Families and communities in every city, town, and rural area in the U.S. are feeling the impact of Alzheimer’s disease and other dementias. Over five million Americans—one in eight age 65 and older and one in three age 85 and older—is living with dementia. They are supported by 15.5 million family members and friends.
Building on the ACT on Alzheimer’s community engagement model employed throughout Minnesota, the Dementia Friendly America initiative is fostering dementia friendliness in communities across the country. The initiative will be deployed through web-based resources and technical assistance.
Tempe, Arizona; Prince George’s County, Maryland; Knoxville, Tennessee; Santa Clara County, California; Denver, Colorado; and the state of West Virginia will be early adopters of the dementia friendly community process.
Minnesota AAA directors receive n4a Innovation Award: (left to right) Linda Giersdorf, Catherine Sampson, Dawn Simonson, Lori Vrolson, Connie Bagley
On July 12, 2015, Minnesota’s Area Agencies on Aging received an Aging Innovations Award from the National Association of Area Agencies on Aging. The award commends the Minnesota Agencies for their partner role in developing the ACT on Alzheimer’s initiative and providing technical assistance and support to communities statewide—helping them assess, analyze and work to achieve community goals for becoming dementia friendly.
Dawn Simonson, executive director, Metropolitan Area Agency on Aging and Lori Vrolson, executive director, Central Minnesota Council on Aging, received the award at the National Association of Area Agencies on Aging annual conference and tradeshow in Philadelphia. Simonson and Vrolson also represented ACT on Alzheimer’s as participants in the conference panel, “Equipping Communities to Support People with Alzheimer’s Disease and Related Dementias.”
Toolkit for Working with Persons with Complex Needs and Older Adults
The goal of this toolkit is to offer resources and guidance to certified Health Care Home clinics caring for seniors and people with disabilities who have complex functional support needs in addition to their medical issues.
The toolkit was developed through the efforts of a formal workgroup of the Multi-Payer Advanced Primary Care Practice (MAPCP) Demonstration. Medicare conducted the demonstration in Minnesota and seven other states. Your clinic is able to bill Medicare monthly for your care coordination services for individuals participating in Traditional Medicare. January 2015.
More than one third of seniors (37 percent) say they exercise every day compared with 26 percent in 2013, and 39 percent say they rely on themselves for the motivation to live a healthy lifestyle.
For many seniors, high activity levels correspond to a positive perspective on life. Seniors who exercise daily are much more likely than those who never exercise to say the past year of their life has been better than normal rather than worse (28 percent compared with 15 percent).
Nearly 7 in 10 (69 percent) find it easy to pay monthly bills, compared with 66 percent in 2013 and 64 percent in 2012.
Younger seniors are the most concerned about community support as they age: Nearly 4 in 10 (39 percent) seniors ages 60-64 feel their communities are not doing enough to plan for the growing senior population.
At the front of the small auditorium in north Minneapolis, Bounleuth Gowing flashes a brilliant smile as she coaxes participants to stretch, shift, align and move. Traditional Laotian music plays in the background as the 20 or so participants respond with graceful, synchronized movements using traditional Tai Chi forms.
The older adults are participating in Tai Chi: Moving for Better Balance, an evidence-based program introduced to the Lao Advancement Organization of America and other metro organizations serving older adults by David Fink, program developer at the Metropolitan Area Agency on Aging (MAAA). The goal of the program is to reduce falls by improving balance, strength, flexibility and physical performance in older adults. “We wanted to find an evidence-based fall prevention program that could be easily implemented by bilingual leaders for non-English speaking older adults, and Tai Chi: Moving For Better Balance has been excellent in meeting that need.”
Fuzhong Li, PhD, at the Oregon Research Institute, developed the community-based Tai Chi program and has offered three 2-day training sessions since 2012 sponsored by MAAA for prospective leaders in the metro area. Bounleuth and her co-leader, Danai Phongthani, and 44 other leaders have attended the training.
Boualay Inthavong, participant
“I was leading various type of classes before we started the Tai Chi program but it was hard to keep people involved or to see progress. The Tai Chi program provides a structure that people like and is easy for me to lead,” says Bounleuth. “We made some modifications to the program to fit our group and to keep it fresh and fun but we stick with the fundamentals of the program. Tai Chi is making a difference for our elders.”
Boualay Inthavong and Sy Inthachinda, participants in the Tai Chi program, came to America from Laos in the late 1970s and early 1980s as refugees after a Communist government came to power in Laos in 1975.
Sy Inthachinda, participant
Boualay and Sy praise the Tai Chi class. “It makes me feel better. I have learned to move in different ways and I enjoy socializing with others before and after the class,” says Boualay. According to Sy, “Before I started the class, I needed a cane to walk. Now I walk without a cane . . . and I walk fast!”
“Our elders like the class very much and don’t want to miss it,” says Bounleuth. “Many of them schedule their appointments around the class. If someone needs to miss a class, I usually get a call saying, ‘don’t take me off the list, I will be back for the next class.’”
You might think that the older adults in northwest Minnesota, predominately of Scandinavian and German descent, would be less likely to take to Tai Chi. Karen Lenius, Senior Programs/RSVP director for the Mahube-Otwa Community Action Partnership is quick to say that’s not true.
Her organization partners with the Land of the Dancing Sky Area Agency on Aging and Central Minnesota Council on Aging to offer Tai Chi in 13 sites in five counties across northwestern Minnesota. Dr. Li has offered two training sessions in the area, training 30 volunteers to lead the Tai Chi sessions. Karen estimates that 196 older adults participate regularly in the Tai Chi programs. “The program is so good for strengthening the core of the body,” says Karen. “After Tai Chi, people have a much better ability to move without over extending. They have improved balance and much less chance of falling.”
Since the 2001 legislative session, the Minnesota Legislature has provided funding each year to the Department of Human Services (DHS) to help communities rebalance their long-term care service delivery system and increase their capacity to help people age 65 and older to stay in their own homes and communities.
These dollars are given out to organizations through the Live Well at Home RFP, formerly known as CS/SD. The purpose of the funding is to expand and integrate home and community-based services for older adults that allow local communities to rebalance their long-term service delivery system, support people in their homes, expand the caregiver support and respite care network and promote independence
Live Well at Home grants help:
Persons age 65+ stay in their own homes and communities
Improve chronic disease management in Minnesota’s communities
Expand long-term care capacity by linking formal and informal long-term care services
Support caregivers and promote independence through market-based solutions
Essential Community Supports including caregiver support, chore, homemaker, personal emergency response devices, home delivered meals
Core Home and Community-Based Services to cover some fixed costs for small non-profit providers offering essential community supports and additional services but not limited home modification and transportation. This may include Faith in Action, Living at Home Networks, Congregational Nurse, or similar community-based programs.
Chronic Care Management to increase access to evidence-based health promotion and disease management
Dementia Capable Health Care Home
Jacqueline Peichel, HCBS Development Lead Department of Human Services, Aging and Adult Services Division PO Box 64976 St. Paul MN 55164-0976
Elsie was diagnosed with Macular Degeneration when she was 79. “I have been afraid of falling for years, but I am especially afraid now that I can’t see well,” says Elsie.
Fear is Risk Factor for Falls
The ‘fear of falling’ is a significant risk factor to falling. Just as many others who are afraid of a fall, Elsie had begun to limit her activity. Inactivity increases the risk of falling that much more. Inactivity leads to isolation, isolation leads to depression. So the downward cycle goes.
Elsie’s building manager suggested she take a class called A Matter of Balance: Managing Concerns About Falls. A Matter of Balance is an 8-week class that helps participants examine their attitudes and habits to reduce the fear that surrounds falling. Participants also evaluate their environments and find ways to increase their activities. The exercises in the class increase strength, flexibility, balance and endurance.
During visits to Matter of Balance (MOB) workshops, Debra Laine, MOB Master Trainer for the Arrowhead Area Agency on Aging (AAAA), noticed at least one if not more participants in each class were having trouble seeing workbooks, following class materials and doing exercises.
“It sent me on a quest to empower those with vision loss to fully access course materials and take advantage of the class,” says Laine. The AAAA applied for a Healthy Vision Community Award grant from the National Eye Institute. Upon receipt of the grant, the AAAA led a collaborative effort with the Duluth Lighthouse for the Blind and Maine Health Partnership to adapt the MOB materials for those with vision impairment.
Adaptations Provide Access for Those with Low Vision
When Elsie arrived at her Matter of Balance class, she told her coaches about her vision loss. They were able to give her a large-print edition of the Participant Workbook and a set of hand-held flip charts so she could easily see what was on the large group flip charts. The coaches also showed videos in smaller segments and used more detailed descriptions of exercises. They were better able to meet her needs because of the training they had gone through for working with participants with vision loss.
If you are interested in low-vision Matter of Balance, check with the Area Agency on Aging in your region. If you represent an agency that would like to use the low-vision adaptations, please visit the national MOB website for the training and to obtain the adapted materials.
For more information on Matter of Balance and the low vision adaptation, please visit one of the following these links:
When I first walked into the home of Guthrie (Gus) Elder, Lakefield, MN, I was not sure what to expect. I was prepared to meet an aging veteran with ALS (Amyotrophic Lateral Sclerosis, “Lou Gehrig’s Disease”) and expected to see only sadness and resignation. A tough guy in a tough spot, for sure.
Well, let’s just say that Gus pretty much swept me off my feet with story after story of his service years, his family, the challenges and joys of these later years. He is still king of his roost, with Janice Reyes as his primary Caregiver and Team Leader managing every aspect of his care. She is also a grand companion who brings quality of life with her smiles, understanding and compassion. In our time together it became very clear to me that Janice is the hub at the center of Gus’s living well at home.
Gus is receiving support from numerous fronts, including planning help from PVA (Paralyzed Veterans of America), the VA and the ALS Association. He raves about the people who provide education and support in his daily contention with the disease. Gus is a great example of what you can do to manage practically any situation so you can live longer in your own home. His story is uplifting, courageous and truly a model that others can follow.
The home that Gus lives in, along with his son and his care providers, is a one of a kind—just like Gus. Built with his exact challenges in mind, every doorway is completely flush with the floor (no bumps), the doors are all wider than usual, the bathroom is a feat of technology and function and yet a very comfortable “normal” feeling room. It’s more like something you would see in a nice hotel or spa than in a medical facility. Well done, Wisconsin Homes.
There are other pieces of technology that make life at home possible including a computer rigged with a special camera and software that allows Gus to control the TV, send email, call family or call for help or just browse the internet—all with just a look from his eyes.
Gus would love to share his thoughts and his strategies for living at home with other Veterans who are facing similar challenges. If you know of someone who needs help to stay in his or her home, think about Gus’s story and reach out to your local Area Agency on Aging and other agencies that can provide the assistance needed.