Social Work Researchers Say Laws, Regional Policies to Senior Abuse Are Scattered, Inadequate (Part One)

Nationwide, public and private sector laws and policies to elder abuse and neglect are fragmented and do not sufficiently address a problem that, if left under-addressed, may grow overtime with the number of seniors in the country’s population, two social work authors of a state law and policy research study on the subject said during their panel at a conference on aging.

Stacey Jirik, BSW, with the DuPage County Senior Services in Illinois and Sara Sanders, Ph.D, MSW, associate professor and Hartford faculty scholar, undergraduate social work program director at the University of Iowa and gerontology and end-of-life care expert, recommended more unified strategies when they discussed their 50-state study of federal and state senior abuse and neglect laws and policies, titled “Elder Abuse in the United States: An Analysis of Elder Abuse Policy and State Elder Abuse Statutes.”

Urging social workers, case managers, state directors of federal Area Agencies on Aging (AAA), registered nurses, home health care workers, elder abuse investigators and academicians to relate their professional experiences with elder abuse and neglect, Jirik and Sanders compared notes about laws and policies of the different states conference attendees hailed from.

During the panel, participants identified their state and the most effective solutions, greatest challenges, funding, attempts at advocacy, training, elder abuse and dependent adult abuse laws, mandatory reporting and penalties confronting elder abuse and neglect.

As the population continues to age, both social work experts said, the specter of elder abuse and neglect will loom larger. Their study, which encompasses legal statutes and policies across the country, found that between 1 to 27 percent of seniors are abused and that, for every case that is reported, 14 are not.

Meanwhile, the two panelists said, the U.S. Census 2010 found seniors make up 13 percent of the nation’s population or 40.3 million people. Government estimates project that, by the year 2030, one of every five persons in the nation will be aged 65 and older. This is, in large part, due to the medical and technological advancements that increase the life span for aging Baby Boomers.

Many researchers believe that senior abuse and neglect law and policy are in the same state that the issue of child abuse had 30 years ago and that the subject of domestic violence had 15 years ago, both said. Some have described the problem of elder abuse as a “patchwork quilt” of so many factors making an influence independently, making for disparate solutions to the problem.

Jirik and Sanders concluded that, over the decades, senior abuse has not received the same level and degree of “attention from professionals or the public” that child abuse and domestic violence have been given.

Both explained that elder abuse is not well-addressed because of the lack of societal value placed on older adults. With respect to detecting, treating and reporting elder abuse and neglect, physicians have not been involved in the overall effort because it has not been incorporated into their medical training, they said.

The public’s ageist attitudes and lack of awareness and an aging victim’s fear of retaliation contribute to inaction, they added. And resources needed to combat elder abuse at the federal, state and local level are limited when compared with that afforded child abuse and domestic violence.

By contrast, they said, government, business and nonprofit efforts are most effective against elder abuse and neglect when the victims of abuse are actively engaged in the fight, a wealth of research exists on the subject and there is a great deal of media attention.

Both social work experts recommended that policymakers and care professionals achieve greater uniformity among state laws in terms of the number of categories of elder abuse and protective remedies enacted and used, including for seniors not covered by dependent adult abuse laws.

They also called for more research on federal and state laws and policies to analyze and interpret such factors as the connection between the wording or length of laws and the types of elder abuse reports, the type of reports accepted or the overall outcome of senior abuse cases. They asked panel participants to deepen their understanding of how the federal and state laws and policies work and to articulate their “positive and negative aspects.”

Jirik and Sanders urged participants to become advocates against senior abuse and make its victims a priority, fighting against accompanying social stigma, a lack of funding for intervention programs and the pervasive ageism that leads to public apathy or inaction.

Continued: Part Two

This article was originally published March 10, 2014 on the website of PharmPsych.com, one of seven websites that comprise The Pharm Psych Network, a medical communications and education company.

Tying Aging in Place to Disability Advocacy Is In the Cards for Senior Long-Term Care (Part Two)

A White House conference for the first time addressed elder abuse. Greenlee said participants talked about financial exploitation and several government agencies such as her own and the Institute of Medicine (IOM) and businesses attended.

“Cognitive impairment is at [the] root of [the] problem,” she said. “It knows no age. It is prevalent in people who are older [but it could be brought on by] traumatic brain injury.”

Laura L. Carstensen, Ph.D., professor of psychology at Stanford University’s Center for Longevity, said connecting aging to disabilities will require changing the conversation about the human life span to focus on seniors rather than just youth.

“Long life in the 21st century,” Carstensen said. “[There is such] complacency [in the use of that phrase]: [we are] familiar with [the] terms. We forget the unprecedented time. In a blink of an eye, we [have] doubled [the human] life span.”

She said that, because of 18 or 20 outliers and through human evolution, life became more extended.

In the 1800s, Carstensen said, a person could only expect to live to his or her 30s. In 1900, the life expectancy expanded to age 47. By the end of the 1900s, it reached age 77. In the new millennium, the average human life span extends to age 78. Additionally, the nation’s fertility rates dropped by half, overtime.

Meanwhile, she added that, in the 20th century, seniors made up four percent of the country’s population. Currently, seniors make up 13 percent of the nation’s population. By 2030, seniors are projected to make up 20 percent.

“The changes in odds of surviving [are dramatic],” Carstensen said. “[The changes in age distribution are] everywhere. [Social] pyramids are being re-shaped. This means babies for the first time can grow older. It is not discussed [in terms of] older people but [in terms of] babies.”

She said, in terms of the survival rates of infants and children, the distant past held high mortality rates. In the 1800s, about 20 percent of the nation’s population died before age 5 and many more died before the age of 12. The percentage of maternal deaths were also high. Science, technology and the study of disease reversed the trends of high infant, child and maternal mortality.

“Garbage collection has [as] much to do with longevity as medicine,” Carstensen said. “[So does] lower fertility rates, an investment in [infants and children], [the end of] exploitive [child labor], more schools [that] charted nutritional needs of your children and food for life programs to prevent pellagra, rickets and gout.”

Most technological and medical advances were aimed at youth, she said.

“We did things to support young life,” Carstensen said. “We [made] advances in technology and medicine. But [our] ancestors did not try to relate [to] aging professionals. [The] actuaries are terrified.

“Humans are creatures of culture. [Around the world, there are] more populations of people [around the age of] 60 than [there are aged] 15. [All of] these things were built for young people.

Trains and hotels are for younger people. Speed, agility and facility [are affiliated with the] young. We only recently lived in [a] world that focused on aging. We need [to make] changes to [the] culture. Science and technology got us where we are today.”

She explained that the national conversation about the human life span should be changed to focus on aging.

“We need [to talk about] Alzheimer’s disease, congestive heart failure and osteoporosis,” Carstensen said. “We need to know what good deaths look like after long, satisfying lives. We need to look at long-term planning, 40 to 60 years out. We need to think [about] lifelong investments to help those over 65.

“[The youth] of today [will be the] centenarians of [the] 22nd century. They are here. It is [our] duty to take them through [the next] decades of life. Aging is not the problem. We must improve aging for all of the population or we will all fail. Societies [must] not only be saved but improved. Aging is inevitable. How we age does not. In the end, it will be about aging. It will be about long life. And it will be our story to tell.”

Read This Article From the Beginning: Part One

This article was originally published March 10, 2014 on the website of PharmPsych.com, one of seven websites that comprise The Pharm Psych Network, a medical communications and education company.

Tying Aging in Place to Disability Advocacy Is In the Cards for Senior Long-Term Care (Part One)

Connecting supporters of aging in place with advocacy for the disabled is the wave of the future for senior long-term care, government agency chiefs said in a keynote speech at a conference on aging.

It will take all the different segments of the senior long-term care industry and supporters of aging in place to ally aging and disabilities, said Kathy Greenlee, U.S. Assistant Secretary for Aging and Administrator of the Administration for Community Living (ACL) of the U.S. Administration on Aging (AoA).

Greenlee made the prediction during the second of a two-part presentation, titled “Aging and Disability, the Alliance of the Future: Long Life in the 21st Century,” at the American Society on Aging’s “Aging in America” conference in downtown Chicago.

“If you are advocating for [the] disabled, [continue to] do it,” she said. “If ACA [the Affordable Care Act] is your middle name, stay that way. If you are passionate about helping people with intellectual disabilities, please stay [that way].”

Joining aging and disabilities advocacy, Greenlee said, means connecting the treatment of chronic disease, caregiving, the high cost of health care, home-based community care (HCBCs), palliative and hospice care.

“[There must be] an alliance of the [issues of the] elderly and the disabled,” she said. “[We must] align programs that support care and [meet] needs. [This means embracing new] challenges, transferring medicine to management of care, changing state government [policy], creating new conversations and [fostering] new changes in communities.”

Greenlee said policymakers and stakeholders should determine what role Medicare and Medicaid can play and how the provisions of the Older Americans Act and the American Disabilities Act can be interpreted and reconciled to support this alliance.

“The healthcare system [can work with] home [health] care,” she said. “[The Area Agencies on Aging can work] with Medicare. [There might be a comparison between what] charity gives [in terms of funding and technical assistance to this alliance] versus [the contribution of] Medicare vendors. [It is a] huge conversation. [You would have to discuss, too] Parkinson’s, paralysis and diabetes.]”

Greenlee mentioned as a potential example of alliance building, the late actor/filmmaker and disabilities crusader Christopher Reeve, who founded and chaired in 1999 his own national nonprofit, the Christopher and Dana Reeve Foundation, and created the Paralysis Resource Center, which offers resources on spinal cord injury, paralysis and mobility-related disabilities and entered a cooperative agreement with the Centers for Disease Control and Prevention (CDC) to make information and other forms of assistance readily available to those who need most. Reeve, who was stricken with a spinal cord injury after a horse-racing competition in 1995, died of a heart attack in 2004.

She prescribed similar partnerships with government agencies, nonprofits and foundations.

“We have HHS and HUD,” Greenlee said. “[They] think we don’t do housing but HHS does. HUD [addresses] senior housing. [Meanwhile] people [are] screaming in [different] states, ‘We have no one to talk to about housing [and seniors].’”

She also added that the role of caregivers in allying aging and disabilities raises questions.

“[Caregivers are in the] workforce,” Greenlee said. “Who will provide care? How can we support direct care? How do we train? How do we [introduce] geriatrics? [The] role of family of caregivers is essential. What is [the] future of caregivers and seniors? We can work on [this] together. It is unleashed potential.”

Gerard Van Spaendonck, general manager and the senior vice president of Philips Healthcare in Boston, the global home monitoring and home health care medical devices solutions segment of the company, said technology will play a role in caregiving.

“Getting older does not mean we get less productive, less active [and] less well,” Van Spaendonck said. “Families [are] changing their roles in health care. Private policies and changing standards of age [are affecting] families, friends and broader communities. You can’t help getting older but you don’t need to get old.”

He said companies like his merge wireless communication and telephones so that seniors can engage with loved ones, friends, government agencies, nonprofits and businesses outside of their homes. Philips’ own line of products include Lifeline Go Safe to help with falls, assisted GPS, WiFi entries, intelligent bread crumbs and two-way voice communication.

“Some seniors stay connected [because they are] frightened. [They are] falling, the streets [are becoming less] safe [and] they are getting lost [when suffering from dementia]. This does not mean [social] isolation but innovation. New technology [can] improve lives. [It will] help seniors live in their own homes.”

Greenlee said policymakers and stakeholders should be encouraged to think unconventionally in order to link aging and disabilities.

“[There is] common space [to] work on these issues,” she said. “Just because [something] does not have [the word] ‘aging’ in its title does not mean it’s not [about] aging.”

Greenlee also said that elder abuse should also be part of the conversation.

“Ask yourself questions,” she said. “ Are the people I serve abused? Do I know who they are?”

Continued: Part Two

This article was originally published March 10, 2014 on the website of PharmPsych.com, one of seven websites that comprise The Pharm Psych Network, a medical communications and education company.

Improvement of Government, Community Resources Would Boost Rural Seniors’ Mental Health in Canada, Panelists Say (Part Three)

Falls and Loss of Mobility

Bacsu added that loss of mobility and falls were other prime concerns. They reflected gender differences and involved no discussion of health care to resolve them. Both worsened respondents’ sense of social isolation, limited activities around the house and fostered a loss of confidence and independence. Particularly, falls incited feelings of stress and anxiety.

SPHERU research in 2011 on falls and physical mobility found that about 85 percent of seniors’ injury hospitalizations stem from falls. About 50 percent of seniors were fallers. If they fell once, it was predicted that they would fall again. About 30 to 50 percent of seniors suffer a fall each year. Up to 25 percent of falls result in serious injuries such as a fracture requiring hospitalization. Falls account for 54.4 percent of all injury hospitalization, 75.7% of all in-house hospital deaths, and cost $6.2 billion per year.

Fall-hospitalization rates were higher for women at 19.2 per 1,000 than for men at 10.8 per 1,000 and survival rates from hospitalizations are lower for men.

“Participants downplayed [the] seriousness of falls,” she said. “Men reported falls performing high-risk activities. Women reported falls performing day-to-day activities. Women often kept falls to themselves. The threats of relocation [to a long-term care facility] and [being] institutionalized [are very real]. [It is] sad and depressing. [As a result, senior respondents to the study doubted any hope of] ever getting better. [After all, their] mobility [was] compromised.”

Comprehensive Solutions

To mitigate the effects of gender, spousal health, finances, social isolation and physical mobility on rural mental health, Novik said seniors must stay active with physical exercise, reading, gardening, music, Sunday worship services and dealing with their ability to drive a vehicle. Such activities will give them a sense of empowerment, she said.

Many seniors interviewed expressed optimism and used their sense of humor. For example, Novik said some seniors said they were lucky to live in a small village where they knew all of the residents who could help them with emergencies and could drive them within a half-hour of healthcare service.

Seniors, she said, want to make decisions and solve problems. They have a strong sense of autonomy and independence and like to take part in organized activities, including those with intergenerational opportunities, improved rather than “sketchy” Internet access, support groups for grief and Alzheimer’s disease, more information about mental health services, home health care, assisted living and nursing home services for seniors, nutritious Meals on Wheels, sun lamps, services for Native American seniors, financing counselors and loan forgiveness.

Additionally, Novik said seniors asked for greater infrastructure accommodation in Saskatchewan, including jets or planes traveling two to three hours, additional jet or plane flights, all-weather roads, trains traveling express and higher ridership on local buses and revamped airports.

Read This Story From The Beginning:
Part One
Part Two

This article was originally published Feb. 19, 2014 on the website of PharmPsych.com, one of seven websites that comprise The Pharm Psych Network, a medical communications and education company.

Improvement of Government, Community Resources Would Boost Rural Seniors’ Mental Health in Canada, Panelists Say (Part Two)

This is because Canada’s rural areas have residents with lower incomes, less education, less adequate housing, less access to rail and public transit services and lower quality of health care than in the country’s urban areas.

“Our rural areas are elderly,” Novik said. “Young people moved to the cities. When we talk rural and remote, we talk about [distance]. [We gain an appreciation for] how rural and remote Saskatchewan is.”

Travel within the province is hard, she added. For seniors who live in Ottawa, Perth is 20 minutes away by car or rail. Rural communities that include the First Nations indigenous populations are one hour away from Watrous and Saskatoon, the province’s largest city with a population of 257,300. Woseley is one hour away from Regina, the capital of Sasketchewan, and a three- to four-hour drive from Preeceville in central Saskatoon. Residents can’t drive in or out of the region.

Yet rural areas are seen in a positive light, masking their socioeconomic problems, Novik said.

“One-dimensional views [of] problems leave little scope for addressing mental health,” she said. “Rural areas [are] often characterized as idyllic and pastoral with less stress, strong community networks and close connections to the land. [Yet, for example,] the provinces built [the] hospitals but [they’re] not sustainable.”

By contrast, research more than one century old did not romanticize the country’s rural areas, she said. In 1908, Canada had less than 10,000 people. “[The] rural [areas were] conceptualized as being underserved, sparsely populated and geographically disperse,” Novik said.

Meanwhile, SPHERU research in the present day found that about 15.4 percent of those 65 years old and older live in Canada. Between the years 2006 and 2026, the number of seniors in Canada is expected to increase from 4.3 million to 8 million. By 2036, seniors will reach approximately 25 percent of the total population.

Seniors made up 85 percent of all hospital patients in 2011. About 47 percent of them have completed hospital treatment but remain in acute care, skilled nursing facilities, nursing homes and rehabilitation because they await a transition to a long-term care facility.

At the same time, 80 percent of Canadians surveyed support the development of more home health care and community-based programs for the elderly.

As a result, more research must be generated to examine and improve the supports that enable rural seniors to stay at home to age in peace, although funding is hard to secure with government budgetary cuts, a troubled global economy and fierce competition for research dollars, Novik said.

“It is challenging to get research dollars,” she said, referring to the interdisciplinary SPHERU studies as focusing on Regina in Saskatchewan with provincial and national funding. “With our research, we can exchange insight and share mental health [facts and statistics].”

Novik said that Canada has adopted the World Health Organization’s (WHO) goals and objectives in 2009 for mental health.

“Addictions and other sources of stress exist [for seniors],” she said. “They [seniors must] cope with stress. [Reiterating WHO’s definition of mental health, it is a] state of well-being in which the individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his own community.”

Senior Community-based Interviews

Based on Canadian psychiatrist, professor and researcher James Cantor’s social care model of 1989 to identify government policy, community and kin-level interventions to improve rural aging, SPHERU’s “Rural Healthy Aging” research concentrated on the subject matter of formal and informal support for rural seniors. Researchers asked extensive questions about how senior respondents were being supported and where the support originated from.

Formal and informal supports meant home health care, senior housing, access to information about senior services, an accommodating public infrastructure and transportation. SPHERU researchers summarized the responses from seniors and interpreted them in five categories in terms of social interaction, independence, cognitive health, mental health, mobility and community involvement.

The project uses the tools of community-based participatory research (CBPR), collaboration and capacity building. Community partners are involved in all stages of the research from other questions that have been asked and investigated previously.

For the academic year of 2009 to 2010, the pilot study conducted 42 interviews over three years with rural seniors in Preeceville, Watrous and Woseley, all in Saskatchewan.

In 2011, SPHERU researchers conducted 40 interviews for 16 men and 24 women aged 64 to 98 years of age. In 2012, 36 interviews were performed with 14 men and 22 women of the same age range. The third wave of interviews occurred in Watrous in April 2012. Researchers completed two interviews with each participant in Woseley and final ones in November 2013.

Juanita Bacsu, project coordinator and a researcher with the Saskatchewan Population Health and Evaluation Research Unit (SPHERU) of the University of Saskatchewan who recently completed her doctorate degree in community health and epidemiology at the school, said there were five key themes to interviewing rural seniors on mental health: gender, spousal health, finances, isolation and physical mobility.

“We looked at socioeconomics,” Bacsu said of the videos of senior testimonies. “They already had risk factors for mental health [problems]. [The research was] interwoven [with testimonies about] gender. Men described greater differences in mobility. [They viewed their] inability to complete outdoor work more negatively.

“Women identified [the] stress of learning new tasks [such as] driving [and] finances when spouses did this before. There is a sense of loss. You could [hear it] in [the] gentlemen’s voices.”

Mental health, she said, was linked to spousal health, especially caregivers. Caregivers often put spouses’ well-being first and they feared spousal separation through long-term care. Grief and loss of their spouses were identified as key issues.

Additionally, Bacsu said, there was a need for service awareness, particularly for respite for caregivers and long-term care for senior patients. A lack of service was a rich source of mental stress.

Women interviewees, she said, worried over the increasing costs of medicine, ambulances, home health care and the cost of living, especially paying their monthly bills. They said training in financing would be helpful and revealed that they handled their finances differently after their husbands died.

Aging respondents also spoke of the negative consequences of physical and mental isolation, Bacsu said.

“[There is] limited interaction [in the] small villages,” she said. “[There is] no running water.

[The] isolation [is] exacerbated by limited mobility and winter [because of] ice, cold [and] daylight. [The] caregivers [are] isolated [and are] unaware of supports. [They are] reluctant to ask for help [because they] don’t [want to] burden others. [There is] limited senior’s housing [so there is a] fear of being sent away [if they inquire about such services].”

Continued: Part Three

This article was originally published Feb. 19, 2014 on the website of PharmPsych.com, one of seven websites that comprise The Pharm Psych Network, a medical communications and education company.

Improvement of Government, Community Resources Would Boost Rural Seniors’ Mental Health in Canada, Panelists Say (Part One)

Greater improvement and coordination of government policy programs and community resources would improve the mental health of rural seniors in Canada, university researchers said during a conference on aging in Chicago.

During their panel presentation titled “Aging and Rural Mental Health: ‘I Don’t Think I’ll Ever Get Better,’” that included a video presentation of testimonies from seniors on quality of life, during the Aging in America conference by the American Society on Aging, program coordinators and researchers from the universities of Regina and Saskatchewan said low- to moderate-income seniors living at home in various towns of the rural western Canadian province of Saskatchewan report that enhancements in senior housing, public transit, Meals on Wheels, health services, home care and public infrastructure would elevate their mental health status.

Nuelle Novik, MSW, PhD, RSW, assistant professor of social work at the University of Regina and a researcher on aging issues, said a winter report titled “Rural Healthy Aging Interventions” focused on the government and community actions taken to enable rural seniors in Saskatchewan, Canada to age in place.

A community-guided research effort of three years, the study was the result of the two universities’ partnerships with local organizations and direct collaboration with members to conduct two years of interviews of seniors in the rural towns of Watrous, Young and Woseley. The work is built on a similar study conducted on the other Saskatchewan towns of Preeceville, Rosetown and lle a la Crosse.

The report can be found at http://www.spheru.ca, the website hosting research work by the Saskatchewan Population Health and Evaluation Research Unit (SPHERU), a bi-university health research department based at both the universities of Regina and Saskatchewan since 1999.

Senior Testimonies Helpful

“There is strength in the stories people tell us,” Novik said. “We recognize the reality [they face]. [We must] pay attention to and acknowledge what seniors are telling us. Health care is over simplified in dollars and seniors are overlooked.”

She explained that, in Canada, there is little government support for helping rural seniors age in place and there is a lack of research on the health needs of rural seniors. Most data and government policies are geared toward seniors in the cities.

Consequently, her goal and that of other SPHERU researchers is to capture and to study the views of rural seniors about their health and quality-of-life needs and share their discoveries with local and provincial government agencies and federal policy makers, including the Canadian Ministry of Health.

If they are aware of the needs of rural seniors, government officials can craft, fund and execute policies that bridge identified gaps in those communities, Novik said.

Specifically, rural seniors in Canada have less access to medical care as many healthcare services have re-located to the cities, she said. The cost of medicine in general and ambulances in the city have become expensive. A shortage of rural physicians force seniors to locate to the cities, thus, compromising their ability to age in place.

When studied by SPHERU, researchers found that seniors did not know enough about the mental health, the medical specialty of podiatry, respite care and cognitive health services covered by Saskatchewan Health on the provincial level to make sound choices about their plan of treatment.

In describing the trials faced by seniors, Novik focused on a testimony by Thelma, a 93-year-old wheelchair-bound widow on a remote farm in Saskatchewan. Thelma recounted how her neighbors bring her water as it is difficult to obtain on the farm. Laughing, Thelma said she used to play cards but now she has no one to play with. She spends her days watching TV and talking on the phone.

SPHERU Research On Rural Isolation

According to SPHERU research, Saskatchewan has a shortage of home care workers, Novik said, making it difficult for rural seniors like Thelma to obtain medical care. Economic changes in the province and the cities brought on youth flight, which, in turn, lowered the population.

SPHERU research finds rural communities in Canada are facing challenges in assisting seniors overall. Saskatchewan has the highest percentages of seniors in the country and is among a few provinces without a masterplan for serving them. Novik pointed out that the province has a size of 251,700 square miles, the second largest land mass in Canada with a population of 1.11 million residents and is bordered on the west by the Province of Alberta, on the north by the Northwest Territories, on the east by Manitoba, and on the south by Montana and North Dakota.

“They have trouble meeting health and mental needs of seniors,” Novik said. “Our population is urbanizing. Some communities have no health workers in those areas. [Some seniors] will be lucky to have mental health services in their homes. They have to travel to get [the] services [they need] or [they] don’t get them.”

Moreover, rural seniors tend to have more mental health stressors than their urban peers, including drug and alcohol addictions, poorer physical health, more functional disability, more sedentary lifestyles, make less use of preventive care and more chronic illness.

Continued: Part Two

This article was originally published Feb. 19, 2014 on the website of PharmPsych.com, one of seven websites that comprise The Pharm Psych Network, a medical communications and education company.

Pets Instrumental To Holistic Health, Healing, Independence for Seniors, Advocates Say (Part Four)

“[The] space [is important]. [The best is to have a] closet with shelving. I’ve never seen a thin community dog [so] you need a doggy [waste material] digester. They are rolling grooming tables in [the] beauty shops [of some senior long-term care community campuses to clean and maintain the dogs].”

All of this is because a pet’s character is crucial in a community’s final decision, Oliva said.

“[The ideal pet] must be able to live with and relate to other animals,” she said. “[The rescue organizations and community representatives] must confer with visitors and new people [in the senior care facility.] Usually, [we] have dogs with short-to-medium hazards. Disabilities are welcome. We don’t shy from dogs with issues.”

Typically, Oliva said, costs for pet care, medicine and food run from $25 to $125 a year in costs. As part of the pet placement process, prospective residential tours are conducted and potential dogs are given initial contact with a senior care community. Residents, she said, are engaged in the initiation process. If the pet is ideal for the senior care setting, he or she is selected and can live on campus.

Upon moving in, Oliva said, an area of the facility is selected for a large or extra-large crate for the dog. The best outdoors areas are identified for a dog’s walking habits and physical exercise regimen.

The senior care center must acquire all the necessary equipment and accessories for the new dog and be open to what Oliva described as a “slow move-in.”

Fliers are posted all over the campus of the senior care facility to introduce the new dog to the residents. Overtime, the dog will cultivate favorite residents. One or two residents will develop a special bond with the new dog.

“They will walk the dog and often will take the dog [back to one of their] apartments for sleeping,” Oliva said.

As Pathway developed its senior pet program over the years, it gleaned insights into how to best manage and lead the initiative effectively, she said.

“The lessons learned are ‘plan on [assigning] staff to handle all of the pet care,’” Oliva said. “Budget accordingly for [the] needs of older dogs. Younger dogs are not [a] fit for [senior long-term care because of tripping hazards and lack of ease of petting]. [Beware of] residents overfeeding [them]. Allow residents [to] make major decisions.”

Read This Story From The Beginning:
Part One
Part Two
Part Three

This article was originally published Feb. 17, 2014 on the website of PharmPsych.com, one of seven websites that comprise The Pharm Psych Network, a medical communications and education company.

Pets Instrumental To Holistic Health, Healing, Independence for Seniors, Advocates Say (Part Three)

For example, she said Jimmy’s Place, a pet hotel, is a safe haven for pets when a senior needs a temporary place for his or her pet to stay. Sponsored by the Osceola Council on Aging in Kissimmee, Fla., Jimmie’s Place offers food, shelter, exercise and basic needs satisfaction for pets. Pet owners can pre-register their pets for the program with their basic information and service preferences.

“[We do this to deal with] elder abuse,” McGill said. “We write a lot of checks to shelters that allow them to bring pets. Some women have not left their homes because their pets [would] be killed.”

Support From Gerontologists

Senior health care specialty groups also contribute to encouraging pet ownership among seniors when designing their medical plans of health care and housing.

“[We help seniors] transition with pets,” said Karen Kolb Flude, a gerontologist and founder and principal of Age with Ease, a Chicago-based organization addressing the needs of the elderly that consults with seniors and their families and friends to create a plan of medical care and independent living that encompasses treatment, therapy, housing, physical exercise, volunteerism and socialization.

“Animals sense change. [We] talk with clients [to see] what they want and [determine] how a pet [will] transition. [We develop] built-in support systems ahead of time and [give seniors a] chance to get more prepared than [they] previously have been. [They] can be better off than when they started.”

Kolb-Flude said that her staff gerontologists can help seniors prepare strategies for the big move, including packing considerations, methods of bringing pets to new housing and care settings, scoping the area for new opportunities, finding local resources and locating new veterinarians.

Members of her medical team can also assist seniors with ordering dogs ahead of time and new pet care supplies to keep for a long time.

To provide such pet ownership services for its patients, Age With Ease has partnered with the Chicago Anti-Cruelty Society; the Animal Welfare League; a cat’s shelter in Chicago’s north side East Rogers Park neighborhood; Chicago Community Humane Center, an in-home pet care facility for seniors, too, in Rogers Park.; PAWS; TreeHouse Animal Foundation; the Gabriel Foundation for bird adoption; Caregiver Volunteers of Central Jersey and KSDS Inc. in Washington, Kan. for therapy dogs.

“[We decide] how to support pets for medical transitions,” Kolb-Flude said. “[We have a] built- in plan for animals for future care, [including] with new beds and new treatments. [We check to see] what resources are available.”

Support From Senior Long-Term Care, Architecture Industry

Aside from receiving funding and technical assistance from philanthropic organizations such as Banfield and counseling from gerontologists, senior long-term care facilities and the architecture industry support pet ownership among seniors with their own internal commercial programs.

An example is Pathway Senior Living, a Chicago-based commercial provider formed in 1997 of 13 affordable assisted living communities of over 1,000 units as well as one market-rate assisted living facility and seven senior independent living apartment buildings in Illinois, Wisconsin and Atlanta, Georgia.

Pathway offers senior care, including active adult homes, senior independent living congregate apartments, skilled nursing facilities and assisted living centers and market-rate and mixed-income housing.

It includes among its many programs one named “See Spot Retire,” a canine companion initiative to improve the lives of older dogs by pairing them with residents for committed relationships.

“We rescue older dogs [with our] Canine Pet Companion Program,” said Maria Oliva, Pathway’s Chief People Officer.
“[We] offer older dogs a new lease on life. [We offer] residents meaningful relationships [to] improve morale, stress relief, better health and unconditional love. They must have a reason to get up every day. They make decisions about people. Our staff helps them to care for pets.”

Such partners as Life Services Network of Illinois and the Affordable Assisted Living Coalition (AALC) support the work of Pathway to provide senior care and housing in the Midwest.

Namely, the chain’s properties include the following:

Age Well Centre for Life Enrichment in Green Bay, Wisc.;
Alexian Village of Elk Grove in Chicago’s northwest suburban Elk Grove, Ill.;
Oak Hill Supportive Living Community in Chicago’s northwest suburban Round Lake Beach, Ill.;
Victory Centre of Bartlett in Chicago’s west suburban Bartlett, Illinois;
Victory Centre of Galewood in Chicago;
Victory Centre of Joliet in Chicago’s south suburban Joliet, Ill.;
Victory Centre of Park Forest in Chicago’s south suburban Park Forest, Ill.;
Victory Centre of River Oaks in Chicago’s south suburban Calumet City, Ill.;
Victory Centre of River Woods in Chicago’s west suburban Melrose Park, Ill.;
Victory Centre of Roseland in Chicago; Victory Centre of Sierra Ridge in Chicago’s south suburban Country Club Hills, Ill.;
Victory Centre of South Chicago, and;
Victory Centre of Vernon Hills in Chicago’s northwest suburban Vernon Hills, Ill.

Oliva related one success story with a visually-impaired and chronically ill dog named Lucky in one of the 120 senior independent living apartments and assisted living centers run by Pathway. “One lady likes to pet the dog,” she said. “She [says she] felt relaxation. She says she loves the dog.”

The elderly woman in question lived in a Pathway community for one year with the dog, who was blind in one eye, which was full of cataracts.

“He was ill,” Oliva said. “I didn’t think he would live. As he got sick, he walked [more slowly]. [But] he helped in our environment.”

She explained that Pathway forms relationships with dog rescue organizations throughout Chicago and representatives from these groups in various communities decide with which senior long-term care facility an assigned dog will live.

Often, facilities will seek out larger dogs that are four years old or older as they do not present tripping hazards and are easier to pet, Oliva said.

Determining factors for a dog’s next place of residence include whether a dog is in foster care and has a foster care record, the history of its owners, how its community members feel about the particular dog in question, how many residents reside in the designated senior care center and whether technical assistance is available to transition the dog from the rescue organization to its new home at a senior care setting.

“Personalities are different,” said Andrew Alden, Living Environments Studio Director of Eppstein Uhen Architects, an architectural firm with branches in Milwaukee and Madison, Wisconsin and Des Moines, Iowa, and one of the four panelists for the presentation.

Continued: Part Four

This article was originally published Feb. 17, 2014 on the website of PharmPsych.com, one of seven websites that comprise The Pharm Psych Network, a medical communications and education company.

Pets Instrumental To Holistic Health, Healing, Independence for Seniors, Advocates Say (Part Two)

Its founding sponsors are the American Pet Products Association, Petco and Zoetis, also known as the one-time animal health business of Pfizer pharmaceutical company.

To support its mission, vision and different facets of work, HABRI has created four work groups, including the Communication and Education Work Group, the Government Affairs Work Group, the Research Work Group and the Support Work Group.

Serving on its steering committees are the American Humane Association, Bayer, Central Garden and Pet, Hartz, Hill’s, Morris Animal Foundation, Dick Van Patten’s Natural Balance Pet Foods, Inc., PetSafe, PetSmart, Purina, Segrest Farms, Sergeant’s and WellPet. HABRI’s association supporters are Pet Industry Distributors Association, Pet Industry Joint Advisory Council and its leader-corporation is the Bramton Company.
McGill said that Banfield has performed much work for seniors and their pets and found success with human hospice care facilities.

“[There are] many stories of people in hospice,” she said, referring to tales on the Banfield’s website at http://www.banfieldcharitabletrust.org “The number of people who asked what would happen to their pets [after they died was high].”

Moreover, McGill said, the American Pet Products Association released a 2012 APPA National Pet Owners survey, after a year of investigating and interviewing individuals with animals at home and various medical care or services settings.

About 1,054 respondents of elderly persons aged 65 and older were surveyed to discuss the health benefits of owning a pet and were followed for a year. In the study, owners sang the praises of their pets.
“[The] owners report a special bond with their pets,” she said. “[They spoke of] companionship, love and friendship.”

The APPA survey revealed that about 59 percent of respondents felt that pet ownership was good for their health and relaxation with 40 percent stating that they could not keep their dogs because they could not afford them. It also included the testimonies of five widows who lost their husbands and who talked about their pet ownership.
“Dogs were a focus of conversation,” McGill said. “[They were a] buffer [against] the sense of isolation. [The respondents were] socializing [with people other than their family members], [were] widowed or [had] no contact with families.”

About 64 percent of respondents were suffering from Alzheimer’s disease and had pets. Researchers noted that pet dogs were assigned to both elderly men and women.

She added that elderly pet owners reported shorter stays in hospitals, nursing homes, skilled nursing facilities and medical specialty clinics to treat their illnesses when living with their pets and experienced lower average medical costs than those without pets.

“Dogs provided substitute comfort because they were a shared part of the relationship,” McGill said about the replies to the survey from respondents who lost spouses. “Dogs provided a safe place to grieve and total acceptance. Dogs provided qualities of a best friend as [they seemed to] listen [and to] comprehend [their owners’ loss].”

According to pet research, about 62 percent of U.S. households own a pet. Of this figure, half of the households owned dogs while the other half owned cats. Dogs lived in 46.3 million American homes while cats were in 38.9 million homes.

Cats were the choice for many seniors, research showed. “[It’s because of] the ease of care,” McGill said. “They can go longer without food [than dogs]. [To address different problems germane to aging such as reduced falling or tripping risk, greater chances for physical exercise, more physical protection or more suitability for treatment of chronic illnesses, seniors tend to get] large breed dogs or personalized dogs.”

She added that much of the same applied for the seniors Banfield serves. The foundation assists seniors to age in place with their pets by covering basic annual expenses for dogs and cats, surgical and routine veterinarian services, pet food, treats and vitamins.

Banfield provides financial assistance and resources for at least 1,540 dogs and 1,217 cats per year. Overall foundation expenses for pets increased from $173 million in 1994 to $53 billion in 2012. Pet food, veterinarian services, medicine and supplies accounted for $45 billion in foundation costs on average overtime.

McGill said most of the seniors served have no pet insurance. Different types of pet assistance programs under Banfield address the needs of the elderly, whether situational and involving physical mobility or medical illness or financial.

Once again, Banfield’s Pet Peace of Mind program helps hospice patients keep the pets through their end of life. Out in the field, she said Banfield delivered three nonprofit hospice programs with assistance with medical care, cost of food and pet care.

The foundation provides placement for pets after the death of their owners. It also provides boarding or foster care assistance if the elderly patient is hospitalized. If seniors in post-surgical or palliative or hospice care want help in getting pets adopted after death, the foundation can help, McGill said.

Banfield partners with various agencies and nonprofits to deliver its programs, she added. The foundation works with the National Veterinary Assistance Programs, the Pet Fund, Red Poverty, In Memory of Magic and the Mosby Foundation. National programs such as PAWS (Pets are Wonderful Support) and SNAP (Spay Neuter Assistance Program) abound nationwide.

McGill said oftentimes the shelters offer the best cost for service. The foundation deals with vaccine clinics for the elderly. One health organization provides mobile veterinary and other pet care service for dogs and cats owned by public services with financial restraints.

Continued: Part Three

This article was originally published Feb. 17, 2014 on the website of PharmPsych.com, one of seven websites that comprise The Pharm Psych Network, a medical communications and education company.

Pets Instrumental To Holistic Health, Healing, Independence for Seniors, Advocates Say (Part One)

Pets are integral to empowering seniors to stay healthy, overcome illnesses and age in place, and industry, agencies and nonprofits must help keep owners and their animals together despite social and economic hardship, commercial and nonprofit advocates said at a conference on aging.

During a panel titled “Growing Older With Pets: Network on Environments, Science and Technology for Maximizing Independence (NEST)” at the Aging in America conference by the American Society on Aging in downtown Chicago, four panelists touted the health benefits of pets for seniors, especially ones who need to maintain good health or are recovering from chronic illnesses.

The panelists encouraged the purchase and maintenance of pets for seniors in their own homes or in forms of long-term care such as assisted living, congregate care, continuing care retirement communities (CCRC), nursing homes, skilled nursing facilities, senior independent living and hospice care.

“Seniors face many issues and [as a result] more people are owning pets,” said Dianne McGill executive director and CEO of Banfield Charitable Trust, a Portland, Ore.-based private foundation dedicated to funding and operating programs that enable nonprofits and medical care and services settings such as hospices, domestic violence shelters and humane societies to keep owners with their pets.

“[We operate a] trust fund and administrative programs to keep pets and people [together]. None of our programs go into play until we have a pet.”

McGill, herself an owner of two English bulldogs, said that Banfield is the only pet assistance charity to help people stay with their pets and care for them.

Established in 2004, Banfield has been assisting 250,000 individuals in keeping their pets with its emergency and preventive veterinary care programs for individuals facing financial struggles and medical emergencies, Pet Peace of Mind program to allow hospice patients to keep their pets, a pet food program through annual holiday events to collect food and money donations and their pet advocacy programs to assist pet-focused groups in developing special projects.

The foundation reacts to the tens of thousands of individuals who are at risk for being forced to give up their pets because of their finances or medical problems. Its programs target low-income persons and seniors as research increasingly demonstrates the physical and mental health benefits of pet ownership.

The American Society for the Prevention of Cruelty to Animals (ASPCA) reports that every year local shelters receive more than two million pets given up by families and more than half of all animals in shelters are put down yearly. The most vulnerable pet owners are low-income families, seniors, the disabled and the homeless as their pets are their sole companion and oftentimes their only reason for living.

Benefits of Senior Pet Ownership, Support From Philanthropies

Through partnerships with long-standing organizations such as the American Veterinary Medicine Association (AVMA) — the human, animal and environmental medical practice professional trade association based in Chicago’s northwest suburban Schaumburg, Ill. and made up 85,000 members — she said the foundation attempts to maintain “the human-animal bond.”

The association’s members — veterinary practitioners — care for the country’s more than 70 million dogs, 80 million cats, 11 million birds, seven million pet horses, and millions of other companion animals. They also aid in medical research, the prevention of bio- and agro-terrorism, and the promotion of food safety.

“[Our foundation assists in the promotion of the] mutually beneficial and dynamic relationship between people and animals that is influenced by behaviors that are essential to health and well-being of both,” McGill said.
“Pets matter. They provide a significant [abundance] of unconditional love and acceptance for owners. Pets provide [healthy] statistics, routine and a sense of normalcy during life transitions. Pets give [their owners] a sense of responsibility and purpose outside of self.”

The Human Animal Bond Research Initiative Foundation (HABRI) — a Washington, D.C.-based research, advocacy and public awareness foundation dedicated to studies on the beneficial roles that pets and animals play in the lives of families and communities — linked the companionship and life enrichment that pets provide support and improve human health by preventing or alleviating such conditions as cardiovascular health, post-traumatic stress disorder (PTSD), autism, Alzheimer’s disease, immunity against childhood diseases, depression and cancer.

HABRI Central’s body of work on the effects of pet ownership on preventative health and chronic health treatment can be found at its website at http://www.habricentral.org

Continued: Part Two

This article was originally published Feb. 17, 2014 on the website of PharmPsych.com, one of seven websites that comprise The Pharm Psych Network, a medical communications and education company.