Everyday for the next 19 years, 10,000 people per day will celebrate their 65th birthday.

Perhaps you are a member of this group, which may explain why you have found yourself interested in reading this column, even though you might have passed by it just a few years ago. There are several generations of older people who are paving the way for baby boomers who are just beginning to experience the challenges associated with aging. Their experiences of aging are diverse. Often times, people who are older, find that the quality of their lives is subject to the newly developing limitations of their body and mind. With life expectancy in the United States at 79.4 years for women and 75.5 years for men, people are living longer. Our challenge is to maintain good quality of life as longevity increases.

As a geriatric care manager, I come across many wonderful older adults who have lived meaningful lives with purpose and direction. Unfortunately, as a result of age-related conditions, some find their world becoming smaller. Due to challenges with impaired eyesight, hearing, mobility, cognitive challenges, chronic pain or other medical conditions, they may become less engaged in purposeful activities. Before they realize it, they no longer recognize the person they’ve become nor do they feel meaningfully connected to the life they are living. This is sad on many levels. However, in his book, Age-ing to Sage-ing, Rabbi Zalman Schecter-Shalomi encourages us to think differently: “Aging doesn’t mean diminishment or exile from the ranks of the living. As the period in which we harvest the fruits of a lifetime’s labor, it gives us the panoramic vision from which spiritual wisdom flows.”

At a time when our elders could benefit from thoughtful, compassionate options to help maintain a precious connection to their own lives, they are often left frustrated and alienated by the possibilities available to them. Fortunately, there are programs being developed that are shifting the way we respond to the lifeline our elders desperately need and deserve.

A new program that focuses on meaningful engagement, specifically for people living with dementia, is the Learning for Life program developed by Hearthstone and it’s president, John Zeisel, PhD. I asked Dr. Zeisel to share the impetus and evolution of this groundbreaking new program:

“Learning for Life is a school for people with memory challenges specially developed to make such challenges irrelevant. Learning for Life is the start of a revolution in dementia care—a movement that will return people with memory challenges to their place in society—with the rights and opportunities they deserve.

One of the commonly held beliefs people have about those living with memory challenges—Mild Cognitive Impairment (MCI), Alzheimer’s and other dementias—is that people living with these conditions are no longer able to learn. This is just wrong and the first Learning for Life Academy—now welcoming students at The Groves a 62+ Senior Living Community in Lincoln, is proving it. People learn in different ways and the brain’s procedural memory and learning systems remain fully functional in this population. That’s why Learning for Life works.

I knew that this program would benefit everyone with memory challenges living at home or in an Assisted Living Residence who misses social contact, meaningful discussion and the joy of learning. Instead of keeping these people safe with continuous caregiver supervision and secure perimeters, why not, I asked, keep them safe by giving them something to care about that keeps them interested and engaged—learning?

Learning for Life was conceived when three things came together: I published I’m Still Here (Penguin, 2006), my book about how people with dementia are very much present throughout their lives and their voyage with dementia; I learned that Maria Montessori’s original subjects for her Montessori Teaching Methods were children with learning difficulties and that these approaches are well suited to helping people with dementia learn new things; and drawing on my background in Environment-Behavior (E-B) studies, I recalled how the physical design of the learning environment can have a truly positive impact on students’ ability to learn.

Learning for Life is a student-driven program where the Director of Learning regularly asks students what is of interest to them and then creates the tools for them to explore those subjects, including architecture, law enforcement, being blind, the history of New England and space travel—among others. The Learning for Life day includes social contact, study, cognitive stimulation, exercise, healthy meals—all the things that research has shown to improve memory and ward off memory loss. Learning for Life principles and practices reinforce decision-making and a sense of time—the past and future—in the lives of students. Experts now agree that brain vitality, including all these elements, is central to maintaining brain health. Learning for Life is based on all these principles.” John Zeisel PhD.

Sandy Simon is the Director of Senior Support Solutions, a Geriatric Care Management company based in Lexington. Sandy and her team of certified geriatric care managers, Rachel Kushner and Carolyn Shea, provide assessment and care planning for older adults. Their mission is to assist older adults and their caregivers with the changing needs associated with aging in order to promote a safe, dignified and purposeful aging experience.

781 862-2829 www.seniorsupportsolutions.com



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Supporting Family Caregivers

A new study from AARP on how well states support family caregivers who support seniors at home ranked Massachusetts 39th in the nation. Let’s just say that leaves plenty of room to improve.

According to AARP, the economic value of family caregiving was $450 billion in 2009 — four times the total that Medicaid spent on long term care. If family caregivers do not receive needed support, they’re more likely to burn out and reduce their efforts. The result would put greater demand on government programs that provide long term care.

In 2004, 72% of older people living in the community who received personal assistance relied exclusively on unpaid caregivers. These caregivers face physical, emotional, and financial stress that put them at risk. Services such as information and assistance, counseling, and respite care can help family caregivers navigate the service system.

In ranking states, AARP measured such items as: the percentage of family caregivers who say they usually or always get needed support; the extent to which the state exceeds federal and state requirements for family leave and mandatory paid sick leave; policies to prevent discrimination toward working caregivers; policies on financial protection for the spouses of Medicaid beneficiaries; and response to family caregiver needs.

Many caregivers are spouses — some with their own health issues. Others are daughters and sons, more than half (58%) of whom are trying to hold down a job, sometimes taking care of their own children as well. “It is critical,” AARP says, that states “recognize, respect, and support family caregivers.” States can help family caregivers by providing supportive services, respite breaks, education and training. In 2009, Massachusetts ranked 31st in the country for the percentage of caregivers who said that they usually or always received the social and emotional supports they needed.

In terms of providing legal and system supports, Massachusetts ranked 26th in the nation. Our state allows families the maximum federal spousal protection of $2,739 in monthly income and $109,560 in assets as the floor of protection when a spouse qualifies for Medicaid nursing facility care. The federal Family and Medical Leave Act allows workers to take up to 12 weeks of unpaid leave in a year to care for themselves or for a parent, spouse, or child with a serious health condition. There are no federal laws that require private sector employers to provide paid sick leave benefits – and only 2 states provide paid sick leave. Massachusetts is not one of them.

Finally, the AARP survey examined 16 home care tasks, including administration of various types of medications, ventilator care, tube feedings, and other kinds of help that many people with chronic conditions need. This help is critical for family caregivers. Allowing nurses to train and delegate these tasks to direct care workers can ease the burden on family caregivers. Massachusetts, which only allows nurses to administer medications, ranked 32nd in the nation on delegating tasks.

To read the full AARP Scorecard report on caregivers and supports, go to www.aarp.org.



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Taking the Fear and Fiction Out of Hospice

By Christine Dixon  |

There are few words that cause more fear, or are more misunderstood, than “hospice”. Mention the “h” word, and most people, including some doctors, have misconceptions about what hospice truly is.

Visiting Nurse and Community Health’s (VNCH) Hospice Care program, which opened in July 2009, has provided compassionate care and dignity for almost 300 end-of-life patients and their families. Many of our patients had little or no idea of what hospice actually entailed until they came under our care. The most common statement made by families who chose hospice for their loved one is “we wish we had known about hospice sooner.” This article is in response to their requests that we help others distinguish between the fact and fiction surrounding hospice.

Here are 10 of the most common myths about hospice care, and the truth about each.

1. Hospice is a place.

True and false. Hospice care is provided wherever the need exists – usually in the patient’s home. About 80% of hospice care takes place in the home, but services can also be delivered in a nursing home, assisted living facility, hospital, or a residential hospice facility.

2. Hospice is a death sentence.

False. Hospice patients live, on average, 29 days longer than non-hospice patients. This is because the patient is in a familiar environment – their home, the assisted living or skilled nursing facility in which they reside – and their symptoms are being managed. All of their needs are being met, not just the physical, but the psychosocial and spiritual as well. Those VNCH Hospice Care patients who had previously experienced numerous or long hospital stays during the course of their illness have told us that their desire to live actually increased after entering our program because they enjoyed a marked improvement in their quality of life.

Patients can remain in hospice longer than six months, and some patients even get better after starting hospice because of the intensity and focus of our services. These patients are no longer considered to be appropriate for hospice care.

3. Hospice is only for old people.

False. Although the majority of hospice patients are older, hospices serve patients of all ages.

4. Hospice is only for cancer patients.

False. Cancer victims make up only about half of hospice patients, according to recent statistics from the National Hospice and Palliative Care Organization (NHPCO). The remainder is comprised of end-of-life patients who have Congestive Heart Failure (CHF), Chronic Obstructive Pulmonary Disease (COPD), liver or kidney disease. Dementia and Alzheimer’s patients can also qualify for hospice once they reach the point where they are not walking and cannot hold a lucid conversation.

5. Hospice doesn’t involve the patient or family in making decisions about treatment.

False. Hospice puts patients and families at the center of care. VNCH’s Hospice Care staff members provide guidance and encourage open, honest communication about individual wishes and choices.

6. Hospice requires that family members are available to provide care.

False. Since a number of end-of-life patients live alone or with family members who are unable to provide care, VNCH’s Hospice Care staff often coordinates non-family resources to make home care possible. They can also help to find an alternative location where the patient can safely receive care.

7. Hospice patients starve to death.

False. Hospice encourages patients to eat for as long as they are willing and able. But patients may, at some point, refuse to eat or drink liquids. It’s not the hospice staff that stops the feeding, it’s a patient’s choice.

8. Hospice patients are taken off all medications.

False. Hospice provides medications related to the disease process and the patient’s comfort. These can include pain medication, anti-anxiety, anti-nausea and vomiting drugs. Another falsehood is that hospice gives the patient massive doses of IV morphine. Morphine can be used to control pain or shortness of breath along with other narcotic medications, but usually is given in pill or by patch applications.

9. Hospice is paid for by the patient.

False. Medicare covers the hospice benefit for those who qualify. Most hospice patients are over 65 and are entitled to the Medicare Hospice Benefit. This benefit covers virtually all hospice services related to the diagnosis, usually requires no out-of-pocket expenditures, and hospice care can be less expensive than other end-of-life care. Many insurances and managed care organizations also have hospice benefits, and VNCH’s Hospice Care staff will be happy to help you understand what payment sources are available.

The hospice benefit also covers medical equipment, appliances and supplies. These can include electric hospital beds, lifts, bedside toilets, shower chairs, wheelchairs, wound care supplies, etc. – whatever is considered necessary for the hospice symptom management in the home. Additionally, hospice includes physician services, nursing care, home health aide services, social work services, spiritual care, volunteer assistance, bereavement services, and physical therapy, occupational therapy and speech/language pathology services.

10. Hospice patients can no longer receive care from their primary care physician.

False. Hospice medical directors work with primary care physicians to manage the patient’s condition. VNCH’s Hospice Care medical director is available 24 hours a day for consultation, but the primary care physician actually follows the patient to ensure that his/her symptoms are managed, and they are getting the best quality of life possible.

Hopefully, we have provided useful information about hospice care. We cannot stress how important it is to learn about your healthcare options, so that you can make informed decisions and choices before you or your family needs care. Learn about what an advanced directive is, and how to implement it. Voice and be specific about your healthcare decisions, and engage others, most importantly family members, to learn about hospice.

VNCH Hospice Care focuses on how the patients entrusted to us live. Their dignity and quality of life, and that of their families, are always foremost in our minds. But when death is inevitable, hospice doesn’t abruptly go away. We provide bereavement counseling and support to family members for 13 months after their loved one’s passing. We also conduct bereavement support groups for residents in the 28 communities VNCH serves, including Acton, Arlington, Bedford, Belmont, Billerica, Burlington, Cambridge, Carlisle, Chelsea, Concord, Everett, Lexington, Lincoln, Malden, Medford, Melrose, Newton, Revere, Somerville, Stoneham, Wakefield, Waltham, Watertown, Wayland, Weston, Wilmington, Winchester, and Woburn.

Our Hospice Care program is also a We Honor Veterans partner. As such, we provide veteran-centric education for staff and volunteers, and identify and honor patients with military experience.

To learn more about VNCH and its Hospice Care program, visit the agency’s website at www.TheVisitingNurses.com, or call 781-643-6090.

Since its founding in 1898, VNCH, a 501(c)(3) non-profit, has had a deep rooted tradition of providing quality health, private pay and hospice care to patients in their homes. Awarded for its quality ranking in the top 25% of home care providers nationally, VNCH is committed to using modern, state-of-the art medical technology to help achieve its goals.



About the Author:

Christine Dixon has been Visiting Nurse and Community Health’s CEO since 2004. She joined VNCH in 1994 as Nurse Team Manager, and quickly rose through the ranks to be named Chief Operating Officer and Director of Clinical services in 1996. She received her diploma in Nursing from New England Baptist Hospital School of Nursing, a BSN from Regis College, and her Master’s degree in Health Care Management from Cambridge College. She serves on the Board of Directors of both the Visiting Nurses of New England and Massachusetts Bay Self Insurance.



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