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In Case You Missed It: Aging Friendly City

We had a great Chicago Bridge educational event on Wednesday! Joyce Gallagher, the Executive Director of the City of Chicago Area Agency on Aging, provided some wonderful background into the Age Friendly movement and then delved deeper into the successes in Chicago. Four neighborhoods have instituted the Age Friendly model with a grass roots effort by neighborhood associations and volunteers, most notably in Englewood and Pilsen. Twenty-one total neighborhoods are on the docket to adopt the model. The Age Friendly initiative also involves every department in the city of Chicago, including the police, fire, HR, and others, and each offers their unique contributions. The City of Chicago and its Area Agency on Aging, with the passionate leadership of Joyce Gallagher, work with other urban governments to continue to bring unique solutions and continued the momentum to the Age Friendly initiative.

Thank you to the Kott Gerontology Institute for the awesome spread of food and drink!

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In Case You Missed It: Older Adults & Immigration

img_5418Last week the Chicago Bridge, in collaboration with Rush University and the Continuing Education Institute of Illinois, hosted a panel discussion on Older Adults & Immigration. The panel participants, Padraic Stanley, MSW of Rush University’s Heath & Aging Department, Yadira Montoya, MSPH of Rush University’s Alzheimer’s Disease Center and Adela Carlin, J.D. of the Legal Assistance Foundation, presented a wealth of information regarding the aging immigrant population in Chicago and across the nation, tips for the clinical practice and wonderful stories about the resiliency of undocumented immigrants who despite contributing to the American economy are often, if not always, locked out of essential services.

Fast Facts

  • 20% of Chicago’s population was born outside of the United States
  • 172,000 Older Adults in Illinois speak limited English
    • 40,000 Mexican heritage
    • 21,000 Polish heritage
    • 11,000 Puerto Rican heritage
    • 9,000 Chinese heritage
    • 91,000 Mix of other nationalities and cultures all at least with 1,000 or more older adults
  • Non-English speaking elderly are 2x more likely to live in poverty
  • There are roughly 511,000 undocumented immigrants in Chicago
  • Roughly $14 billion in taxes are filed by those who do not have Social Security numbers — this amount has been attributed to the contributions of undocumented immigrants through the use of a Individual Taxpayer Identification Number or ITIN
  • 50%-60% of those left uninsured after the passage of the Affordable Care Act are undocumented immigrants

Tips for Clinical Practice

  1.  Know when you need to know immigration status & when you do not. Is there is a funding source that requires this information?
  2. Ask what the client’s preferred language ?
  3. Why did the client move to the United States? Were they coming to meet family? For work? Fleeing violence? Knowing this can give you an idea of what background/perspective they may be coming from.
  4. If not familiar with a culture or nationality seek out experts that can connect you with resources or groups that may serve as a support for the client. Seek out historical information about that culture and their movement into the U.S.
  5. Find out how the client is surviving? Do they have family or community support ? What are their resiliency factors?

Resources

Coalition of Limited English Speaking Elderly (CLESE)

CLESE – Profile of Limited English Speaking Older Adults in Metro Chicago

Migration Policy U.S. Data Tools

Latinos in America – PBS Special 

National Hispanic Council on Aging – Status of Hispanic Older Adults: Recommendations from the Field

Internet Comes Through In A Big Way for 89-Year Old Popsicle Man 

Hunger Among Seniors In Cook County (PDF)

LEP Older Adults Metropolitan Chicago Report (PDF)

LEP Populations Over 65 By Township (PDF)

 

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Elderly with no nearby family to help them need safety net, experts say

The brother and sister, both unmarried, childless and in their 80s, had been fending for themselves in their Vernon Hills home: avoiding neighbors, ordering groceries, skipping doctors’ appointments.

“They lived in a home that was like something out of the reality show ‘Hoarders,'” says professional patient advocate Teri Dreher, who was called in by a local hospital after the brother fell down the stairs, fracturing some ribs.

“They had five to six years of newspapers and magazines, they were paranoid, they had neighbors who were trying to have them sign papers (giving up) control of their finances.”

Sometimes called elder orphans, seniors with no relatives available to help them manage aging and illness are a large and likely growing group, according to Dr. Maria Torroella Carney, chief of geriatrics and palliative medicine at Northwell Health in New Hyde Park, N.Y. Roughly 22 percent of adults over the age of 65 are elder orphans or are at risk of becoming elder orphans because they don’t have spouses, children, or siblings who live nearby, according to an analysis by Carney and three co-authors that was presented at the American Geriatrics Society’s 2015 annual meeting.

“We’re seeing these individuals, they’re right under our noses, we just are not necessarily alert to them,” Carney said.

“Maybe that’s where we can start improving things: We can have the awareness and try to bring in family members that are available to be more involved. Let’s educate patients that we see as physicians that might be elder orphans, while they have their independence, about how are you going to deal with living in the community for as long as possible?”

Almost 19 percent of women ages 40 to 44 are childless, as compared to about 10 percent in 1980, according to U.S. census data quoted in Carney’s presentation. And a third of Americans ages 45-63 are single, an increase of 50 percent since 1980.

That could leave more of us without ready access to family support as we age.

Cook County Public Guardian Robert Harris said an increasing number of elderly people with cognitive disabilities need guardians to handle their financial assets, and private agencies have been cropping up to fill the need. His office provides guardianship to 650 people with cognitive disabilities, most of them elderly.

Harris recommends drawing up a will, an advance directive and power of attorney documents while you’re still in good health, so that your wishes are clear and someone else can make decisions on your behalf, should that become necessary.

“If you don’t have children or relatives, you can name a really good friend, or you can set up a bank or some other institution as a fiduciary to take care of you,” he said.

Carney said her 22 percent figure for elder orphans is only an estimate, based on the University of Michigan’s Health and Retirement Study. More work is needed, she said, both to ascertain the number of older Americans at risk, and to develop strategic plans for the hospitals, government health agencies and private nonprofits involved in their care.

Elder orphans are at higher risk for isolation, depression, not following up with doctors’ treatment recommendations and being readmitted after a hospitalization, Carney said.

She’d like to see interdisciplinary teams with medical professionals and social workers act as resources for doctors treating elder orphans; the teams could do comprehensive assessments and link patients with the services they need to stay independent.

As for the brother and sister in Vernon Hills, by the time Dreher, owner of North Shore Patient Advocates in Chicago, was sent in to do an assessment, both had diabetes and showed signs of early dementia. The sister’s ankles were swollen to three times their normal size, likely from congestive heart failure.

Neither sibling ever married or had children, but the brother had done well in the stock market, and had money to pay for good care.

“We had to call Catholic Charities and get a court-appointed guardian for them,” Dreher said.

“They ended up moving into a nice assisted living facility (and) they did quite well. Catholic Charities had volunteers go over and pick them up and take them to their doctors’ appointments and visit them and everything. Their nutrition improved, and they did much better.”

nschoenberg@chicagotribune.com

Twitter @nschoenberg

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What is Brain Health? Laugh Lines

This past weekend members of the Chicago Bridge leadership core along with professionals from numerous aging organizations and community members joined together to engage their brains through story telling. The audience was guided through stories and memories from seven story tellers who took listeners on international adventures, humorous everyday moments and brought childhood memories to life. Each tale provided a glimpse into the storyteller’s past and taught the audience important life lessons. In between stories the host CBS’s Ryan Baker provided the audience with important tips on how to keep your brain healthy and active.

Six of the participants were competing for title of best storyteller and a free class at Second City’s Humor Doesn’t Retire: Improv for Seniors.

In case you missed the event we invite you to listen to all the stories, including the winner Omiyale Duparte’s follow @ACLbrainhealth on Facebook or Twitter. If you would like to learn more how to keep your brain engaged visit brainhealth.gov.

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In Case You Missed It: Death Cafe

On Wednesday May 20th, Chicago Bridge hosted a Death Cafe at the Replogle Center in downtown Chicago. The event was coordinated by Grace Thornton and Dan Bulf. Elise Magers of the Replogle Center (location host) and Lydia Morris from Gentle Home Care (our generous food sponsor) gave a brief presentations about the services that their agencies provide. Dan Bulf gave an overview of the history and philosophy behind Death Cafes, which are being hosted around the world to facilitate conversations about death and dying. Dan led us in a conversation about our own experiences and beliefs, including questions like: What do you consider a “good” death? Whose death affected you the most and why? and What do you want your legacy to be? Along the way, we discussed our feelings surrounding these conversations about death, and how both talking and listening to others speak about death and dying affected us. Overall, the evening was a wonderfully eye-opening and reflective experience. You can learn more about Death Cafes at: http://www.deathcafe.com

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Chicago Bridge Networking March Event

Join us at the 2015 American Society on Aging, Aging in America Conference. Chicago Bridge will be meeting at Big Bar located at the Hyatt Regency Chicago Hotel.

Food and drinks will be available for purchase on your own. Conference registration is not required.

 

When: Wednesday, March 25th, 2015
Where: Big Bar, Hyatt Regency Chicago Hotel, 151 East Upper Wacker Drive, Chicago, IL
Time: 5:15-7:15pm
RSVP Here
We look forward to seeing you!
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Save the Date: The Annual Planning Meeting!

What does 2015 hold for the Chicago Bridge?  

Bring your ideas to the Annual Planning Meeting to give your input!

Chicago Bridge members will brainstorm future events and share ideas on where to take the Chicago Bridge into the New Year. Please join us! Our generous sponsor, The Terraces at The Clare, will once again provide a 5-star food experience with dinner and wine provided. The event will be held on the 53rd floor with great views of the lake. This is sure to be another successful event!

If you have never been to a Chicago Bridge meeting or if you are a seasoned member, please know that everyone is welcome!

When: Wednesday, January 21, 2015 from 6pm-8pm.

Where: The Terraces at The Clare 55 E. Pearson St. (53rd Floor) Chicago, IL  60611

Parking & Transportation Details: Complimentary valet parking will be available at The Clare on the Rush Street entrance. The Clare is also accessible via the CTA Red Line Chicago stop, as well CTA Bus #: 3, 10, 26, 36, 66, 125, 143, 146, 147, 148, 151.

Please RSVP by Wednesday, January 14 at: 

https://docs.google.com/forms/d/1zzn2r2VJhq1C06sXXggUsEO-VyEPPbzwbRaNQSffRj0/viewform?usp=send_form

We look forward to seeing you there!!

– Chicago Bridge Leadership Teams (2012-2014 & 2015-2017)

 

Volunteerism in Older Adulthood

This past week, I had the pleasure of working with the volunteers who run and operate Highland Park Access Television. They had asked me to come to the station to speak about the benefits of Assisted Living. The experience brought my attention to the value that volunteering can bring to the lives of seniors.

Highland Park Access Television is quite unique because it is operated and run entirely by volunteers over the age of 65.  The Highland Park Senior TV Production Team known as Highland Park Senior Producers is affiliated with Highland Park Senior Center, and each month they produce a 30-minute program that features agency programs and services available through CJE SeniorLife. The participants’ average age is the mid-seventies. They recruit for show producers, directors, camera operators, audio technicians, and character generator operators. Some producers have physical limitations, but there is a job for everyone. It truly takes a team to complete a show.

There has been an influx of older adults choosing to volunteer later in life. Currently, we have a dozen older adult volunteers at the assisted living community in which I work who conduct lectures, educational seminars, lead religious services, help serve at mealtime and assist in creative arts programming.

According to the Administration on Aging, volunteering by older adults (65 and older) has increased in recent years. A recent report by The Corporation for National and Community Service states that the number of older adults who serve as volunteers has risen from 7.7 million in 2002 to 9.1 million in 2009.

There are many benefits for older adults when volunteering, for example their physical and mental health can improve. Some benefits to volunteerism include:

1. Sense of purpose and self-worth.
2. Improved mental and physical health.
3. Increased confidence in one’s ability to make a difference in the community.
4. Greater social support and community involvement.
5. Exposure to new experiences and perspectives.
6. Increased connection to younger generation.

Some feel that volunteering also helps to decrease loneliness. Chicago Bridger Sharon Belloff’s post “Volunteerism: One Remedy for Loneliness in Aging” highlights how loneliness in older adults can be more harmful than smoking and how having an older adult engaged in volunteering decreases feelings of loneliness and depression.

For many years, my grandmother volunteered at Chicago Botanic Gardens in Glencoe. She would greet guests and work with inter-city youth to give them an experience in gardening and identifying vegetables. She spoke of her volunteer work with great enthusiasm, achievement and happiness. It provided her with a sense of worth and gave her a purpose. I feel it contributed positively to her mental health. Specifically, age can be a factor of the positive benefits of volunteering. While younger volunteers may be volunteering out of obligation, older adults see volunteering as having a sense of purpose.

How can older adults get involved in volunteering?

There are many volunteer opportunities for older adults in the Chicago Area. Some specific opportunities are available at the local hospitals, religious institutions, museums, retirement communities, and libraries. As described by Chicago Bridger Jeff Nelson, The Jane Addams Hull House Association’s Retired Senior Volunteer Program provides the opportunity for older adults to volunteer at over 137 nonprofit organizations.

It is never too late to give back to the community. No matter how old you may be, there is always an opportunity to find meaning and to make a difference especially by volunteering.

Thanks to Martha Tierney for editing this post and Jonathan Schmid for the photo.

Near Death Experiences

We may not always want to acknowledge it, but often we know a relative is dying. Improved technology is allowing doctors to better predict when the end is near. Many patients are opting for hospice and palliative care at the end of their lives. This time can be exceptionally difficult for families. In addition to the stress of loss and grieving, many find they must also handle the financial and business affairs of their relative. Unfortunately, there is not a guidebook for end of life legal issues. Chicago Bridge member Amy Roth asserts, “Death is the one outcome we are sure of, yet most of us choose to avoid thinking about it or planning for it until something happens.”

7 Legal Steps You Can Take When a Loved One is Dying

Here is a list of some common concerns and how you can address them.

1. Prepare Powers of Attorney
If your relative has not prepared powers of attorney, and they are still competent to do so, this is the most important thing to do. A power of attorney for health care allows a designated agent to make medical decisions when the patient is unable to do so. A power of attorney for property allows an agent to make financial decisions for the patient. Without these, it may be necessary to open up a guardianship – a process that is much more expensive and time consuming. Powers of attorney are inexpensive and easy. When a serious illness is first diagnosed it is important to get this done quickly before the client’s condition worsens.

2. Mind the Medical Treatment
Few things are as important as getting good medical care. Whoever is designated as the agent under the power of attorney for health care will have the responsibility to advocate for their relative. As dementia or terminal illness progresses, the patient becomes less able to advocate for themselves. At times, it can help to consult with a care manager . Involving a friend or relative with a medical background can also be a help.

3. Protect the Finances
The person who is the agent under a power of attorney for property has the responsibility of protecting the monetary assets. Often, the named agent is a spouse or child who is already grieving. Worse, they may not have any experience handling the finances. Remember that you can get professional help performing these tasks (example: The Sprau Advocate Group). There are a number of common pitfalls to consider:

A. Keeping the bills current – when somebody is in residential care for a period of months, it can be easy to forget that utility bills are accumulating. If the gas gets turned off, pipes could burst, electronics could be ruined. These can be expensive problems.
B. Monitor the mail – many of these issues can be avoided by making sure that you are monitoring the mail. If you cannot physically get it from the house, go to the post office and have the mail forwarded to you.
C. Check the insurance – Allowing a lapse in insurance coverage can have disastrous consequences. A term life insurance policy could expire just at the time that the benefits may be needed. Long term care insurance or disability insurance could be lost at the time it is most needed. Remember, too, that many homeowner’s insurance policies do not cover a house that is unoccupied. If the homeowner has been in a nursing home for several months, this could be an issue.
D. Remember the taxes – it is still necessary to file taxes for your relative who is incapacitated. This includes real estate taxes, state and federal income taxes. Sometimes it is not possible to gather enough information to file on time, but at least you should file for an extension. An accountant or lawyer can help gather the required documents.

4. Estate Planning
Everybody puts off estate planning. It is just one of those things can be hard to prioritize when you are healthy. If your relative is one of those people who put it off, this is the time to address it. For some, the decision to make a plan is simply too late. If the person has lost the ability to make decisions, they will not be able to prepare a will or trust. If they still have the capacity, you need to act quickly to help them complete the plan they want and sign it. Even if they have an estate plan, this is a good time to make sure that things are set up correctly. For example – many people prepare trust agreements, but never take the final step of putting their assets into the name of the trust. When this occurs, the trust cannot perform its intended function of avoiding probate. This is a problem that can be fixed if you act quickly. If successful, this type of change could allow the estate to pass quickly and seamlessly to the survivors – as opposed to being tied up in probate court for a year or more.

5. Seek Advice

Before you take any steps to move money or change how assets are titled, you should consult with a professional.

Many well meaning people have shuffled assets in the final weeks of a relatives life, only to defeat the purpose of that person’s estate plan. Closing an IRA and putting it into a joint checking account, for example, not only changes who will receive the money, but may also have serious tax consequences. Most good lawyers will agree to a free consultation to discuss these issues. If you come to that meeting organized, you can get a lot of your questions answered.

6. Have a Discussion About End of Life Issues
Some of this discussion may happen when your relative prepares the power of attorney for health care. Still, it is good to discuss these issues with immediate family so that everybody knows their wishes. Then you can go about making sure that the correct measures are in place: plans for hospice care, a Do Not Resuscitate order, powers of attorney and perhaps a living will as well. Chicago Bridge member, Arlene Wanetick, offers a variety of examples of how a person can take creative ownership over their own funeral.

7. Enjoy The Time Remaining
Nothing is more important than being with your loved one in their final days.

Getting your relative’s legal house in order early will give them peace of mind. It will help free you up to spend time with them in their final days. It also honors them by ensuring that their wishes are observed.

Thanks Anne Marie Crowe for her work editing the article and Paul Moody for the photo.