My heart broke a little bit earlier this week

At the same time I was heartened, knowing we play a critical role in connecting our clients with needed care.

A volunteer called saying one of their people was extremely short of breath and was having difficulty speaking. Their “person” is a young 95 year old, legally blind, lives alone, doctors infrequently and has no family. Along with a formal Power of Attorney for finances, we are their only connection to the “outside world”. Six days a week we bring not just a meal, but also a conversation with a smile in our voices to this individual.

I called the client to check in and see how they were doing; not so good. They could barely talk – needing to take a breath after every 1-3 words. They were confused – when they’re usually very alert.

Initially, they were not interested in having us call 911. I asked them if they wanted us to call their doctor (they have difficulty seeing the buttons to dial out). They said they didn’t really have one. I asked where they usually went for medical care, and if I could call there. They replied “they wouldn’t know me.”

Their breathing remained shallow and labored. I could hear the anxiety in their voice and change in timbre. I could see their confusion in making a relatively simple decision – part of their mind knowing they should get help, but also uncertain if they “really” needed medical care.

I gently asked what they wanted to do to get help with their breathing. They replied “Well, I guess I should go see a doctor.” I quietly told them I was concerned about their difficulty breathing and that I thought it would be a good idea for the EMTs to come and help them get medical attention. They agreed.

I ended the conversation saying I was going to call 911 and would then call them back. With a sigh and crackle in their voice, they said “Oh, I’ve been such a fool…”

“More than a meal” could almost be our tagline.

• Our volunteers let us know when things aren’t “normal” with their people and we follow-up with those concerns.
• Small, handmade cards, placemats and other crafts from area school-aged children bring a bit of joy to someone who might be feeling a bit “blue”.
• Volunteers encounter situations where their quick response ends up saving lives.
• A birthday card and individual piece of cake (or sugar free candy) is sometimes the only recognition a client receives – not because of cultural or religious preferences, but because they have no one left.
• It’s a brief visit, but we break down the walls of social isolation.

As I finish writing this, I’m saddened as I imagine what it must be like to grow old and to have out-lived family and friends; to be visually impaired to where I can’t even see the buttons on the phone; and to become so confused, when I’m normally very alert, I can’t make decisions for myself. But there is a silver lining: I know that because of Meals on Wheels, because of the care and concern our volunteers have for “their people”, this person received medical attention they might not otherwise have received. Medical attention that sometimes saves a life.

by Beth Adams
Director, Ann Arbor Meals on Wheels

When to Make a Referral

It seems that we always get more referrals this time of year – the weeks between Thanksgiving and the New Year. We attribute it to younger family members seeing their aging parents or grandparents, and realizing their loved one could benefit from home delivered meals.

Mayo Clinic has a good article “Aging Parents: 7 warning signs of health problems” that provides useful suggestions and action steps for those who are starting to care for aging family members or friends. Below is a quick overview:

1. Are your aging parents taking care of themselves. We, including our volunteers, pay attention to our clients’ appearance – has there been a change in how they’re caring for themselves and their home? Is there heat? Is the yard overgrown? Are they able to clear snow/ice from their driveway and stairs to the house?

2. Are your aging parents experiencing memory loss? We all occasionally forget things. But there’s a difference between normal memory loss and that associated with types of dementia. Misplaced keys, glasses, and other items are “normal’. Getting lost in familiar neighborhoods is more concerning.

3. Are your aging parents safe in their home?

4. Are your aging parents safe on the road?

5. Have your aging parents lost weight? Weight loss can be attributed to difficulty cooking, loss of taste/smell or underlying health conditions such as depression, malnutrition, or cancer.

6. Are your aging parents in good spirits? What is their mood like? Have there been any changes? Depression and anxiety are not part of normal aging; they can be treated at any age.

7. Are your aging parents able to get around? Are they unsteady on their feet? Is it difficult for them to use stairs? Have they decreased their physical activity?

Programs like Ann Arbor Meals on Wheels can help if your loved one is having difficulty preparing meals due to physical and emotional health problems. The visit by the volunteer who delivers the meal also serves as a wellness or safety check. We contact you if there concerns and can make referrals for support services.

For more information about eligibility visit http://www.med.umich.edu/aamealsonwheels/mealmakereferal.html.

October is Health Literacy Month

By Cyndi Lieske and Beth Adams

Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.

People with limited health literacy are more likely to have chronic conditions, are less likely to effectively manage their health and tend to have higher health care costs. Nearly 9 out of 10 adults have difficulty using basic health information. Challenges include:

• Navigating the health care system, including filling out complex forms and finding a health care provider;
• Understanding test results such as cholesterol and blood sugar levels;
• Choosing between health plans and comparing prescription drug coverage;
• Sorting through large amounts of health information, including separating myths from facts;
• Managing chronic diseases, such as knowing the symptoms of low blood sugar AND how to correct it; and
• Knowing what each medication is for and taking the right medicine at the right time.

Health literacy challenges are greater for older adults than younger populations. They have more chronic illnesses and use health care services at higher rates. Limitations of physical and/or cognitive functioning add another layer of difficulty. Even mild vision and hearing loss can make it difficult to process information that is otherwise understandable.

How health care providers present information, availability of culturally appropriate information, the environment in which it’s presented and are significant, contributing factors to health literacy.

Knowing how to talk with your doctor and other health care staff is one part of health literacy. Here are some ideas to help you communicate:

• Write down your questions before your appointment. Record their responses.
• Write down new information from your doctor and their staff. Ask them to repeat and further explain if it is not clear to you.
• Ask clarifying questions or statements such as “So since this new pill is twice the strength, I just need to take 1 pill rather than 2. Correct?”
• It’s okay to say you don’t understand something! Let your doctor and others know that you do not understand what they are telling you. Health care providers are often rushed and use a lot of medical terminology. Background noise can also make it difficult to process what is being said. Ask your doctor, nurse, pharmacist and others to use plain, non-medical words.
• Get a phone number for the nurse or clinic, so you can call with questions you think of after you have left or if you have forgotten something.
• Volunteer to go with a friend or loved one to their next medical appointment. Help them take notes and ask questions.

http://www.cdc.gov/healthliteracy/pdf/olderadults.pdf
http://www.ahrq.gov/news/columns/navigating-the-health-care-system/090710.html
http://www.health.gov/communication/literacy/quickguide/Quickguide.pdf

Make a Difference…Volunteer!

Volunteers are the backbone of Ann Arbor Meals on Wheels. Not only do Volunteers deliver meals to the homebound in our community, they also provide companionship and a warm, friendly smile. Ann Arbor Meals on Wheels Volunteers may be the only person a client sees all day. The meals you deliver are the primary source of nutritious food for most of our clients.

Summer is hard for the program because school is out and volunteers take vacations. Ann Arbor Meals on Wheels has also lost volunteers because of their advancing age and this will continue as our population ages.

Why Volunteer?
• Connect to your community. The simple act of offering your 1-2 hours of your time and compassion positively impacts the daily lives of those in need, as well as your own.
• Engaging in service to others is an invaluable experience.
• Be a force for social change and an inspiration to others.
• At risk and elderly community members will eat because of you.

We need YOU!
Volunteers of all ages to deliver meals to the homebound in the Ann Arbor area. Drivers must be at least 18 years or older and able to use their personal vehicles to deliver meals. Persons under 18 can volunteer if accompanied by an adult.

We offer flexible scheduling.
You can choose:
1) the day – Monday to Saturday, and
2) the frequency – weekly, biweekly, or monthly.

We deliver meals 6 days a week.
Mon – Fri: Meal pick-up at 11:30am.
Sat (Jan – Aug): Meal pick-up at 10:30am.
Sat (Sept – Dec): Meal pick-up at 9:30am.
Average delivery of meals takes 1 – 2 hours.

“I would have a hard time continuing to live in my house. Ann Arbor Meals on Wheels helps very much to make it possible. Thank you.” — Ann Arbor Meals on Wheels client

Interested? Contact us! Please feel free to call (734) 998-6686 or send an email to aamealsonwheels@umich.edu.

Join Us at Metzger’s German Restaurant (June 18)

See you at the 2014 Senior Living Week Expo!

We are very excited for the 2014 Senior Living Week Expo on Friday, May 2nd at the Ann Arbor Marriott Ypsilanti at Eagle Crest (1275 S. Huron, Ypsilanti) and we hope you are too! Don’t forget to stop by our table and say hello – we’d love to meet you and tell you all about Ann Arbor Meals on Wheels!

Below is a flyer of the workshops that will take place at the Expo, as well as a workshop registration form. If you have any questions about the Expo workshops or any of the workshops that will take place during Senior Living Week (May 2 – 10), please don’t hesitate to contact De Bora McIntosh at the Housing Bureau for Seniors at (734) 998-9338.

Support Ann Arbor Meals on Wheels – Sponsor the Judy Fike Golf Outing

We need your help! In your own neighborhood a homebound older adult needs food. You can make a difference by sponsoring the 2014 Judy Fike Golf Outing to benefit Ann Arbor Meals on Wheels. We are asking for your support.

The outing will take place on Monday, July 14, 2014 at Reddeman Farms in Chelsea. Last year, we raised funds to pay for over 4,100 meals! This year, our goal is to have 128 golfers and raise $30,000.

How you can help:

• We have several opportunities for you to sponsor this event. Our sponsorship levels reflect that every $6 pays for a meal. Click here for the Sponsorship Forms outlining the options and benefits of your contribution.
• Our golfers would also be delighted with any donated items for our raffle, door prizes, and silent auction. We make sure that all our golfers leave with a door prize!

We’re turning 40 this year! Since 1974, Ann Arbor Meals on Wheels has reduced hunger and food insecurity and promoted the dignity and independence of the homebound in our community. Six days a week we deliver nutritiously balanced meals to those who, because of their health, are unable to shop or cook for themselves. We are a community-supported program of the University of Michigan Health System and about half of our revenue comes from external sources. Your sponsorship is crucial to our continuing to feed the homebound.

Please join us to help provide much needed nutrition for our homebound clients.

On behalf of our staff, volunteers and the clients we serve, thank you.

Coming Soon – The Judy Fike Annual Golf Outing to benefit Ann Arbor Meals on Wheels!

Winter Snow, Ice, and Bitter Cold

I think most of us have, at one time or another, dealt with the headache of snow removal from our walkways and driveways (or at the very least, around our cars).  Snow removal is not for the faint of heart or those who have heart problems, especially when temperatures become frigid.  During the latest big snow storm and negative temperatures and wind chills, I saw several of our neighbors (including my spouse) working together to remove snow from sidewalks, and even a portion of the street!

While our block has mainly young couples and those in our 40s/50s, that’s not the case in many areas throughout the County.  There are many neighborhoods, where residents may not be physically able to shovel the snow off the sidewalks. Exposure to the cold puts additional strain on the heart and seniors and those with chronic medical conditions are at an increased risk.

Seniors may also be unable to afford to have a service do it for them. If you’re able, please consider offering your elderly or disabled neighbor help with snow removal, especially if you’ve noticed that it doesn’t get done within 24 hours of the end of a storm.  This is especially important since many cities and towns, including Ann Arbor, Chelsea, Dexter, Manchester, Saline, and Ypsilanti have snow removal ordinances which will penalize homeowners with fines.

Snow removal also helps the volunteers at Meals on Wheels deliver food to frail, homebound persons in our communities.  At Ann Arbor Meals on Wheels, several customers often call to cancel meal delivery following a winter storm because they’re unable to remove the snow and are concerned for the safety of our volunteers.  Helping your neighbors by removing snow from their driveways and walkways can mean the difference in whether they eat that day.

Why is this so critical?  The inability to continue with typical maintenance, heavy chores, and yard work are often what lead an older homeowner to consider moving.  At the Housing Bureau for Seniors, we can recommend our HomeShare and our Housing & Caregiver Counseling programs for those looking to transition from one living situation to another.  But if affordable assistance can be brought in, why move?

Be neighborly! Check on your elderly and disabled neighbors, and if you can help in some small way, please do so.

Community Programs & Services – 2013 Accomplishments

“Success is to be measured not so much by the position that one has reached in life as by the obstacles which he has overcome.”
Booker T. Washington

It’s the beginning of a new season. As I reflect on our previous seasons, that combined to create our first year, I am amazed at what we accomplished. FY2013 was one of the most challenging times in my 25 year tenure with UMHS. We came to the table optimistic but determined to do our part to address the financial deficit within the health system; working together to create OUR plan.

Despite the challenges, we accomplished some amazing tasks that support our health system and our community, both internally and externally.

Accommodations Program
– We made 11,574 reservations for patients, families and visitors to UMHS via the Patient and Visitor Hotel Accommodations Program – that’s an average of 965 reservations per month! The onsite Med Inn Hotel averaged 100% occupancy for 12 months. And, we launched our partnership with the Ann Arbor Mennonite Guest Home – a six year project to bring additional lodging to our patients and their families.

Adolescent Health Initiative
– Lauren Ranalli, Director of the Regional Alliance for Healthy Schools (RAHS), was successfully hired as Director of the Adolescent Health Initiative and we received a grant from MDCH to hire a program manager. Physician Adolescent Champions have been identified and with medical director, Maggie Riley, MD (Family Medicine) we are firmly on our way to doing great work. Planning for the first state-wide conference on adolescent health in Michigan is, also, underway for April 2014. The conference will focus on translating knowledge on working with adolescents to practice.

Ann Arbor Meals on Wheels
– We marked 2 million meals served (since the late 1980’s) with a celebration and open house in January 2013 that recognized our staff, volunteers, donors and funders for support for nearly 40 years. Our annual volunteer-driven golf fundraising event, The Judy Fike Golf Outing to benefit Ann Arbor Meals on Wheels, raised over $25,000 this year which will be used to provide meals to area homebound seniors and others.

Comprehensive Gender Services Program
– The Gender Program saw the largest increase in new client enrollment for calendar year 2012 with 108 new clients (a 40% increase our previous high of 43 new patients in 2007) since the program’s inception in 1995. (Notably, that growth shows no sign of slowing, as the program has enrolled 158 new patients to date in 2013.) In addition, the program created two support groups: one for the parents and guardians of gender-variant children, and the second for spouses and partners of transgender adults. The program also increased its ties with the Disorders of Sexual Development clinic and maintains a strong connection to Family Medicine, Plastic Surgery, Urology and Reproductive Endocrinology in providing support for our clients. The first gender variant youth and sibling event will be held at CPS in October in direct response to the increasing needs of this special population. The UMHS-CGSP is the only university-based, multidisciplinary gender program in the United States.

Friends Gift Shops
– Provided over $200,000 in grants to support patients and family programs within the health system (this includes $150,000 in core awards given to support Child & Family Life, Social Work Guest Assistance Program (GAP), Trails Edge Vent Camp (for ventilator dependent children) and the Patient Education Advisory Committee). Some of the other awardees for FY2013 include the East Ann Arbor Surgical Center, Adult Medical Observation Unit, Transplant House, the Brandon NICU, the Depression Center and Canton Radiology.

Housing Bureau for Seniors
– Celebrated 30 years of serving area seniors and their families. The yearly conference, Senior Living Week that provides education and information about aging in place, resources to support housing transitions and contact with experts in the field of housing and aging support celebrated its 15th anniversary. One of the highlights of HBS, our HomeShare Program is the only official program of its kind in the state of Michigan and has proven demonstrably effective in the community as an alternative method for allowing seniors to remain in their home.

Interpreter Services
– Launch of two innovative new classes – Interpreting in Palliative Care and Interpreting in Mental Health, both new classes are the one of the firsts trainings of their kind offered nationally. In addition to these two new courses, we successfully offered professional trainings classes for Bridging the Gap, Medical Terminology and Body Systems and Foundations for Medical Interpreter (formerly Medical Interpreting – Basic Skills ASL). These course offerings make our program a standout for promoting medical interpreting as a profession. The next step on our journey is the accreditation of our training program.

Program for Multicultural Health
– Partnered with the brothers of Kappa Alpha Psi Fraternity, Inc. to present a successful African-American Men’s Health Symposium with significant contributions from Dr. Ken Jamerson, Frederick G L Huetwell Collegiate Professor of Cardiovascular Medicine and Professor of Internal Medicine (former medical director, Program for Multicultural Health), Brian Frey, UM School of Public Health Intern, Community Programs and Services, and Dr. Rohan Jeremiah, Paul D. Cornely Postdoctoral Scholar, UM School of Public Health. This symposium was Phase I of our partnership with Kappa Alpha Psi Fraternity, Inc. The symposium had barely closed before discussions began for Phase II — a Midwest regional symposium in 2014. The symposium also provided an opportunity to create an African-American Male Community Health Advocate group for the community. We are excited to train men how to educate other men on health issues (e.g. Hypertension, Diabetes, and Prostate Cancer) that are disproportionately experienced by African-American men.

– We enjoyed a successful summer teaching over 40 children (between the ages of 5 and 12) about nutrition. The children, summer camp participants at either the Parkridge Community Center in Ypsilanti, MI or Peace Neighborhood Center in Ann Arbor, MI learned about healthy eating, made health snacks, and participated in “taste-testing” vegetables and fruits not normally a part of their diet. (https://www.med.umich.edu/multicultural/‎)

Regional Alliance for Healthy Schools
– We experienced a period of transition within our program. Jennifer Salerno, the long-term director and visionary for RAHS left to pursue other endeavors. Lauren Ranalli, MPH, was hired to take her place at the helm. Lauren hit the ground running in March; working to successfully manage the challenges created by the merger of two school-districts. Economic challenges for both Ypsilanti Public Schools and Willow Run Community Schools districts drove a merger which had the potential to affect three (3) of our school-based health centers. Following the merger, we efficiently closed the Ypsilanti Middle School health center and moved those services to the Lincoln Middle School. This move expanded services in the school district and provided support for our Lincoln High School school-based health center. We were the award recipient of nearly $400,000 from HRSA to improve the Ypsilanti High School Health Center. The award will allow us to renovate our clinic space to provide more privacy and efficient flow for students visiting the school-based health center.

– Developing the next generation of “leaders and best,” staff and students attended “Advocacy Day” (students, accompanied by RAHS staff, visited Michigan State Legislators to garner support for school-based health centers) in Lansing and participated in Project VOICE on the UM Flint campus.

Volunteer Services
– Reorganized and streamlined volunteer training and orientation sessions successfully. Created a process to efficiently onboard non-student volunteers (retirees, stay-at-home parents, and others). Allowing equal access to community volunteers to support our patients, their families, faculty, and staff. But more importantly, we continue to average close to 2,000 volunteers providing support to our institution.

This is, by no means, an exhaustive list of our many accomplishments during FY13. I would still be writing!! Instead, this is just a sample of the excellent support we provide to the University of Michigan Health System and our patients, their families and friends and the community. We are a valuable resource. We will continue to flourish to provide quality and consistent energy and passion in support of the vision, mission and goals of the health system.

The best is, truly, yet to come!

Warmly,

Alfreda Rooks

“Success in any endeavor does not happen by accident. Rather, it’s the result of deliberate  decisions, conscious effort, and immense persistence…all directed at specific goals.”
-Gary Ryan Blair