The value of our Foundation's grantmaking is greatly enhanced when others in the field of gerontology learn from the experiences of those we fund.  Some grants we make are not intended to have a broad impact -- others are made with the intention of shaping thinking, policy, advocacy, research and service on behalf of older persons.

Toward this end, we have created this page to list grantees whose work we hope can shape the success of others working in our field.  We hope you learn from it, and we ask that you share what you see here with any individuals or groups you feel might also benefit.  If you find something particularly useful, let us know by e-mailing us at info@rrf.org.

Grants improving the availability and quality of community based and institutional long term care.

BOSTON COLLEGE STUDY FOCUSES ON CONSUMER-DIRECTED CARE
FOR MENTALLY ILL
(Grantee:  Boston College)

VERMILLION COUNTY, ILLINOIS MOBILIZES AROUND ELDER ABUSE
(Grantee:  Community Research, Resource, Information and Services for Seniors

ROOSEVELT PLACE OPENS AFTER TEN-YEAR EFFORT
(Grantee:  Intercommunity Housing Corporation)

RELIGIOUS INSTITUTES RECEIVE PERSON-CENTERED CARE TRAINING
(Grantee:  National Religious Retirement Office

ELDERSPIRIT EXPANDS ITS CO-HOUSING MODEL NATIONALLY
(Grantee:  Federation of Communities in Service, Inc.)

ACCESS COMMUNITY HEALTH OPENS FIRST SENIOR CLINIC
(Grantee:  Access Community Health)

EASTER SEALS PROMOTES TRANSPORTATION SOLUTIONS FOR SENIORS
(Grantee:  Easter Seals)

JEWISH HEALING NETWORK LAUNCHES NURSING HOME VISITING PROGRAM
(Grantee: Jewish Healing Network)

RRF GRANTEE USES TELECONFERENCING TO EMPOWER AGENTS OF CHANGE IN NURSING HOMES
(Grantee: National Citizens' Coalition for Nursing Home Reform)

AT-RISK SENIORS OF CAROL STREAM, ILLINOIS RECEIVE FIRST-TIME SERVICES
(Grantee:  Outreach Community Ministries, Inc.)

Seeking causes and solutions to significant problems of older adults through support of selected applied and policy research for which federal funding is not available.

NATIONAL CONSUMER LAW CENTER TACKLES ISSUE OF ELDER CREDIT CARD DEBT
(Grantee:  National Consumer Law Center)

Grants increasing the number of professionals and paraprofessionals adequately prepared to serve the elder population through support of selected education and training initiatives, which enhance knowledge and skills of participants.

DYSTONIA FOUNDATION ADDS AGING SECTION TO WEBSITE
(Grantee:    Dystonia Foundation)

U. OF ST. FRANCIS STRENGTHENS NURSE TRAINING IN GERIATRICS
(Grantee:  University of St. Francis)

GRANDPARENTS RAISING GRANDCHILDREN: POLICY OPTIONS FOR STATE LEGISLATURES
(Grantee:  National Conference of State Legislatures)

RRF FUNDS TWO CONTINUING EDUCATION CONFERENCES
(Grantees:  Wayne State University and University of Colorado at Colorado Springs)

Grants for Organizational Capacity Building 

SO NO SENIOR GOES HUNGRY
(Grantee:  Meals on Wheels Foundation of Cook County)

RRF GRANT BUILDS CAPACITY OF NW SUBURBAN VOLUNTEER CENTER
(Grantee:  The Volunteer Center of Northwest Suburban Chicago)

Center on Aging & Work
Boston College
3 Lake St. Building
140 Commonwealth Ave.
Chestnut Hill, MA  02467
Michael A. Smyer, Ph.D.
Phone:    (617-552-8401)
Website: www.bc.edu/agingandwork

2004, one-year grant of $27,832 in partial support of research comparing the effectiveness in three states of consumer-directed care under Medicaid Waiver Program for two groups of service recipients: those with and those without a diagnosis of mental illness.

Boston College received this grant to study the effectiveness of consumer-directed care on mentally ill persons receiving community-based long-term care.  The project addressed the question: Who thrives and who does not under consumer direction, and why?  The study compared the impact of consumer-directed care on those recipients with and without a diagnosis of mental illness. 

The study involved an examination of the Cash and Counseling Demonstration Project, which is a model of community-based, consumer-directed long term care.  The Cash and Counseling Program provides clients with a monthly allocation to spend as they choose on services to help them avoid nursing home placement.  Clients are allowed to purchase services which are otherwise not reimbursable under state service programs.  Clients may hire providers themselves and schedule care to fit their needs.  

The study’s first objective was to confirm the rate of diagnosed mental illness among Cash and Counseling Program participants.  Preliminary analysis of the initial project data showed rates of mental illness ranging from as low as 12% to as high as 44%.  The project established and applied decision rules for classifying the presence or absence of mental illness by using data from the Arkansas Cash and Counseling Demonstration site and data on mental illness status from Medicaid and Medicare claims.

The second objective was to compare the impact of the Cash and Counseling approach on those with and without the diagnosis of mental illness. The study examined the use of services and funds, patterns of hospitalization, use of long-term care, and participant satisfaction. The study found that the Cash and Counseling Project works as well for mentally ill clients as for those without mental illness. The findings held up across a variety of outcomes, including consumer satisfaction with paid caregivers (e.g., their reliability, schedule, performance, relationship, and attitudes) and perceived quality of life.  There were no instances of abuse by caregivers for either the mentally ill or non-mentally ill clients.

The project’s third objective was to develop guidelines and materials for technical assistance to states undertaking community-based, consumer-directed care.  The project team presented information at the annual meeting of The Gerontological Society of America and published an article in The Gerontologist.  The team will be providing a briefing for the Cash & Counseling Network of 15 states.  

Although the project was successfully completed, it ran into problems in obtaining data form the states.  It took six months to negotiate for data, thus requiring a slight extension of the grant.  Arkansas' data became available first, and RRF funds were used for this analysis.  Data from two other states ( New Jersey and Florida) became available much later.  Federal funds are being used for analysis of this data.  Additional federal funding will be forthcoming for analysis of other states’ Cash & Counseling data.

This is a very important and timely project.  There is an increased interest in consumer-directed care as a result of the recent Olmstead Supreme Court decision, which mandates that states provide the least restrictive alternative for long-term care.  Adding to the interest is the shortage of long term care workers, states’ concerns about the cost of care, and an increase in consumer advocacy.  The President’s New Freedom Commission on Mental Health has also called for consumer-directed approaches and has urged the use of demonstration projects like Cash and Counseling to form the basis of evidence-based approaches.  This RRF-funded study has the potential to contribute to building such evidence-based knowledge.  

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Community Research, Resource, Information and Services for Seniors (CRIS)
309 N. Franklin
Danville, Illinois  61832
Amy Henkelman, M.Ed., Chief Executive Officer
Phone:    (217-443-2999)
Website:    home.insightbb.com/~uwda/cris/cris.htm

2005, two-year grant of $85,564 to conduct a public awareness campaign on elder abuse.

With this grant, CRIS has been educating residents and service providers of Vermillion County about the silent crime of elder abuse.  By building awareness of the signs and indicators of elder abuse, CRIS believed it would see an increase in the identification of abuse victims and an opportunity to deliver appropriate services to them.  According to the Illinois Attorney General's Office, only one out of every 14 elder abuse cases is reported.  In Vermillion County, with 16% of its population age 65 and over, there may be as many as 2,600 seniors who are suffering in silence.

CRIS used a variety of community outreach methods to increase awareness of elder abuse.  They made presentations and provided training to community groups, medical professionals, law enforcement officers, and social service agencies.  CRIS also launched a billboard campaign throughout the County, released public service announcements to local radio and TV stations, and participated in health fairs.  The agency distributed placemats and napkins with information on abuse to local restaurants and bars, organized an elder abuse awareness walk, and visited senior housing sites.

CRIS tracked information about the number of elder abuse cases, as well as the origin of the reports.  Elder abuse intakes increased during the grant period, although many reporters did not directly identify the source of their information.  Only 14 of 229 made a direct link to a project educational activity.  However, it is likely that those reporting were indirectly influenced, given the extensive community outreach that occurred.  During an 18-month period, there were 316 intake reports.  This compares to 238 intakes during the previous 18 months.  In recognition of its effective partnership with providers, CRIS received a grant from the Illinois Violence Prevention Authority to continue educating health care and mental health personnel about elder abuse.

Cris is committed to keeping the issue of elder abuse in the forefront of its community to urge the reporting of suspected abuse and encourage victims to seek help.  It has received funding from the Illinois Health Cares 2008 Program to continue collaborative efforts with the Vermillion State's Attorney, the medical community, and a local domestic violence agency.

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Intercommunity Housing Corporation
1246 W. Arthur Avenue, No. 1
Chicago, Illinois  60626
Sister Catherine McHugh, BVM, President
Phone:    (773) 338-2828

2006, one-year grant of $25,000 to furnish the common spaces of Roosevelt Place, an independent living facility for older adults with modest incomes and resources.

In 1986, RRF made a $25,000 grant to the Intercommunity Retirement Project for Religious and Clergy to study the housing needs of retired Catholic Sisters.  The study highlighted the shortage of affordable retirement housing for religious who had worked for years for less than market salaries.  It recommended building the full spectrum of retirement housing--from units for well elderly to assisted living and nursing care.  The cost was estimated at $22 million.

Faced with too daunting a fundraising task, the group decided to begin by building a residence for well retirees.  In 1990, the group created the Intercommunity Housing Corporation as a not-for-profit entity to raise seed money and find a suitable, affordable location for the retirement residence.  At various points over many years, several plots of land had been promised but, for one reason or another, unfulfilled.  Finally, in 2004, low-income housing tax credits were awarded.  Land was acquired through the city at a reduced cost and some government financing became available.  The Intercommunity Housing Corporation fundraised to meet the balance. 

A 68-unit building of one- and two-bedroom apartments was finished this past year and is now available for 74 elders.  In 2006, RRF made a $98,348 grant to the Intercommunity Housing Corporation to furnish the counseling rooms, multi-purpose and computer rooms, lobby, office, and kitchen.

The building is managed by East Lake Management, the company that was instrumental in securing the land and tax credits.  There were originally 145 retired sisters on the wait list.  However, over time, the numbers dwindled as many become too frail for independent living or died.  By October 31, 2007, the building was fully occupied.  Because it was built with some public funding, Roosevelt Place has to be available to both lay and religious.  However, the majority of the residents are either religious or former religious. 

The project faced many problems.  It had to contend with cost increases over time, difficulty in securing the land and funds, delays in the city permit process, and environmental problems on the site, which caused additional cost for cleanup.  However, the group persevered through it all and now has a lovely facility for many low-income elderly.

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Institute of Medicine
500 5th St., NW
Keck 716
Washington, DC  20001
Tracy A. Harris, DPM, MPH
Phone:    (202) 334-2352
Website:    http://www.iom.edu/

2006, fifteen-month grant in partial support of a national consensus study on the health care and workforce needs of an aging population. 

RETOOLING FOR AN AGING AMERICA: BUILDING THE HEALTHCARE WORKFORCE

National Religious Retirement Office (NRRO)
3211 Fourth St., NE
Washington, DC  20017-1194
Sister Janice Bader, CPPS, Acting Director
Phone:    (202-541-3215)
Website:    www.nccbuscc.org/nrro

2006, sixteen-month grant of $182,446 to design, implement and evaluate a pilot training and education project in Person-Centered Care Best Practices for 75 religious institutes.

In 2005, the National Religious Retirement Office (NRRO) received a 16-month, $182,446 RRF grant to train the leadership staff of its member institutes in the principles and practices of person-centered long-term care.  The plan was to contract with Mather Lifeways Institute (the research and training arm of Mather Lifeways) to develop the educational modules and train two leadership staff from each of 75 NRRO institutes (long-term care facilities).  These leaders would then train the managers and direct care staff of their home facilities. 

Mather Lifeways Institute completed the development of person-centered care training modules for NRRO in four skill areas:  teamwork, programs, environment, and dementia care.  The project’s advisory group identified these four areas as the most important ones on which to focus.  On October 31 and November 1, 2006, NRRO held a conference using a train-the-trainer format, to roll out the four modules.  The conference rapidly filled to overflowing, indicating a high level of interest in person-centered care.   A total of 168 persons from 84 of NRRO’s institutes participated and gained the skills to go back to train staff at their own facilities. 

Within six months, 135 of those trained (80%) had delivered at least one of the four person-centered care modules to 1,782 care workers.  Project outcomes were very positive.  Following the training, attitudes and knowledge scores on person-centered care improved significantly on six of eight tested items by an average of 30.1%.  For example, an item testing agreement with the person-centered care principle that all daily routines are opportunities for meaningful activity and relationship-building rose from 2.7 (out of a 4-point scale) to 3.68. 

To gain additional input, NRRO asked the trainers to complete a six month follow-up survey.  Institute trainers evaluated each module on format or structure, content, training exercises, visual aides and supplemental materials.  The mean score for each module was at least 3.2 (on a 4-point scale).  Ninety percent reported improvements in resident quality of life and greater person-centeredness among the care staff at their facility. 

The trainers provided valuable suggestions for improving training materials.  They suggested reducing the volume of reading and shortening the duration of training to make it easier to schedule.  Most trainers expressed confidence in their ability to deliver the training.  Eighty percent of survey respondents indicated they were likely or very likely to implement person-centered care training at their facilities on a consistent basis and to include new staff as they are hired. 

The project also asked for feedback from direct care staff after those who attended training presented it at their facility.  Some indicated they learned new information about the elders in their care.  Others relayed feeling closer to other staff because of better communication in caring for elders.  Others pointed to the value of the person-centered care approach in fostering their teamwork. 

This project exceeded expectations in terms of numbers reached, preparedness of trainers, outcomes of training at NRRO institutes, and quality of evaluation.  With NRRO’s 945 institutes caring for 31,000 elderly religious across the country, there is great opportunity to reach many more now that the training program and materials have been developed.   With $8,000 in unexpended funds, Mather Institute arranged for the training manual to be translated into Spanish.  Thus, the training can more easily be used with NRRO facilities’ Hispanic care staff.

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Federation of Communities in Service, Inc.
ElderSpirit Community
370 E. Main St.
Abington, Virginia  24212
Monica Appleby, Director
Phone:  (276) 628-8908
Website:  www.elderspirit.net

2005, two-year grant of $123,770 to facilitate replication of the ElderSpirit community concept in six new locations.

With this RRF grant, FOCIS, the Federation of Communities in Service, Inc. has begun to encourage the development of new residential communities based on its ElderSpirit model.  The model grew out of the ideas of Drew Leder, who developed them when he was an RRF fellow at the Park Ridge Center.  ElderSpirit is the only co-housing model that has late-life spirituality as its primary goal.  FOCIS built the first and only ElderSpirit community in Abingdon, Virginia with an initial three-year $240,089 RRF grant.  It is a 29-unit co-housing neighborhood with a common house and spiritual center.  Occupancy began in 2005.

The second RRF grant has enabled FOCIS to develop the tools and educational processes to use in encouraging other communities to adopt the ElderSpirit model.  FOCIS created a “response and resource team” of persons with a variety of technical skills needed by groups interested in adopting ElderSpirit.  Team members have made site visits to six communities, held two learning workshops at Abingdon, and conducted a workshop in North Carolina.  FOCIS established the key elements that distinguish an ElderSpirit community.  It also developed the eligibility criteria that determine whether groups may join the FOCIS “Community of Communities,” an informal network of those interested in pursuing the adoption of the ElderSpirit model in their area.  FOCIS has also produced a comprehensive resource handbook. 

RRF staff consider this project to be successful because the potential for expansion of ElderSpirit communities is very promising.  The ElderSpirit model has received considerable attention by the media and professionals in housing and aging.  FOCIS has received hundreds of inquiries.

Twelve communities are now in various stages of ElderSpirit development.  Six of the twelve have signed an agreement with ElderSpirit to take steps to establish a similar community in their geographic area.   Pre-development organizations are set up and functioning in Florida, Kansas, Virginia, Illinois, and two in North Carolina.  A few of the groups are very close to finding land and formalizing contracts with developers and builders.  The other six groups have not yet signed an agreement but are participating in the Community of Communities network.

Five of the first six groups that have been involved with FOCIS were interviewed to evaluate the usefulness of the ElderSpirit resource team and to gather suggestions for improvements.  The resource team received high marks for openness, willingness to help, and the quality of technical assistance materials, but lower marks for fostering communication among the emerging groups. The resource handbook has been especially well received. 

One of the principal lessons reported by FOCIS is that developing the ElderSpirit model cannot take a cookie-cutter approach.  For example, FOCIS established the Abingdon community by forming a housing development corporation, but the new groups are using many different strategies.  Some are contracting with established developers.  One is building upon a naturally occurring retirement community.  One is considering forming a housing cooperative to buy several neighborhood homes where individuals will contribute either through rent or owner equity.  Another is exploring the formation of a trust to hold the land in common and build owner-financed homes.

In 2007, FOCIS has received a third-year RRF grant for $68,284 to increase the organization's capacity to assist emerging groups in developing ElderSpirit communities.

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Access Community Health Network
1501 S. California Avenue
Chicago, Illinois  60608
Kathleen Gregory Guerrero, Project Director
Director, Planning & Development
Phone:    773-257-5611
www.accesscommunityhealth.net

2005, one-year grant of $60,000 to establish an interdisciplinary geriatric primary care center for low-income seniors on Chicago's south side.  

This grant was given to the Access Community Health Network to develop a model for a senior health center that could eventually be replicated in its other clinics across the city.  Access operates an integrated network of 44 community health centers in low-income, underserved Chicago-area communities.  Its clinics primarily serve African American and Hispanic populations.

To establish its first senior clinic, Access took over a private internal medicine practice at 41^st and King Drive on Chicago’s south side.  The clinic had previously been run by a part-time geriatrician.  He had asked Access for help because he recognized that his schedule did not permit him to address the needs of the patients.  Access agreed to assume all clinic management responsibilities.  It initially planned to nearly double the number of seniors who were reportedly seen at the clinic from 1,100 to 2,000.

However, as Access began serving the seniors, it learned that most who had previously been seen had such complex medical conditions that it became more important to increase the amount of time and frequency of visits than to focus on increasing the patient census.  There are now 813 seniors served by the clinic.  Of these, 141 are new patients.

In the first year, patients were seen an average of 4.5 times.  Eighty percent have more than one major chronic disease of aging, most commonly arthritis, cardiovascular disease, hypertension, and diabetes.  All of the seniors are being screened for mental health problems as depression has been found to be prevalent, although specific numbers are not available.  Access has enhanced the clinic’s service by adding a licensed clinical social worker, especially to meet the mental health needs of the elderly.  Physician assistants have also been added.

Every senior has also been screened for benefits eligibility.  So far, 49% have been found eligible for benefits for which they had not enrolled.  

Access has had difficulty raising sufficient funds to cover some of the services it planned to provide and to meet all of its space renovation needs.  As a result, transportation for seniors to and from the clinic has not been offered as planned.  The proposed addition of a part-time internist from another Access site had to be scrapped.  Access is still seeking additional funding from other foundations.  

Despite these constraints, seniors served by the clinic are receiving better coordinated care, important social services, and essential benefits.  The senior clinic experience is also teaching Access much about the delivery of geriatric care.  It plans to share its experience with internists and family practitioners at the other Access health centers.  In recognition of its progress, Access has received a $49,000 grant from RRF to continue the senior clinic.  

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Easter Seals, National Office
230 W. Monroe St., Suite 1800
Chicago, Illinois  60606-4802
Lisa Peters-Beumer, MPH
Project Director, Transportation Solutions for Seniors
Phone:  312-726-6200
http://www.easterseals.com

2005, two-year grant of $220,900 to involve three Easter Seal affiliates in demonstrating local transportation solutions for seniors and their caregivers and mentor other affiliates and service providers on solutions.  

RRF made this grant to Easter Seals for its “Local Transportation Solutions for Seniors” project.  With prior funding from the Administration on Aging, Easter Seals had developed a transportation training package, entitled Transportation Solutions for Caregivers.  However, it had not had an opportunity to disseminate these materials or test them as a catalyst for improving transportation options at the local community level.  Easter Seals planned to work closely with three local affiliates to test different local transportation solutions.  Each of the affiliates would test a specific transportation solution and become a “Center of Excellence in Senior Transportation.”  As such, each would mentor other Easter Seals affiliates and senior service providers.  Easter Seals’ national office would provide technical support, develop additional training materials as needed, and continue to advocate at the national level on this important issue for seniors.

Easter Seals fully met the objectives of the project.  Three affiliates were selected to use the Local Solutions training materials in different ways.  Easter Seals South Florida focused on the training of escorts.  The training was initially intended to better equip caregivers who transport their family member in their own vehicles.  However, as demand grew, the program provided training to local service and transportation providers in the areas of communication, sensitivity, and physical assistance.  The affiliate trained 338 drivers and agency staff.  The affiliate also created a volunteer transportation and escort program to fill a gap in the community.  At the close of the grant, 23 volunteer drivers/escorts had been recruited to serve 51 seniors.  Initially, escorts and drivers were recruited from AmeriCorps and then sought from the broader community.  The affiliate translated marketing and recruitment materials, as well as the escort policy and procedure manual, into Spanish.   

Easter Seals Florida, which serves Brevard County, used the components of the Transportation Solutions training materials to focus on driver safety.  It provided safe driver training to 60 older caregivers.  The affiliate also trained 63 volunteer drivers through the local RSVP.  Feedback from caregivers indicated that, as a result of the training, they were more comfortable in providing physical assistance and in using techniques to help them deal with agitated behavior.  They felt they had acquired better defensive driving skills and stated they would recommend the training to others.  

The third affiliate, Easter Seals Iowa in Des Moines, focused on community-wide coordination of transportation for seniors.  Early in the project, federal legislation was passed to require municipalities to develop and coordinate community transportation plans.  The legislation provided enormous momentum for the Iowa Easter Seals affiliate.  It developed a partnership with its Regional Transit Authority, which resulted in an extensive needs assessment and service inventory.  The affiliate became a strong partner with the Transit Authority in creating a Passenger Transportation Development Plan.  A universal eligibility process for para-transit was implemented.  This assured consistency and increased access to para-transit service for all elderly and persons with disabilities.  All three affiliates are continuing their work, and the coordinators have been mentoring other affiliates as planned.  

At the national level, Easter Seals gathered additional materials developed by the three affiliates and developed new materials on escorts, which have been added to the national Local Transportation Solutions training package.  Perhaps Easter Seals’ most significant accomplishment was the creation of the National Center on Senior Transportation, now funded by the U.S. Department of Transportation.  The RRF grant enabled Easter Seals to position itself to receive the federal grant to lead the National Center.  All of the materials developed under the Local Transportation Solutions project have been transferred to the National Center.  

This project far exceeded expectations, certainly in the areas of advocacy and training.  The National Center and the availability of mentors for Easter Seal affiliates and other transportation providers are lasting legacies of this grant.  

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Jewish Family and Community Services
216 W. Jackson Blvd.
Suite 700
Chicago, Illinois  60606
Tracey Lipsig Kite, LCSW
Coordinator, Jewish Healing Network
Phone:  847-568-5200
Website:  www.jcfs.org

2003, three-year grant of $120,000 to recruit and train volunteers to work with Jewish residents of area nursing homes to provide companionship and emotional and spiritual support.

With this grant, the Jewish Healing Network of Chicago has created a Nursing Home Visiting Program for Jewish elderly.  The program decreases the isolation of Jewish residents of nursing homes by providing companionship and a connection to the outside world.  The Healing Network established the program because it recognized that many residents were receiving no regular visitors as friends and family died or moved out of town.  The residents were no longer members of synagogues because of perceived or real financial limitations and increased frailty.  The Healing Network also realized that overworked nursing home staff would not take responsibility for training and supporting the volunteers.  Thus, the organization stepped in to assume the leadership in recruiting and matching volunteers with residents of nursing homes in Chicago and the northern suburbs.

The grant enabled the Jewish Healing Network to hire a coordinator who had extensive experience in working with elderly and nursing homes.  The coordinator recruited volunteers and matched them with nursing homes and assisted living facilities; coordinated a five-week training program each spring and fall; met with nursing home activity directors to assess the needs of Jewish residents; responded to community members and agency staff referrals; provided support and consultation for individual volunteers; and co-led quarterly volunteer support groups.  She also trained groups of high school student volunteers to lead religious services and activities at the long-term care facilities.  A chaplain assisted with the training and volunteer support groups and revised prayer materials used by the volunteers. 

The Jewish Healing Network successfully met the project’s objectives.  During the grant period, 88 adult and teen volunteers visited Jewish elderly in 19 nursing homes and assisted living facilities and led Sabbath and holiday services.  Volunteers were expected to make a bi-monthly commitment, but many visited weekly.  The number of residents involved with volunteers has been steadily growing.  The Healing Network conducted five training programs for adults, four for groups of high school students, and three refresher classes for previously trained para-chaplains.  One of the para-chaplains has been leading five elderly women in preparing for their Bat Mitzvah, a major sacrament in the Jewish faith.

While very successful, the visiting program faced challenges in forming and maintaining connections with the nursing home staffs.  While staff were eager to have volunteers at their facilities, they lacked the time to respond to volunteer calls.  This meant that the Healing Network’s coordinator had to provide the volunteers with more support than initially anticipated.  In addition, due to time limitations and turnover, the nursing home staffs rarely completed evaluations of the program’s effect on residents.  Evaluations completed by volunteers, on the other hand, indicated high satisfaction with the program. 

Aspects of the visiting program are now being replicated by Jewish organizations in Orlando and Philadelphia.  The Healing Network’s involvement in the National Center for Jewish Healing has resulted in a number of inquiries, and the program is sharing its marketing and training materials.  The National Center has distributed the Network’s materials to more than 3,000 people over the past three years and included the Network in presentations that have reached more than 750.  The Network’s Nursing Home Visiting Program continues to flourish with additional support from another foundation.  The Healing Network is also trying to raise additional funds to establish an endowment for the program.

For an article on the Jewish Healing Network and the nursing home visiting program, go to:  http://www.jcfs.org/news-article.cfm?id=5.

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National Citizens' Coalition for Nursing Home Reform (NCCNHR)
1828 L Street, N.W., Suite 801
Washington, DC  20036
Alice Hedt, Executive Director
Jessica Brill, Project Director
Phone:    202-332-2275
Website: www.nursinghomeaction.org

2005, one-year  grant of $87,955 to give families, residents, and advocates information on specific best-practices in person-directed care and strategies to get these practices adopted in nursing homes around the United States.

The National Citizens’ Coalition for Nursing Home Reform (NCCNHR) received this RRF grant to develop a series of six training teleconferences.  The purpose of the training was to equip and empower residents, their families, ombudsmen, and other advocates to promote quality care practices in nursing homes.  The rationale behind the project was that those who are in nursing homes on a daily or regular basis have the potential to become agents of change if they receive concrete information and consumer-friendly resources in an efficient manner.

NCCNHR devised a series of training teleconference calls that linked consumers with national experts on six topics.  The subjects were entitled:  Resident-Directed Care Planning; Quality Care Practices Preclude Restraint Use; Affirming Dignity and Individuality: a Look at Residents’ Rights; Staff Communication & Respectful Work Environments; Eating with Dignity: Nutrition and Hydration; and Incontinence and Quality Care.  On each call, a provider who had achieved quality care in a nursing home discussed the practices that had been successfully implemented.  Each call provided an opportunity for the participants to engage in a dialogue with experts and practitioners and brainstorm advocacy strategies with one another.  Each registrant received concrete information about individual and system advocacy.  Materials included NCCNHR’s booklet, How to Participate in the Care of Your Loved One During a Nursing Home Stay, fact sheets, and a video.  After each call, a follow-up conference call was held to answer more questions, discuss strategies that callers had tested, and establish a network of consumers and advocates.  Each call lasted 60 to 75 minutes. 

The project successfully met its objectives.  NCCNHR attracted 514 unduplicated registrants from 40 states to the series.  Many call registrants had an additional one to five non-registered individuals sit in on the calls.  NCCNHR estimates that over 1,000 individual consumers received training, which far exceeds the projection of 500 participants.  NCCNHR created an educational Consumer Center on its website with a consumer voice page dedicated to the call series.  The page includes information about family councils, culture change, and care planning.  More than 55,000 users visit NCCNHR’s website monthly with an average of 11 hits per user.

NCCNHR surveyed the callers to get their feedback on the series.  Of 98 respondents, 86% indicated the call helped them understand the topic better, and 55% felt the call gave them sufficient information upon which to become an advocate.  Most commonly, respondents indicated they planned to use the information with nursing home staff and administrators (57%), other nursing home residents or the resident council (53%), other family members or family council members (49%), and ombudsmen (42%).  Almost 30% indicated they would use the information to try to get better care for their loved one, and 15% said they would try to get better care for themselves.  As a result of their participation, nearly 60% of the callers were able to cite specific persons with whom they advocated for change.  One caller reported that the training session on care planning motivated her to go to a care planning meeting.  She felt that it was the first time that she had effectively communicated during such a meeting.  Almost 93% of call participants indicated they would like to participate in future conference calls. 

NCCNHR is making CD recordings of each of the teleconferences for those who were unable to participate in a particular call or want to share it with others.  NCCNHR is contacting each of the 1,000 plus participants to inform them about additional fact sheets and the CD recordings. 

NCCNHR had never before tested the use of training calls for consumers as an empowerment and information tool.  The success of the project demonstrated to NCCNHR that there is considerable demand for this type of training and that teleconferencing is a feasible method for empowering consumer leaders to promote quality practices in their facilities.  NCCNHR plans to use such methods in the future.  

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National Consumer Law Center
77 Summer St., 10th Floor
Boston, MA  02110-1006  
Deanne Loonin, J.D., Staff Attorney, Project Director
Phone:  617-542-8010
Website:  www.consumerlaw.org

2005, one-year grant of $100,000 in partial support of research and advocacy to facilitate administrative, budgetary, and legislative changes protecting seniors from abusive creditors and credit counselors.

NCLC began by reviewing existing data and studies on elder credit card debt, analyzing abuses by creditors, and conducting interviews with consumers and advocates.  Its research found that, while older consumers generally hold less credit card debt than those who are younger, they are catching up quickly.  The average credit card debt for Americans age 65 to 69 years old rose 217% between 1992 and 2001, to $5,844.  Elderly are filing for bankruptcy in record numbers.   Many elderly are using credit cards as a “plastic safety net” to make essential purchases that they cannot otherwise afford.  NCLC’s research found widespread financial illiteracy among older Americans.

Its research documents several key factors that are pushing the elderly toward dependence on credit cards.  They include: incomes that stagnated or declined during most of the 1990s while basic costs increased; higher expenses such as housing, medical costs, property taxes, and energy; creditor practices that push consumers to borrow beyond their means; and harmful practices such as punitive fees, changes to credit limits, deceptive marketing, and debt collection abuses.  

NCLC published two reports.  The first focuses on the nature of the problems and includes a list of policy recommendations regarding credit practices and credit cards.  The second includes resources to help older consumers with credit card debt.  The reports can be found on NCLC’s website at http://www.consumerlaw.org/initiatives/seniors_initiative.  NCLC’s website also contains educational information for older consumers and their advocates, testimony by NCLC advocates in legislative forums, and comments to administrative agencies.  NCLC has engaged the media in significant public awareness building around the issue.  Its reports and findings were covered by MSNBC Money and several major papers and are linked to a number of key websites.

NCLC designed a curriculum on credit card issues to be used in educational sessions with older consumers.  It tested the curriculum in four cities, reaching about 250 consumers directly.  The curriculum is highly interactive and engages consumers in a discussion of the problems associated with use and abuse of credit cards.  Frequently, discussions with seniors in these sessions emphasized how easy it is to send an older consumer into a spiral of late fees and increased rates that are impossible to escape. 

NCLC conducted trainings for 225 advocates in three sessions in Montana, Iowa, and Nebraska .  These sessions included a “train the trainer” component and provided a workbook entitled “Surviving Credit Card Debt.”  The focus of the sessions was on how to communicate about debt with elders.  An abbreviated version was presented at the National Aging and Law Conference.  NCLC’s reports and training materials have been publicized widely.  As a result, NCLC is beginning to get calls from senior advocates who are now taking on the credit card debt issue.  For example, a New York City community group is using the NCLC report to advocate with a major nationwide credit card lender to adopt better policies for consumers who need help because of overwhelming credit card debt. 

NCLC has worked hard to take its research and experience to a national policy level.  It has made three presentations to the Federal Reserve Board and another three to the Board’s Consumer Advisory Council. It has submitted formal written testimony.  NCLC’s input will hopefully lead to regulatory changes by the Federal Reserve Board as it reassesses the entire scheme of disclosures and substantive consumer protections for credit cards.

NCLC has also met with representatives from the two main credit counseling trade associations to discuss the findings of its report.  It has publicized the report to funders and key organizations that develop and promote assistance programs for older consumers.  This fall, NCLC convened consumer, civil rights, and labor organizations to discuss a set of principles it has developed around credit card debt.  These principles will become part of a campaign that the consumer coalition, Americans for Fairness in Lending, launch in early 2007.  Several groups focusing on seniors are participating and may become formal partners in the campaign.  AARP has agreed to publish articles about the campaign in their magazine and is considering including ads with links to a campaign website that has helpful resources.  NCLC went beyond expectations in terms of its level of effort, creative and varied strategies, and its elevation of the project to a national policy level.

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Dystonia Medical Research Foundation (DMRF)
One East Wacker Drive, Suite 2430
Chicago, IL  60601 -1905
Janet L. Hieshetter, Executive Director
Phone:    (312) 755-0198
Website:    http://www.dystonia-foundation.org/pages/dystonia_and_aging/324.php

2006, one-year grant of $5,000 to include information on aging on their new website.

The Dystonia Medical Research Foundation (DMRF) received this grant to improve the way its website presents information on aging.  Although adults over age 55 with dystonia have unique issues compared to younger patients, there has been little information published to address them.  DMRF recently completed a revision of its website and created a section entitled “Dystonia & Aging.” 

The new Dystonia & Aging section includes information on medications, conditions affecting bones and joints, mobility and balance, fatigue, physical fitness, emotional health, vision, care by doctors in multiple specialties, and communication with physicians.  Since this section of the website was launched last April, it has averaged 300 hits per month.  The volume is greater than that of the sections on children and teens.  

DMRF also created a Patient Navigation Program to help its members create their own online support networks with assistance from leaders in the dystonia community.  Persons with dystonia can contact a Patient Navigation Program volunteer through the website to obtain assistance in finding resources.  This service is available to all persons with dystonia regardless of age. 

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University of St. Francis
College of Nursing and Allied Health
500 Wilcox Street
Joliet, Illinois  60435
Catherine Ferrario, DNSc., FNP, APRN, BC
Phone:  815-740-3360
Website:  www.stfrancis.edu

2003, three-year grant of $95,159 to develop a comprehensive geriatric nursing curriculum.

With this grant, the University of St. Francis succeeded at strengthening its geriatric nursing curriculum for all levels of nursing students and developing stronger geriatric expertise in its faculty.  Sixty nursing students each year are now required to take a sequence of courses each of which incorporates aging content, including a new course, NURS 270:  Health and Aging.  Some have added readings related to research on aging, others have added specific content (e.g. on mental health in aging).  St. Francis how has eleven faculty with training in gerontology.  Two College of Nursing faculty completed masters-level gerontology courses and enrolled in the John A. Hartford Foundation’s Institute for Geriatric Nursing Review Course and nine others took some, but not all, of the modules.  

The two geriatric-trained faculty members led the project, which began by mapping existing geriatric content within the College of Nursing ’s courses.  A detailed list of important geriatric content to be infused in the curriculum was developed.  Content included 35 subjects such as pharmacology, depression, ethics, sleep, mobility, communication/sensory changes, normal aging, demographics, and attitudes about aging.  All faculty members were required to revise courses as needed and introduce geriatric concepts and materials.  The mapping process was repeated annually.

There were several significant outcomes of the project.  The PIs were able to document increased integration of geriatric content across classes.  In the initial mapping, only six out of 16 classes showed inclusion of aging content.   By the final map, there were only two that had no such content.  A new course, focusing on aging and health, is now required for all undergraduate nursing students.  This means that at least 25 new students per year will become exposed to aging very early.  Since most of these students stay in the Joliet area, this bodes well for the community.

Four on-line geriatrics training modules were developed for the faculty and provide continuing education credits. Students gained greater practical experience during the course of the grant.  They made 36 various presentations on primary and secondary prevention to 202 elders in various community settings.  They covered topics such as nutrition and wellness and management of various chronic diseases of aging.

As a result of this very successful project, all nursing undergraduates will now have a core course on aging and advanced students will be exposed to extensive content on aging in two practice classes.  The College of Nursing is committed to improving its outreach and selection of sites for student presentations.  The University provided a grant to the College of Nursing to conduct research to determine if nursing students’ attitudes toward aging are improving and whether the changes in attitude can be attributed to improvements in the nursing program.  The nursing school is working with the USF marketing department to reach out to the broader Northern Illinois Community (e.g. beyond Will County ), with a package of materials about the training program.  They will set up meetings to engage hospital nursing staff to sign up for the modules through USF. 

To view a statement from the College of Nursing articulating the College's commitment to integrating knowledge about the health of older adults throughout its curriculum, go to http://www.stfrancis.edu/news/nursing_grant.htm.  

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National Conference of State Legislatures
7700 East First Place
Denver, Colorado  80230
Nina Williams-Mbenque, Senior Policy Specialist
Phone:  303-364-7700
Website:  www.ncsl.org

2005, one-year grant of $55,926 to educate state lawmakers on the complex issues facing grandparents and other relatives raising grandchildren.

This RRF grant has enabled the National Conference of State Legislatures (NCSL) to assist state lawmakers understand and develop appropriate policies on issues facing grandparents and other relatives caring for children in the child welfare system.  One of the most important results of the project was the creation of the Kinship Care Legislative Policy Network as a resource and opportunity for peer exchange on state initiatives on grandparent caregiving.  The Network includes 158 legislators and staff from 26 states. 

Through the project, NCSL staff gained a more complete understanding of the complex issues facing grandparent and other elderly relative caregivers. The staff gained knowledge about the various policy options available to lawmakers, child welfare and other state human service agency administrators, and they learned about state program practices, models, and experiences.

NCSL staff shared its knowledge in several ways.  A resource bank was developed and made available through the NCSL website.  It includes summaries of all kinship care legislation enacted from 1998 to 2005 pertaining to relative placement, medical consent and school enrollment, subsidized guardianship, de facto custodianship, and kinship care navigator programs.  It also includes reports on the mental health needs of grandparent caregiver families and health care issues for children in kinship care.

During the one-year grant period, NCSL received 38 information requests from legislators and legislative staff.  This compared to a total of 34 over the three preceding years.  Its website received 30 to 50 hits per week.  To view NCSL’s child welfare kinship and foster care website, go to http://www.ncsl.org/programs/cyf/fostercare.htm.

NCSL produced a LegisBrief that described state laws on enrolling children in school and obtaining necessary medical care and treatment.  The brief was distributed to key legislative staff in every state and was put on NCSL’s website.  NCSL’s magazine also included an article on kinship care policy.  This publication goes to state legislators, members of Congress, governors, lobbyists, political scientists, libraries, and universities.

NCSL conducted a session entitled “Supporting Grandparent and Relative Caregivers: Lessons from Illinois ” at a Chicago forum.  Ten states’ legislators and their staff attended.  NCSL also conducted a 90-minute web-assisted audio conference in which 68 legislators, legislative staff, child welfare administrators, researchers, funders, child advocates, and others were updated on recent legislation to support grandparent and other relative caregivers of children. 

NCSL has committed to continuing the Kinship Care Legislative Policy Network, monitoring and informing on kinship care legislative activity, and responding to legislative requests for information, research, and policy analysis.

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Wayne State University
656 W. Kirby
Detroit, Michigan  48202
Peter Lichtenberg, Ph.D., ABPP, Director, Institute of Gerontology
Phone:  313-577-2297
Website:  http://www.iog.wayne.edu

2007, one-year grant of $24,000 for one-day seminar New Tools and New Methods for Enhancing Mental and Physical Health in Late Life.

With this grant, on May 14-15, 2007, Wayne State University’s Institute of Gerontology held its 20th annual continuing education conference:  New Tools and New Methods for Enhancing Mental and Physical Health in Late Life.

The conference extended over two days and a total of 340 persons attended.  They included nurses, social workers, physicians, psychologists, continuing care community administrators, and students from a variety of fields.

The focus of the first day was on optimizing physical and behavioral health in persons with dementia.  Topics included recognizing and evaluating incontinence, understanding the use of neuropsychology in differential diagnosis, implications of personhood for caregiving, and the benefit of home care for physical and mental functioning.  The focus of the second day was on innovations in promoting older adult physical and mental health.  Topics included examining barriers and impacts of substance abuse on older persons, use of artificial intelligence in supporting wellness and aging-in-place, and effectiveness of comprehensive home monitoring services.  Many of the presentations at this year's conference, including those on caregiving, community mobility and home visits, were products of the RRF-funded initiative, "Building Occupational Therapists' Skills and Competencies to Advance Mental Health Practice."

University of Colorado at Colorado Springs
1420 Austin Bluffs Parkway
Colorado Springs, Colorado  80918
Sara Honn Qualls, Ph.D., Director, Gerontology Center
Phone:  719-471-4884
Website:  http://web.uccs.edu/agingcenter/

2007, one-year grant of $25,000  in partial support of a third year of Clinical Geropsychology Conference Series.

The University of Colorado at Colorado Springs received this grant for its third National Clinical Geropsychology Conference.  Entitled Aging Families and Caregiving, the conference was co-sponsored by Division 20 of the American Psychological Association and the Colorado Chapter of the National Association of Social Workers.  Twelve continuing education sessions were offered.   Objectives of the conference were to discuss implications of demographic changes on family structures in later life; analyze family dynamics that provide context for common tasks and challenges of later life; describe developmental changes experienced by families during later life; and explore alternative assessments and interventions useful with later life families.   The keynote speaker was Orien Reid, Ph.D., from Alzheimer's Disease International.

The conference attracted 61 participants from 16 states with 39 from Colorado.  Participants included clinical psychologists and neuropsychologists, clinical social workers, geriatric care managers, psychiatric nurses, graduate students, and individuals from other health care organizations.

A book based on the Conference presentations is scheduled to be published by Wiley and Sons in May 2008.

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Meals on Wheels Foundation of Cook County (MOWF)
208 S. LaSalle St., Suite 1900
Chicago, Illinois  60604-1001
Ann McLone Cooper, CEO
312-207-5290
Website:    www.mowcookcounty.org

2005, two-year grant of $75,000 to hire a Director of Development to enable this public awareness program to become financially independent and stronger in its ability to raise funds for the Community Nutrition Network, which provides home-delivered meals to seniors.

MOWF raises funds for the Community Nutrition Network and Senior Services Association, which is the agency that provides meals for elderly who are isolated and at risk for poor nutrition.  The meals program serves the elderly of Cook, Kendall, and Grundy Counties.  This grant enabled MOWF to hire its first resource development staff.  Over the two-year period, they raised more than $ 440,000 in new money (over and above RRF funds).  This was almost three times the projection of $158,000 over two years.  MOWF more than doubled its donor base from 6,000 to 13,000.  It purchased Razors Edge software to track donor giving, manage the growing direct mail campaign, and improve the donor acknowledgement system.  MOWF has identified at least 70 individuals as the bases for a new major donor and planned giving program.

With improvements in fundraising, MOWF was able to increase significantly the number of meals it supports.  Since the start of the grant, the number of meals supported by MOWF rose from 8,000 to over 19,000 per year, an increase of more than 325%.

MOWF also worked on board governance and added three new board members.  RRF made a second OCB grant to MOWF in May 2007 to continue working on board development and its major gifts and planned giving programs.

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