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

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.

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.

Support Ann Arbor Meals on Wheels – Sponsor the 5th Annual Judy Fike Golf Outing

2 Million Meals…and Counting!

WOWZA! 2 million meals is a lot of meals delivered to the homebound in Washtenaw County. And the best part is that we know we’ve delivered a lot more than 2 million meals. We have delivered friendly smiles, caring hearts, and respect…and it shows. Ann Arbor Meals on Wheels opened its doors (as Motor Meals of Ann Arbor) in 1974. A partnership with the University of Michigan Hospital and Health Systems formed, followed by a name change to align with the national Meals on Wheels Association of America, and here we are today.

The experience of Meals on Wheels, both from the volunteer delivering hot and nutritious meals to the client receiving the care and the helping hand, is invaluable. Seeing clients’ faces light up when the volunteers arrive is pure joy. The relief and gratitude of family members who live far away and are unable to care for older family members as they might wish is palpable.

We are so very thankful to have reached this milestone and we couldn’t have done it without the generosity of our volunteers, staff, and donors.

Thank you!

   

Meals on Wheels and Senior Services Programs Face Budget Reductions in January!

The Budget Control Act of 2011 is the debt ceiling and deficit reduction legislation signed into law in the summer of 2011. This Act also created the “Super Committee” to produce a debt reduction plan with projected savings of more than $1 trillion dollars over 10 years.   When this committee failed to come to an agreement, a process known as “sequestration” was triggered to begin on January 2, 2013. (For more information on sequestration: http://www.fas.org/sgp/crs/misc/R42050.pdf)

If Congress cannot agree on ways to reduce the total budget, or fails to pass a Budget Resolution, then an automatic form of spending cutbacks will occur. “Sequestration” is a process of automatic, largely across-the-board spending reductions under which budgetary resources are permanently canceled, with no departmental or agency control, to enforce certain budget policy goals.

Most exempt programs are mandatory, and include Social Security and Medicaid; refundable tax credits to individuals; and low-income programs such as the Children’s Health Insurance Program; and Supplemental Security Income.

Senior meal programs, as well as all other programs authorized by the Older Americans Act (OAA) are subject to the automatic spending cuts of sequestration. Current projections indicate a 7.8% – 8.4% cut in funding will occur in January of 2013.

What does this mean for older adults in Michigan, and across the U.S.?

If sequestration occurs, over $1 million dollars in home-delivered meal funds will be cut in Michigan alone. This funding translates into over 1.4 million meals for over 15,000 homebound Michigan seniors for one year. Across the country, over 17 million older adults will no longer receive home-delivered meals.

This reduction will exacerbate an already growing number of seniors who face food insecurity.  In 2010, over 14% of seniors in Michigan faced the threat of hunger. Nationally, the number of seniors facing this threat has increased significantly.

Food programs protected from sequestration include Child Nutrition Programs (School Lunch, School Breakfast), Child and Adult Care Food, and Supplemental Nutrition Assistance Program.  But ,Senior Nutrition Programs are not protected.  Congregate and home-delivered meal programs deserve parity with these other federal nutrition programs also serving vulnerable populations (children, low-income individuals).

There are very real consequences to funding reductions for seniors and older adults: compromised health, poorer nutrition, increased isolation, and higher risk of falls and injury.  Reduced energy, muscle strength, functionality; reduced skin integrity; susceptibility to infection; and longer, more frequent hospitalizations are just some of the effects of under- and malnutrition. A 64 year-old suffering from hunger is likely to have the functional limitations of a 78 year-old.

The consequences will cause huge negative ripples throughout our public health and our social services infrastructure.

Support Meals on Wheels and help us end senior hunger!  Contact your Senators and Representatives and urge them to work out a budget agreement without automatic spending cuts to Older Americans Act programs! To find your Representatives and Senators go to: http://house.gov or http://www.senate.gov.