Submitted By: Wendy Haus Hanevold Ph.D.
Wendy Haus Hanevold is a licensed clinical psychologist who focuses on working adults and families who have experienced complex developmental trauma. She specializes in working adults (50 Plus) who need to get back on track when life knocks them off balance. Her interests revolve around building positive and healthy attachments, acceptance of grief and loss, and helping people and families bloom where they are planted. (Her Website is www.WendyHanevoldPhD.com)
This column/blog is designed to explore how Mental Health and Illness manifests during late adulthood . It is created to provide practical information to professionals, volunteers and family members who are not mental health professionals but who are working and living with older adults.
Providers and Caregivers need information and tools to screen for problems and challenges that are common to all ages as well as emerging issues that are more prevalent among older adults. They need to know what questions to ask and what to observe on both the non-verbal and verbal levels. Examples of questions include: Can the person I am working with hear? Can they see? Did I remember to ask about substance use and sexual behaviors? ( Or did I assume they are too old for that kind of stuff). And of course, the specter of cognitive impairment raises its scary head. The bugaboo of medical problems complicates the appearance of mental health challenges. The impact of medication(s) further complicates the story. This is in addition to loss, transitions and change.
Grief, for example, is a common challenge caregivers encounter in older adults. Grief is not depression. Yet an individual may have a long history of recurring or ongoing depression complicated by grief. Grief may set off old trauma symptoms that had been held in abeyance through a secure connection to a loved one who is now lost. Grief may result in a return to old addictions—like alcohol or food. Grief may be a transition time that needs to be navigated with wisdom, support and companionship but does not need “treatment.”
Over the next several months, we will explore the major categories of Mental Health Diagnoses and how they manifest in the general adult population and in older adults. Major Mental Disorder categories include depression, anxiety, substance abuse, mood disorders, and eating disorders. Lifelong challenges revolving around social communication, attention, and learning issues do not disappear just because someone is older. Personality disorders can muddy multiple levels of interactions. Early development trauma, acute stress and chronic stress further complicate the presentation of problems. These challenges need to be balanced with explorations of resilience, earned wisdom, ability to be present in the here and now, family, community, and skills in navigating life’s trials and tests.
Resources will be shared for providers and family members. Tips for managing challenging behavior will be provided. Landmines to avoid will be identified. Guidelines for consultation with family members will be given. Web and print resources will be shared. The goal of this blog is to become an ongoing resource for providers and family members on Mental Health and Illness. It will not explore issues connected with Alzheimer’s or dementia beyond the screening level. Information will be shared. Answers will be gathered. Experts will be consulted. Please join us on this journey of healing and support. Please send suggestions for topics and questions you would like to be addressed to firstname.lastname@example.org. Together we can become sources of knowledge, compassion and healing for the adults in later life and families with whom we work and live.
During the holiday season, long-term care facilities including nursing homes, personal care homes and assisted living communities, receive a high volume of visits from families, friends, local organizations and faith-based groups. These visits are extremely important to residents of long-term care facilities. Residents feel less depressed and isolated when visitors come to see them regularly. In addition, regular visitors may serve as advocates for resident care.
Generally, long-term care facilities residents have the right to receive visitors. Family members may visit any time. Long-term care ombudsman, the resident’s physician, the resident’s attorney, and clergy members may also visit the resident any time. Other visitors, including friends, neighbors and others may visit during the facility’s visiting hours. Federal and state laws and regulations address residents’ rights to visitors. The Centers for Medicare and Medicaid Services (CMS) have guidelines about residents’ rights. CMS explains that the resident has a right “to visit and be visited by others outside the facility.” This means that, in addition to receiving visitors at the facility, residents have the right to leave the facility temporarily to visit with others in the community. Residents have the right to go out to lunch or dinner or some other event with family and friends. To learn more about rights to return to the facility including bed hold policy when a resident has an overnight visit away from the facility click this link:
Long-term Care Ombudsmen are advocates for residents of long-term care facilities. Ombudsmen services are confidential; ombudsmen advocate according to the resident’s wishes. Each county in Georgia is served by the Ombudsman program. A list of the programs and contact information is available at www.georgiaombudsman.org. Ombudsmen are dedicated to advocating for long-term care residents regarding many issues, including their right to have visitors. Ombudsman can help by 1) informing the facility about visitation rights and 2) accompanying a visitor during a visit to ensure the resident’s rights are respected.
Tips for Visitors:
Melanie McNeil, Esq., State Ombudsman said, “The holidays are a time for reminiscing and creating new happy memories. Visits are important at this holiday season, and also throughout the year. Visiting helps each resident to stay connected with his or her community and helps to improve residents’ lives.”
If you are concerned about the care or treatment your loved one is receiving in a long-term care facility, or if your loved one expresses concerns, remember the best place to solve most problems is right where you are — in the facility. Try to clearly identify what the problem is then approach the administrator, director of nursing or facility social worker with your concern. Discuss possible solutions and ask when and how the concern will be addressed. If the problem remains unresolved, the Long-Term Care Ombudsman Program is there to help. The name and contact information for the local ombudsman is posted prominently in every long-term care facility. You may also find the local ombudsman by calling 1-866-552-4464 or on the web at www.georgiaombudsman.org.
On October 3, 2018, Georgia Governor Nathan Deal joined with Department of Human Services Commissioner Robyn Crittenden, Division of Aging Services Director Abby Cox, State Long-Term Care Ombudsman Melanie McNeil, Long-Term Care Ombudsman Advisory Council members, volunteers, and the staff of the Office of the State Long-Term Care Ombudsman to proclaim the month of October as “Residents’ Rights Month”.
In 2018, more than 1,000 nursing home residents from across the state sent letters and petitions to Governor Deal and their state House and Senate members asking for an increase in the Personal Needs Allowance (PNA). Governor Deal and the members of the Georgia General Assembly responded positively. Funds were recommended in the governor’s budget and increased by the legislature so that all residents will now have a PNA of $65 – an increase of $15 per month. Many of the Ombudsman Representatives across the state encouraged and facilitated the effort. In addition, Governor Deal signed several bills including SB 406 related to long-term care background checks and HB 803 related to trafficking an individual for his or her benefits.
We strongly encourage the community to participate in Residents’ Rights Month activities and to visit residents, who continue to be important members of our communities. Our staff and volunteers advocate for Georgia’s long-term care facility residents empowering residents to exercise their rights to make their own decisions.
Submitted by the State Long-Term Care Ombudsman Office.
Looking for resources on Falls Prevention? Here are a few of our favorites:
Please click below to access the report that covers the description, results, and lessons learned from the mini-grants awarded this spring by GGS! These organizations used different methods for reaching direct care workers for training and education including online and in-person. This project began with the research and work from the GARD Service Delivery work group in addressing barriers to training. This work aligns with goals of the GARD State Plan to increase education and training for direct care workers.
Diabetes is a serious public health concern in the United States. According to the National Diabetes Statistics Report, 2014 from the Centers for Disease Control and Prevention, it affects 29.1 million people, or approximately 9.3 percent of the population. This percentage is expected to increase (Source: Lin et al. Population Health Metrics (2018) 16:9 Projection of the future diabetes burden in the United States through 2060). Health disparities in diabetes exist among racial/ethnic and other populations such as rural and low-income, resulting in higher rates of
diabetes in these communities.
In order to improve health equity by improving health literacy and quality of care among people with diabetes, the Centers for Medicare & Medicaid Services (CMS) launched Everyone with Diabetes Counts (EDC), a self-management education program offering evidence-based workshops in targeted communities. EDC is administered in Georgia by Alliant Quality using trained diabetes peer educators to provide free six-week workshops throughout the state. To learn more about the EDC program, and how to refer your patients to a local workshop – or how we can provide our six-week workshops in your practice – please contact Jeana Partington, Diabetes Task Manager at 919-745-4729 or Jeana.Partington@alliantquality.org.
If you are a member of GGS, you should be receiving a monthly newsletter, the GGS Connector, every month. Our newsletter includes Member Spotlights, GGS Updates, Aging Resources, Advocacy Updates, Gerontology and Aging News, Upcoming Events, and more. If you are a member and are not receiving the newsletter, please email the Executive Director at email@example.com. If you are not a member, please visit our Membership Page to learn more about the benefits of joining today.