 Ableton on Air is sponsored in part by Green Mountain Support Services, empowering neighbors with disabilities to be at home in the community. Additional support for Ableton on Air is sponsored in part by Washington County Mental Health Services, where hope and support come together. Thank you to our sponsors. Welcome to this edition of Ableton on Air, the one and only program that focuses on the needs, concerns and achievements of the differently abled. In Vermont and beyond, I've always been your host, Lauren Syler Arlene, is off today. Before we get to our guests from the Council on Aging, I would like to mention, according to the BBC News reports and reports from the news lately, there's been a polar vortex of a very bad cold snap that's been happening in our country right now, and 21 people, according to news reports, 21 people have passed away due to that. Speaking of which, the Attorney General's Office warns of increased hypothermia, risk for vulnerable Vermonters, and there's heating assistance available. Why don't we go to our guests so they can explain more about that. Our guests today are from the Council on Aging. Vermont, why don't you guys introduce yourselves? I'm Chris Shaw, I'm from the Central Vermont Council on Aging, and I provide information and assistance in our very office. Good. And? Hi, I'm Barb Asen at the Central Vermont Council on Aging. I'm the Director of Family Caregiver Support. Since we spoke about, before we get to the missions and goals of your program, since we spoke about the heating assistance and all the problems that we're having now with the cold snap and vulnerable populations, explain what your office can do for that particular program or for vulnerable Vermonters. What we can do is connect people with a variety of programs. There's the, well, LIHEAP, low-income heating assistance. There's also Crisis Fuel for people who maybe weren't eligible for that program or got a benefit from that program and have used it. And with temperatures like we have this year, your benefit gets used up pretty quickly. There are also some things like the weatherization program. There are some other sources of funds sometimes for heat or for maybe some extra weatherization, things like that. Well, okay. What are the missions and goals of the Council on Aging, since we're on the topic? Well, our mission is to support seniors, particularly in living with dignity and with their own choices of the way they wish to live. Okay. Since you said that, you can chime in on this as well. Being part of a community is vitally important, especially for elderly or seniors. How does your program bring all of that into force, like really helping people being part of a community? Yes. Well, say from the outset that we have many partners that we work with. No one organization, let alone one person, can do this alone. So for example, we help people who are looking to have connection in community find adult day services, like Project Independence or one of the other adult days in our region. And we cover Washington County, LaMoyle County, Orange County and some outlying towns. So it's pretty big scope out there. That's one way. We offer some direct activities when you want. We can talk specifically about how we're reaching out to family caregivers and people who are living with dementia. Okay. Now, since you mentioned Alzheimer's and dementia, people get confused between the two. What is the definition? You know, the short of it. What is the definition of Alzheimer's and dementia and how does that all play into? Okay. Well, briefly, dementia is talking about brain changes that affect people's judgments and their thinking and their memory quite often too. So it's an umbrella term under which there are many different specific conditions. Alzheimer's is the most widely diagnosed one that we find probably 60% of dementias are diagnosed as Alzheimer's. Do Alzheimer's and dementia happen just in seniors or can it? No, and of course there are other causes too. So Alzheimer's disease and other dementias like vascular dementias that might be caused by a stroke or Parkinson's disease might have a dementia aspect of it. And diseases can hit people at different times. Most common with Alzheimer's, most common in the population 65 years and older and especially over 80. You mentioned project independence. What exactly is that and the difference between game programs and so on and so forth. Right. So we have just to distinguish, there are many senior activity centers in our area and they are a vital place where people come together for congregate meals, for sharing meals as well as many activities, educational activities and we do outreach with them. For people who have needs to be safe and engaged and have community and maybe even have some medical assistance during the day such as taking medications or perhaps even bathing, adult day programs can address that level of care. And so they're actually really important as a kind of a social club. So more than a place just for safety, it's really to enrich the lives of people who can use that, you know, at that point. And it's true that if it benefits caregivers very much too because they know that their loved one is in a place. So it's like a respite of sorts. That's an aspect of it for sure. It's respite for the caregiver. But probably most important is that it's social engagement and, you know, engagement on various levels with live music and fun conversation and people of different abilities and different conditions can go. Okay. Well, you mentioned different programs. What if, here's the scenario, what if someone needs further care such as a nursing home or nursing facility? Does your program at Council on Aging help with transitioning from that? Let's talk first about, again, it depends on the exact situation. If people maybe are getting services through long-term care Medicaid, that program is called Choices for Care. So people have a choice of receiving that care in their own home, in a residential care, like an assisted living type facility or in a nursing home. So that may be a continuum for that person. What's the difference between a nursing home and a facility, a living facility? Assisted living residential care type facility is for people generally who don't have quite the level of medical need that somebody would have in a nursing home. So a nursing home would be considered a level three? A nursing home, basically a hospital is a level one. A nursing home for most people is a level two. Sometimes they get some level one services, but generally it's level two. A residential care home for the most part are level threes, which means they have some nursing oversight. Medication help, et cetera. Right. Some places have a nurse 24-7. Some people have a nurse who maybe comes in a couple of times a week. It depends. And the level of care that a residential care home would be willing to provide varies from one home to another, depending on their setup. They tend to have- How long has Council on Aging been around or doing programs in Vermont itself? I mean, what is the history of, some of the history of Council on Aging? It was, the agencies on aging originally were created by the Older Americans Act in 1964, same time as Medicare. Originally, it was kind of a diverse situation where a number of the meal sites might have had some advocacy services and they would provide transportation to meal sites. And in the 80s, I believe, they basically construed the language of the Older Americans Act a little differently and looked more closely, which said that the agencies on aging should not be providing those types of direct services. Why is that? I mean, those services are important. Oh, they are. And what happened is that they transferred the way that they provide those services. A big part of our funding now is funds that go out to support senior centers, transportation, the nutrition programs, those things. So we support those programs, but they're run independently. So they contract to us to provide those services. And we oversee some of those services. Maybe you could also talk about what options counseling is, how people find out about those services. Yeah, like some people might be scared of, okay, I'm a certain age now and I need, I would like to go to some of these programs if I don't know about them. So yeah, how does the counseling part work? Or the intake. Most often those things come in through our helpline, our statewide 800 number. Which we can mention at the end of the program. Which we will. Sometimes we get referrals from doctors' offices or neighbors or any number of other entities in the community. And usually at that point we would reach out to someone and do options counseling, which is really just to sit down with somebody and let them know what's available out in the community to look at what their specific goals are, what they want, what they're willing to take, what they don't want to hear about. What do you mean by what if they're willing to take and what if they don't want to hear? What do you mean? Well, I can't tell you how many people have said I am never ever going to a nursing home. So that's fine. And we can talk about, okay, these are some things that you can do that will make it easier, safer, better for you to be in your home. These are some other options that would be out there for you. Yeah, I was looking at a listing. There's lots of listings, or several listings in Vermont, of nursing home and care facilities and those things. Matter of fact, one of them is run by CVH. So, you know, those are important for those who need it. Absolutely. But a person, in my opinion, I feel that, I mean, a person shouldn't be forced to go into those, if they don't have to, right? Or how does that work? There are a lot more options now for people to get care at home. Long-term care Medicaid can pay for care in the home. There are some other programs, depending on people's financial eligibility, that could pay for care in the home. Oh, it has to go according to financial eligibility. It depends. Some things do, long-term care Medicaid can pay for a lot of care in the home. There are some other programs, moderate needs is for people who need a little help. Maybe it's a couple hours a week. What is the moderate needs program? It's an offshoot of long-term care Medicaid. And it's intended, it's through Medicaid. The financial piece is more lenient than long-term care Medicaid. Paperwork is much more lenient. And it's for people who don't need a whole lot. Maybe they need somebody to go to the grocery store or somebody to make some meals and put them in the fridge so they could microwave them later. Or someone to help clean the apartment. Right, yeah, heavier things that they can't do. I mean, this is an area where advocacy is an important dimension, too, because there's really quite a bit less funding for stuff like moderate needs than is needed. And if you look at it as a preventive factor for helping people get that level of need so that their situation doesn't worsen, it's really good investment. A meaning that if they don't have help with getting their meals together, then their health condition could deteriorate. So it's a good investment to do that more upstream level of care. You could spend a little bit of money now, which may prevent them needing a nursing home in the future. And so that we do want people to know about that service, but in terms of managing expectations about it, we often are hitting limits about the availability. Because... And then it might become more available. One of the ways that moderate needs is used is to pay for adult day services as well. When we talk about nursing homes, also, Chris is going to briefly mention this. I've heard in different states they've had issues with nursing home abuse and certain programs with abuse with patients. And does Council on Aging advocate for programs that deal with abuse and elderly? Or how does your program help with that? Absolutely. One of the services that we contract to is Vermont Legal Aid, which has the long-term care ombudsman who deals with direct issues. If a particular person isn't getting the services that they need or has a complaint about something, they will try to work, hopefully, in a negotiable way with the nursing home to try to figure those things out. Because I've heard in the past, I've heard some horrible stories on the news about abuse and nursing homes and that type of thing. We also work with Adult Protective Services, which is a state agency, which does investigate issues with nursing homes. If we make a complaint, we're also mandated reporters. So if we see something... Say, if you see something, they have it in New York too. You see something? Say something. Exactly. We're required by law to do that. We don't do a lot of direct work within nursing homes, though. We're working with folks who are in the community. Sometimes there is some transition going on where we might get involved. Would you say that to the case? There are a lot of people who are there short-term for rehab, maybe had a hip replacement or had pneumonia and are there something like that. So we help people transition back into the community. So I mean, we do a fair amount of work, not with people who are long-term in the nursing home, but we go to discharge planning meetings, help people figure out what do you need to accomplish in the nursing home so that you can safely go home? Do you need something different when you get home than you've had so that you don't have to come back? Because one of the things that we're mentioning on your program today is it's vitally important on this program today to say that what your program does is remarkable because you don't want to take the person's independence away. And that's why you have project independence. Because a lot of people are scared of getting older. So what are some of the myths or the misconceptions around elderly people if a person is special needs and elderly at the same time? What are some of the misconceptions around that people might be afraid of or so on? Well, one would be that people are not able to learn new things when actually they really are and even for people with dementias, they're still able to enjoy many important things in life. Some of the information isn't there, but all of the feelings are intact. So in terms of being able to have joy and have relationships and experience quality of life, that's still there. Since we mentioned quality of life, I noticed you have an event coming up. Explain about the member bull times cafe. Be glad to. So there is an international movement that's been going on for years called memory cafes. And in central Vermont, we actually for four and a half years had been running Montpelier memory cafe at the Montpelier Senior Activity Center on Saturday mornings. And that was going very well, four and a half years good run. And we came to think that we might want to try a different venue and a different time of the week to reach people we hadn't reached before. We got connected with a region wide, what they call the memory cafe percolator, which is cute when you think about coffee and percolators. And to get the benefit of what people in the broader region, this is talking about Boston region and New England, we're finding and some of the things that were important are what we have brought to a reconfiguration of memory cafe that we now call memorable times cafe. It's a monthly activity. It's a social activity for people with refreshments and activities for people with early to middle stage memory loss. We wouldn't turn anybody away, but that's who it really works for best. And they're care partners. It's not a drop off thing. It's a way that friends, family members, your spouses can come and be in a space where they don't have to feel embarrassed or misunderstood because they're having difficulties with memory or with speech or with, you know, doing some things that they used to do. But the whole activity is aimed toward bringing out what people still can enjoy. This activity, which is held at the Vermont History Center, we meet the third Wednesday of every month from 1.30 to 3.00 PM. Yeah, it's just here for more information. For the memory cafe, you can... That's me. Go ahead. That's me. At the Council on Aging. But we're doing this in partnership with the Abel Library of the Vermont Department of Libraries, which formerly was called the Special Services Unit. But they moved from the Pavilion Building in Montpelier to the Vermont History Center, that gorgeous building. It was the Spalding High School originally, has the Robert Byrne Statue in front, that wonderful building with exhibits that are standing exhibits and changing exhibits. And the Abel Library, Abel stands for Audio, Braille, Large Print, and Electronic Media. They're great partners because they bring in all these resources that we actually use in the Memorable Times Cafe, books that we look at together. We've had some, they have these things called Remembrance Kits that the Library owns. Braille, for what I understand, I'm visually impaired myself. Braille, when you print a book, it's a huge print. So, yeah. And they have talking books. And actually, since we've been partnering together since October, it's been wonderful because people who are coming to Memory Cafe because they want that social activity have had access to the staff and the resources. And it's all free. They get signed up. They're able to receive the talking book materials at home by mail. You return it by free from mail. And it's just been a wonderful partnership. And we're reaching a lot of new people. They're really enjoying it. And the best part is that with some of the prompts that we bring in, people are telling their own stories. I mean, stories are so rich and so important. And you'll see family members, you know, hearing stories for the first time, even from their spouse. And it's been very gratifying to be part of that. So that's a once-a-month activity that is a dementia-friendly community initiative. Okay. Now, in terms of... So, explain some of the... Let's go into the meat of this. Okay, so you have various programs. Explain some of the other programs that you guys have that are vitally important for people to know about. Well, we provide support to local transportation. We have a volunteer program which can do kind of odd things that don't come from other places. For example? Some of it's just socialization. Somebody needs a visit. Sometimes it's a little housework. A common thing because there aren't a lot of programs that cover people who have some kind of a short-term medical issue. You know, I broke my arm and I can't wash the dishes for the next six weeks, things like that. They're not going to be eligible for other support programs because it's so short-term. But we can often provide a volunteer who can provide that short-term support that they need until they're functional again. Some of our volunteer programs, too, are a way that older Vermonters can contribute themselves. So it's really important on both sides, we're serving older Vermonters, but also engaging older Vermonters to contribute that way. In fact, the senior companion program, people can work for a stipend, a tax-free stipend, if they themselves are age and income-eligible for up to 20 hours a week. And some of those relationships that are formed are great. We have a beautiful video on our website that features that program. Anybody who might be interested should take a look at that. Go ahead. That's another case management piece. I've also got our information and assistance department for people, again, with maybe a single issue, trying to figure out something short-term, or we'll get people say, well, I'm 95 and I'm doing great, but I just want to know what's out there for when I get old. And we'll go meet with people and just talk about, okay, at a point, if you're not doing great, these are some possibilities. Or there may be some issue going on right now that somebody needs help with, and those people would be seen by our information and assistance department. Do you think people are scared of services? Oh, absolutely. And why is that? Their biggest fear is that somebody's going to make them go to a nursing home, take away their independence in some way, make choices for them, make them do something. They're going to make me move out of my house, and that's where I want to be. And that's not at all what we do. I mean, our job is to help people do the things that they identify that are important to them, which for many people is staying in their house. For some people, it's, you know, I'm tired of this big house, and I don't want to mow the lawn anymore, but where else can I go? And we can help people identify those things as well. Yeah. We do case management for people who have long-term needs, who are going to need ongoing support. I notice you have a diagram there. We do, so then. Well, you can show the diagram. We can, we can put it up. Can we put it, this would be a, yes, we could put that up. Well, let me just, I don't see if we can show that. Can you, how do we? Well, so what exactly is this diagram showing? Okay, those are some numbers and statistics, but for different programs that we provide. So if you want to go through that, if you can, to a point. Nutrition services. We funnel a great deal of money, supports the senior centers, most of which have nutrition programs. Yeah, so how do, yeah, the Montpelier Senior Center, for example, how does that work within your program? Like, because I know they have meals there. Right. They're an independent entity. We provide some money that supports them, and we provide some money that supports nutrition through them. The amount that. The Barry Senior Center as well, or just the Montpelier? The Barry Senior Center gets some financial support. They're not a meal site. Oh, they're not? They're not. And generally, all of the senior centers do some fundraising on their own, because the federal funds that we have to pass to them are not as much as they really need. Do you work with meals on wheels as well? Yes, some of our money also goes to support meals on wheels. We do training for. Now, Meals on Wheels is a program where, I guess, when someone either can't cook a meal or doesn't want to cook, they bring food to them. Is that how it works? Yes, they get meals. It varies depending where they are different. Some of the senior centers, for instance, are only open two or three days a week. So they would provide a home-delivered meal on those days. They can generally get frozen meals for the other days that they could microwave. And there are all kinds of reasons people take meals on wheels. It could be a temporary thing. They just got out of the hospital. They're not really up to cooking. It could be a long-term thing. It could be a financial thing. Do you guys also, in the Council on Aging, help people with independent living skills as well? For example, if someone has a stroke and wants to learn how to cook again, or even as simple as dressing of sorts, do you guys help? We don't do that, but we would help them connect with services that would do that. That would often, that would be maybe an occupational therapist through one of the home health agencies, sometimes through some other services, other support services. One of the biggest things we do is connect people to other services that provide whatever specific support it is that they need. And I'll chime in. Of course, one of the big branches of what we do is family caregiver support, because in this network of what's the community made of, caregivers are a big part of holding that net together. Family caregivers unpaid primary caregivers, whether they actually live in the same home as the care receiver or they don't. They might be a spouse. They might be an adult child. They might be another relative. They may be a non-relative, a friend who's really helping this person. And so we see the importance of recognizing all that caregivers are doing and how much it can feel like they're alone. So what we offer are resources, information, activities to help caregivers, first of all, know that they're not alone, validate that they need a break from what they're doing, that they need help. They can't do it all on their own. Yeah, I noticed that, well, when you say can't do it all on your own, some people need respite. So explain what that might mean for a caregiver working with a loved one. Absolutely. Thank you. And so, you know, respite is talking about giving, getting a break. And by the way, sometimes the care receiver needs a break from the caregiver. It can be mutual, you know, and have a relationship. You laugh, but how important is that, having a break? Well, certainly for the caregiver, it's enormous. It's one of the things where people find a great deal of stress is feeling like they don't have any time for their own thoughts. And everybody needs to feel, everybody, a care receiver, caregiver needs to feel like they're a person. They're just not this role of caregiver or care receiver. So doing things that, you know, nurture their sense of their own self, their own humanity. We have one program, I'll mention specifically, that does have state funding called Dementia Respite Grant Program. And that is recognizing that the caregivers for people with Alzheimer's and related dementias are especially vulnerable to a high level of stress that can have medical implication too. And so we have grants available. They run with the state budget year. They are renewable for people who qualify for that, but don't yet qualify for choices for care, the long-term care Medicaid. And that allows the caregiver to hire substitute care, whether from a licensed agency or an individual that they want to hire and for whom we assist them for free with getting a background check cleared. You mentioned, I apologize, you mentioned choices for care. What exactly is that? That was, Chris was referring to it earlier. That's the state's long-term care Medicaid program, right? So this is for people who are still in the home, you know, in our service area, the caregiver again can hire substitute care. They can also use grant funds to do things that take some of the stress off of the overall load. So hiring some housekeeping or some help sometimes with the outside work, doing some simple home modification like putting in grab bars so that they're not constantly worried about what's going to happen when their caregiver is having trouble, you know, transferring from one place to another. And, you know, always available to give more information about that to folks who call us. Okay. Since we only have a couple of minutes, well, I mean, we have some time left, but phone numbers, addresses, the importance of getting in touch with Counseling Aging. Well, the helpline, which is often usually the best way to access us is 1-800-642-5119. Mm-hmm. That number is plastered all over everything. And the way that number works is that it connects you to the agency that serves the area you are calling from. There are five. For example. There are five agencies on aging and theoretically, when you call that 800 number, it will connect you to the one that serves where you're standing at the time. In the age of cell phones, sometimes that does not work as well. What do you mean? Well, I live in central Vermont, and if I dial that number, I get connected to the agency in Chinden County. But you can just ask for central Vermont. Yes. We'll get you where you need to go. So it doesn't act, that number doesn't act like 2-1-1, or is it similar to? It is, like, yeah. It is really a 2-1-1 for seniors and differently-abled people. Can you repeat that number again one more time, please? 1-800-642-5119. And before we end the program, the future goals of the importance, well, this was extremely important today, but what are the future, some future goals of Council on Aging? I'll mention one of the kinds of outreach that we want to do to support family caregivers who will then help their loved ones stay at home, is to do some education at work sites. There are so many caregivers who are still doing their best to hold down a job in the community, have challenges with that. They may or may not actually be known to their employers being caregivers. There may have been some sense that that's a risky thing to disclose. So to give employers education and to provide education and resources on site at work sites to reach those folks who are burning the candle at both ends. Well, okay. Well, you say burning the candle at both ends. What exactly does that mean and tell? It might be working in the community at a workplace during the day and coming home or stopping at the home of your parent or something to make sure that their needs are met so that you're working kind of around the clock. And, you know, that there are many things that employers can do to help bring information and resources and support to maintain, to retain really good employees and to see that this is only going to grow. The segment of the population that's providing care as our demographic ages and grows, it's just going to be a more and more present issue for people to be managing the care of loved ones as they are trying to live their lives as well. Okay. Can you mention again the Numerable Times Cafe? Certainly. Numerable Times Cafe is the third Wednesday of each month from 1.30 to 3pm at the Vermont History Center. We also have a course coming up in the spring and we'll offer it in Barry, which is Powerful Tools for Caregivers. That's two hours and afternoon six times, so once a week for one afternoon for two hours. And that is a way that caregivers can meet with other caregivers. It's an evidence-based course. People, we talk about dealing with stress, communication. It's not easy dealing with stress. Not at all. Communication, dealing with family members. It's a mixed bag often times, making hard decisions, taking care of the, the focus is on taking care of the caregiver so that they can be of use. Could you, is there, I noticed a number down here for Council on Aging. Could you give that number, please? So for the Family Caregiver Support Programs, like Numerable Times Cafe, the Dementia Respite Grant, Powerful Tools for Caregivers, and Caregiver Tee, which we actually have every other month on a Friday afternoon, the Family Caregiver Support Program is 476-2681. Can you repeat that? Yes, 476-2681 in the 802 area code. Okay. And is there an email that they can reach you guys? CVCOA at cbcoa.org. Okay. For more, more information on Council on Aging and its programs, you can reach 802-476-2681 or at cbcoa.org. Again, I would like to thank you for joining us on this edition of Abledon on Air. For more information on Abledon on Air, you could reach me at my email address at abletv980 at gmail.com. Again, we would like to thank our sponsors. Arlene is not here today, but tune in for another exciting episode of Abledon on Air. See you next time. I'm Lawrence Seiler. See you next time. Abledon on Air is sponsored in part by Green Mountain Support Services, empowering neighbors with disabilities to be at home in the community. Additional support for Abledon on Air is sponsored in part by Washington County Mental Health Services, where hope and support come together.