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An Informative Interview with Linda Ziac on “The Value of Healthcare Advocacy”

A healthcare advocate helps you maneuver through the complex & confusing healthcare maze.


This month Jen Graziano interviewed Linda Ziac a board certified case manager and advocate on her radio show Time to Talk.

Together Jen and Linda talked about the steps in identifying a person’s wishes and needs, while developing a comprehensive care plan (road map) to address the person’s health, safety, independence and quality of life.


TO LISTEN TO THIS INFORMATIVE CONVERSATION click here:

http://archives.warpradio.com/btr/wgcharchives/timetotalk/030117.mp3


TIME TO TALK is a weekly radio show hosted by Jen Graziano on Wednesdays from 9:30 am to 10:00 am on 1490 AM WGCH in Greenwich.

Jen Graziano is an attorney and co-owner of Coxe & Graziano Funeral Home in Greenwich. She is a 4th generation funeral director who for many years has overseen operations of her family’s other firm, Coxe & Graziano of Westchester.


At the start of every radio show Jen shares “As part of our commitment to the community I come to you every Wednesday talking to people that matter – about things that matter – in a place that matters right here in Greenwich.”

Each week Jen presents a guest and together they discuss poignant matters that currently touch our lives or the lives of those we know. Some of the topics that are covered by Jen and her guests include healthcare; issues affecting seniors, caregivers and their loved ones; legal planning; preparing for aging, and end of life issues.

Linda Ziac is the owner and founder of The Caregiver Resource Center which has been providing a spectrum of health and mental health case management and advocacy services for seniors, people with special needs and their loved ones since 1990.


Photo from Microsoft

The information in this article is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be patient education, does not create any patient provider relationship, and should not be used as a substitute for professional diagnosis and treatment.

Please consult your health care provider for an appointment, before making any healthcare decisions or for guidance about a specific medical condition.

_______________________________________________


Linda Ziac is the owner and founder of The Caregiver Resource Center. The Caregiver Resource Center is a division of Employee Assistance Professionals, Inc. which Linda founded in October 1990. The Caregiver Resource Center provides a spectrum of concierge case management and advocacy services for seniors, people with special needs and families.

Linda’s professional career spans more than 40 years in the health and mental health field as a CT Licensed Professional Counselor, CT Licensed Alcohol and Drug Counselor, Board Certified Employee Assistance Professional, Board Certified Case Manager, and Board Certified Dementia Practitioner. In addition, Ms. Ziac has 15 years of experience coordinating care for her own parents.

Linda assists seniors, people with special needs and their families; in planning for and implementing ways to allow for the greatest degree of health, safety, independence, and quality of life. Linda meets with individuals and family members to assess their needs, and develop a Care Team, while working with members of the Team to formulate a comprehensive Care Plan (a road map).

Once a plan is in place, Linda is available to serve as the point person to monitor and coordinate services, and revise the plan as needed. This role is similar to the conductor of an orchestra; ensuring that there is good communication, teamwork, and that everyone remains focused on the desired goal.

http://www.CaregiverResourceCenter.com


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2-1-1 Info & Help is a Phone Call Away

INFO-LINE 211 - A FREE Nationwide Information Database


By Linda Ziac
March 14, 2017
The Caregiver Resource Center
www.CaregiverResourceCenter.com



DO YOU EVER NEED TO LOCATE A RESOURCE, BUT AREN'T SURE WHERE TO LOOK?

You may be looking for information about:

• Childcare in your area

• How to file for social security disability

• Substance abuse treatment facilities

• Eligibility requirements for food stamps

• Autism services

• Help for depression and thoughts of suicide

• Veteran benefits


Did you ever think it would be great if you could place one phone call, have access to a huge data base network, and have a person available to help you locate the information you need?


WELCOME TO INFOLiNE 2-1-1


2-1-1 is a free and confidential service that helps people find needed resources 24 hours a day, 7 days a week.


According to the Federal Communications Commission, in July 2000 the dialing code 2-1-1 was reserved throughout all 50 states, Washington D.C and Puerto Rico; to be a universally recognized and easily remembered number.

The 2-1-1 data base resource number is operated by a private non-profit community service organization, local government, or local affiliates of the United Way of America.

2-1-1 reaches approximately 270 million people (90% of the total U.S. population), covering all 50 states, the District of Columbia, and Puerto Rico


“In many states, dialing “2-1-1” provides individuals and families in need with a shortcut through what may be a bewildering maze of health and human service agencies’ phone numbers. By simply dialing 211, those in need of assistance are referred, and sometimes connected, to appropriate agencies and community organizations.”

Source: The FCC (Federal Communications Commission


THE AMAZING THING ABOUT 2-1-1

The amazing thing about dialing 2-1-1 is that no matter where you live in the U.S. or Puerto Rico, you will receive access to information and referrals regarding local and national assistance, on topics such as:

• Governmental agencies

• Non-profit organizations

• Social service programs

• Physical and Mental Health Resources

• Work Support

• Support for Older Americans and Persons with Disabilities

• Children, Youth and Family Support

• Emergency Suicide Prevention

• Volunteer opportunities


WAYS TO ACCESS INFOLINE 2-1-1

1. You can pick up the phone and dial 2-1-1


2. You can visit - http://www.211.org

You will be taken to a website where you can search for by zip code, city, or state

This can be especially helpful if you are searching for resources for a friend or family member who lives in another area of the country.


SEARCH EXAMPLES:


SEARCHING BY ZIP CODE:

if you type in a zip code such as 06830 (a Greenwich zip code), the website produces the following information.

211 Dial 2-1-1 from service calling area

(800) 203-1234 Alternative Number

(860) 522-4636 Alternative Number

2-1-1 information, referral and crisis intervention


SEARCHING BY CITY:

If you type in a city such as Rye NY, the website produces the following information.

2-1-1 United Way of Westchester and Putnam

211 Dial 2-1-1 from service calling area

(800) 899-1479 Alternative Number

(914) 993-3700 Alternative Number


SEARCHING BY STATE:

If you select a state such as Hawaii, the website produces the following information.

Aloha United Way 211 (Hawaii)

211 Dial 2-1-1 from service calling area

(808) 536-1951 Alternative Number

(877) 275-6569 Alternative Number

2-1-1 information and referral service for Hawaii.


HELP IS JUST A PHONE CALL AWAY


When you need help and aren’t sure who to look.

Call 2-1-1

A call specialist will be there to help point you in the right direction.


Photo courtesy of Infoline 2-1-1


The information in this article is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be patient education, does not create any patient provider relationship, and should not be used as a substitute for professional diagnosis and treatment.

Please consult your health care provider for an appointment, before making any healthcare decisions or for guidance about a specific medical condition.

____________________________________________________________________

Linda Ziac is the owner and founder of The Caregiver Resource Center. The Caregiver Resource Center is a division of Employee Assistance Professionals, Inc. which Linda founded in October 1990. The Caregiver Resource Center provides a spectrum of concierge case management and advocacy services for seniors, people with special needs and families.

Linda’s professional career spans more than 40 years in the health and mental health field as a CT Licensed Professional Counselor, CT Licensed Alcohol and Drug Counselor, Board Certified Employee Assistance Professional, Board Certified Case Manager, and Board Certified Dementia Practitioner. In addition, Ms. Ziac has 15 years of experience coordinating care for her own parents.

Linda assists seniors, people with special needs and their families; in planning for and implementing ways to allow for the greatest degree of health, safety, independence, and quality of life. Linda meets with individuals and family members to assess their needs, and develop a Care Team, while working with members of the Team to formulate a comprehensive Care Plan (a road map).

Once a plan is in place, Linda is available to serve as the point person to monitor and coordinate services, and revise the plan as needed. This role is similar to the conductor of an orchestra; ensuring that there is good communication, teamwork, and that everyone remains focused on the desired goal.

http://www.CaregiverResourceCenter.com

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Creating a “Coping Ahead Plan” for Seniors

“A Pro-Active Road Map”


By Linda Ziac
March 7, 2017
The Caregiver Resource Center
www.CaregiverResourceCenter.com


Aging in Place is the ability to live in one’s own home and community safely, independently, and comfort-ably regardless of age, income, or ability level.” Source: CDC

Successful aging extends beyond physical health; incorporating cognitive function, social support, and satisfying life experiences.


MAINTAINING INDEPENDENCE WHILE BEING PRO-ACTIVE

No one looks forward to an unexpected personal or medical situation that catches you off guard; which can be costly, time consuming, complex, and over- whelming.

The time to plan for your aging is now, while you are still healthy, active and able to make decisions on your own.

A personalized “Successful Action Plan”, can help prevent unexpected events from turning into a crisis, which have the potential to negatively impact on your health, safety, independence, and quality of life.


PLANNING NOW FOR YOUR FUTURE

One thing we can all be sure of is we’re aging, and with aging comes challenges.

• Not all problems occur as a crisis, but evolve in a series of warning signs spanning weeks, months, or even years.

• While most seniors are healthy and function at a high level, it’s inevitable that as we age, issues will surface related to our independence


DON’T WAIT FOR A CRISIS – PLAN NOW


CREATING A PRO-ACTIVE ROAD MAP

Our “Action Plan for Successful Aging” Program helps evaluate your current life situation, and creates a road map that addresses your current needs, while preparing you for potential future challenges.

Our strategies focus on health and mental health, case management and advocacy, home safety, transportation, and advance care planning to name a few.


SOME AREAS WE EXPLORE

• Do you want to remain in your home?

• Are you eligible for state/federal benefits?

• Do you understand Medicare benefits?

• Are you and your family prepared for a medical emergency?

• Do you have Advance Directives?

• Do you have Long Term Care Insurance and understand your policy benefits?

• Are you aware of area transportation?

• Do you understand CT homecare services?

• What case management & advocacy services would benefit you?



A SUCCESSFUL AGING ACTION PLAN ON YOUR TERMS

Creating a Pro-Active Road Map

• Personal Life Assessment
• Home Safety Assessment & Action Plan
• Discussion and Planning for Future “what-ifs”
• Advocacy
• Individual Care Plan Development
• Case Management & Advocacy
• Crisis Management
• Family Support & Counseling
• Referrals to Specialists
• Family Talks * Issue Mediation
• Insurance Claims Research & assistance
• Monitoring of Homecare Services
• Many More


Individually Customized to Meet Your Unique Needs


We’re unique in that we’re there for our clients whenever and whenever they need us.

Onsite services in your home, doctor’s office, ER, hospital, short-term rehab, assisted living facility and nursing home

- 24/7 for client emergencies

- 7 days a week by appointment


For more information contact Linda Ziac at 203-861-9822

or

Visit us at www.CaregiverResourceCenter.com



Photo from Microsoft

The information in this article is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be patient education, does not create any patient provider relationship, and should not be used as a substitute for professional diagnosis and treatment.

Please consult your health care provider for an appointment, before making any healthcare decisions or for guidance about a specific medical condition.

__________________________________________________________________________

Linda Ziac is the owner and founder of The Caregiver Resource Center. The Caregiver Resource Center is a division of Employee Assistance Professionals, Inc. which Linda founded in October 1990. The Caregiver Resource Center provides a spectrum of concierge case management and advocacy services for seniors, people with special needs and families.

Linda’s professional career spans more than 40 years in the health and mental health field as a CT Licensed Professional Counselor, CT Licensed Alcohol and Drug Counselor, Board Certified Employee Assistance Professional, Board Certified Case Manager, and Board Certified Dementia Practitioner. In addition, Ms. Ziac has 15 years of experience coordinating care for her own parents.

Linda assists seniors, people with special needs and their families; in planning for and implementing ways to allow for the greatest degree of health, safety, independence, and quality of life. Linda meets with individuals and family members to assess their needs, and develop a Care Team, while working with members of the Team to formulate a comprehensive Care Plan (a road map). Once a plan is in place, Linda is available to serve as the point person to monitor
and coordinate services, and revise the plan as needed. This role is similar to the conductor of an orchestra; ensuring that there is good communication, teamwork, and that everyone remains focused on the desired goal.

http://www.CaregiverResourceCenter.com

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Fairfield County’s Giving Day - March 9, 2017

A powerful 24-hour online fundraising competition to benefit area non-profit agencies


March 9, 2017 - Remember the date and donate online on March 9th

Won’t you help make a difference in a someone’s life?


Fairfield County's Community Foundation has organized and is running Giving Day (https://fcgives.org) for many worthy charities

Fairfield County’s Giving Day is a powerful 24-hour online fundraising competition that unites our community around local causes close to your heart. Last year, this amazing day of giving had extraordinary results: $1,246,964 donated by 11,000+ individuals.

For more information visit https://fcgives.org


HOW TO GIVE?

All you have to do is go to this site on March 9th to make a donation:

https://fcgives.org


A donation form will automatically appear a minute after midnight on March 9th.

As you scroll down the page, there will be a section entitled “Search by Categories” which will list of all the eligible agencies to whom you may donate.

In order to donate, you will need to enter the agency to whom you would like to donate, your donation amount, your contact information and credit card number.


ABOUT FAIRFIELD COUNTY’S COMMUNITY FOUNDATION

Serving Connecticut Charities Since 1992

We bring you together with other passionate people, charities, and trusted resources to create lasting change in Fairfield County, Connecticut.

As a trusted community leader, we invite to the table leading experts, bold leaders and far-sighted funders to work together on solving our region’s challenges.


WHAT IS A COMMUNITY FOUNDATION?

Community foundations are one of the fastest-growing sectors of philanthropy in the United States. They are tax-exempt, place-based public charities created to help individuals, families and companies make a difference in their community.

The first community foundation was established in Cleveland in 1914. Today, there are 808 community foundations throughout the United States and 1,837 worldwide, collectively stewarding $63.1 billion in assets. In 2013, community foundations awarded $4.98 billion in grants to nonprofits.


HOW COMMUNITY FOUNDATIONS WORK

Each community foundation is made up of a collection of charitable funds established by individuals, families, public charities, and businesses. Fund assets are pooled, invested and safeguarded to generate an ongoing, steady resource for community giving.

Those who conduct their charitable giving through a community foundation can make contributions for the general benefit of the community; or designate their funds for specific purposes, causes or nonprofit organizations. Donors can contribute to local, national and international causes through their community foundation. There are no geographic boundaries to the term “community.”

To learn more about the worldwide community foundation movement, visit the Community Foundation Atlas.


ADVANTAGES OF GIVING WITH A COMMUNITY FOUNDATION

• You can name your fund and designate its purpose in perpetuity

• You receive immediate tax benefits, even if you wait to recommend grants from the fund you established

• You receive guidance, information and advice to help you give in a way that is strategic and impactful.

• Your fund can benefit charities locally, nationally, and internationally.

• Your fund benefits from professional financial stewardship.

• You may engage family members in philanthropy, and name a successor as a fund advisor.

• You may give anonymously.


FOR MORE INFORMATION

For more information please contact:

Fairfield County's Community Foundation
383 Main Avenue
Norwalk, CT 06851-1543
203.750.3200
Fax: 203.750.3232
info@fccfoundation.org
http://fccfoundation.org


Source: Fairfield County's Community Foundation


Photo from Fairfield County's Community Foundation


The information in this article is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be patient education, does not create any patient provider relationship, and should not be used as a substitute for professional diagnosis and treatment.

Please consult your health care provider for an appointment, before making any healthcare decisions or for guidance about a specific medical condition.

_______________________________________________


Linda Ziac is the owner and founder of The Caregiver Resource Center. The Caregiver Resource Center is a division of Employee Assistance Professionals, Inc. which Linda founded in October 1990. The Caregiver Resource Center provides a spectrum of concierge case management and advocacy services for seniors, people with special needs and families.

Linda’s professional career spans more than 40 years in the health and mental health field as a CT Licensed Professional Counselor, CT Licensed Alcohol and Drug Counselor, Board Certified Employee Assistance Professional, Board Certified Case Manager, and Board Certified Dementia Practitioner. In addition, Ms. Ziac has 15 years of experience coordinating care for her own parents.

Linda assists seniors, people with special needs and their families; in planning for and implementing ways to allow for the greatest degree of health, safety, independence, and quality of life. Linda meets with individuals and family members to assess their needs, and develop a Care Team, while working with members of the Team to formulate a comprehensive Care Plan (a road map).

Once a plan is in place, Linda is available to serve as the point person to monitor and coordinate services, and revise the plan as needed. This role is similar to the conductor of an orchestra; ensuring that there is good communication, teamwork, and that everyone remains focused on the desired goal.

http://www.CaregiverResourceCenter.com


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The Law – “Observation Status While in the Hospital”


Knowing these facts may save you a lot of frustration and money down the road.


By Linda Ziac
February 28, 2017
The Caregiver Resource Center
www.CaregiverResourceCenter.com



BEING AN EDUCATED CONSUMER

It’s not unusual for The Caregiver Resource Center to receive a phone call concerning a senior who was placed on observation status in the hospital, only to be told later that the senior doesn’t qualify for Medicare covered short-term rehabilitation after discharge. If the senior wants to receive rehab services in a short term rehab facility, the senior will need to pay out of pocket.

Taking a few minutes to read this article may save you and your loved ones, a lot of frustration and money down the road.


MEDICARE OBSERVATION STATUS

President George W. Bush is attributed with creating Medicare’s “Observation Status” classification. In an effort to cut down on the rising healthcare costs, the President implemented an auditing system to check hospitals for over payments, or patients who were improperly admitted. If hospitals are found to be in violation, the hospital is required to return all Medicare payments related to the violation.

According to Kaiser Health there has been a 69% increase in the number of patients being placed on Medicare “Observation Status” vs. Admission, over the past five years.

In October 2014, CT implemented a law regarding an Observation Notice Requirement. Only recently has Medicare taken steps to require hospitals to notify patients that they are in the hospital on “observation status”.


NEW MEDICARE REGULATIONS TO BE ENACTED

With the rise of Medicare beneficiaries in the hospital on Observation Status vs. an Inpatient Admission and the confusion that follows, the Centers for Medicare and Medicaid Services (CMS) enacted new regulations on August 6, 2015 entitled Notice of Observation Treatment and Implication for Care Eligibility Act, also known as the Notice Act,

In order to better educate Medicare recipients to this new Notice Act, Medicare created a document in December 2016 entitled Medicare Outpatient Observation Notice, also known as “MOON”.


The MOON helps to inform Medicare beneficiaries about a number of important facts including:

• coverage for a person in the hospital on Observation Status (outpatient coverage) vs a hospital admission (in-patient coverage)

• that people on observation status are not admitted as an inpatient to the hospital, and as a result will be receiving large out of pocket expenses as a result of their hospital stay

• time spent under observation does not count toward their eligibility for short term rehab coverage in a Skilled Nursing Facility (SNF), under Medicare Part A.

• the effects that outpatient status can have on short term rehab eligibility and cost


THE MOON TAKES EFFECTIVE MARCH 8, 2017

Written Notification

Effective March 8, 2017 hospitals and critical access hospitals must provide a written MOON to all Medicare beneficiaries who have been placed on observation status as an outpatient for longer than 24 hours. The hospital must provide the MOON within 36 hours of the outpatient care, and no later than 36 hours from the start of outpatient services; sooner if the patient is to be discharged.


Oral Notification

Upon presenting a person in the hospital with the written MOON, hospital personnel must also provide an oral explanation of the document.

Once it is clear that the Medicare beneficiary understands the purpose and terms of the MOON, the beneficiary or their representative will be asked to sign the form acknowledging their understanding.


UNDERSTANDING MEDICARE OBSERVATION STATUS

Observation Services are those services furnished by a hospital on its premises, including the use of a bed, periodic monitoring by nursing and other staff, and any other services that are reasonable and necessary to evaluate a patient’s condition or to determine the need for a possible (inpatient) admission to the hospital.

• Hospitals can utilize any specialty inpatient areas (e.g. ICU or CCU) to provide observation services (e.g., telemetry).

• While the Medicare suggested time for observation status is 24 to 48 hours, many hospital stays have been extended up to 14 days.

• CT has had a law in effect since October 2014 entitled “An Act Concerning Notice of a Patient on Observation Status”.

• Effective March 8, 2017 Medicare will have a new regulation in place entitled “Notice of Observation Treatment and Implication for Care Eligibility Act”, also known as the Notice Act,




INPATIENT vs. OUTPATIENT STATUS

Medicare beneficiaries are increasingly being admitted for treatment at hospitals on "observation status" (covered by Medicare Part B), instead of as inpatients (covered by Medicare Part A).

Medicare Part A (Hospital coverage) covers inpatient hospital services. This usually means you pay a one time deductible for all of your hospital services for the first 60 days that you are in the hospital.

As an inpatient, Medicare Part B (Medical Insurance) covers most of your doctor services.

Under “observation status”, you are an outpatient and responsible to pay 20% of the Medicare approved amount for doctor services, after paying your Part B deductible.


HOW MUCH WILL OBSERVATION STATUS COST ME?

The potential impact is great.


OBSERVATION STATUS IS COVERED UNDER MEDICARE PART B


As I shared earlier, Medicare Part A pays for inpatient stays, including medications.

When a person is in the hospital under “observation status” this is not considered an in-patient stay and Medicare Part A does not pay for the person’s hospital stay.


WHAT WILL I HAVE TO PAY UNDER MEDICARE PART B?


If a person has Medicare Part B coverage and is in the hospital under “observation status”,, Medicare will cover 80% of the physician and outpatient services that are provided to the patient.

For a hospital stay classified as observation status" under Medicare Part B, you are required to pay a copayment for each individual outpatient hospital service (e.g. medication).

You will also be responsible to pay 20% of the total Medicare approved amount after you have met your Part B deductible.


WHAT IF I DON’T HAVE MEDICARE PART B?

It is estimated that as many as 3.9 million Medicare beneficiaries have chosen not to pay to receive Medicare Part B coverage.

Unfortunately, if you don’t have Medicare Part B coverage, then you will be responsible to pay the full cost of your “observation status” hospital stay.


MEDICARE COVERAGE FOR SHORT TERM RHAB IN A SKILLED NURSING FACILITY

To qualify for short term rehabilitation services in Skilled Nursing Facility (SNF) under Medicare, a Medicare beneficiary must have had a three night inpatient hospitalization.

A patient’s time spent on "observation status" does not meet this three day requirement.

The cost of a SNF out of pocket may be as high as $500 per day.


CT - AN ACT CONCERNING NOTICE OF A PATIENT’S ONSERVATION STATUS

According to the Center for Medicare Advocacy, “On June 12, 2014, Connecticut Governor
Dannell Malloy signed into law a requirement that took effect on October 1, 2014, requiring Connecticut hospitals to give oral and written notice to patients placed on observation status for 24 hours or more.

Similar laws exist in New York and Maryland.


SPECIFICALLY, CONNECTICUT’S LAW REQUIRES:

1. A statement that the patient is not admitted to the hospital but is under observation status;

2. A statement that observation status may affect the patient's Medicare, Medicaid or private insurance coverage for hospital services, including medications and pharmaceutical supplies, or home or community-based care, or care at a skilled nursing facility upon the patient's discharge; and

3. A recommendation that the patient contact his or her health insurance provider or the Office of the Healthcare Advocate to better understand the implications of placement in observation status.



To read a copy of CT Public Act No. 14-180 “An Act Concerning Notice of a Patient’s Observation Status” you can click on

http://www.cga.ct.gov/2014/ACT/PA/2014PA-00180-R00HB-05535-PA.htm


To read more about the “Medicare Outpatient Observation Notice (MOON)” you can click on

http://www.medicareadvocacy.org/cms-issues-instructions-regarding-the-medicare-outpatient-observation-notice-moon/



Photo from Microsoft


The information in this article is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be patient education, does not create any patient provider relationship, and should not be used as a substitute for professional diagnosis and treatment.

Please consult your health care provider for an appointment, before making any healthcare decisions or for guidance about a specific medical condition.

____________________________________________________________________

Linda Ziac is the owner and founder of The Caregiver Resource Center. The Caregiver Resource Center is a division of Employee Assistance Professionals, Inc. which Linda founded in October 1990. The Caregiver Resource Center provides a spectrum of concierge case management and advocacy services for seniors, people with special needs and families.

Linda’s professional career spans more than 40 years in the health and mental health field as a CT Licensed Professional Counselor, CT Licensed Alcohol and Drug Counselor, Board Certified Employee Assistance Professional, Board Certified Case Manager, and Board Certified Dementia Practitioner. In addition, Ms. Ziac has 15 years of experience coordinating care for her own parents.

Linda assists seniors, people with special needs and their families; in planning for and implementing ways to allow for the greatest degree of health, safety, independence, and quality of life. Linda meets with individuals and family members to assess their needs, and develop a Care Team, while working with members of the Team to formulate a comprehensive Care Plan (a road map).

Once a plan is in place, Linda is available to serve as the point person to monitor and coordinate services, and revise the plan as needed. This role is similar to the conductor of an orchestra; ensuring that there is good communication, teamwork, and that everyone remains focused on the desired goal.

http://www.CaregiverResourceCenter.com

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Decision Making

7 key steps in the decision making process.


By Linda Ziac
February 21, 2017
The Caregiver Resource Center
www.CaregiverResourceCenter.com



HOW MANY DECISIONS DO YOU MAKE IN A GIVEN DAY?

Would it surprise you to know that on average a person in the U.S. makes about 35,000 decisions each day?



WHAT IS DECISION MAKING?

Basically decision making is the action of choosing between 2 or more options known at any given time. When we look back on a decision hours, days or even years later, we may second guess ourselves and say “Maybe I should have done this instead.”

Hindsight is wonderful, but it often comes too late.

When making a decision we need to base our choice(s) on all the information available to us at that time. Keep in mind however, that there is nothing wrong with modifying your decision, based on new information that has become available.

It’s important to keep in mind that doing nothing, is making a decision.


DECISIONS CAN BE BROKEN DOWN INTO 3 BASIC CATEGORIES

1. Life changing decisions – e.g. getting married, having children, buy a house.

2. Major decisions – e.g. when to get up, what to eat, do I go to work or school today

3. Minor decisions – e.g. what color shirt do I wear, should I have oatmeal or eggs,


7 STEP DECISION MAKING PROCESS


Use this process to aid you in making important decisions.


STEP 1 – Identify the Decision

Identify the decision to be made. You realize that a decision must be made. You then go through an internal process of trying to define clearly the nature of the decision you must make. This first step is a very important one.


Ask yourself:

• What is the problem or situation?

• Why does this problem or situation need to be addressed?

• Who are the key people likely to be affected the problem or situation?

• Does the problem or situation have a deadline or a specific timeline?


STEP 2 – Gather Relevant Information

Gather relevant information. Most decisions require collecting pertinent information. The real trick in this step is to know what information is needed, the best sources of this information, and how to go about getting it.

Some information must be sought from within you through a process of self-assessment; other information must be sought from outside yourself from books, people, and a variety of other sources.

This step, therefore, involves both internal and external “work”.


STEP 3 – Identify the Alternatives

Identify alternatives. Through the process of collecting information you will probably identify several possible paths of action, or alternatives.

You may also use your imagination and information to construct new alternatives.

In this step of the decision making process, you will list all possible and desirable alternatives.


STEP 4 – Weigh the Evidence

Weigh evidence. In this step, you draw on your information and emotions to imagine what it would be like if you carried out each of the alternatives to the end.

You must evaluate whether the need identified in Step 1 would be helped or solved through the use of each alternative. In going through this difficult internal process, you begin to favor certain alternatives which appear to have higher potential for reaching your goal.

Eventually you are able to place the alternatives in priority order, based upon your own value system.


STEP 5 – Choose among Alternatives

Choose among alternatives. Once you have weighed all the evidence, you are ready to select the alternative which seems to be best suited to you. You may even choose a combination of alternatives.

Your choice in Step 5 may very likely be the same or similar to the alternative you placed at the top of your list at the end of Step 4.


STEP 6 - Take Action

Take action. You now take some positive action which begins to implement the alternative you chose in Step 5.


STEP 7 - Review Your Decision and Consequences

Review your decision and consequences. In the last step you experience the results of your decision and evaluate whether or not it has “solved” the need you identified in Step 1. If it has, you may stay with this decision for some period of time.

If the decision has not resolved the identified need, you may repeat certain steps of the process in order to make a new decision.

You may, for example, gather more detailed or somewhat different information or discover additional alternatives on which to base your decision.

Information Source: UMass Dartmouth


When making a decision it’s always a good idea to outline your options, and then weigh the pros and cons of each option. Keep in mind however, that you can always modify your decision when new information becomes available.


Photo from Microsoft


The information in this article is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be patient education, does not create any patient provider relationship, and should not be used as a substitute for professional diagnosis and treatment.

Please consult your health care provider for an appointment, before making any healthcare decisions or for guidance about a specific medical condition.

____________________________________________________________________________

Linda Ziac is the owner and founder of The Caregiver Resource Center. The Caregiver Resource Center is a division of Employee Assistance Professionals, Inc. which Linda founded in October 1990. The Caregiver Resource Center provides a spectrum of concierge case management and advocacy services for seniors, people with special needs and families.

Linda’s professional career spans more than 40 years in the health and mental health field as a CT Licensed Professional Counselor, CT Licensed Alcohol and Drug Counselor, Board Certified Employee Assistance Professional, Board Certified Case Manager, and Board Certified Dementia Practitioner. In addition, Ms. Ziac has 15 years of experience coordinating care for her own parents.

Linda assists seniors, people with special needs and their families; in planning for and implementing ways to allow for the greatest degree of health, safety, independence, and quality of life. Linda meets with individuals and family members to assess their needs, and develop a Care Team, while working with members of the Team to formulate a comprehensive Care Plan (a road map).

Once a plan is in place, Linda is available to serve as the point person to monitor and coordinate services, and revise the plan as needed. This role is similar to the conductor of an orchestra; ensuring that there is good communication, teamwork, and that everyone remains focused on the desired goal.

http://www.CaregiverResourceCenter.com

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What is Care Planning?


Proactive steps to help ensure your health, safety, independence and quality of life.


By Linda Ziac
February 15, 2017
The Caregiver Resource Center
www.CaregiverResourceCenter.com


While studies show that most seniors are healthy and function at a high level, it’s inevitable that as we grow older, issues will surface related to our health, safety, independence and quality of life.

Eldercare often requires a multi-disciplinary approach that encompasses many aspects of life such as healthcare, activities of daily living, transportation, finances, social, and emotional well-being.

To ensure the highest quality of life for the longest time possible, it’s crucial that seniors people with special needs, and their loved ones begin a dialogue to discuss the topic of aging. This process needs to focus on the person’s hopes and desires, short and long term goals, and their abilities and needs; while at the same time establishing a spectrum of resources that will address the person’s evolving needs.

WHY ARE THINGS GETTING WORSE?

All too often, Linda Ziac receives a call at The Caregiver Resource Center from a family telling her that they hired an agency or someone privately to provide caregiving services for a loved one, only to have things get much worse.

Well-meaning families often see that a senior or person with special needs is struggling, and quickly jump into action in an effort to help, without considering all the facts. Instead of taking time to properly evaluate the person’s abilities, needs, and developing an appropriate care plan, the family hires a caregiver to come in and help.

But help with what?

A SAMPLE CASE

Sally is married with three children, and just received a promotion at work in a high pressure job.

Sally has been helping her mother Mrs. Jones, visiting every couple of days, fixing dinner and paying bills.

Over the past several weeks, Sally has noticed her mother is more confused, argumentative, anxious, and repeating herself more.

Worried about her mother and believing her mother is developing Dementia, Sally calls a homecare agency, and the agency sends over a caregiver to work four hours a day.

The situation continues to get worse. But why?

Upon further investigation Linda learns that:

- Mrs. Jones has a urinary tract infection (UTI), which is known to cause confusion, anxiety and irritability.

- Mrs. Jones isn’t taking her medication as prescribed – sometimes forgetting to take her pills and other times taking too many pills.

A PERSON’S CARE NEEDS

Evaluating a person’s care needs is like putting a jigsaw puzzle together. The more pieces of the puzzle you have the clearer the picture.

Care for seniors and people with special needs often requires a multi-disciplinary team approach consisting of a variety of members such as the primary care physician, cardiologist, neurologist, physical therapist, occupational therapist, certified case manager, and caregiver, to name a few.

Linda often refer to the client’s team as being like an orchestra, with each member having a unique set of skills and talents that they bring to the group. Linda’s role as a board certified case manager (CCM) and board Certified dementia practitioner (CDP) is to serve as the conductor of the orchestra; ensuring that there is good communication, teamwork, and that everyone remains focused on the client and family's goals.

There are a number of steps involved in the development of a comprehensive care plan (road map) to help address a person’s current and evolving needs – the “what-ifs”.

To follow is an overview of four key steps in this process.

STEP 1 The Senior's Wishes and Desires

The first step in this process is to talk with the senior in order to understand their feelings related to aging, as well as their wishes and desires moving forward. It’s important to recognize the senior's right to make their own choices related to their care; even if you don't agree.

Opening a dialogue may progress smoothly or pose a challenge depending on:

- your relationship with the senior (open and trusting vs. distant and strained).

- the senior's present mental status (ability to communicate and process information vs. the presence of a disability such as depression or dementia).

- the senior’s s present functional status (independent and active vs. struggling to provide self care).

- the manner in which the discussion is initiated (genuine concern vs. intrusiveness).

To the extent possible, it’s important to initiate this dialogue as soon as possible, and hopefully while the senior is able to openly voice their current and future wishes and desires. Of course, this won't always be possible, so if you encounter resistance or difficulties, you may want to seek assistance from a professional to help facilitate the process.

Step 2 Obtaining an Assessment

Before you can begin to develop an appropriate care plan for a senior, I’s first necessary to determine the senior's ability to remain safely independent, along with their strengths, weaknesses, and areas of concern. The best way to determine the needs of a person, is by means of a Comprehensive Geriatric Assessment, that can be provided by a number of trained professionals, including a board certified case manager.

A Comprehensive Geriatric Assessment is a multidimensional diagnostic process designed to evaluate the person's medical, mental, physical, social, environmental, and financial status.

This process is used to determine the seniors’ capabilities, and will be used as a baseline, for moving forward in the development of an individual care plan.

STEP 3 Developing a Care Plan

Once the person has undergone a comprehensive assessment, the information obtained will be used to design a care plan (road map).

The care plan will identify 1. each senior need (e.g. medication compliance), 2. goals (e.g. ensure that all medication is taken as prescribed), 3. a specific action plan to address the need (e.g. a monthly pill box will be set up noting daily medication, and a checklist to use to record times when medication is given), and 4. the team members responsible for this aspect of the care plan (e.g. daughter will set up monthly pill boxes, and the homecare agency caregiver will cue the senior to take her medication).

It’s important to have the certified case manager and team review and modify a client’s care plan every 60 days, or when there’s been a status change in the client (e.g. fall, heart attack, increased cognitive decline).

Based on the individual senior, it may be possible for the individual to remain in their own home with family or paid caregivers, or they may need to look at alternative housing, such as an assisted living facility or nursing home. It’s important to continually monitor the client, and as their needs change, the care plan will need to be modified to address their evolving needs.

STEP 4 Important Legal Documents

Have you ever wondered what would happen if a person became incapacitated, and was unable to communicate their wishes, related to their medical care or financial affairs?

All too often a person becomes incapacitated, and their family scrambles to locate important financial and legal documents, in an effort to ensure that they receive necessary care. You may not even be sure if the senior ever put their wishes in writing.

What now! Unfortunately, if the senior has not taken a pro-active approach prior to this point, their loved ones are bound to face a very stressful and overwhelming task.


Advance directives are a written document that provides medical personnel with clear and legal instructions about medical care decisions, should a patient be unable to make decisions on their own behalf. These documents combined with a healthcare agent/ medical power of attorney help medical professionals treat a patient by honoring the patient’s wishes, and minimizing discrepancies between what the patient wants and what the family wants.

A health care Advance Directive, also called “Medical Power of Attorney,” gives instructions for health care in the event that, in the future, a person is unable to make their own decisions for whatever reason (e.g. traumatic brain injury, unconsciousness, cognitive impairment).

It doesn't take much, for a senior and their loved ones, to ensure that all their personal affairs are in place. By having an attorney, prepare a set of documents in advance, the senior or person with special needs can ensure that their wishes will be honored.

THE ROLE OF A BOARD CERTIFIED CASE MANAGER

Certified Case Managers (CCM) are specialists who assist seniors, people with special needs and their families; in planning for and implementing ways to allow for the greatest degree of health, independence, safety and quality of life.

CCMs meet with the client and /or family members to assess their needs, develop a Care Team, and work with members of the Team to formulate a comprehensive Care Plan (a road map).

Once a plan is in place, CCMs are available to serve as the point person to monitor and coordinate services, and revise the plan as needed. The CCMs' role is similar to the conductor of an orchestra; ensuring that there is good communication, teamwork, and that everyone remains focused on the desired goals.

Case management is a collaborative process that consists of four steps:

1. Assessment

2. Development of a Care Plan (based on the unique needs of the client)

3. Implementation & Monitoring of the Plan

4. Ongoing Evaluation of the Plan Effectiveness, and Plan Modification as Needed


Photo from The Printshop

The information in this article is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be patient education, does not create any patient provider relationship, and should not be used as a substitute for professional diagnosis and treatment.

Please consult your health care provider for an appointment, before making any healthcare decisions or for guidance about a specific medical condition.

___________________________________________________________________________

Linda Ziac is the owner and founder of The Caregiver Resource Center. The Caregiver Resource Center is a division of Employee Assistance Professionals, Inc. which Linda founded in October 1990. The Caregiver Resource Center provides a spectrum of concierge case management and advocacy services for seniors, people with special needs and families.

Linda’s professional career spans more than 40 years in the health and mental health field as a CT Licensed Professional Counselor, CT Licensed Alcohol and Drug Counselor, Board Certified Employee Assistance Professional, Board Certified Case Manager, and Board Certified Dementia Practitioner. In addition, Ms. Ziac has 15 years of experience coordinating care for her own parents.

Linda assists seniors, people with special needs and their families; in planning for and implementing ways to allow for the greatest degree of health, safety, independence, and quality of life. Linda meets with individuals and family members to assess their needs, and develop a Care Team, while working with members of the Team to formulate a comprehensive Care Plan (a road map).

Once a plan is in place, Linda is available to serve as the point person to monitor and coordinate services, and revise the plan as needed. This role is similar to the conductor of an orchestra; ensuring that there is good communication, teamwork, and that everyone remains focused on the desired goal.

http://www.CaregiverResourceCenter.com

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Happy Valentines’ Day

What Does Valentine's Day Mean To You?



By Linda Ziac
The Caregiver Resource Center
February 14, 2017
www.CaregiverResourceCenter.com


It’s estimated that 150 million Valentine's Day cards are exchanged each year.


DID YOU KNOW?

Valentine’s Day is known to be celebrated in at least 5 countries – The United States, The United Kingdom, Canada, Mexico, and Australia. It is believed that Valentine’s Day began to be celebrated in Great Britain around the 17th century.

As the celebration grew, it became common for people of all social classes to begin to exchange hand written notes and tokens of affection be the middle of the 18th century. With the expansion in printing technology, it became more common for people to begin sharing printed cards in the 1900’s.

Don’t forget to tell the people in your life how much they mean to you – and not just on Valentine’s Day.


Happy Valentine’s Day!



Photo from The Print Shop

The information in this article is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be patient education, does not create any patient provider relationship, and should not be used as a substitute for professional diagnosis and treatment.

Please consult your health care provider for an appointment, before making any healthcare decisions or for guidance about a specific medical condition.

__________________________________________________________________________

Linda Ziac is the owner and founder of The Caregiver Resource Center. The Caregiver Resource Center is a division of Employee Assistance Professionals, Inc. which Linda founded in October 1990. The Caregiver Resource Center provides a spectrum of concierge case management and advocacy services for seniors, people with special needs and families.

Linda’s professional career spans more than 40 years in the health and mental health field as a CT Licensed Professional Counselor, CT Licensed Alcohol and Drug Counselor, Board Certified Employee Assistance Professional, Board Certified Case Manager, and Board Certified Dementia Practitioner. In addition, Ms. Ziac has 15 years of experience coordinating care for her own parents.

Linda assists seniors, people with special needs and their families; in planning for and implementing ways to allow for the greatest degree of health, safety, independence, and quality of life. Linda meets with individuals and family members to assess their needs, and develop a Care Team, while working with members of the Team to formulate a comprehensive Care Plan (a road map).

Once a plan is in place, Linda is available to serve as the point person to monitor and coordinate services, and revise the plan as needed. This role is similar to the conductor of an orchestra; ensuring that there is good communication, teamwork, and that everyone remains focused on the desired goal.

http://www.CaregiverResourceCenter.com


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Steps to Identify & Protect Yourself from Pneumonia

“Causes - Symptoms - Treatment – Prevention”


By Linda Ziac
The Caregiver Resource Center
February 7, 2017
www.CaregiverResourceCenter.com



Pneumonia is the 6th leading cause of death in the United States, with seniors age 65 and older being at greatest risk.

According to the CDC, pneumonia can result from more than 30 different causes, including viruses, bacteria and even assorted chemicals.


KEY FACTS

Pneumonia can be caused by viruses, bacteria, or fungi.

Pneumonia can be prevented by immunization, adequate nutrition, and by addressing environmental factors.

Pneumonia caused by bacteria can be treated with antibiotics, but only one third of children with pneumonia receive the antibiotics they need.

Pneumonia is an inflammation or infection of the lungs, which makes it difficult for a person’s body to get enough oxygen.

Bacterial pneumonia is known to be the most deadly form of pneumonia, even when antibiotics are given.


PNEUMOCOCCAL VACCINE

A pneumococcal vaccine is a safe, effective way to avoid pneumonia. Up until now, it was believed by many health officials that one vaccine was sufficient for people between the ages of 50 and 65 and for anyone with a chronic disease or weak immune system.


According to the CDC there are 2 types of pneumococcal vaccines:


TYPE 1 - PCV13 - for Infants, Children, and Adults which protects against 13 types of pneumococcal bacteria.

The CDC recommends the PPSV23 vaccine for a person who meets any of the following criteria:


ADULTS

The CCD recommends that all adults age 65 years and older receive one dose of PCV13.

In addition, adults who are between 19 years of age and 64 years of age who have not yet received a PCV13 and who have any of the following conditions

- Immunocompromising conditions (e.g., congenital or acquired immunodeficiency, HIV, chronic renal failure, nephrotic syndrome, leukemia, lymphoma, Hodgkin’s disease, generalized malignancy, iatrogenic immunosuppression, solid organ transplant, and multiple myeloma)

- Functional or anatomic asplenia (e.g., sickle cell disease and other hemoglobinopathies and congenital and acquired asplenia)

• Cerebrospinal fluid (CSF) leak

- Cochlear implants


Since seniors age 65 years and older are at increased risk for pneumococcal disease. the PCV13 vaccine is recommended for all adults 65 years of age and older.



2. PPSV23 - for Children and Adults which protects against 23 types of pneumococcal bacteria.

It’s important to check with your doctor to see what is recommended for your particular situation.

Regardless of what you and your doctor decide, keep in mind that the CDC says that you should never receive both vaccines at the same time.

The CDC recommends the PPSV23 vaccine for a person who meets any of the following criteria:

• Age 65 years and older

• Age 2 through 64 years with any of the following conditions

- cigarette smokers age 19 years and older

- alcoholism

- chronic liver disease, cirrhosis

- chronic cardiovascular disease, excluding hypertension (e.g., congestive heart failure, cardiomyopathies)

- chronic pulmonary disease (including COPD and emphysema, and for adults age 19 years and older, asthma)

- diabetes mellitus

- candidate for or recipient of cochlear implant

- cerebrospinal fluid (CSF) leak

- functional or anatomic asplenia (e.g., sickle cell disease, splenectomy)

- immunocompromising conditions (e.g., HIV infection, leukemia, congenital immunodeficiency, Hodgkin’s disease, lymphoma, multiple myeloma, generalized malignancy, immunosuppressive therapy)

- solid organ transplantation; for bone marrow transplantation

visit www.cdc.gov/vaccines/pubs/hemato-cell-transplts.htm

- chronic renal failure or nephrotic syndrome


SIGNS AND SYMPTOMS OF PNEUMONIA


According to the CDC symptoms of pneumonia varies depending on whether a person has bacterial pneumonia or viral pneumonia.


BACTERIAL PNEUMONIA


SIGNS AND SYMPTOMS


• cough with yellow, green, or blood-tinged mucus

• chest pain that worsens when coughing or breathing

• sudden onset of chills

• fever of 102 degrees or above (lower than 102 in older people)

• headache

• muscle pain

• breathlessness or rapid breathing

• lethargy and general fatigue

• moist, pale skin

• confusion (especially among seniors)

• nausea

• vomiting

• bluish lips and fingertips


If you are experiencing the symptoms of the flu, pneumonia or another health concern, or you aren’t sure what to do – call you doctor.


In case of an emergency call 911.


TREATMENT OF BACTERIAL PNEUMONIA


Here are some of the ways that medical professionals treat bacterial pneumonia.

• get plenty of bed rest

• drink lots of fluids

• your doctor may prescribe:

- an antibiotic to fight the specific bacterium that is believed to be causing your infection

- a cough medicine to calm the cough and to help you release the sputum

- fever medication to help lower your temperature


VIRAL PNEUMONIA


In 2012, The World Health Organization reported that viral pneumonia is the leading cause of death for children worldwide. It’s estimated that 1.4 million children under the age of five die every year from viral pneumonia.


SIGNS AND SYMPTOMS

It’s important to contact your doctor or other medical professional if you are experiencing a health or medical concern.


Here are some common symptoms of viral pneumonia.

• cough

• fever of 102 F

• weakness

• headache

• shaking chills

• muscle pain

• fatigue

• shortness of breath

• sweating

• blueness of the lips


If you are experiencing the symptoms of the flu, pneumonia or another health concern, or you aren’t sure what to do – call you doctor.


In case of an emergency call 911.


TREATMENT OF VIRAL PNEUMONIA

Keep in mind that antibiotics are not prescribed for viral pneumonia, since antibiotics are used to treat bacteria, not viruses.

When you see a doctor for what is believed to be viral pneumonia, the doctor will first exam you, and most likely order some tests such as a chest x-ray, blood work, and sputum culture, to name a few.

If you are found to have viral pneumonia the doctor will most likely take a two prong approach, which includes providing treatment 1) to help lessen the symptoms of your infection, and 2) use antiviral medication to help rid your body of the underlying infection.

Source: Centers for Disease Control (CDC)


Photo from Printshop

The information in this article is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be patient education, does not create any patient provider relationship, and should not be used as a substitute for professional diagnosis and treatment.

Please consult your health care provider for an appointment, before making any healthcare decisions or for guidance about a specific medical condition.

__________________________________________________________________________

Linda Ziac is the owner and founder of The Caregiver Resource Center. The Caregiver Resource Center is a division of Employee Assistance Professionals, Inc. which Linda founded in October 1990. The Caregiver Resource Center provides a spectrum of concierge case management and advocacy services for seniors, people with special needs and families.

Linda’s professional career spans more than 40 years in the health and mental health field as a CT Licensed Professional Counselor, CT Licensed Alcohol and Drug Counselor, Board Certified Employee Assistance Professional, Board Certified Case Manager, and Board Certified Dementia Practitioner. In addition, Ms. Ziac has 15 years of experience coordinating care for her own parents.

Linda assists seniors, people with special needs and their families; in planning for and implementing ways to allow for the greatest degree of health, safety, independence, and quality of life. Linda meets with individuals and family members to assess their needs, and develop a Care Team, while working with members of the Team to formulate a comprehensive Care Plan (a road map).

Once a plan is in place, Linda is available to serve as the point person to monitor and coordinate services, and revise the plan as needed. This role is similar to the conductor of an orchestra; ensuring that there is good communication, teamwork, and that everyone remains focused on the desired goal.

http://www.CaregiverResourceCenter.com

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Greenwich’s Own - River House Adult Day Center


By Linda Ziac
The Caregiver resource Center
January 31, 2017
www.CaregiverResourceCenter.com


“A lifeline for anyone facing the challenges of dementia.”


As a CT licensed professional counselor, board certified case manager and board certified dementia practitioner Linda Ziac works with seniors, people with special needs and their families; dealing with a wide range of issues, including the challenges of dementia.


JUST THE FACTS

- 1 in 3 seniors die each year with Alzheimer's disease or another form of dementia

- As of 2015, there were an estimated 46.8 million people with dementia worldwide. An increase of 2.4 million people within the past two years.

- A new case of dementia is diagnosed every 4 Seconds.

- The number of people diagnosed with dementia is expected to double every 20 years, reaching 75.6 million in 2030, and 135.5 million by the year 2050.

- Early diagnosis improves the quality of life of people with dementia and their families


Due to the ever-increasing number of calls Linda has been receiving from people around the country, struggling with the impact of dementia in their lives, Linda wrote an article a few weeks ago entitled “The Many Facets of Dementia”. The article provided an overview of dementia, symptoms, stages, and some available resources.

As a follow up to that article, Linda thought it would be helpful to readers, to spotlight a local Greenwich program that offers services to individuals and families dealing with dementia, regardless of their ability to pay.

Linda contacted Donna Spellman MS the Executive Director River House Adult Day Center a not for profit organization located in Cos Cob, CT, to see if Donna would be open to being interviewed on the subject of dementia and adult day care programs.

Donna graciously agreed and Linda had an opportunity to interview Donna Spellman on Friday 1/27/16 at the River House in Cos Cob, CT.


To follow is Linda Ziac’s interview of Donna Spellman, Executive Director of River House Adult Day Care Center.


WHAT DO YOU SEE AS THE CHALLENGES FACED BY INDIVIDUALS AND FAMILIES WHO ARE DEALING WITH DEMENTIA?

When asked what Donna sees as the challenges of dementia, Donna said “There is a slow decline. A slow breakdown. The challenge in the early stages is that people try and keep things as normal as possible; although nothing is normal.”

The one thing that I hope that people will take away from this article is to not wait for a crisis, and to be proactive when it comes to families dealing with dementia.”

Donna shared. ”For the individual with dementia there is awareness and often frustration. That frustration may lessen as the dementia progresses. For everyone, there is a sense of loss of the way things used to be.”


One of the things that Donna felt it was important to point out is that the National Institute on Aging reports that some 100 conditions that mimic serious disorders, are actually reversible. Deteriorating intellectual capacity may be caused by a variety of diseases and disorders. These conditions are sometimes called "pseudodementias" and are often treatable.

Donna emphasized the importance of anyone who suspects that a person may have cognitive issues to seek out qualified professionals as early as possible, in order to obtain a comprehensive assessment, an accurate diagnosis, a plan of action and help in finding appropriate resources.


WHAT IS AN ADULT DAY CARE CENTER?

According to the CT General Assembly (2011):

“Adult day care centers,” (also known as “adult day centers,” “adult day health centers,” or “senior day care centers”) are facilities where frail seniors and disabled adults can go during the day if they cannot, or do not wish to, be home alone.

They provide supervision, social and recreational activities, personal care, lunch and snacks, and often medical care and health monitoring from a nurse on the premises. Most attendees need some supervision or medical services and are able to travel to the center during the day.

Family members care for them at night and on weekends. The centers are one way for the elderly or disabled to avoid or delay entering a nursing home and to give family members who care for them a chance to continue working at their jobs or have some respite during the day.

Adult day care centers are operated on a “social model” or a “medical model.” The social model serves people who need supervision and activities to reduce social isolation, but not extensive personal care and medical monitoring.

The medical model provides health monitoring and administration of physician prescribed medications and treatments, coordinated care with personal physicians, personal hygiene and bathing, individual assessments and care plans and toileting while also including all of the aspects and benefits of the social model.


THE BENEFITS OF AN ADULT DAY CARE CENTER FOR THE PERSON WITH DEMENTIA

When Donna was asked about the benefits of an adult day care program for people with dementia, Donna shared “It’s all about ensuring that we are a good fit and that our members can indeed benefit from being here. We provide support to our members and their families, which enhances their quality of life – resulting in a happier, healthier, better life for both seniors and their caregivers. River House is a medical model adult daycare center and we are committed to supporting our families in the most comprehensive and caring manner possible.”

“We help our members create a healthier, more stimulating and social environment, so both days and evenings are better. Our members leave after a great day which results in a more restful and calm night. Agitation due to a lack of stimulation and care dissipates and the entire family functions better. “

Donna said that the River House team also works with members and their loved ones to help identify needs for additional support. “Oftentimes families require additional home-based services in order to address the ever-changing needs of their loved ones. River House works with families to identify available services so that the entire family can improve their quality of life.”

Donna outlined that a member may attend River House for eight hours a day at a cost of $95 - where they can receive comprehensive medical support, socialization, mentally stimulating activities, personal hygiene, haircuts, and a hot meal provided by a professional team; vs. remaining isolated in their home with a caregiver at a cost of $200 for the same eight hour period of time.

Donna also stated that River House would never turn away a family in need, despite their ability to pay.


THE BENEFITS OF AN ADULT DAY CARE CENTER FOR THE FAMILY

When Donna was asked what the benefits to the family are of an adult day care program, Donna responded, “Knowing that your loved one with dementia is well taken care of, having his or her needs taken care of, decreases the stress exponentially for the family. Our support helps families remain safely together in the familiarity and comfort of their homes.”


River House Adult Day Center - Greenwich CT

Donna Spellman MS is the Executive Director of River House Adult Day Center, a not for profit organization located in Cos Cob, CT which has been serving the Greenwich area since 1977.


River House’s Mission

“River House Adult Day Center addresses the impact of aging on families in our community by providing comprehensive, supportive services in a compassionate, safe and engaging setting.”

“As a medical model adult day center, we cater to those who want to live at home but need varying assistance during the day.”


A BRIEF HISTORY OF RIVER HOUSE ADULT DAY CARE CENTER

On May 2, 1977, Greenwich Adult Day Care, then known as the Witherell Pavilion Club, opened its doors at Nathaniel Witherell.

The program began as a one-year pilot project spearheaded by a United Way study and the Greenwich Commission on Aging

In 1981 The Pavilion Club moved to the Greenwich Senior Center. Under the auspices of the Town Board of Health a new Board of Directors was formed and a year later the program name changed to the Greenwich Pavilion Club.

In December 1984, the Greenwich Pavilion Club changed its name to Greenwich Adult Day Care (GADC), and the following year moved back to Nathaniel Witherell.

In 1995, GADC became one of the first day care centers in Connecticut to be certified by Connecticut Association of Adult Day Centers.

In March 2006, construction began at the historic 1927 Railroad Pump House on the corner of the Post Road and River Road Extension in Cos Cob.

On June 18, 2008, GADC held its ribbon cutting ceremony.

July 1, 2008, was the FIRST DAY at GADC now known as River House Adult Day Center

Donna proudly shared, “We will be celebrating our 40 year anniversary in September of this year.”


WHAT IS THE RANGE OF STAFF ON YOUR TEAM?

According to the River House website:

“Our staff works as a team to provide direct care to our members. There is a ratio of at least one staff person to every seven members.”

The professional staff consists of registered and licensed nurses, specially trained health, Alzheimer’s and rehab aides, a licensed clinical social worker, therapeutic recreation director, recreation assistants and music, dance/movement and art therapists.”


THE BENEFITS OF RIVER HOUSE ADULT DAY CARE CENTER

When asked what the benefits of River House are, Donna shared, “People come because they need our help in order to improve their quality of life. We customize our services based on our members’ needs.”

According to the River House website:

“River House is best for adults who:

- Have physical or cognitive limitations

- Find staying home alone during the day too challenging

- Want more social activity

- Require assistance with eating, walking, toileting, bathing, dressing, and/or may be Incontinent

- Take medications and/or need treatments


WHAT TYPES OF PROGRAMS AND SERVICES DO YOU OFFER YOUR MEMBERS?

Donna shared “We are committed to keeping people engaged in the community. We make it a point to welcome members of the community to River House and travel to community-based gatherings and offerings on a regular basis.”

“Meals at River House are nutritious, delicious and fun. We have a chef who prepares hot nutritious meals that we serve restaurant style.”




Our programs and services include:

Recreation & Socialization

- Socialization and friendships

- Mentally stimulating activities

- Visits to local cultural organizations

- Music therapy

- Animal and horticultural therapy


Health & Personal Care

- Health monitoring & administration of physician-prescribed medication and
treatments

- Coordinated care with personal physicians

- Personal hygiene and bathing

- Daily therapeutic exercises

- Hot nutritious meals

- Individual assessments and care plans

- Toileting

- Podiatry services

- Haircuts and shaves


Alzheimer’s & Special Needs

“River House offers customized programs designed to meet the needs of individuals requiring more attention and those with advanced dementia/ Alzheimer’s disease. The program emphasizes one-on-one attention and care and utilizes various specialized therapies led by professionally trained and experienced staff.”


MasterMind at River House

Donna shared that “The River House Master Mind program is designed to enhance brain function.”

Participants in this weekly group engage in challenging and fun activities to enhance memory, verbal fluency, flexible thinking, attention and communication. “Not only does mind fitness improve brain function, but participating in a small group setting increases socialization which in turn elevates mood.”

For more information:

Visit www.theriverhouse.org or contact info@theriverhouse.org or (203) 622-0079


DO YOUR SERVICES INCLUDE FAMILY SUPPORTIVE PROGRAMMING SUCH AS CAREGIVER SUPPORT GROUPS, SOCIAL WORKER CONSULTATION, OR REFERRALS?

Donna was very excited when asked this question, and Donna was quick to respond “Absolutely! River House provides a wide range of services, not only to improve the lives of our members, but their loved ones as well.”

This includes:

- Individual and family counseling, care planning, and referrals for additional support, whenever necessary.

- Assistance with obtaining financial aid and entitlements.

- Care Plan for Caregivers closely evaluates an individual’s situation and seeks out ways to best manage the challenges of caregiving, and searches for ways to get the caregivers life back under control.

- Our many Caregiver Support Groups are open to the community and provide
assistance and peer support to professional and family caregivers.


Caregiver Circle

“The Caregiver Circle is a four part series held over 8 weeks designed to give caregivers the resources and support they need. Participants receive vital information on caregiving, a support network of peers, a wealth of information and insight from professionals in the field and a vast knowledge of available community resources to best assist in caregiving.

The Caregiver Circle is free of charge and is open to the community. “

Donna shared “We provide free on-site respite support, while the caregiver attends the program.”


For more information:

Visit www.theriverhouse.org or contact info@theriverhouse.org or (203) 622-0079




WHEN IS RIVER HOUSE ADULT DAY CARE CENTER OPEN?

According to Donna “River House is open 6 days a week, and a member is welcome to come from one to six days per week.”

Hours of Operation are

Monday through Friday
7:30 am to 4:30 pm

Saturday
8:30 am to 4:30 pm.


WHAT IS THE COST OF RIVER HOUSE ADULT DAY CARE CENTER?

When asked what is the cost for a member to attend the River House, Donna proudly shared that,

“No one is ever turned away for financial reasons. We work very hard to identify scholarships, grant programs, financial aid and sliding scales to make it work for families who can benefit from being at River House.”

For more information:

Visit www.theriverhouse.org or contact info@theriverhouse.org or (203) 622-0079


IS TRANSPORTATION AVAILABLE FOR RIVER HOUSE MEMBERS?

“Yes. Transportation Association of Greenwich (TAG) has a contract with River House to provide escorted, handicap available, door-to-door transportation throughout Greenwich and Stamford.

Donna added “There is no additional cost for transportation for our members.”


HOW DOES ONE BECOME A MEMBER OF RIVER HOUSE ADULT DAY CARE CENTER?

Donna shared that “Everyone is welcome at River House. The process starts with a phone call to (203) 622-0079 and a visit.”


DOES RIVER HOUSE HAVE VOLUNTEERS?

When asked if River House has volunteers, Donna shared “We are surrounded by wonderful volunteers of all ages, who share their talents and desire to assist our members.”

If you are interested in volunteering at River House in any capacity, please email info@theRiverHouse.org


DOES RIVER HOUSE ACCEPT DONATIONS?

The River House is a 501c3 nonprofit organization.

Charitable gifts made to most nonprofit organizations that are officially recognized by the Internal Revenue Service (IRS) as having 501(c) (3) status are considered to be tax deductible contributions.


If you’d like to make a financial donation to River House Adult Day Center please visit:

www.theriverhouse.org or call (203)622-0079.


HELP IS AVAILABLE

If you or someone you know is struggling with the challenges of dementia, why not place a call to River House today, to learn about the many services available.

River House
125 River Road Extension
Cos Cob, CT 06807
203-622-0079 •
www.theriverhouse.org



RESOURCES

Remember that help is just a phone call away!


River House
125 River Road Extension
Cos Cob, CT 06807
203-622-0079
www.theriverhouse.org


Alzheimer’s Association – 24 hour helpline
800-272-3900


Area Agency on Aging (Southwestern CT)
203-333-9288


Assisted Living Deration of America
703-894-1805


CDC – Centers for Disease Control
800-232-4636


CT Department of Social Services
800-842-2159


Elder Abuse Reporting (CT)
888-385-4225


Elder Abuse Reporting (NY)
800-342-3009


Eldercare Locator (National)
800-677-1116


Federal Information Center
800-FED-INFO


National Adult Day Care Association
877-745-1440


National Association of Homecare & Hospice
202-547-7424


The Caregiver Resource Center
203-861-9833


Veterans Affairs Customer Service
800-827-1000


Photo from the River House

The information in this article is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be patient education, does not create any patient provider relationship, and should not be used as a substitute for professional diagnosis and treatment.

Please consult your health care provider for an appointment, before making any healthcare decisions or for guidance about a specific medical condition.

______________________________________________________________________

Linda Ziac is the owner and founder of The Caregiver Resource Center. The Caregiver Resource Center is a division of Employee Assistance Professionals, Inc. which Linda founded in October 1990. The Caregiver Resource Center provides a spectrum of concierge case management and advocacy services for seniors, people with special needs and families.

Linda’s professional career spans more than 40 years in the health and mental health field as a CT Licensed Professional Counselor, CT Licensed Alcohol and Drug Counselor, Board Certified Employee Assistance Professional, Board Certified Case Manager, and Board Certified Dementia Practitioner. In addition, Ms. Ziac has 15 years of experience coordinating care for her own parents.

Linda assists seniors, people with special needs and their families; in planning for and implementing ways to allow for the greatest degree of health, safety, independence, and quality of life. Linda meets with individuals and family members to assess their needs, and develop a Care Team, while working with members of the Team to formulate a comprehensive Care Plan (a road map).

Once a plan is in place, Linda is available to serve as the point person to monitor and coordinate services, and revise the plan as needed. This role is similar to the conductor of an orchestra; ensuring that there is good communication, teamwork, and that everyone remains focused on the desired goal.

http://www.CaregiverResourceCenter.com


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