About Beth Adams

Director, Ann Arbor Meals on Wheels and Housing Bureau for Seniors University of Michigan Health System

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

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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

Celebrate National Nutrition Month – Enjoy the Taste of Eating Right!

Contributed by Area Agency on Aging 1B, Karen Jackson- Holzhauer, RD & Justine Yaldo- Wayne State University, Dietetic Intern

NNM - spoons and forks2014 National Nutrition Month is celebrating “Enjoy the Taste of Eating Right”! The theme puts local foods and the diversity that Southeast Michigan has to offer at the center of the plate. Drawing from a variety of foods and cultural traditions, the rich heritage of Metro Detroit is reflected in our restaurants, farmers markets, local gardens, neighborhoods and senior centers. Family elders play a leading role in cultivating food traditions and creating food memories with familiar flavored dishes and family recipes passed down by each generation to the next. These recipes originate from the Metropolitan Detroit area family’s ancestral ties which have circulated the globe. This year we are celebrating healthy food traditions with dishes prepared using locally grown vegetables. NNM also coincides with spring’s first crops of asparagus, beets, broccoli, wild mushrooms, cabbage, and also carrots that are still available from winter storage.

The diversity in our meals also plays a role in getting a balanced and nutrient rich diet. Incorporating different spices and herbs along with recipes featuring local foods makes National Nutrition Month a memorable family affair. It is important to remember that getting plenty of fluids and incorporating physical activity into your daily routine is important part of healthy aging.

This recipe is adapted from the Michigan Bean commission “Well-Red Bean & Green Salad“ and uses a base of brown rice, red and green vegetables, dried fruit, and fresh herbs with healthy oils. This is designed to increase the flavor profile of familiar ingredients like beets and red beans in combination with rice and broccoli to target essential nutrients for healthy aging. This includes the excellent sources of fiber in the main ingredients and high quality protein and potassium found in the dried beans. This unique vegetable combination contains cancer fighting antioxidants as well as anti-inflammatory components which are also good for heart health.

Healthy Snacks for Seniors

* Pre-cut Veggies * Natural Granola Fresh Fruit * Nuts * Cheese * Dried Fruit * High Fiber Cereal* Green Salads * Greek Yogurt * Peppers

Remember to always Eat in COLOR!

Grocery Shopping Tips for One or Two

  1. Don’t shop when you are hungry.
  2. Buy seasonings that can be used in multiple recipes.
  3. Plan out a weekly menu and bring a list when grocery shopping.
  4. Rethink your shopping list and buy in small sizes as needed to keep foods fresh and avoid a spoilage or waste.
  5. Clip coupons and toss them in an envelope that is convenient when shopping.
  6. Check out senior discount days.
  7. Take the time to read the Nutrition Food Labels on products before you buy.
  8. Find out when the store restocks its fresh produce.
  9. Shop the parameter of the store for fresh foods and avoid the grab and go and impulse items at the ends of each aisle.
  10. Eat before you go to the store.

Well-Red Bean & Green Salad

Salad

30-ounce cooked Dark Red Kidney Beans,

1 cup long-grain brown rice, uncooked

1 cup fresh broccoli, florets cut, stems sliced, and blanched

or 1/2 pound asparagus, chopped grilled

1/2 pound mushrooms, sliced thin (about 2-1/2 cups)

4 to 6 scallions, sliced

Dressing

1/4 cup olive oil

2 tablespoons lemon juice

3 tablespoons vinegar

2 cloves garlic, minced

3/4 teaspoon tarragon

1/2 teaspoon salt

1/2 teaspoon black pepper

Garnish

Spring Greens for serving

Michigan dried cherries

Diced beets

PREPARATION

Cook rice. In a large bowl, combine all salad ingredients, including the cooked rice. In a jar, combine all dressing ingredients. Cover the jar, shake well, and pour dressing over the salad mixture. Toss salad to mix thoroughly. Refrigerate salad until serving time. On a large platter, serve salad on a bed of mixed spring salad greens and garnish with Beets and Cherries.

NUTRITIONAL INFORMATION (per serving)

Servings per recipe: 6

Serving size: 1-1/4 cups

Calories: 273

Carbohydrates: 37g

Fat: 10g

Cholesterol: 0mg

Protein: 10g

Fiber: 8g

Sodium: 120mg (320mg if using canned beans)

Adapted from The Michigan Bean Commission. 

Winter Snow, Ice, and Bitter Cold

512px-0312_December_2003_snowstormI 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.

Clearing_the_snow_-_Flickr_-_Al_Jazeera_EnglishSeniors 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.

Providing Nutrition and Peace of Mind

Last week, I had the opportunity to give a presentation to the Ann Arbor Downtown Kiwanis Club about Ann Arbor Meals on Wheels and the Housing Bureau for Seniors. The Kiwanis Club is already familiar with both programs, as they’ve been supporting us for several years. They go a step further with Meals on Wheels and have their own daily route, plus an additional weekly route.

During the Q&A session, several members had questions about the operational side of MOW, shared how much they got out of delivering and their own personal experience with Ann Arbor MOW. One member had heart surgery and the meals were a life saver during his at-home recovery. He wouldn’t have eaten were it not for MOW. Another shared about his experience as an adult child of a parent who was receiving meals from us.

The volunteer showed up at his mom’s house and when they entered the home saw that she appeared to have had a stroke. They called us, we in turn called 911 and the ambulance came and took her to the hospital. She had indeed suffered a stroke. While she never returned home, having moved to a long-term care facility, the family was extremely grateful for the service.

Because we check in with our clients every day, or most every day, we often see older adults more frequently than their family. And sometimes, we serve as that critical lifeline. While most situations we encounter are not true emergencies, like the Kiwanian’s mother, we let family members or emergency contacts know when:
• there are concerns about a client’s hygiene or upkeep of their home,
• we notice a decline in a client’s health or functional status, and
• we can’t reach a client for a scheduled meal delivery.
We provide peace of mind to adult children – especially those who don’t live in the area and can’t check in on their aging relative as often as they’d like.

The delivery of the meal also provides our clients with the opportunity to briefly socialize with our volunteer. For many of our clients, the volunteer is the only person they see all day. We have some volunteers who will save their “favorite” client for last so that they have time to visit without feeling rushed in needing to get to the next stop on the route. I know when I deliver to a client who is lonely or loves to chat, it’s really hard to tell them I can’t visit any longer because I still have 10 meals to deliver!

Our volunteers deliver 10-13 meals, taking 1-2 hours to complete a route. Meals are picked up at our office at 2025 Traverwood Suite F, Ann Arbor at 11:30am Monday – Friday, and at 9:30am or 10:30am on Saturday depending on the time of year (read Michigan football season).

Volunteers can deliver as often as they want. We have some volunteers who deliver once a week, others once a month and some don’t have a regular schedule, but instead serve as subs – coming in when we have an opening. We have parents and grandparents who bring their children, golf buddies, lifelong friends, spouses and partners, service club members….the list goes on!

A few years ago, one of our clients told us “The food event and the social event are each in their own way the most important events of the day for lonely, elderly folks.”

If you have time to give, and want to make a difference among the homebound “lonely, elderly folks” in Ann Arbor who are unable to shop and cook for themselves, we’d love to hear from you!

Give us a call at (734) 998-6686 or send us an email at aamealsonwheels@umich.edu.

State Funding for Home Delivered Meals at Risk

The Governor’s budget proposal is set to reduce funding for home delivered meals by $671,100. State funding for this program has been flat since 1998, yet the aging population during the past 10 years has grown, and continues to grow.

Proper nutrition is a major determinant of successful aging and is more important than heredity in avoiding age-related declines; 87% of older Americans have chronic conditions that can be improved with proper nutrition. Conversely, poor nutrition prolongs recovery from illness and increases the cost and incidence of institutionalization.

Programs like Ann Arbor Meals on Wheels makes a difference in the lives of almost 400 clients every year, and has delivered over 1.37 million meals since FY 2000. Every day, we’re making a difference in the lives of those we serve. Consider the following:

  • Over 95% of our clients are unable to shop and cook for themselves.
  • 94% say the meals they receive are their most important source of nutritious
    food.
  • 97% say the meals they receive make it easier for them to live
    independently (remain at home).

Supporting the independence of our seniors in the community ultimately saves the State of Michigan money. Please urge your State Representative to restore funding for home delivered meals, and the remaining $1.58 million in Office of Services to the Aging funding slated for reduction, and help keep our seniors in the community.