Options for older people improve

By Mary Stamp

Anticipating a wave of people aging as baby boomers retire, the new and retiring executive directors of Aging and Long Term Care of Eastern Washington (ALTCEW) expect many more people will need financial, care giving, legal, nutrition, transportation and the other assistance they facilitate.

In 2030, one in five people in the state will be 65 or older.

Lynn Kimball succeeds Nick Beamer as the executive director of Aging and Long Term Care of Eastern Washington.  Nick has seen changes in services over 27 years.

The end of January, Nick Beamer, who has been executive director for 27 years, retired and turned over his responsibilities to Lynn Kimball. 

In retirement, he will continue to promote senior services through advocacy.

For seven years, Lynn, who became executive director Dec. 15, has been preparing for her new role by visiting partner agencies in North Ferry, Stevens, Pend Oreille, Whitman and Spokane counties to learn about issues, needs and concerns of older people, and to engage with partners in planning, networking and advocacy.

She said ALTCEW’s priorities today are to integrate health care with social services, build a workforce with more paid and volunteer caregivers, develop future long-term care options, help people access senior services and be a catalyst for developing new programs.

Lynn Kimball

After earning a bachelor’s degree in social work in 2004 at the University of Alaska in Fairbanks, she completed a master’s degree in social work in 2007 at Eastern Washington University.  During her studies at EWU, she was an intern with ALTCEW for a year and has continued since then on staff, most recently as the planning and resource director. 

Over the years, Nick has seen many changes in work with older adults.

Now many older adults work longer, some by choice and some not.  Some lost 401Ks, and Social Security is not enough to live on, so more will face financial difficulties, he said.

When he started, the Older Americans Act (OAA) of 1965 and the Senior Citizens Service Act were funding the work. The OAA provides federal funding for in-home and community-based programs for older people.  Amendments in 1972 and 1973 called on states to establish Area Agencies on Aging.  There are now 650 such agencies helping seniors find services to remain independent and safe in their homes as long as possible.  In addition, about 240 more agencies have been established to serve Native Americans.

ALTCEW partners with other organizations in the region to both coordinate and provide services for adults 60 and older, and for people with disabilities.

It provides home and local services to support “healthy living” so people can “age in place.” 

Lynn said that by visiting in the counties and listening, she has learned of the changing world of aging so ALTCEW can help provide solutions that improve elders’ quality of life—wellbeing, independence, dignity and choice.

Established in 1978 as the Eastern Washington Area Agency on Aging, it became Aging and Long Term Care of Eastern Washington in 1994.

In the late 1980s and early 1990s, most funding developed senior centers, nutrition programs, information resources and case management.

Nick Beamer

“In 1994, Medicaid Waiver Services began in our state,” Nick said, “providing additional options for care so people would not have to go to nursing homes if that level of care was not necessary.  People who qualified could stay in their homes and have access to a case manager and home care providers paid by Medicaid.”

Over the years, that has expanded the number of Medicaid-eligible people the ALTCEW serves to about 3,400 people today.

“Medicaid added personal care to chore services, covering such tasks as bathing and toileting, in addition to cooking, cleaning, essential shopping, transportation and other assistance,” Nick said.

Caregivers provide one-to-one-services for two or three clients, based on the hours of care Medicaid approves for a client.  Family or others may do the rest. 

The program includes nurse consultation to help caregivers understand how to manage medications and chronic illnesses, such as skin-pressure ulcers, Lynn said. 

Nick said the Older Americans Act has expanded to add family caregiver support, so ALTCEW works with family and volunteers, who are unpaid caregivers, to prevent burnout with respite care, information, training and family support groups.

Since starting caregiver training classes in the late 1990s, more than 4,000 home caregivers and nursing assistants have attended these classes for certification.

Needs are still greater than the number of people trained, Lynn said.

In the 1990s, the Statewide Health Insurance Benefit Advisors (SHIBA) formed, involving more than 40 trained volunteers in Spokane and Whitman Counties to help people understand their Medicare benefits, particularly Part D for prescription drug coverage, Nick said.

“Volunteers need to understand the twists and turns of Medicare programs,” he said.  “For example, if someone is taking 12 prescription drugs, it’s hard to find the right Medicare Part D insurance plan to cover them.”

The Washington State University School of Pharmacy added a component for students to help seniors assess drug combinations.  They find some take three to four duplicate drugs.  At retirement communities, they also offer drug education on interactions of drugs and supplements not reported to doctors.

“Education on medicines helps keep people stable, because some medicines contribute to falls, poor quality of life and repeat hospitalizations,” Lynn said.

In 1995, Medicaid allowed ALTCEW to expand the age range of clients to include people 18 and older who have disabilities.

They now can provide in-home and personal care for younger, disabled people.  Some work, so caregivers help the person get ready to go to work.

With the OAA, Medicaid expansion and caregiver training, ALTCEW and its network of contractors serve nearly 10,000 people a year. SHIBA serves more than 5,000.

Many services are provided through contractors and subcontractors, such as Greater Spokane County Meals on Wheels, Rural Resources Community Action, the Council on Aging and Human Services of Whitman County, Elder Services and Gonzaga’s Legal Assistance programs.

Since the Affordable Care Act passed three years ago, ALTCEW has helped patients released from regional hospitals.  The program, “Bridging Care,” provides care transition coaches to see patients in the hospital and in their homes to prevent unnecessary readmissions.

Because hospital stays are shorter, people need more assistance when they are discharged.

The Health Homes program works with managed care plans to provide care coordinators to work one-to-one with people to decide health priorities and navigate the complex health care system, especially for people at a high-risk, such as with chronic conditions, mental health, substance abuse and kidney failure, said Lynn.  The coordinators build communication between medical and social service providers.

Social service providers see people in their homes and are aware if they are struggling to pay for food and rent, while the medical providers may not be aware of those conditions, she said.

The Community Living Connections program, Nick said, “helps us enhance information and assistance with person-centered plans to help people access resources, consider options, evaluate if in-home care, nursing homes or assisted living would help.”

Lynn said that means developing relationships with other agencies working with older adults to reduce the run-around and confusion of referrals, and to solve problems more effectively.

The Kinship Caregiver Support Program, started in 2005 under the OAA, offers legal and financial help for grandparents raising grandchildren.

“More grandparents or older adults are helping raise children because of more two-wage-earner families, more divorces and more multi-generational households,” said Nick.

“Our agency is a catalyst to  help people access services from other agencies and to bring people together to start programs as needs arise,” said Lynn, a member of St. Aloysius Parish.

Motivated by her faith’s call for social justice and to care for the poor and vulnerable, she said, “Key to our society is how we support young people and old people.  We need to take care of each other.”

Nick, who grew up Episcopalian and attended Disciples of Christ churches for many years, has attended First Presbyterian since 1993.

“Churches call us to help people in need and bring about social justice,” he said.  “ALTCEW’s mission is compassion.” 

Congregations also provide meal sites, sources of volunteers for programs and sites for education programs.

In retirement, Nick expects to advocate at the state level to assure programs have funding, and advocate at the federal level so Social Security, Medicare and Medicaid will continue. 

“Volunteers are always needed,” Nick said, “so I hope as my generation retires, there will be more volunteers to deliver meals, provide rides and be caregivers.”

For information, call 458-2509 or visit altcew.org.

Copyright © February 2015 - The Fig Tree