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How to ensure a smooth transition

HOSPITAL to HOME

Published quarterly by Michigan’s Area Agencies on Aging

MichiganGenerationsTMSpring 2010

Also in This Issue: n Ask the Expertn Caregiving News & Notes

SPRING 2010 Published quarterly through a cooperative effort of Michigan’s Area Agencies on Aging.

For information contact:Jenny [email protected]

Editorial Project Development:JAM Communications, Atlanta, GA

Design and Production:Wells-Smith Partners, Lilburn, GA

On the Cover: Discharge planning is a critical part of your loved one’s transition home, following a hospital stay. It can mean the difference between continued recovery and rehospitalization. Here’s everything you need to know about this important process. See story, page 4.

GenerationsMichigan

Spring 2010 Volume 7, #4 © 2010 by the Michigan Area Agencies on Aging. The information contained herein has been obtained from sources believed to be reliable. However, the Michigan Area Agencies on Aging and JAM Communications make no warranty to the accuracy or reliability of this information. No part of this publication may be reproduced or transmitted in any form or by any means without written permission. All rights reserved.

Whether you are an older adult your-self, a caregiver or a friend concerned about the well-being of an older adult, Area Agencies on Aging (AAAs) are ready to help. AAAs in communities across the country serve as gateways to local resources, planning efforts, and services that help older adults remain independent.

AAAs were established under the Older Americans Act in 1973 to respond to the needs of Americans aged 60 and over in every com-munity. The services available through AAA agencies fall into five general categories: information and consultation, services available in the community, services in the home, housing, and elder rights. A wide range of programs is available within each category.

The services offered by

Michigan’s 16 AAAs cover a broad spectrum of needs, such

as information and referral, case management, in-home services,

home-delivered meals, senior centers, transportation, and special outreach.

To read more about each of Michigan’s AAAs and the services available, turn to page 8 of this issue. MI

Welcome toMichigan Generations

Michigan is

divided into

16 AAAs,

each serving

a different

part of the

state.

They are:1 1

10 9

7

5

1A

1C2

8

14

6

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3C4

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1ADetroitAreaAgencyonAging

1B AreaAgencyonAging1-B

1C TheSeniorAlliance

2Region2AreaAgencyonAging

3AKalamazooCo.Health&CommunityServicesDept.Region3A

3B RegionIIIBAreaAgencyonAging

3C Branch-St.JosephAreaAgencyonAgingIIIC

4RegionIVAreaAgencyonAging

5ValleyAreaAgencyonAging

6Tri-CountyOfficeonAging

7RegionVIIAreaAgencyonAging

8AreaAgencyonAgingofWesternMichigan

9NEMCSARegion9AreaAgencyonAging

10 AreaAgencyonAgingofNorthwestMichigan

11 UpperPeninsulaAreaAgencyonAging

14 SeniorResourcesofWestMichigan

VisittheAAA’sstatewebsiteatwww.mi-seniors.net

AAAs —‑Gateways to Community Resources

2009

Retirees who have been carefully feeding their 401(K) and individual retirement accounts for years face a

psychological hurdle when they have to switch gears and start withdrawing money.

Financial planners give this advice: Plan for both sooner and later. The phases of retirement are often called the go-go years, the slow-go years and the no-go years. You should

plan for your lifestyle during each of these periods — perhaps traveling and hob-

bies in the early years, followed by a slow-down during the next phase. Then expect spending to increase again because of health-care costs in your final years.

Spring 2010 �

Surfing the NetEach issue of Michigan Generations

offers several websites devoted to caregiving information and

resources:www.scambusters.org alerts readers to a long list of Internet, phone and mail scams, as well as identity

theft threats.www.centerforpositiveaging.org provides a complete range of information about housing and senior services to assist in positive, successful aging.

CAREGIVINGNews&Notes

Seniors are known for their love of walking. But pounding the pavement, or even the walking trails, can take its toll on your

feet. While sitting in a chair, try the following foot-friendly exercises.Marble Pickups — Strengthens muscles in the bottom of the

foot and eases arthritic joints in mid-foot. Use your toes to pick up marbles from the floor. Drop marbles into a bowl.

Arch Rolls — Eases heel pain and loosens tight arches. Roll a tennis ball or water bottle back and forth under each foot.

Toe Writing — Maintains range of motion in your toes, feet and ankles. Raise one foot. Write the alphabet in the air with your toes, making big letters. Repeat other foot.

Towel Scrunches — Strengthens mid-foot muscles and eases discomfort from fallen arches. Lay a hand towel on the floor. Use your toes to scrunch and pull the towel toward you.

Your family member may have been referred to rehab after

being in a hospital due to illness, injury or surgery. Rehabilitation (or simply “rehab”) is treatment to help patients regain all or some of the movement and function lost because of current health problems.

Patients often work with two or more rehab services. These include physical therapy (PT), occupational therapy (OT), speech therapy and psychological counseling (or simply “therapy”).

Here are five important points to remember:

1 The goal of rehab is to help patients be independent — doing as much for themselves as they can.

2 Rehab is done with a patient, not to a patient. Your family member must be willing and able to work with rehab ser-vices during active treatment and, later, with caregivers or by themselves at home.

3 The patient’s chronic (long-term) health conditions, such as high blood pressure or cholesterol, are treated during rehab, but they are not the reason the patient is in rehab.

4 Most rehab services last weeks, not months. In general, you will find rehab has a “workout” atmosphere.

5 Most insurance policies cover rehab when ordered by a doc-tor, but there will probably be extra costs.

Excerpted from www.nextstepincare.org

Heart attacks can occur with various symptoms — or with no symptoms at all. Chest pain, a pain in the left arm, nausea or

intense sweating are all warning signs.If chest pain wakes you up from a deep sleep, take these steps:

Immediately chew two aspirins and swal-low them with water. They will get into your system faster by chewing before swallowing.

Call 911 and say that you may be having a heart attack. Say that you have taken two aspirins.

Unlock your door, sit down on a chair or sofa and wait for their arrival.

Doctors believe that during the early stages of a heart attack aspirin — which is known for preventing blood platelets from sticking together — can prevent a clot from getting bigger.

•

•

•

What You Should KnoW about

Why KeepKeeping Your in Tiptop Shape

Rehab

Nest EggYour Retirement

Aspirinby your

Bedside?

� Michigan Generations

Paul, 86, is hospitalized for severe shortness of breath and is diagnosed with congestive heart failure. He is put on oxygen and new medications, and his condition stabilizes. In fact, the hospitalist okays his discharge.

His wife, Karen, also 86, takes Paul home, along with a long and complicated-looking list of instructions. A few days later, Karen is struggling. She’s still trying to figure out how to help Paul get up and down the stairs, which medications he’s supposed to be taking now and where to get an oxygen machine. In short order, Paul’s condition worsens and he is rehospitalized.

The above scenario is fictitious but alarmingly common. Having a loved one hospitalized is an unfamiliar, stressful situation. Many times you and your loved one are so focused on getting better and getting out of the hospital that you don’t pause to consider what comes next. Yet, discharge from a hospital does not mean the patient is fully recovered — it just means he no longer needs hospital-level care.

“You can have great hospital care and you can have great home care,” says Linda Pekar, vice president of clini-cal services for the Visiting Nurse Association of Southeast Michigan in Oak Park. “But if there is no connection between the two, if they are fragmented, then the patient and family suffer.”

A thoughtful, well-crafted discharge plan can bridge the gap between hospital and home, making the difference between continued recovery and rehospitalization. How will the patient’s condition be monitored once he is home? Does he understand how to take his medications, includ-ing new ones that were introduced in the hospital? Does he or his caregiver know the red flags that would indicate his condition is worsening? Has the necessary in-home care and

equipment been put in place? Who can his caregiver call with questions or concerns?

Knowing the answers to these questions and others is critical for a smooth transition from hospital to home. How-ever, in these days of shorter hospital stays and understaffed facilities, discharge planning is often minimal at best. That means it’s up to the caregiver to be proactive, ask the right questions and insist on answers.

What is discharge planning?Medicare says discharge planning is “a process used to

decide what a patient needs for a smooth move from one level of care to another.” Only a physician can authorize a discharge. The official discharge planner is often a nurse or social worker. However, it takes a multidisciplinary team to work out all the details of an effective discharge plan. “It truly is a team effort, and we work closely with all the disciplines, including nurses, physicians, physical and occu-pational therapists, dieticians, pharmacists, home health agencies and skilled nursing facilities,” says Sue Belknap, administrative manager in care management (internal medi-cine) at Beaumont Hospital in Royal Oak. “Social workers are also an integral part of the team, evaluating complex psychosocial cases. Before discharge we evaluate if the patient has an appropriate support system in place. Can he get to the doctor and can he get his medications? Can he function in the environment he’s going to? If not, there’s a good chance we’ll see him back in the hospital.”

And all too often that’s just what happens. A full 20% of Medicare patients are readmitted to the hospital within 30 days of discharge, usually within just 7 to 8 days. Half of these

How to ensure a smooth transitionBy Martha Nolan McKenzie

HOSPITAL to HOME

GONEHOME

Spring 2010 �

patients have not seen their primary care physician for a follow-up visit before they are readmitted. About 42% of discharged patients have test results pend-ing at the time of discharge, and 61% of physicians are unaware of the results of tests performed in the hospital.

Michigan’s readmission stats are no better. “A study by Dr. Steve Jenks showed that Michigan had a 19.4% readmission rate, which put us in the 74th percentile,” says Sam Watson, senior vice presi-dent of patient safety and quality for the Michigan Health and Hospital Association (MHA) in Lansing. “However, we had a large variation — from 14.5% to almost 23% — so we believe there are regional factors within the state that bring about the higher risk for rehospitalization — maybe problems with the discharge planning process or lack of commu-nity resources to care for patients in outpatient set-tings. We’re trying to account for the variations.”

Catherine Pirkola has some ideas. A social worker for Dickenson County Memorial Hospital in rural Iron Mountain, Pirkola contends patients are often sent home too early. “With shorter hospital stays, sometimes patients are discharged before they are ready — physically or emotionally,” says Pirkola. “Elderly patients, especially, may not have a strong support system at home and just get overwhelmed when they get there.”

But whatever the reason, hospitals in Michi-gan, and across the country, have lots of room for improvement when it comes to discharge planning.

Role of the caregiver in discharge planning

In discharge planning, as in most areas of health care, the patient must assume more responsibility for his own care. For some, that’s good news. “Patients can be wary of me because they think I’m there to tell them what to do,” says Patty Switalski, director of case management at Cheboygan Memo-rial Hospital. “The patient is the boss. They have the right to make their own decisions regarding their discharge plan, and I provide assistance. I collaborate with their physician and the patient’s family if the patient allows. I give advice, but ulti-mately the patient is in control of the plan and who is included in that plan.”

Many times, however, an elderly hospitalized patient is not in the best position to be his own advocate. He is ill, perhaps frightened and likely a bit overwhelmed. Thus, responsibility for the patient’s care often falls to the caregiver. Ideally, even if several members of the family are involved, one member should serve as the point person for the rest of the clan. “There really needs to be one person who is the central point of communica-tion for the family,” says Bill C. Paskoules, senior

services program manager for Henry Ford Health System in Detroit. “If you think about it, if every doctor, nurse and case manager has to re-explain Mom’s or Dad’s condition every time they are con-tacted by a different family member, it would take away from the actual time they have to spend with the patient.”

And in some cases, the caregiver can give a more reasoned assessment of the patient’s situation than the patient himself. “Very often the patient wants desperately to get back to their own home, so they can paint a rosy picture,” says Pekar. “When people start talking about the fact they may need help, they become afraid of losing their indepen-dence, so they say, ‘Of course I can handle it.’ So often it’s the caregiver who can give us a more accu-rate appraisal of their ability to cope with all the challenges they may be facing.”

Just as the caregiver needs to give a realistic assessment of the patient’s capabilities, he or she needs to be clear on what they can and cannot do for the patient. As a caregiver, chances are you have other responsibilities — a job, children, health problems of your own, etc. If you cannot be avail-able 24/7, let the discharge planner know that. The discharge team needs to know what tasks you can and cannot do so they can plan for any needed help.

“We had an elderly mom caring for her adult son who still needed extensive wound care after he was discharged,” says Belknap. “The mother had never dressed a wound before, but she insisted on taking him home. A plan was created, teaching was accomplished and the patient was discharged with skilled home care visits arranged. The son was readmitted within a few days. The mother over-estimated her abilities to provide the comprehen-sive care her son needed.”

And sometimes the patient isn’t the only one who ends up hospitalized. “We admitted a patient yesterday and during the initial assessment it was noted that the patient’s wife (who was also his caregiver) was in need of care herself,” says Marie Doherty, director of care management for Beau-mont Hospital in Royal Oak. “Sometimes it takes a hospitalization for families to face the reality that their loved ones need more assistance than they previously thought.”

The caregiver also needs to make sure what is supposed to happen with a discharge plan does, in fact, happen. Discharge planning is supposed to begin on the day the patient is admitted to the hospital, but too often that is not the case. Some-times instruction is given hurriedly at the time of discharge, making it all but impossible to absorb. If the discharge planner does not introduce himself early in the hospital stay, you need to go seek him out. Ask questions about your loved one’s condition, treatment and prognosis. Start watching how the

HOSPITAL to HOME

6 Michigan Generations

nurses administer his care so you’ll be more prepared to take it over. Ask for training in care techniques. The longer you have to prepare, the easier the transition will be.

Key elements of a discharge planWhile discharge plans are as unique as individual

patients, certain basic elements are necessary for any plan to ensure a safe transition from hospital to home:

Medication reconciliation. “Probably the No. 1 reason why patients are readmitted to the hospital is prob-lems with medication reconciliation,” says Paskoules. “When patients are discharged, they are often on new medications, in addition to, or replacing ones they were taking before they were admitted. It can be very confusing. This is why it is critically important for patients and family members to bring in or give a list of home medications to the hospital doctor.”

A caregiver can help by getting the answers to such questions as: If the patient was put on new medications in the hospital, how long should he take them? Does the medi-cation have side effects? Should it be taken at meals or at certain times each day? Can it safely be taken with other medications the patient is using?

A Medication Management Guide, which can help you organize your loved one’s medication information, is avail-able on www.nextstepincare.org.

PhYSician viSit. “There is a sweet spot of about three days after discharge in which the patient needs to get in to see his primary care physician for a discharge follow-up appointment,” says Paskoules. “Two weeks out just isn’t good enough. Especially with senior patients, they could end up back in the hospital before that two weeks is up.”

In fact, a post-discharge doctor’s visit is so important that some hospitals have begun to make the appointment for the patient while he is still in the hospital. At Bay Regional Medical Center, discharge planners will set up appointments for heart failure patients to see their regular physicians prior to discharge. “Heart failure patients represent our longest stays and greatest readmissions, so we are focusing on them first,” says Sandy Garzell, director of patient care services at the center. “We not only make the appointment for them, we follow up with another call after they are home to make sure they went to it.”

Even before that doctor’s visit, however, the caregiver should notify the patient’s primary care physician about the hospitalization. Patients often assume hospitals do this automatically, but that is not necessarily the case. It’s a good idea for the caregiver to alert physicians about the hospi-

talization, keep them updated and make sure they get the results of any tests done in the hospital.

red flagS. The patient and/or caregiver need to under-stand the red flags that would indicate the patient’s condi-tion is worsening and what to do in that event. The caregiver should get a written copy of these red flags upon discharge.

contact nuMber. A discharge plan should include a phone number the patient or caregiver can call 24/7 once they are home. Caregivers should make sure they know who they can call when they have questions, because they cer-tainly will have them.

PerSonal health record. This is a tool the patient manages that captures key health care information (all with phone numbers), including: primary care physician, special-ists, pharmacy, home health agency, community services (such as Meals on Wheels), advanced directives, medical history, immunizations, red flags (see above) and medication list, including dose, reason and start date. The patient should take this record to every doctor’s appointment.

Going home or to a facilityIf the patient is going to go back to his home once he is

discharged, he may need additional equipment or services to support him. He may need help with personal care (bath-ing, eating, dressing, toileting), household care (cooking, cleaning, laundry, shopping), health care (medication man-agement, physical therapy, injections, medical equipment and techniques) and/or emotional care (companionship, conversation).

“What we’ve found is that for someone being discharged after an illness or surgery, medical services are most imme-diately important, but in the long run, most of the services needed are non-medical,” says Roy Schultheiss, owner of Comfort Keepers, a Bay City private duty agency. “For exam-ple, say the washer and dryer are down in the basement. Can the patient safely negotiate the stairs, especially carry-ing a laundry basket? They might need someone to come in to help with laundry.”

The discharge planner can help you identify which ser-vices the patient will need and identify community resources that can meet those needs. Ideally, you want to have the services and equipment in place before the patient comes home, but all these decisions involve evaluating the choices — if you are going to use a home-health aide, do you want to hire an individual directly or go through an agency? If you need to modify the bath, what options are available? If you need a ramp, who will install it? The more time you have to weigh these choices, the more informed your decisions can be.

Once you are home, if there are any snags, let the discharge planner know. In Tawas City, caregivers have an additional resource available — the St. Joseph Health System’s Faith Community Nurse Program. Although the volunteer nurses are not involved in the discharge process, they can help with health education, referrals, counseling or answering questions. “We believe in healing of body, mind and spirit and most of this is done by education that will then prevent problems if people are knowledgeable in pre-venting them,” says Kim Easterle, parish nurse coordinator

The discharge planner can help you identify which services the patient will need and identify resources that can meet those needs.

Spring 2010 �

for the program. “Parish nurses throughout the U.S. save millions of dollars a year in health care costs through education.”

If the patient is being discharged into rehab or a nursing home, the planning process is a bit different. For one thing, you have to decide on a facility, which can be stressful in the best of times and overwhelming if done in a rush. You may simply be given a list of nearby facilities, but you’ll want to evaluate the quality of care they offer. Ask if a social worker can help you sort through the options. You can also consult with a geriatric care manager. These managers charge an hourly fee, but they keep up with the quality of local facilities, which ones have waiting lists and which ones have had problems. (To find a geriatric care manager, contact the National Association of Geriatric Care Managers at 520-881-8008 or www.caremanager.org.)

As a caregiver, you still need to be involved to ensure continuity of care. Make sure the facility receives the current list of medications, test results, condition update, etc. And keep asking questions. You need to understand what type of care the patient is going to receive at the facility. Who is going to be in charge of his care in the facility? Who can you contact with questions? How long will he likely need to stay?

There is often a lot of pressure to discharge the patient as soon as possible — the hospital needs to free the bed and the patient wants to go home. However, if you feel your loved one is not well enough to be discharged, you can appeal the deci-sion. By law, the hospital must let you know how to appeal and explain what will happen. Make sure the hospital provides you with contact information for the local Quality Improvement Organization (QIO) that reviews such appeals.

Who pays for care after discharge?Unless you have a specific long-term care

policy (which very few people do), insurance will not pay for services and items that are needed at home unless they are deemed “medically neces-sary.” The discharge planner or social worker can help you decipher what things will and will not be covered.

“Our case managers and social workers stay on top of all of it,” says Garzell. “They know what is covered by Medicare, what is paid for by private insurance, what the co-pays are. We’ll go the extra mile to help them when we can. We had one patient on IV antibiotics who had a co-pay of $1,000. We knew she couldn’t afford that, so we kept search-ing until we found someone who could supply it for about $60.”

Even if someone tells you that Medicare or other insurance won’t pay, check it out yourself

through your State Health Insurance Assistance Program (SHIP). The Michigan SHIP is the Medi-care/Medicaid Assistance Program of Michigan (MMAP) at 1-800-803-7174 or 1-517-886-1029 or the Medicare Rights Center (212-869-3850 or www.medicarerights.org).

Improving the systemEfforts are underway nationwide to improve the

fractured, inconsistent nature of discharge plan-ning. In Michigan, 15 hospitals are participating in a three-state initiative aimed at reducing avoidable rehospitalizations. Known as MI STAAR (Michigan State Action on Avoidable Rehospitalizations), the initiative is being coordinated by MPRO, Michigan’s Quality Improvement Organization, and the Michi-gan Health & Hospital Association (MHA).

“We are trying to change how hospitals look at the discharge process,” says MHA’s Watson. “We want them to look at it more as a transition. ‘Dis-charge’ says ‘I’m done with you.’ ‘Transition’ implies I’m still involved.”

Improvements in the discharge process will start with enhanced assessments upon admission. “Assessments are done concerning their needs at home, but they are often not as comprehensive as they could be,” says Watson. “For example, if a patient has congestive heart failure, we need to know if there is a clinic for that condition in his area. Can he afford to purchase his medications?”

Hospitals are also starting to use the “teach back” method of educating patients about how to care for their conditions. “Typically the nurse gives the patient or caregiver the discharge instructions and asks if they understand them,” says Watson. “They say ‘yes’ whether they do or don’t. We are now asking them to teach what we have just told them back to the nurse so we can make sure they understand. That’s a major leap forward in terms of how we interact with our patients.”

The MI STAAR initiative is working to ensure that patients have an appointment with their pri-mary care physician before they are discharged and that they receive detailed, understandable instruc-tions about their medications and how to take them. It is also formulating a statewide referral form to standardize and streamline patient information. “We are identifying what things are more important to know about a patient,” says Pekar. “It’s impossible to absorb the whole medical record, so we need to develop policies for what information is needed dur-ing transitions.

“I think it’s important to remember that dis-charge planning is planning for the transition of a human being, and that goes beyond diseases and medication,” continues Pekar. “It is important to think about the safety and comfort not just of their body, but of their heart and soul as well.” MI

REGIoNAlNews

In communities

across the U.S.,

Area Agencies on

Aging (AAAs) serve

as gateways to local

resources, planning

efforts and services

that help older adults

remain independent.

Here are the

programs and

services offered by

Michigan’s AAAs.

1 1

10 9

7

5

1A1C

2

8

14

6

3B3A

3C4

1B

6 Tri-CountyOfficeonAging

7 RegionVIIAreaAgencyonAging

8 AreaAgencyonAgingofWesternMichigan

9 NEMCSARegion9AreaAgencyonAging

10 AreaAgencyonAgingofNorthwestMichigan

1 1 UpperPeninsulaAreaAgencyonAging

14 SeniorResourcesofWestMichigan

1A DetroitAreaAgencyonAging

1B AreaAgencyonAging1-B

1C TheSeniorAlliance

2 Region2AreaAgencyonAging

3A KalamazooCo.Health&CommunityServicesDept.Region3A

3B RegionIIIBAreaAgencyonAging

3C Branch-St.JosephAreaAgencyonAgingIIIC

4 RegionIVAreaAgencyonAging

5 ValleyAreaAgencyonAging

� Michigan Generations

Spotlight on…

Region VII Area Agency on AgingServing Bay, Clare, Gladwin, Gratiot, Huron, Isabella, Midland, Saginaw, Sanilac and Tuscola counties

Reg 1-A / Detroit AAA Reg 1-B / AAA 1-B Reg 1-C / The Senior Alliance, Inc. Reg 2 / Reg 2 AAA

Reg 3-A / Kalamazoo Cty. HumanServices Dept. (Region 3)

Reg 3-B / Burnham-Brook Reg IIIB Reg 3-C / Branch-St. Joseph AAA (IIIC)

Reg 4 / Reg IV AAA

Reg 5 / Valley AAA Reg 6 / Tri-County Office on Aging Reg 7 / Reg VII AAA Reg 8 / AAA of Western Michigan

Reg 9 / NEMSCA Reg 9 AAA Reg 10 / AAA of Northwest MI Reg 11 / Upper Peninsula AAA Reg 14 / Senior Resources ofWest Michigan

Personal Action Toward Health (PATH) is designed to help adults

who have a chronic disease better manage their health conditions. PATH does not replace regular medical treatment, but provides workshops to teach techniques and strategies for the day-to-day management of chronic disease. The PATH program was developed by the Stanford University School of Medicine in California.

Each PATH workshop is held for six weeks, conducted in two and a half hour sessions. Although PATH is intended to benefit adults with chronic or long-term health condi-tions, family members, friends and caregivers are also encouraged to

attend. The fun, interactive sessions include topics such as:

Ways to deal with frustration, fatigue and painGoal setting and problem solvingManaging medicationsHow to plan visits with a health

care provider Ways to talk with family and

friends about a chronic conditionUsing the power of mind to help

manage symptomsFor more information about the

PATH program, or to place your name on a list for an upcoming workshop, please contact the Region VII Area Agency on Aging at 1-800-858-1637.

For further information about services,

•

•••

•

•

contact Region VII, 1615 S. Euclid Ave., Bay City, MI, 1-800-858-1637, www.region7aaa.org.

PATH Program Teaches Management of Chronic or long‑Term Disease

Personal ActionToward Health

Detroit Area Agency on AgingServing Detroit, Highland Park, Hamtramck, Harper Woods and the five Grosse Pointes in Wayne County

Spring 2010 �




Reg 4 / Reg IV AAA



Economic Security Initiative Targets Detroit Area older Adults

With a grant from the National Council on Aging

(NCOA), the Detroit Area Agency on Aging (DAAA) will partner with Elder Law of Michigan, AARP Michigan, Community Foundation of Southeast Michigan and other stakeholders to provide economic security case management services. The initiative targets low-income, older adults who are among those most impacted by Michigan’s unem-ployment, foreclosures, bankruptcy and credit card debt.

Program participants will be assessed and provided with a per-son-centered economic security plan, receive intensive wraparound services and be referred to financial literacy training. These services are designed to strengthen the capacity of communi-ties to provide assistance to vulnerable older adults whose needs have stretched the limits of their personal resources. The goal of collaborative partners is to improve the economic security of participants by screening them for public and private benefits.

“For the first time in the

�0‑year history of the

Detroit Area Agency on

Aging, economic security is as

important to us as meeting

the health, wellness and

long‑term care needs of our

consumers.” —Paul Bridgewater,

President & CEO, Detroit Area

Agency on Aging

Silver Circle Programs at WCCCD to Enhance Adult learning opportunities

The Wayne County Community College District (WCCCD) is collaborating with the Detroit Area Agency on Aging and other partners to make finan-

cial literacy and other workshops available to older persons through its Silver Circle Senior Engagement Program. In a new series of workforce development and continuing education programs, WCCCD will combine scheduled classes and on-demand workshops to help low-income participants improve their knowledge, skills, abilities, attitudes and quality of life related to economic security. Referrals will come from DAAA and partner agencies. Silver Circle programs will cover such financial literacy issues as preparing for retirement, protecting assets, pre-serving purchasing power, estate planning, having an adequate income, and mak-ing money last.

For information on WCCCD course offerings, visit www.wcccd.edu or call 313-496-2600.

Employment and Training Services Expand with DAAA and City of Detroit Initiative

Sixty or more low-income Detroit residents, age 45 years and over,

will be eligible for new employment and training services through the Detroit Area Agency on Aging and its Mature Workers pro-gram. After appropriate screening and assessments, candidates will be trained for one or more positions in office, health or long-term care professions, including: Office Professional I and II, Certified Nurse Assistant, Home Health Aide, Long-Term Care Consumer Advo-cates, and Long-Term Care Navigator. The $250,000 grant will come from the City of Detroit’s Department of Human Services after approval by the Detroit City Council.

During its annual conference in Chicago, NCOA convened partners from 11 locations in the U.S., including the Detroit Area Agency on Aging, for a day-long meeting related to the new Economic Security Initiative. Each of the teams received a $50,000 grant for this pilot project. In Detroit, the grant will jump-start the Detroit Economic Security Collaborative Network, which is also supported by a $25,000 grant from the Community Foundation of Southeast Michigan.

For information on the economic security initiatives mentioned here, contact: Detroit Area Agency on Aging, 313-446-4444

PHOTO

ByJUlIETUR

KEWITz

Deborah (Debbie) was born with Down syndrome in 1951. She

was the oldest of six children, and her parents vowed she would always be taken care of. When Debbie’s mother passed away a few years ago, care for Debbie was passed to her brothers and sisters. A happy and vivacious person, Debbie functions at the level of a five- or six-year-old, so she requires constant care and supervision. Through the Home and Community Based Medicaid Waiver Program, Debbie now resides with her brother Steve and his wife, Trish, who is also Debbie’s care provider. As a direct care worker employed

through a funded health care provider of the Area Agency on Aging 1-B, Trish is paid for the services she pro-vides to Debbie.

Steve and Trish are very grateful for the Medicaid Waiver Program. Steve says, “If it wasn’t for the AAA 1-B helping out, Debbie

would have ended up in an Adult Foster Care Home” — as Trish would have needed to return to the workforce, and they would have been unable to afford the level of care Deb-bie would need during the day.

Debbie enjoys watching television, rug hooking, puz-zles, and going to church every Sunday, and loves the sum-mer, when she can go outside and play. Her favorite foods are ice cream and milkshakes. Surrounded by the love of her family and the two family

dogs, Candy and Shadow, Debbie is safe and secure in the comfort of her home.

Serving the counties of livingston, Macomb, Monroe, oakland, St. Clair and Washtenaw




Reg 4 / Reg IV AAA



Area Agency on Aging 1-B


Medicaid Program Provides Support in the Home

Resource Center The AAA 1-B Resource Cen-

ter, staffed by certified Alliance of Information and Referral Systems (AIRS) Resource Specialists, pro-vides comprehensive information, assistance and outreach regarding services for older adults, people with disabilities and their families. To speak with a Resource Specialist, call 1-800-852-7795 or complete an email form on our website at aaa1b.com.

MI Choice Home and Community Based Medicaid Waiver Program

The Medicaid Waiver Program pro-vides services for adults age 65 and over and younger persons over age 18 with disabilities, to help them remain

living in the community instead of a nursing facility. Individuals must meet Medicaid income requirements and qualify medically for nursing home admission.

Nursing Facility Transition Program

This service helps provide options for eligible nursing facility residents to transition from a nursing facility back to the community and is available to all nursing home residents who are cur-rent or potential Medicaid recipients.

Community Care ManagementThe Community Care Manage-

ment program helps provide in-home services such as personal care and homemaking to help older adults who

are at risk of being placed in a nursing home but do not financially qualify for the MI Choice Home and Community Based Medicaid Waiver Program.

Out of Home Respite ProgramThe Out of Home Respite Program

provides family caregivers access to 24-hour care for their older or dis-abled loved one in a licensed Adult

Area Agency on Aging 1‑B Services

Steve, Debbie (center) and Trish.

Spring 2010 11

Your Thoughts are Valuable

Christmas is a special time when we get together as a family,

church congregation, neighborhood or group of friends. We remember oth-ers, giving gifts and sending salutations. During this time, our sense of com-munity is heightened. This past Christ-mas, employees and businesses in Jackson, Hillsdale and Lenawee coun-ties gave generously to help seniors feel the spirit of the holidays. The community bonded together and col-lected almost $2,000 to bring cheer and goodwill to more than 60 seniors!

The Area Agency on Aging’s Sun-shine Committee worked with the community to collect supplies, gift certificates, gift baskets and food to deliver during the Christmas season.

Seniors were overwhelmed with gratitude, saying, “I had something to open on Christmas day” and “It’s the best thing I got!” One woman was so excited that she asked if the volun-teers could stay and sing a few carols with her. One couple said that their

Applebee’s restaurant coupon was like going on their first date again.

We are all part of a community. It defines who we are, what we believe in and what we value. How we treat others reflects on us all, and can have a healing impact. The charitable spirit shown by individuals this holiday season speaks well of the local busi-

ness environment, and we applaud all efforts that go toward appreciating and helping our seniors. After all, they are the ones who taught us in our youth what it means to be a community.

For more information, contact Barbara Stoy at the Region 2 AAA at 1-800-335-7881.

Serving Hillsdale, Jackson and lenawee counties




Reg 4 / Reg IV AAA



our Community loves Seniors

Region 2 Area Agency on Aging

Local businesses, like TLC Community Credit Union, gave generously so seniors could enjoy the Christmas holiday.

1-800-852-7795

Foster Care Home or Home for the Aged. Caregivers can make reserva-tions for their loved one up to two weeks at a time, twice a year. The caregiver or care recipient must be age 60 or older, and the care recipient must reside in the Region 1-B service area and require assistance with two or more activities of daily living, such as personal care, eating or bathing.

Medicare Medicaid Assistance Program (MMAP)

MMAP is Michigan’s State Health Insurance Program and is funded through grants from the Centers for Medicare and Medicaid Services. Local MMAP counselors help Medi-care beneficiaries or their families understand Medicare and Medicaid, compare or enroll in Medicare Pre-scription Drug Coverage, review Medicare supplemental insurance needs, understand Medicare health plans and apply for Medicaid or the Medicare Savings Program.

Each year the Area Agency on Aging 1-B (AAA 1-B) devel-

ops an area plan that outlines how approximately $20 million of state and federal funding will be used to help older adults remain living in their home or community for as long as possible. We are very interested in hearing from older adults, their care-givers, service providers and other individuals about how these funds are being used. The AAA 1-B would also greatly appreciate learning more about needs of seniors that are cur-rently not being met.

To give interested parties an opportunity to provide thoughts

and input on the 2011 area plan, the agency will be holding a public hear-ing on Tuesday May 25 from 1:00 p.m. to 3:30 p.m. at the Area Agency on Aging 1-B office located at 29100 Northwestern Highway, Suite 400 in Southfield.

A draft of the plan will be available on the AAA 1-B website (www.aaa1b.org) by early May. If you are unable to attend the hearing, comments can also be submitted to the Area Agency on Aging 1-B by e-mail to [email protected], or through our website. For more information please call Amy Smyth at the AAA 1-B at 248-213-0545.

For more information on AAA 1-B services call


“Promote and Preserve the Inde-pendence and Dignity of the

Aging Population” is the Tri-County Office on Aging’s (TCOA) mission statement. TCOA has many programs that work toward that mission, includ-ing Information & Assistance and Cri-sis Services for the Elderly.

For over 35 years, Information & Assistance has been an important resource in the community and is con-tinually expanding. Bill was referred by his doctor to TCOA for Medicaid assistance. Bill’s wife had always helped him with paperwork and record keep-ing, but she recently passed away. TCOA assisted him in completing the application. During that process it became apparent that Bill was not

receiving food stamps — so he agreed to apply, and is now get-ting $200 a month in food stamps. TCOA also helped Bill to make an appointment with AARP tax volun-teers to look at home heating and property tax credits that he had never applied for.

Crisis Services for the Elderly is available 24 hours a day, seven days a week. It provides response to non-medical emergencies in need of immediate assistance in the Greater

Lansing area when there are no other resources avail-able to help. Trained volun-teers assess the situation and help arrange necessary services, with the individual’s

consent. There is no cost for Crisis Services for the Elderly, but donations are accepted.

For more information about these and other TCOA programs, please call 517-887-1440 or 1-800-405-9141, or visit our website at www.tcoa.org.

Tri-County Office on AgingA consortium of Clinton, Eaton and Ingham counties and the cities of lansing and East lansing




Reg 4 / Reg IV AAA



Tri‑County office on Aging Serves the Elderly

Many people slip into the role of caregiver over time as they

begin to help their loved one more and more. If you provide support for a family member or friend, you can ask yourself these questions:

Do you…Feel responsible for the care of a

loved one?Run errands, or drive loved ones

to their errands?Provide housekeeping or home

maintenance?Make appointments and go with

your loved one?Manage the finances?If you answer yes to any of these

questions, then you are a caregiver.One way the Area Agency on

•

•

•

•

•

Aging is able to support caregivers is through a monthly newsletter, packed with quick tips and resources to make the job of caregiving easier. Subscrib-ers use the information to learn to develop better coping skills or gain new insights. The publication is filled with uplifting, practical content in an easy-to-read format peppered with illustrations and caregiver self-care tips, and includes feature articles and links to key resources.

Articles cover how to avoid stress and burnout, encouraging use of back-up care; communication with the fam-ily and care team; coping techniques; health and well-being; advice from experts; local resources; and more.

The Area Agency on Aging knows the challenges and joys of caring for another person. The caregiving news-letter is offered to anyone looking for ideas about how to balance, restore and rejuvenate life.

If you wish to subscribe by mail, call the Info Line for Aging and Long-Term Care at 1-800-654-2810. The newsletter is also available on the Area Agency on Aging’s website at www.AreaAgencyOnAging.org.

For more information, contact the Region IV AAA at 269-983-0177 or 1-800-442-2803.

Region IV Area Agency on AgingCovering Michigan’s Great Southwest including Berrien, Cass and Van Buren counties




Reg 4 / Reg IV AAA



Are You a Caregiver?

TCOA staff member Judy Christie assists Bill with his Medicaid paperwork.

Spring 2010 1�

Sunrise Side Senior Services, located in Arenac County, offers

a number of programs to seniors, but they are especially proud of their adult day center, Pleasant Days.

Housed within the Omer Senior Center, Pleasant Days Adult Day Car-ing offers family caregivers and their loved ones a break from their daily routine. The adult day center provides a safe environment and failure-free activities for seniors struggling with symptoms of dementia or diminish-ing physical abilities. The staff enjoys the opportunity to reminisce with the adult day center participants and encourages them to get to know each other and share their commonalities.

Pleasant Days is open five days

aa week from 8 a.m. to 2 p.m. Transportation arrangements are available if needed. Lunch and a snack are provided. For more infor-mation, contact director Karen Pitylak at 989-653-2692 or toll-free 1-888-370-7184.

The Iosco County Commission on Aging’s (ICCOA) purpose is

to promote the health, welfare and independence of seniors in its area. ICCOA offers services such as home-delivered meals, respite care, home-making and personal care. Congregate meals are held at four sites: Hale, Oscoda, Sand Lake and Tawas. Each site offers a number of daily activities

that might include tackling a new craft project, taking part in a spirited card game, presentations on health-related topics or an afternoon at the movies.

Services are provided for individu-als age 60 and older, but anyone can take part in the congregate meals. Each hot, well-balanced meal provides one third of the recommended daily requirements for nutrition. An added bonus of the meals is the opportu-nity to socialize with others in the community. For more information, contact the ICCOA main office at 989-728-6484.

For other county referrals and information, call 1-800-219-2273, ext. 216.

NEMCSA Region 9 Area Agency on AgingCovering 12 counties of Northeast Michigan




Reg 4 / Reg IV AAA



Arenac and Iosco County Highlights

UPCAP, in its role as the Upper Peninsula Area Agency on Aging

(UPAAA), carries out a wide range of functions and systems that are designed to assist older persons in leading independent, meaningful and dignified lives in their own homes and communities for as long as possible. As part of this mission, the UPAAA is required to develop and implement an Area Plan each year. The Area Plan provides a blueprint for helping to make the U.P. a great place in which to grow old — a place where older adults can live life on their own terms with dignity and a sense of purpose.

As part of the development of the 2011 Area Plan, the UPAAA is

conducting a public hearing. This hearing will allow older adults, their caregivers, service providers, and the general public to voice their opinions, concerns and preferences about the

types of services and programs that may be funded by UPCAP. We are particularly interested in hearing com-ments that focus on unmet needs, long-term care and current services that may be a priority to older adults living in the U.P.

Anyone wanting to provide input into the 2011 Area Plan is invited to attend the public hearing on Friday, April 23, at 1:00 p.m. The hearing will be held in the UPCAP conference room located at 2501 14th Avenue South in Escanaba. UPCAP encourages anyone who wants to be a part of the planning process to attend this session. We specifically appreciate hearing from seniors and their caregivers about issues and services important to them.

Individuals who are unable to attend the public hearing may sub-mit written comments to: Executive Director, U.P. Area Agency on Aging, P.O. Box 606, Escanaba, MI 49829.

For more information about the UPAAA’s Area Plan, call UPCAP at 1-800-338-7227, or dial 2-1-1.

Upper Peninsula Area Agency on AgingServing all 1� counties of Michigan’s Upper Peninsula




Reg 4 / Reg IV AAA



The U.P. Area Agency on Aging Needs Your Input

Seniors and caregivers are invited to attend a public hearing.

What does the term “caregiver” mean?the term “caregiver” has a wide range of meanings. It is typically asso-ciated with someone who assists an elderly person who needs mental, emo-tional or physical support. A caregiver can be someone who regularly visits an elderly person, someone who has taken on responsibility for overseeing the wel-fare of an elderly person, or someone who is the power of attorney or guardian for an elderly person.

Who is a typical caregiver?caregivers are usually family members. But other people such as close friends, privately hired nurses, designated patient advocates or court-appointed guardians also can have caregiver roles.

What can a caregiver do if someone they are caring for is not getting good care in their nursing home or hospital?concern over quality of care is something that caregivers often face, but usually do not know how to effec-tively address. Caregivers may feel timid about raising concerns with nursing home or hospital staff and management. They may feel like they do not have the expertise to second-guess facility staff

when obvious problems arise, or that the facility may retaliate against them. If the caregivers do raise concerns, nursing home or hospital staff may react nega-tively, which often further increases the caregiver’s stress level.

There are, however, practical steps that every caregiver can take when a problem with quality of care arises. Typical problems can include simple concerns like dirty or un-kept rooms, or serious issues such as the develop-ment of bedsores, dehydration, improper nutrition, a lack of safety rails, or failure of care coordination among physicians and facility staff.

One of the most effective measures is to make frequent visits on irregular schedules. If a caregiver visits at the same time of the day or week, the facil-ity staff may start to predict the care-giver’s schedule and put things in order in anticipation of the visit. Arriving at irregular times can help a caregiver gain a true understanding of the typical qual-ity of care that the facility provides.

Another important measure is to take photographs of the facility living condi-tions. Photographs can help document assessments and add credibility to formal complaints that a caregiver may raise.

If a caregiver cannot get resolution of their concerns from a facility’s staff, another option is to contact the local Area Agency on Aging and ask for an ombudsman to help resolve the issues. Ombudsmen provide an unbiased anal-ysis of a caregiver’s concerns and can help to facilitate open communication between a facility and a caregiver.

What are some examples of real problems that caregivers might face?often caregivers lack the expertise to solve problems easily on their own, or they may feel uneasy about raising

complaints about quality of care. For example, a caregiver recently attempted to work directly with a nursing home to increase the quality of care her mother was receiving. The nursing home was aware that her mother was diabetic and was not to be given food with high sugar content, but the staff continually fed her mother honey at meals. It was necessary to emphasize to the staff that the mother’s care plan specified her dietary require-ments. Posting these instructions directly above her bed helped the staff become aware of her diabetic condition.

Another example occurred when a caregiver was searching for a nursing home for her mother-in-law that was close to her family in Oakland County. The mother-in-law was in the process of applying for Medicaid after a hospital stay, and the hospital social worker told the family that the only available nurs-ing home was in Wayne County. After additional research on nearby facilities, the family was able to coordinate with Medicaid to place the woman in an Oakland County nursing home where her family could visit her daily. Medic-aid initially said that they had lost the woman’s original application, but they finally agreed to expedite a new applica-tion since the mother-in-law was close to death and needed to remain close to her family.

A word of advice: Every care-giver needs to speak up if they sense something is wrong and not accept sub-standard care under any circumstance.

Jamie m. Verdi is a health care and elder law attorney who regu-larly represents caregivers. You can reach her at 248-410-4945 and www.mipalhealth.com.

ASKtheExpert Jamie M. Verdi

A Closer Look

at Caregiving

1� Michigan Generations

Do you have a caregiving question?Write or email your question to our

“Expert” at: Jenny Jarvis, Area Agency

on Aging 1-B, 29100 Northwestern

Highway, Suite 400, Southfield, MI 48034;

[email protected]. We will make every

effort to answer your question in an

upcoming issue of Michigan Generations.

Spring 2010 1�

STATEWIDE RESOURCES

Bureau of Health Services (nursing home complaints) . . . 1-800-882-6006Department of Consumer Industries (adult foster care complaints) . . . . . . . . . . . . . . . . . 1-866-685-0006 Medicare/Medicaid Assistance Program (MMAP) . . . . . . . 1-800-803-7174Michigan Office of the Attorney General . . . . . . . www .seniorbrigade .comMichigan Office of Services to the Aging . . . . . . . . . . www .miseniors .net

REgIONAl RESOURCESdetroit area agency on aging (1a):Information and Assistance . . . . . . . . . . . . . . . . . . . . . . 313-446-4444

Outreach & AssistanceBridging Communities — Detroit . . . . . . . . . . . . . . . . . . . . . . 313-361-6377Detroit Senior Citizens Department — Detroit . . . . . . . . . . . 313-224-1000Neighborhood Legal Services Michigan — Redford . . . . . . . 313-937-8291Services for Older Citizens — Grosse Pointe . . . . . . . . . . . . 313-882-9600

Senior CentersAssociation of Chinese Americans, Inc . . . . . . . . . . . . . . . . . . 313-831-1790Delray United Action . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 313-297-7921Latino Family Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 313-841-7380North American Indian Assn . of Detroit . . . . . . . . . . . . . . . . . 313-535-2966St . Patrick Senior Center . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 313-833-7080St . Rose Senior Citizen Center . . . . . . . . . . . . . . . . . . . . . . . . . 313-921-9277Virginia Park Citizens Service Corp . . . . . . . . . . . . . . . . . . . . . 313-894-2830Reuther Older Adult & Wellness Services . . . . . . . . . . . . . . . 313-831-8650

area agency on aging 1-b:Information and Assistance . . . . . . . . . . . . . . . . . . . . . 1-800-852-7795Catholic Social Services of Washtenaw County . . . . . . . . . . . 734-971-9781Deaf and Hearing Impaired Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . .248-473-1888; TTY: 248-473-1875Greater Detroit Agency for the Blind & Visually Impaired . 313-272-3900Livingston County Catholic Social Services . . . . . . . . . . . . . . 517-545-5944Oakland Livingston Human Service Agency (OLHSA) Oakland . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 248-209-2600 Livingston . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 517-546-8500The Council on Aging, Inc ., serving St . Clair County . . . . . . . 810-987-8811The Macomb County Dept . of Senior Citizen Services . . . . . 586-469-6313The Monroe County Commission on Aging . . . . . . . . . . . . . . . 734-240-7363

region 2 area agency on aging:Information and Assistance . . . . . . . . . . . . . . . . . . . . . 1-800-335-7881MI Choice Medicaid Waiver Program . . . . . . . . . . . . . . . . . . 1-800-335-7881Hillsdale County Senior Services Center . . 517-437-2422 or 1-800-479-3348Jackson Department on Aging . . . . . . . . . . . 517-788-4364 or 1-800-788-3579Lenawee Department on Aging . . . . . . . . . . . . . . . . . . . . . . . . 517-264-5280Legal Services of South Central Michigan . . . . . . . . . . . . . . . . 517-787-6111

region iv area agency on aging:AAA Info-Line . . . . . . . . 1-800-654-2810; www .AreaAgencyOnAging .orgCustom Care — Care Connections of Southwest Michigan . . . . . . . . . . . . . . . . . 1-800-442-2803; www .AreaAgencyOnAging .orgElder Care Locator . . . . . . . . . . . . . . . 1 -800-677-1666; www .eldercare .govSenior Nutrition Services . . 1-800-722-5392; www .seniornutritionregiv .orgSenior Volunteer and Intergeneration Programs . . . . . . . . . . . . . . . . . 1-877-660-2725; www .AreaAgencyOnAging .org

tri-county office on aging (region 6):Information and Assistance — Clinton, Eaton and Ingham Counties . . . . . . . . . . . . . . . . .1-800-405-9141 or 517-887-1440; www .tcoa .org

Project Choices . . . . . . . . . . . . . . . . . . . . 1-800-405-9141 or 517-887-1440 For in-home service assistance and the Medicaid home/community-based services waiver (MI Choice)

Meals-On-WheelsGreater Lansing . . . . . . . . . . . . . . . . . . . . . . . 517-887-1460 or 1-800-405-9141 Clinton County . . . . . . . . . . . . . . . . . . . . . . . . . 989-224-3600 or 1-888-224-3030 Eaton County . . . . . . . . . . . . . . . . . . . . . . . . . . 517-541-2330 or 1-866-541-5444 Rural Ingham County . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 517-676-2775Senior Dining Site Information . . . . . . . . . . . 517-887-1393 or 1-800-405-9141 AARP Tax Assistance . . . . . . . . . . . . . . . . . 517-887-1440 or 1-800-405-9141

region vii area agency on aging:Information and Assistance . . . . . . . . . . . . . . . . . . . . . 1-800-858-1637Alzheimer’s Association of Mid-Michigan . . . . . . . . . . . . . . . 1-800-337-3827Citizens for Better Care (Nursing Home Advocacy Ombudsman) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-800-284-0046Lakeshore Legal Aid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-866-552-2889MI Choice Medicaid Waiver Program . . . . . . . . . . . . . . . . . . 1-800-858-1637 Bay Co . Division on Aging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .989-895-4100Clare County Council on Aging . . . . . . . . . . . . . . . . . . . . . . . . 1-800-952-3160Gladwin County Council on Aging . . . . . . . . . . . . . . . . . . . . . 1-800-952-0056Gratiot County Commission on Aging . . . . . . . . . . . . . . . . . . . . 989-875-5246Human Development Commission (Huron, Tuscola and Sanilac counties) . . . . . . . . . . . 989-673-4121 or 1-800-843-6394Isabella County Commission on Aging . . . . . . . . . . . . . . . . . 1-800-878-0726Midland County Council on Aging . . . . . . . . . . . . . . . . . . . . . 1-800-638-2058Saginaw County Commission on Aging . . . . . . . . . . . . . . . . . 1-866-763-6336

nemcsa region 9 area agency on aging:Information and Assistance . . . . . . . . . . . . . . . . . . . . . . 989-356-3474Long-Term Care Ombudsman . . . . . . . . . . . . . . . . . . . . . . . . 1-866-485-9393

Multi-purpose Senior CentersAlcona County Commission on Aging . . . . . . . . . . . . . . . . . . . 989-736-8879 Alpena Area Senior Citizens Council . . . . . . . . . . . . . . . . . . . . 989-356-3585 Arenac County Council on Aging . . . . . . . . . . . . . . . . . . . . . . . 989-653-2692 Cheboygan County Council on Aging . . . . . . . . . . . . . . . . . . . . 231-627-7234 Crawford County Commission on Aging . . . . . . . . . . . . . . . . . 989-348-7123 Iosco County Commission on Aging . . . . . . . . . . . . . . . . . . . . 989-728-6484 Montmorency County Commission on Aging . . . . . . . . . . . . . 989-785-2580Ogemaw County Commission on Aging . . . . . . . . . . . . . . . . . 989-345-5300 Oscoda County Council on Aging . . . . . . . . . . . . . . . . . . . . . . . 989-826-3025 Otsego County Commission on Aging . . . . . . . . . . . . . . . . . . 989-732-1122Presque Isle County Council on Aging . . . . . . . . . . . . . . . . . . 989-766-8191Roscommon County Commission on Aging . . . . . . . . . . . . . . 989-366-0205

upper peninsula area agency on aging/upcap:Information & Assistance . . . . . . . . . . . . . . Dial 2-1-1 or 906-786-4701Outside the U .P . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-800-338-7227U .P . Long Term Care Ombudsman . . . . . . . . . . . . . . . . . . . . . 1-866-485-9393

UPCAP Care Management/Field Offices Escanaba . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 906-786-4701Houghton . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .906-482-0982Iron Mountain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 906-774-9918Marquette . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 906-228-6169Sault Ste . Marie . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .906-632-9835

RESoURCE GUIDEfor Michigan Caregivers and Seniors

Clip and Save this list of important statewide and regional resources and services.

American House

Adult Communities with Services Unlike Any OtherStop by any of our 31 locations in Oakland,

Wayne, Macomb, Washtenaw and Genesee counties or visit us online at www.americanhouse.com

J & B Medical Supply• Diabetes Supplies• Incontinence Supplies• Home Delivery & Quality You Can Trust

We are your solution for all your medical supply needs. Call 1-800-737-0045 or visit our website www.jandbmedical.com

SPoNSoRS

For more information on becoming a sponsor of MichiganGenerations, please call Jenny Jarvis at 248-262-9202 .

This event is proudly sponsored by:

On Thursday, June 10, 2010, hundreds OF senIOrs will gather in Lansing for the 3rd annual Older Michiganians Day Rally. Participants will gather on the lawn of the Capitol and urge legislators and the governor to:

Protect services for the most vulnerable.Invest in prevention programs that work and save money.Make Michigan a retirement destination of choice.Close tax loopholes, reform government and restructure taxes to

raise needed state revenue.We encourage seniors to get involved and par t icipate in

this event. For more information on how to be part of Older Michi-ganians Day, contact your local Area Agency on Aging or visit www.oldermichiganiansday.com.

••••

Take a Stand for Senior Services

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