GRAY MATTERS
Notes, News & Musings on Elder Care

Alzheimer’s Tennessee invites you and your loved ones to participate in our annual spring workshop designed to help caregivers better understand Alzheimer’s and related dementias, as well as common behaviors, caregiving strategies and legal issues.

“Caring & Coping”  Caregiver Workshop

for families and professionals

Wednesday, March 12, 2014

Laurel Church of Christ

3457 Kingston Pike, Knoxville, TN 37919

Registration 8 am | Welcome 8:30 am

Lunch Included | Workshop ends 3:30 pm

Register HERE Today!

The Alzheimer’s Tennessee’s Caregiver Workshop aims to provide the following:

  • A better understanding of Alzheimer’s disease, related dementias and available treatments.
  • Practical tips for caring for the individual with dementia.

Presenter: Melanie Bunn is a dynamic lecturer and skillful clinician in the areas of gerontological nursing and dementia. Each year, Melanie gives more than 100 presentations to health professional groups, educators, the community, law enforcement, and families. She has been a volunteer as an Alzheimer’s support group facilitator for over 20 years.

Melanie holds a B.S.N. from UNC – Chapel Hill, an M.S. in Family Health Nursing from Clemson University, as well as a Post-Master’s Gerontological Nurse Practitioner Certificate from Duke University. She is founder of Bunn Consulting and is a Dementia Training Specialist for Alzheimer’s North Carolina.

Registration: The full-day training will include all handouts as well as a snack and lunch.

Advanced registration is required and seating is limited.

Conference fees:

  • $20 for family care partners
  • $40 for professional care partners (professional fee includes 6 CEUs for administrators of residential homes for the aged as well as assisted living facilities).

Register Online today! Click HERE

Download Form to Complete and Return HERE

QUESTIONS? For more information, please contact Linda Johnson, Director of Programs 865.544.6288 x227 or Toll-Free at 888.326.9888.

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Friday, January 31, 2014 9am-3pm
Saturday, February 1, 2014 9am-4pm
Knoxville Convention Center

Admission is $10
Seniors FREE on Friday
Children 12 and under FREE

More FREE tickets here.

FREE Health Screenings

Visit participating Expo exhibitors for FREE and reduced cost health screenings.

  • FREE Health Screenings
  • FREE Samples
  • DISCOUNTED Health Screenings

For a complete list of Health Screenings available at the Expo, click here.

For more information on Senior Day, click here.

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Recently, I had the opportunity to talk with my daughter’s Girl Scout troop about Alzheimer’s disease and other related dementias as part of their work with the Alzheimer’s Pansy Project.  I have worked in geriatric health for almost 20 years now and have had many opportunities to speak with groups about memory loss—teens volunteering with HABIT dogs, caregivers needing support and education, those diagnosed with a dementia—but this was the first time I had spoken with such a young audience on the subject.  I did my homework, carefully thought about what to say and how to present it, decided on some basic analogies; but when I started to talk with the children, all of that planning went out the window.

The audience asked some very serious and heartbreaking questions about people they know who have dementia.  A little girl with sad eyes asked, “Why do people have to get Alzheimer’s disease?” They talked about loved ones who forget their names and asked questions about what to do to help them.  They also had plenty of non sequiturs; after all, when your friends are raising their hands, you want to also have something to say!  I hadn’t planned on giving as much detail about the chemistry behind dementias but these kids were smart, and they wanted to know more.  I realized I’d stepped a little too far into science, though, when I was asked if the tangles in their hair would go into their brains.

I left the meeting with a confirmed belief that kids are a lot smarter than adults give them credit for being.  Every time I volunteer at school or church or talk with the children in my life, I’m reminded of that fact.  Kids are insightful.  They “see” our feelings.  They take in much more information than we realize.  They learn by watching, and boy do they watch!

After the talk, I decided to see what other resources were available to help educate younger children about dementia.  I wanted to have a list of resources to hand out when I give my next talk.  I found the usual checklists and FAQ pages on websites like the Alzheimer’s Association about talking with children about dementia.  I wanted more.  I wanted something that children would be able to relate to and learn from.   As I was typing words into my search engine, I looked over at our home office bookshelf, packed with children’s books.  Aha! That’s it!  Quickly, I typed in “children’s books that deal with Alzheimer’s disease”.  I keyed the lists into the Knox County Library search engine and a week later picked up a bag full of books.

Below you will find the list of books that I reviewed.  I never found what I would call that perfect book—that perfect mix of information, emotion, and understanding.  Maybe I’ll convince Monica or Susie to write it for us!  Maybe Alzheimer’s is too complex of an issue to fit into one book that a child can read and understand.  Regardless, what I found were some books that can be shared with the young children in your life as a way to help them not feel so alone in their experience.

Another bonus that you’ll find in many of these books is that they give the reader some concrete ideas of what to do with their loved one with dementia—sing with them, talk about memories, make a scrapbook, look at photos, tell funny stories.  It reinforces something that I learned a long, long time ago.  Hope comes through action.  When we take action to in some way impact our situation, we feel a little better about it.  Kids need that just as much as grown-ups do.  Give them activities they can do when visiting loved ones in nursing homes (pick a bouquet of flowers from the garden to bring to Grandma, water her plants in the window sill, draw a picture, bring a photo to talk about).  At the same time, do not give them false hope that what they do will cure the illness.  Instead focus on how it helps their loved one in the here and now.  “Did you see Grandma smile when you gave her the bouquet? I bet she really liked those flowers!” For more ideas on making visits go more smoothly, go here.

If you know of other children’s books that you would like to recommend our readers, please include them in the comments section or post them to our Facebook page.

The Memory Box by Mary Bahr—An adolescent boy visits his grandparents for the summer and learns that his grandfather has Alzheimer’s disease.  They make a memory box where they store photographs and memorabilia about times they have had together and favorite stories.

Tip-Tap Pop by Sara Lynn—For a younger listener/reader, a young girl and her grandfather are tap dancing pals.  As his dementia progresses, she learns that in spite of the memory problems he still remembers music.  The power of music therapy is reinforced as a way for children to connect with their loved ones with dementia.

Singing with Momma Lou by Linda Jacobs Altman—This was the only book that I found with photos and a story line from African-American culture.  An adolescent girl makes weekly trips with her parents to see her grandmother with dementia in the nursing home. She finds the trips difficult until she discovers that she can coax her grandmother into a conversation by showing her scrapbooks, other memorabilia, and singing songs with her.

Remember Me?: Te acuerdas de mi? by Sue Glass—This was the only book that I found with both Spanish and English text. A young girl’s grandfather can’t remember her anymore, and she believes that she has done something wrong to make him mad at her.  This story reinforces for parents the importance of talking with children about dementia.  Without having all of the information, the girl blames herself for her grandfather’s behaviors.  After she shares her worries with her mother, her mother confesses that they were trying to protect her by shielding her from what was happening with her grandfather.

Still My Grandma by Veronique Van den Abeele—Shows what Grandma is like as dementia progresses and reinforces that even though Grandma is acting differently she is still the same person inside.

Really and Truly by Emilie Rivard—Tells about a young boy and his Grandpa interacting through stories.  Later when the grandfather’s dementia progresses, the boy learns that he can get his grandfather to smile and laugh by telling him magical, funny stories.

Wilfred Gordon McDonald Partridge by Mem Fox—This was probably my favorite book out of all that I read because it normalized children interacting with the elderly, something that unfortunately is not seen in many books today.  A young boy has an elderly friend with a similarly long name who is losing her memory.  After inquiring about what a memory is, he gathers some of his favorite things that have strong memories for him.  He shows them to her, and she shares stories and memories from her past with him.  The importance of reminiscing with loved ones with dementia is reinforced.

What’s Happening to Grandpa by Marie Shriver—This book had the most information about what Alzheimer’s is and how it affects a person and is probably best for an older adolescent reader.

Curve Ball, the Year I lost My Grip by Jordan Sonnenblick—This was the only book that I found for a young teen, independent reader.   While well written and does a good job of addressing the importance of open communication when concerned about a loved one with memory issues, at one point in the book the 9th graders go to a party after a swim meet and get drunk.  Parents can take that information into consideration when choosing whether or not to read the book.

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The Knoxville-Knox County Council on Aging will meet on Thursday, January 9 at 2 p.m. at the O’Connor Senior Center, 611 Winona Street, Knoxville.

Craig Leuthold, appointed Knox County Trustee in July, will discuss “Knox County Senior Property Tax Relief and Tax Freeze Programs.” For the 2013 property tax season, income limits have increased for both programs.  Bring your property tax questions.

This program is free and open to the general public.  Refreshments will be provided by Comfort Keepers.

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Tennessee has a new program aimed at getting important health information in the hands of first responders immediately following a serious accident:

The Tennessee Yellow DOT Program is designed to provide first responders with an individual’s medical information in the event of an emergency on Tennessee’s roadways.  The information can mean the difference between “life and death” in the “Golden Hour” immediately following a serious incident.

Participants in the program will receive a Yellow DOT decal, a Yellow DOT folder, and a medical information sheet; a personalized photo will be taken and placed on the sheet.  The participant will complete the medical information sheet which consists of their emergency contact information, medical information, recent surgeries, hospital preferences, current medications, insurance and physicians’ information.  This information will be the sole responsibility of the participant.

The Yellow DOT decal will be placed on the driver’s side rear window of their vehicle.

Enrollment sites are being setup across the state. Click here or the link below for the locations of these sites.

To download the form or for more information, go here.

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Alzheimer’s Tennessee, Inc. is presenting “Alzheimer’s 101” sessions in various locations.  These events are FREE and open to any professional or family caregiver who would like to attend.  You can register by clicking the links below. Please share and take advantage of these FREE presentations.

December 11th
Claiborne County
Claiborne County Senior Center
12:30 – 3:45 pm
Register Here

January 28th
Roane County
Roane Medical Center Community Room
8:30 – 11:45 am
Register Here

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Center for Medicare Advocacy
(November, 2013 Update)
Late November is often a time for gatherings with family and friends – Thanksgiving and Hanukkah, soon followed by Christmas and the New Year. Nursing home residents often want to participate in these gatherings but may worry that they will lose Medicare coverage if they leave the facility to do so. Residents and their families can put their minds at ease. According to Medicare law, nursing home residents may leave the facility for holidays without losing their Medicare coverage. However, depending on the length of their absence, beneficiaries may be charged a “bed hold” fee.

The Medicare Benefit Policy Manual recognizes that although most beneficiaries are unable to leave their facility,

“an outside pass or short leave of absence for the purpose of attending a special religious service, holiday meal, family occasion, going on a car ride, or for a trial visit home, is not, by itself evidence that the individual no longer needs to be in a SNF for the receipt of required skilled care.”[1]

A facility should NOT notify patients that leaving the facility will lead to loss of Medicare coverage. The Medicare Benefit Policy Manual says that such a notice is “not appropriate.”[2]

If the resident begins a leave of absence and returns to the facility by midnight, the facility can bill Medicare for the day’s stay.[3] If the resident is gone overnight (i.e., past midnight) and returns to the facility the next day, the day the resident leaves is considered a leave of absence day. Clarifying what seemed to be conflicting provisions in the Manuals, the Centers for Medicare & Medicaid Services (CMS) confirms that the facility can bill a beneficiary for bed-hold days during a SNF absence.[4]

Chapter 6 of the Medicare Claims Processing Manual provides that the facility cannot bill a beneficiary during a leave of absence, “except as provided in Chapter 1 of the manual at §30.1.1.1.”[5] That section authorizes skilled nursing facilities (SNFs) to bill a beneficiary for bed-hold during a temporary “SNF Absence” if the SNF informs the resident in advance of the option to make bed-hold payments and of the amount of the charge and if the resident “affirmatively elect[s]” to make bed-hold payments prior to being billed.[6] Charges to hold a bed and maintain the resident’s “personal effects in the particular living space…are calculated on the basis of a per diem bed-hold payment rate multiplied by however many days the resident is absent, as opposed to assessing the resident a fixed sum at the time of departure from the facility.”[7] CMS distinguishes bed-hold payments from payments for admission or readmission, which are “not allowed.”[8]

Residents can leave their SNFs for short periods, such as a day or two, to enjoy the holidays with their families and friends without losing Medicare coverage. Their SNFs are, however, allowed to bill them to hold their beds under Medicare rules.

For more information, contact attorney Toby S. Edelman (tedelman@medicareadvocacy.org) in the Center for Medicare Advocacy’s Washington, DC office at (202) 293-5760.

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First posted in 2010, this “News” bears repeating as we celebrate Thanksgiving this week.

Once again Science, via controlled empirical study, has affirmed an experiential truth: a grateful heart is a happier heart.

I love that researchers are more engaged in the pursuit of Happiness. It seems like a no-brainer, but there was a time, not so long ago, that the roots of happiness were believed to dwell somewhere deep beneath a wounded unconscious.  Painful excavation was considered necessary to discover and eject the demons responsible for igniting individual and collective angst. The “proof” of a positive relationship between happiness and gratitude offers profound hope to seekers. Punitive superego: move over. We can actually get there from here!

Co-Investigators Robert A. Emmons, University of California, Davis and Michael E. McCullough, University of Miami are engaged in a long-term research project, inquiring into the nature of gratitude and thankfulness and its impact on health and wellbeing.

They found that grateful people report higher levels of positive emotions, life satisfaction, vitality, and optimism and lower levels of depression and stress.  Grateful people do not deny or ignore the negative aspects of life. Gratitude appears to enhance pleasant feeling states more than it diminishes unpleasant emotions.

The researchers also note that those strongly disposed toward gratitude have the capacity to be empathic and to understand the point of view of others. People in the social networks of those that are grateful are rated as more generous and more helpful by others (McCullough, Emmons, & Tsang, 2002).

There is huge value in “practicing” gratitude in concrete ways, thus becoming more aware of blessings. Keeping a gratitude journal on an at least weekly basis by taking just a few minutes to list those things for which one is grateful had a significant impact upon study participants. They reported more regular exercise, fewer physical symptoms, feeling better about their lives overall, and were more optimistic in the following week compared with those who recorded problems and stresses, or neutral life events (Emmons & McCullough, 2003).

A related benefit was observed in the realm of personal goal attainment:  Participants who kept gratitude lists were more likely to have made progress toward important personal goals. Gratitude also translated into decreased envy and materialism!

I think most profound and important is a major Kumbayah factor: the finding that grateful people are more likely to acknowledge a belief in the interconnectedness of all life and a commitment to and responsibility to others (McCullough et. al., 2002). (!)

The happy fruits of gratitude are borne through mindfulness: becoming conscious and attentive to the blessings in your life. This Thanksgiving begin the lucrative practice of creating a list of blessings for which you are grateful. Then at least weekly take a little time to focus on the abundance in your life by continuing to journal simple lists. And breathe deeply. And celebrate.

“Both abundance and lack exist simultaneously in our lives, as parallel realities. It is always our conscious choice which secret garden we will tend… when we choose not to focus on what is missing from our lives but are grateful for the abundance that’s present — love, health, family, friends, work, the joys of nature and personal pursuits that bring us pleasure — the wasteland of illusion falls away and we experience Heaven on earth.” –Sarah Ban Breathnach

Happy Thanksgiving from Monica, Judy, Susie, Trish, Gwen, Gabe, Brooke, Glen  and  Scout!

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To all of the men and women currently serving and to the many veterans who proudly and honorably served, we salute you.  To all of the families who have lost loved ones in battle, we remember you and thank you for the service that was given.  Veteran’s Day only lasts a short time, but our gratefulness does not end.  Thank you!

In honor of the day, we compiled some links and websites related to Veteran’s Day. To learn more about its history, go here.

Organizations

There are some fantastic organizations working with our veterans.  See the links below to learn more about the programs and how you may be able to help.

  • Train a Dog—Save a Warrior connects warriors with PTSD with trained TADSAW’S PTSD service dogs. Although TADSAW is based in San Antonio, Texas, the program has Dog Trainers and Teams in-training all over the United States, including Tennessee. It is a small organization taking on the weight of the problem, and not putting limitations as to the Veterans surviving with PTSD from World War II to the present.  In Tennessee, TADSAW has taken 91 applicants with 55 training or waiting to find a shelter dog and 14 service dog teams accredited.  Go here or here to learn more about their organization and how you can help.
  • Honor Air Knoxville is a local organization providing free trips to Washington DC for area veterans.  They are currently accepting applications for veterans of WWII and Korea.  Many of our clients have had the opportunity to fly with Honor Air and describe it as a trip of a lifetime. Go here for more information about applying for a vet, volunteering, or donating.
  • The Wounded Warrior Project has a mission to raise awareness and enlist the public’s aid for the needs of injured service members.  To learn more about this national organization, go here.
  • One more simple way to help those currently serving in the military is to send them coupons that they can use at commissaries.  Gabrielle’s daughter’s Girl Scout troop is collecting current and expired coupons (the commissaries will take them up to 1 month from expiration) to mail to a regional military base.  If you would like to help, you may drop off or mail coupons to our office to Gabrielle Blake’s attention. This project will last through April of 2014.

Veteran’s Services

For services for veterans, the US Dept of Veteran’s Affairs and the State of Tennessee Office of Veteran’s Affairs are fantastic resources.  The State of Tennessee Office of Veteran’s Affair office in Knoxville is where we recommend clients visit when applying for Aid and Attendance.  Contact our office if you have any questions about how these resources might fit into your Life Care Plan.

Freebies and Fun

Many stores and restaurants offer discounts or freebies for military men and women and veterans.  For a listing of some of these great deals, go to Real Housewives Clip Coupon’s blog post here.  If you are looking for a fun activity for today, consider attending the Knoxville Veteran’s Day Parade.

Thank you to our veterans!  God Bless our great United States of America!

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The Office on Aging has hosted an annual fall workshop, Aging: A Family Affair, since 1984.  The workshop is offered in the fall, usually on the second Thursday in November, though the date can vary.

This year, the event is on November 14 at Rothchild Conference Center, 8807 Kingston Pike, from 8:30 a.m. to 3:45 p.m.

The daylong workshop provides practical information on a variety of topics for caregivers, seniors, and aging network professionals. The cost for the day is $35 and includes lunch, an exhibitors’ fair, and materials. The day starts with a keynote address that is attended by all who have registered.  After that, speakers who are considered experts in their fields offer advice, guidance and encouragement in the workshop’s nine seminars.

Our very own, Monica Franklin, will be speaking on “Navigating the Long Term Care Maze”.  For a full list of vendors, go here.  To register as an exhibitor or an attendant, go here.  We hope to see you there!

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