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Dementia Training to Promote Involvement in Meaningful Activities
(06/30/10)
In 2007, RRF made a $173,346 grant to the University of Iowa to develop and implement an evidence-based training program to teach all professionals in nursing homes how to provide meaningful activity-based care for older persons with dementia. The result was "The Meaningful Activities in Dementia Training," an evidence-based CD program that teaches nurses, social workers, licensed therapy professionals, certified nurse aides, and other assistive personnel in long-term care settings about involving older adults with dementia in day-to-day activities that are enjoyable and meaningful to them. The training includes recognizing unmet activity needs among persons with dementia, applying appropriate activity assessment methods, adjusting care routines to include enjoyable activities, and monitoring outcomes related to activity involvement. This evidence-based program offers a variety of learning formats, including patient simulations, video presentations, and workplace exercises.
This CD-based product provides a quality, cost-effective training opportunity for your staff without them having to leave the workplace. The package may be purchased for $50.00, and it is approved for 9 contact hours of continuing education for nurses, or a Certificate of Completion for all other disciplines, through January 31 2011.
Additional information may be found at the University of Iowa website:
http://www.healthcare.uiowa.edu/igec/e-learning/meaningful-activities/.
New Website Will Provide Courts with Information, Resources, and Training
In 2008, RRF made a $158,886 grant to National Center for State Courts (NCSC) to
launch the Center for Elders and the Courts to serve as the primary resource for judiciary and court management on issues related to aging. On June 15, World Elder Abuse Awareness Day, NCSC launched a new website, http://eldersandcourts.org, to provide the nation's courts with resources, information, and training related to aging, probate issues, and elder abuse.
The new website will serve as an online clearinghouse of information on aging issues, as well as an online community where judges and court personnel can exchange information. The site will also feature the following resources:
- an interactive map that allows users to access information on specific state laws related to elder abuse and adult guardianships as well as links to state resources on aging
- a database of "promising practices," such as court technologies and administration procedures that have been successfully implemented by courts
- ten training videos that cover topics such as creating an elder justice center, creating an elder protection court, and working with adult protective services
- an elder abuse curriculum designed for presentation by state judicial educators
The site will also feature the Elder Abuse Toolkit for the Courts, which includes an interagency coordination guide, model practices, a data collection guide, and performance standards. The toolkit, which was funded by a grant from the Bureau of Justice Assistance, is scheduled to be available in the winter of 2010.
In 2005, RRF made a $5,500 grant to University of Indiana South Bend to enable Dr. John McIntosh to disseminate training and educational materials that he developed on suicide in late life. According to most recent statistics, one in every six suicides in the U.S. is committed by an elder (age 65 or over). In 2006, this amounted to 5,300 elder suicides. Suicides are over represented among Older Americans (they are 12.6 percent of the population but 15.9 percent of all suicides), but elderly are underrepresented in mental health services.
Dr. McIntosh has made recent suicide statistics available in slides and PowerPoint on his webpage at http://mypage.iusb.edu/~jmcintos/ . You will find them on the left side of the page. His page also provides links to many other education and training materials on suicide in late life.
Wayne State University and University of Colorado at Colorado Springs, with funding from The Retirement Research Foundation, recently completed and successfully tested modular, DVD-based training programs addressing mental health issues that interfere with successful rehabilitation of older adults. The Wayne State program, Integrating Mental Health into Occupational Therapy with Older Adults, teaches rehabilitation and home care professionals how to identify and screen for mental health problems. The training was developed by Geropsychologist Peter Lichtenberg and Occupational Therapist Cathy Lysack of Wayne State University's Institute of Gerontology. While the training program was designed with occupational therapists in mind, its content will be fully relevant for the wide range of therapists and other professionals who work with them in serving this population, such as social workers, home-health workers, physical or speech therapists, activity therapists, etc. The training program is available from Wayne State and can be ordered on-line at: http://www.iog.wayne.edu/pdfs/iog-sage.pdf.
The University of Colorado program, Mental Health Training for Home Health Care Professionals, covers much the same content. As with the Wayne State training, Colorado's approach relies heavily on videotaped interactions with real clients struggling with depression, confusion, and anxiety. The training package incorporates written, video, and audio formats to accommodate different learning styles. Both programs offer CEU credits for completion. An adaptation of the Colorado program for nonprofessional home care staff is under development. For more information, contact Geropsychologist Sara Honn Qualls at: Squalls@UCCS.edu.
In 2007, RRF made an 18-month grant of $150,000 to the National Senior Citizens Law Center (NSCLC) to protect access to long-term care for Medicaid beneficiaries. Previously, RRF had awarded NSCLC two-year funding of $200,000 for this project.
Over the past 18 months, the demand for NSCLC’s advocacy has increased. The move by states and the federal government to restructure long-term care delivery coupled with mounting pressures on Medicaid budgets have threatened access to long-term care for vulnerable elderly. During the course of the grant, NSCLC counseled advocates that were litigating cases in Maryland, Georgia, North Dakota, and West Virginia. It advised advocates in eight other states (Rhode Island, Connecticut, Virginia, Missouri, Illinois, Kentucky, Oregon, and New Hampshire) as they monitored state proposals for long-term care delivery. NSCLC also educated advocates nationally on Medicaid long-term care coverage through a series of educational briefs, articles, teleconference calls, and newsletter articles.
NSCLC won important victories on behalf of Medicaid beneficiaries. The victory in Maryland was probably most noteworthy. NSCLC won a court case that overturned the state’s narrowed clinical eligibility standard for Medicaid-funded long-term care. The decision was based on a Kentucky case in which NSCLC successfully assisted local attorneys to win reinstatement of benefits after the governor had declared coverage would be narrowed. In another case, nursing home residents who had applied for Medicaid incurred growing outstanding bills during the lengthy application process. NSCLC won a victory in Georgia, after that state had threatened to evict these residents while the application process was pending.
Advocates called upon NSCLC when Rhode Island won approval for a waiver from the Centers for Medicare and Medicaid Services to establish a new “Choices for Care” program and established some state regulations that were in opposition to federal law. NSCLC prepared an analysis of the Rhode Island statute for advocates who used it to gain state legislative protections for nursing home-eligible seniors on Medicaid. The most notable change assured that persons already enrolled in Medicaid would be covered under the new Choices for Care Program.
During the grant period, NSCLC became an expert on two waiver programs that are driving changes in state long-term care systems: “Money Follows the Person” and “Nursing Home Diversion.” Both of these programs expand access to home- and community-based services but risk narrowing clinical eligibility for nursing home care. NSCLC prepared briefs on these two programs and widely disseminated them.
For information on the Rhode Island Medicaid global waiver as it relates to long-term care eligibility and analyses of Money Follows the Person and the Nursing Home Diversion Program, go to http://www.nsclc.org/areas/medicaid,
This project is important because it continues to protect the rights of elderly needing long-term care by giving advocates on the ground the tools they need to be effective. NSCLC is raising awareness of the need to protect seniors at a time when pressures on the Medicaid program, the primary public source of long-term care support, threaten to erode their rights.
In 2003 and 2005, RRF made two grants totaling $324,222 to the University of Kentucky Sanders-Brown Center on Aging to produce a national study on older adult public guardianship. The only previous related study, Public Guardianship and the Elderly, was produced in 1981 by Professor Winsor Schmidt and colleagues. Their study included a statutory and case analysis, a survey of public guardianship options, and intensive site visits in six states. This recent study, a collaboration between University of Kentucky, the American Bar Association Commission on Law and Aging, and Washington State University, compares the state of public guardianship in 2007 to the findings of the 1981 study.
This collaborative study resulted in the publication of a book, entitled Public Guardianship After 25 Years: In the Best Interest of Incapacitated People?: National Study of Public Guardianship. It includes: extensive site visit studies of public guardianship programs in seven states; an update on state models of public guardianship or guardianship of last resort; statutory and programmatic profiles of each state's guardianship system; statutory charts; and conclusions and recommendations, including a Model Public Guardianship Act.
The collaborators distributed 1,225 copies of their 12-page Executive Summary and 275 copies of the full report. They presented findings at several conferences. The Executive Summary can be found at http://www.abanet.org and the full report at http://www.calegaladvocates.org.
In 2008, The Retirement Research Foundation funded The Healthy Aging Research Network through a grant to the University of Washington to disseminate evidence-based interventions for screening, diagnosing and treating older adult depression. The Network held a national conference and webinar series reaching 100s of providers.
With additional support from the National Council on Aging, the CDC, SAMHSA, the State of Georgia, the National Association of State Mental Health Program Directors, and the National Association of Chronic Disease Directors, the Network has since created a set of Action Briefs to assist nonprofits in adopting the evidence-based depression interventions discussed during the conferences. Four are covered: REACH, IMPACT, PEARLS, and Healthy Ideas. The Action Briefs summarize each program and provide contact information for the experts who developed them.
RRF encourages agencies serving large numbers of older adults to download these guides, familiarize themselves with the interventions and assess which may be feasible to implement. To access the Briefs, click on the links below:
http://www.prc-hanconferences.com/action-briefs
http://www.prc-hanconferences.com/webinars
To date, little evidence exists about the impact of various housing with services models on resident, cost, and community outcomes. The purpose of this research project is to help build the evidence base on the value of linking health-related and supportive services and publicly subsidized rental housing for low-income seniors with declining health and increasing disability. A descriptive evaluation was performed and detailed case studies were completed of 3 housing properties in the state of Colorado, each taking a different approach to providing a service link within their properties. Findings indicate that housing residences with greater service enrichment have positive effects on resident functional status and general satisfaction. Additionally, a wide range in terms of both availability and quality of the resident data currently being collected by housing providers was found.
The publication is available for download on the IFSA website. Authors: Michelle Washko, Ph.D.; Alisha Sanders, M.P.Aff.; Mary Harahan; Robyn I. Stone, Dr.P.H. & Enid Cos, D.S.W.
The Reconstructionist Rabbinical College has developed materials that make Jewish holiday and Sabbath workshop accessible to frail elderly in long-term care facilities. These kits make everything that staff or volunteers without Jewish background need to create a holiday celebration for Jewish elders: a booklet containing background on each Jewish holiday, a step-by-step guide for celebrating the rituals, large-type handouts of prayers and blessings for participants, and a CD recording of songs and blessings. The kits can be viewed and downloaded from www.sacredseasons.org.
The Chicago Senior Empowerment Project, a community-based geriatric assessment, group and individual counseling program, produced a trainer's manual to be shared with senior centers and service providers interested in replicating the project. The manual, Favorite "Recipes" for Engaging Older Adults, prepared by Nancy Bailey, MSW, LCSW, includes a history and description of the project, how to involve a retiree corps of professionals, materials used in support groups, and tips for successful project implementation. For more information on the manual, check their website, www.whitecranewellness.org, or contact Elizabeth Cagan, Executive Director, White Crane Wellness Center, 1355 W. Foster Avenue, Chicago, IL 60640, phone 773-271-9001, e-mail wcrane@enteract.com.
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