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**AoA Update******

**Volume 2Issue****8-Administration on Aging - August****1997**

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#### AoA Issues Long-Term Care OmbudsmanReportWhite Paper Addresses Coming Challenges ofGlobal AgingCO-AGE Keeps Elderly’s Concerns inLegislative ForefrontComputers for Seniors Offers Access toInternetLos Angeles Holds Meetings to Alert Seniorsto Abuse and FraudNews Notes-- Connecticut Sets Up BeneficiaryOutreach Coalition-- Gerontological Society Home Page-- Managed Care Phamphlets AvailableAARP Survey Says Elderly Want Privacy

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### AoA Issues Long-Term CareOmbudsman Report

An anonymous caller to a Long-Term Care Ombudsman Programalleged that a frail elderly woman, living in a board and carehome, was being overmedicated with a psychotropic drug intendedto cause her death. 

The ombudsman went to the home, found the resident in acatatonic state, and immediately called law enforcementofficials, Adult Protective Services, and an ambulance whichrushed the woman to an acute emergency center for respiratoryfailure.

Further investigation revealed an intricate conspiracy betweenthe owner of the facility--the woman’s ex-son-in-law--and aphysician. The ombudsman probably saved the woman’s life andhelped to pull together the investigatory forces and informationthat ultimately led to criminal conviction of the guilty parties.

Sound like a Hitchcock thriller? It is not. It is just one ofsome 218,000 cases handled by the Administration on Aging’sLong-Term Care Ombudsman Program each year, and chronicled in thenew report, "Long-Term Care Ombudsman Annual Report FiscalYear 1995." 

While most of the complaints, made by over 162,000individuals, the report notes, are not so dramatic, the 913 paidfull-time long-term care ombudsman staff and over 6,000volunteers carry on unrelenting efforts to make our nation’slong-term care facilities safe and responsive to the needs oftheir 2.4 million residents.

The report notes that the presence of ombudsmen in long-termcare facilities helps to prevent and reduce the incidence of poorcare, neglect, and abuse. Ombudsmen also play an important rolein detecting, reducing and preventing costly Medicare andMedicaid fraud. 

Acting Principal Deputy Assistant Secretary for Aging, WilliamBenson, said, "This report is about people and a program onthe front line in protecting the rights of, and advocating for,good care for one of the most vulnerable groups in oursociety--older people living in long-term care facilities."

According to the report, over 85 percent of complaints relateto nursing home residents, while most of the remainder involveresidents of board and care (B&C) facilities. Nearly 75percent of the complaints are fully or partially resolved.

In nursing homes, the majority of complaints center aroundaccidents and the improper handling of patients, lack of respectfor patients, the quality and quantity of food, personal hygiene,and unanswered requests for assistance.

In B&C homes and related facilities, most complaintsinvolve the quality and quantity of food served; fire safety,poor lighting and hazards created by failure to repair equipmentand buildings; the administration and organization ofmedications; cleanliness and infestation of insect and animalpests; and lack of respect on the part of staff toward residents.

Ombudsmen at the state and local levels also work to resolvemajor issues that affect large numbers of residents. They providetechnical training and assistance to other ombudsmen in thestatewide program, as well as the managers and staff of long-termcare facilities, and provide information and consultation toindividuals. Ombudsmen visit residents on a regular basis andwork with the media to publicize residents’ concerns.

Copies of the report are available on the Internet addresslisted at the end of this issue of the AoA Update. Additionalinformation is available from: Sue Wheaton at (202) 619-7585, ore-mail at [email protected]

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### White Paper Addresses Coming Challenges ofGlobal Aging

For decades, world population issues have centered around highbirth rates which created growing populations of young people,particularly in developing countries. Now all that is beginningto change.

In developed nations around the globe, and in developingcountries as well, lowered fertility rates and increased lifeexpectancy are creating older populations that often havesignificantly different needs from their younger cohorts. Thispopulation shift has led the United States, Japan, and a numberof European countries to begin exchanging information and toinvestigate the need to change policies and societal attitudestoward their older citizens--from early retirement, to pensions,to health care.

The Denver Summit of Eight, which includes the United States,Canada, Japan, Germany, France, Italy, Great Britain, and Russiamet to discuss population aging and ways in which Summit memberscan assist one another in meeting the challenges and tapping theresources of their growing numbers of elder citizens throughpolicies that encourage and tap into "Active Aging." 

As part of its initial contribution to the Summit of Eight,the United States presented a paper entitled "Active Aging:A Shift in the Paradigm," which outlines the state of agingin the United States and in other nations. The paper was preparedwith the assistance of Administration on Aging (AoA) staff andoffers suggestions for creating a new view of aging, as well asinnovative ways to deal with the challenges of an expanding olderpopulation. 

The paper says that, "Active aging means more than simplypaid employment among seniors. Rather, it raises broader socialand political issues. Our societies should foster sociallyimportant activities like volunteering, household and child carehelp, caregiving to the disabled elderly, and support for socialservice organizations."

There are solid reasons for making these recommendations. Oneis declining disability rates among the elderly not only in theUnited States but in many developed countries. Thus, while thenumber of persons 85 and older is increasing rapidly (the age atwhich the incidence of illness and disability tends toaccelerate), the challenge of caring for large numbers of personswith disabilities may be less serious than previously thought. 

Increased life expectancy, improved health, and lessdisability, the paper notes, make it possible for older people tocontinue to contribute in the work place, thus lessening theeconomic burden on governments and on younger workers whosecontributions largely pay for public and private pension plansthat increasingly have to support retirees over a period of twoto four decades. Retirement policies that encourage older workersto remain in the labor force, and which offer phased retirementand part-time work, can do much to lessen the burden on pensionplans, the paper notes.

The paper urges a new and more realistic view of present andfuture cohorts of older persons from one that often views them asunwell and dependent to one that sees them as healthy, active,and contributing members of their communities and families. 

The paper suggests thatSummit of Eight members exchange information on ways to extendthe number of years of active work, provide better support forretirement pensions, explore new and creative ways to fund andsupport long-term health care, offer volunteer opportunities, andexplore additional ways to limit chronic disease and disability.

 

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### CO-AGE Keeps Elderly’s Concerns inLegislative Forefront

On Friday, March 28, the Coalition of Advocates forGeorgia’s Elderly (CO-AGE) was celebrating the successfulpassage of three CO-AGE bills. Two bills addressed elder abuseand the third, guardianship.

In addition, for the first time in CO-AGE’s history, $4.7million additional state dollars ($11.2 million when combinedwith federal monies) were appropriated for home andcommunity-based services for the elderly. Six short years ago,the budgeted amount for home and community-based services was$1.3 million in state funds.

Through the cooperative efforts of over 200 statewideorganizations, consumers, and individuals representingGeorgia’s 17 area agencies on aging, and a statewidepartnership among concerned individuals and groups, CO-AGE worksto improve public policy affecting the elderly and theirfamilies.

The Georgia Council on Aging (GCOA), created 20 years ago bythe Georgia Assembly on Aging, advises state government on allmatters affecting the state’s elderly. Ten years ago, theGCOA founded CO-AGE as a way to receive input from citizensacross the state. The GCOA volunteer board of 20 appointedmembers commits a significant portion of GCOA resources to CO-AGEby providing leadership, staff support, and a portion of itsbudget.

CO-AGE convenes four times a year during the first month ofeach quarter. The January and July meetings are held in the statecapital, Atlanta, while the April and October meetings are heldin the southern or northern parts of the state.

This year’s CO-AGE April meeting was held inVidalia--famous for its sweet onions--where the accomplishmentsand "sorrows" of the legislative session were discussedand a call for next year’s legislative issues was given.

Between April and July, GCOA staff and volunteers work withCO-AGE participants to ensure diverse interests are involved andto assist individuals in researching their ideas, and writing andevaluating the issues they want to present to other participantsduring the priority-setting meeting in July.

In July, participants choose three legislative and two budgetissues, from some 25 which are presented to them, for the nextyear. This is also the time when Legislative Awards are presentedto representatives and senators who have worked diligently onCO-AGE bills.

In October, CO-AGE participants learn about new legislativeissues during an in-depth training session from their peers.Participants also make commitments to serve on telephone treesfor advocacy alerts, issue research committees, and the speakersbureau. Between October and January, people spend time educatingtheir organizations, associations, civic groups, senior centers,and communities about CO-AGE issues.

Lt. Governor Pierre Howard says, "...the leadership heresupports the idea that the elderly people in this state are ofthe utmost importance." Senator Richard Marable says that hefinds it very effective "that CO-AGE prioritizes andconcentrates its efforts rather than bringing too much to thelegislative agenda."

One incident illustrates, in a very good-naturedway, the importance of CO-AGE in the legislative arena. Duringthe floor presentation of one of CO-AGE’s bills thissession, Representative Billy Randall requested that a separatepiece of legislation be attached as a rider to the bill.Representative Barbara Bunn’s call to question was honoredand she asked, "Does CO-AGE support this bill you arewanting to attach as a rider to their bill?" RepresentativeRandall replied, "Yes ma’am, the bill that I amattaching is another CO-AGE bill; I wouldn’t make thatmistake, no ma’am."

Indications are that CO-AGE has earned the "Good HouseKeeping Seal of Approval" for aging issues in Georgia. Otherstates can do the same. For more information, please contact:

Georgia Council on Aging 2 Peachtree St., N.W. Suite 135-457Atlanta, GA 30303-3142

 

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### Computers for Seniors Offers Access toInternet

The Department of Health and Human Services’(HHS) new Computers for Seniors Program is offering olderAmericans access to the Internet so that they can make better useof Medicare, Medicaid, and other HHS programs.

The Health Care Financing Administration (HCFA) is loaningmore than 500 surplus computers to senior centers supported bythe Administration on Aging. The computers will offer access tothe AoA web site: ( http://www.aoa.dhhs.gov); HCFA’s web site: (http://www.hcfa.gov);the National Institute on Aging: ( http://www.nih.gov/nia ); the"healthfinder" web site: ( http://www.healthfinder.gov); and the HHS home page: ( http://www.hhs.gov).

HCFA will provide personal computers and basic Windows and DOSoperating software to senior centers across the country. Thecenters will be responsible for installing and maintaining theequipment, as well as providing a modem and additional phonelines, if necessary.

"HHS is committed to using Internet technology to serveall Americans better," said HHS Secretary Donna E. Shalala."Our department-wide web presence now includes some 62sites, covering the range of HHS activities. Many of these sites,as well as many web sites outside of HHS, will be of specialvalue to older Americans, and we want to help them use thisresource to the fullest."

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### Los Angeles Holds Meetings to Alert Seniorsto Abuse and Fraud

The County of Los Angeles Community and Senior Services AreaAgency on Aging (AAA) held 15 "Countywide Forums on ElderAbuse" May 5 through July 16. The Forums, which drew between50 to 100 seniors at each session, were presented by the LosAngeles County AAA in partnership with the County Departments ofConsumer Affairs, the Los Angeles County Sheriff’s Office,the State of California Department of Insurance, and the LegalCorporation of Los Angeles.

Seniors were invited to hear expert panelists whoaddressed Medicare fraud (Operation Restore Trust); elder abuse;home lien scams; and telemarketing, real estate, and insurancefraud; and the role of law enforcement.

Seniors could select a panelist who personally contacted themby phone to discuss their concerns. A short needs assessment wasdeveloped to further understanding of seniors’ needs. Thepanel discussions were video taped, and a resource directory ofcommunity services, a law enforcement map of available resourcesand telephone numbers were provided to the host site which wasdesignated as an elder abuse prevention site. 

On September 15, the Los Angeles County AAA will join forceswith the Veterans Administration to hold a teleconference whichwill allow seniors a chance to participate in the fight againstfraud and abuse.

Additional information concerning the forums and theteleconference is available from:

Pam Smith Human Services Administrator County of Los AngelesCommunity and Senior Services Area Agency on Aging 3175 W. 6thSt. Los Angeles, CA 90020 (213) 738-2628

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### News Notes

#### Connecticut Sets Up BeneficiaryOutreach Coalition

In an effort to enhance the services and information availableabout Medicare, a number of groups involved in Medicare issues,including CHOICES for Aging Issues, run by the area agencies onaging, have formed the Connecticut Beneficiary OutreachCoalition.

The Coalition is currently focusing on education and outreachdirected toward Medicare beneficiaries, service providers,caregivers and others interested in benefits, rights, andresponsibilities, as well as Medicare waste, fraud, and abuseissues.

Additional information is available from CHOICES ProjectDirector, Mimi Peck-Llewellyn, at 860-424-5244.

#### Gerontological Society Home Page

The Gerontological Society is posting short news releases onits home page which is located on the Internet at: http://www.geron.org . When thesite appears, click on the news release button.

#### Managed Care Pamphlets Available

The Federal Consumer Information Center is offering a freepackage of three publications to help seniors find the besthealth care sites on the Internet, understand alternative medicaltreatments, and get the latest information on Medicare managedcare. Managed Care, prepared by the Health Care FinancingAdministration, discusses the differences between managed careand fee-for-service plans and provides tips and advice onchoosing the plan with the best benefits. To order the three freepublications, call (719) 948-4000 and ask for the Health CareChanges package.

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### AARP Survey Says Elderly Want Privacy

According to Assisted Living and Private Rooms: WhatPeople Say They Want, issued by the American Association ofRetired Persons (AARP), 82 percent of older persons surveyed saythey prefer a private room, and 87 percent say that they wouldtake a small private room over a large one that had to be shared.

Copies of the survey are available from:

Consumer Team Public Policy InstituteAmerican Association of Retired Persons601 E Street, NWWashington, DC 20049

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AoA Update

**WilliamBenson**Acting Principal Deputy Assistant Secretary for Aging

**JudySatine**Director, Executive Secretariat

**JuneB. Faris**Editor

**AoAUpdate**Administrationon AgingU.S. Department of Health & Human ServicesWashington, DC 20201(202) 619-0724TDD: (202) 401-7575 FAX: (202) 260-1012E-mail: [email protected]Internet Web Site: http://WWW.AoA.DHHS.Gov