how to age in place panel

On November 12 and 13 at First United Methodist Church in Cary, Aware Senior Care moderated a question and answer panel.  The Live Well at Home panel featured great people in the community providing products and services to enable seniors, the chronically Ill or the disabled to age in place safely and thrive in their homes.

First United Methodist Church Cary “Live Well at Home Panel” Nov 12-13th, 2015

Live Well at Home, How to Age in Place Panelists:

Home Care (Personal and Companion Care) Aware Senior Care.  Gina and Tim Murray [email protected]  [email protected], Website (P) 919-436-1871.
Personal Access Solutions: Areas of Expertise: Home Safety and Home Renovations:  We are Independent Living Strategist committed to the mission of safely maximizing independence in homes.   Jacqi Dix Office 919-267-2610 [email protected]
Cary Senior Center Jody Jameson [email protected]   (919) 469-4081
Heartland Home Health and Hospice Amanda Clark, Senior Account Liaison, 919.235.7243 [email protected] Website
Medical Alert Technology.  Mary Ann Holder, Connect America HealthCare Division, [email protected] 800-249-3204.
Geriatric Care Advocacy and Management.  Nancy Ruffner, NAVIGATE NC, [email protected] 919.628.4428
Pharmacy Home Delivery.  Steve Adkins, 919.847.7645, [email protected] Website:
Estate Planning and Special Trusts.  Devan Culbreth, Attorney at Law, [email protected] 919-948-7633.  Website

Home Care (In-home personal and companion care)

Gina and Tim Murray ([email protected] [email protected] , Aware Senior Care 919-436-1871.
Link to our website FAQ

Q.  There are many home care agencies. What makes you different?
Personal Experience.  Tim and Gina, the owners, have been through what you’re likely going through right now – researching and finding the best options for an aging loved one and we have been caregivers to our own parents.
Medical references.  We are one of the few Home Care agencies that I’ve seen who have active MD references that will both refer and be a reference for the care that Gina Murray has provided for the elderly, chronically Ill and disabled.  Gina is a registered nurse and a graduate of the Villanova University School of Nursing.  Gina has spent more than 30 years in the field of gerontology. She spent over 15 years at one of the top skilled nursing facilities in our region, serving as a supervisor, Nurse Manager, and Assistant Director of Nursing. She also worked for Hospice of Wake County and was instrumental in the opening and management of the first inpatient hospice facility in our area (now Transitions LifeCare).
Family References.  We have families who will talk to prospective families about our services and our wonderful caregivers.  See
Highly trained staff.  During initial hiring all caregivers go through our one-day caregiver orientation training.  At least quarterly we do in-service training and we will be offering advance training on care for people with chronic illnesses.  Training is a key part of who we are.
Extensive caregiver screening.  We background check all of our caregivers using state of the art background web-based software from  Through TalentWise, we automatically check US wide criminal database, sex offender and DMV.  We drug screen and TB test all of our candidates and we do a thorough review of the NC Registry for CNAs.  All caregivers are personally interviewed and screened.  If hired, all caregivers go through one-day orientation and we schedule at least quarterly in-service training.  All training is done by our RN staff.

Q.  Can your caregivers provide transportation?
A.  Yes. Caregivers drive to doctors’ appointments, senior centers, etc. If driving your vehicle, there is no extra charge. A standard per-mileage rate applies if using the caregiver’s vehicle.

Q.  What areas do you serve?
A.  Cary, Raleigh and parts of Apex in Wake County, North Carolina.

Q. Will my Long Term Care Insurance cover your services?
A.  In most cases, Long Term Care Insurance does reimburse for services. We are happy to help determine eligibility requirements for your insurance company. For former US service personnel, the Veterans Administration offers the “Aid & Attendance” pension homecare benefit.

Personal Access Solutions: Areas of Expertise: Home Safety and Home Renovations:  We are Independent Living Strategist committed to the mission of safely maximizing independence in homes.
Jacqi Dix Office 919-267-2610 [email protected]

Q.  What is an Independent Living Strategist?
A.  Independent Living Strategists help to identify issues and partner to devise solutions that include home modifications and equipment. We orchestrate and supervise construction and installations, help to provide referrals to other resources, and strive to increase awareness of universal design.Q.What are some types of simple bath modification that can be done in my home?
A. A few quick tips of simple home modifications are to make sure lighting is good especially at night by installing a reliable nightlight, a lighted path to the bathroom, or even lighted grab bars. Installing grab bars on the side of the tub or shower and around the toilet area, or install a floor to ceiling vertical rod, sometimes referred to as a safety pole, these poles are removable and relocatable. Also the use of a sturdy shower seat is an important addition. A raised toilet or bidet can be of assistance.

Q.  What are some kitchen modifications that can be done?
A.  Well one of the easiest is to add a sturdy chair in the kitchen so that food preparations can be completed while sitting.  Adjustable countertops heights. Replacing knobs on kitchen hardware with loop/bar, and having easy glide cabinet inserts in both upper and lower cabinets installed can be most helpful with independence. Adding in molded flatware, and dishes with contours can help with comfortable eating.Q.What are some of the things that are examined on a home consultation?
A.  We look at is there at least one entrance/exit from the home that is “vistable”, so that if friends of family are coming to visit, is there one barrier free entrance into the home.
We look at doorway widths, are they 36 in into a bathroom? Are the faucets lever touch, or do they have knobs? How is the lighting within and outside of the home?  Is the home free of tripping hazards? Interior and Exterior.   Does the main door to the home have a peephole for security purposes? Where are the light switches and controls located?

 Can you make the entrance or exit from a home barriers free without using a ramp?
A.  Yes, there are various options to using grading and landscaping. Additionally we have portable threshold ramps that can be used only when necessary.
Cary Senior Center
Jody Jameson [email protected]  (919) 469-4081
The Cary Senior Center is a recreation facility for people ages 55+ (including some for 50+!) where we provide opportunities for Creating Active Retirement Years through a variety of wellness programs for all interests!Link to the Fall Cary Senior Center BrochureLink to the Resources for Seniors Guide in .pdf.
Scroll down to Industry Downloads and select the “Resources for Seniors Directory 2015”Home Health and Hospice – HeartlandAmanda Clark, Senior Account Liaison, 919.235.7243  [email protected]
 What is the difference between home health, hospice, and palliative care?
 Home health- patient must be home bound, goal is to provide therapy and nursing to get patient back to baseline, or close to 100% rehabilitation. Palliative Care- for patients with chronic pain concerns that do not have a limited diagnosis, or chronic symptoms that they would like treated at home.  Hospice- patients who have an advanced illness, get full support of health care team to remain at home with comfort care, symptom management, as well as psychosocial and spiritual support.Q.  How do we pay for home health, hospice, or palliative care?
A.   Medicare, Medicaid, private insurance, and with Heartland, no insurance. Different agencies take different private insurances, so be sure to check and shop around to see who is in network.Q.  How can I get referred to home health, hospice, or palliative care?
A.  You may refer yourself to any of these services, however, for care to start, you must have a doctor’s order.  Your order can come from a PCP, a hospitalist, or any specialist. The doctor must then agree to follow your plan of care while you are on service with a given provider.Q. How long will services last?
A.  Depends on the level of care needed.  Home health will work with you to come up with a goal for recovery, and work towards that goal, may be a few weeks to a few months.  If being seen by a HH nurse for wound care, can receive care for years.  Hospice care is meant to be in place for the last 6 months of one’s advanced illness, however many patients are on longer when they show a gradual decline based on their diagnosis and disease progression.  Palliative Care- Can be on for a longer duration than HH and hospice since this care is meant for chronic illness/pain.

Q.  Can I go see my doctor or go to the hospital while receiving any of these services?
A.  YES!  All 3 services work in collaboration with the medical care provider you chose, so they will have all up to date plans of care for these services.  You may go to the hospital at any time while on these services as well. The company you are with may have you sign off of service during your hospital stay, however, you may sign back on afterwards to avoid double billing by Medicare/Medicaid/insurance.

Medical Alert Technology
Mary Ann Holder, Connect America HealthCare Division, [email protected] 800-249-3204

Q.  What is a personal emergency response system?
 It is a system with two-way voice communication that you can use to get help anytime day or night in the event of an of emergency simply by pressing a waterproof button worn around the neck or on the wrist which communicates with a base system and connects you to an operator.

Q.  What type of systems do you offer?
 We have the standard landline (for those who still have a landline phone, a wireless for those who do not have a landline (no landline, no cell phone, no problem) and a mobile/gps for those who could benefit from help at home and away from home.

Q.  What if I fall and am not able to press the button to get help.
A.  We offer a fall detection button that can be worn around the neck and if you fall and can’t press your button, It will automatically send a signal and you will get help.

Q.  Do I have to sign a long term contract like you do with other providers?
A.  No, our systems are rented on a month to month basis.

Q.  What happens if I press my button and no one can hear me through the two-way speaker on the base system?
A.  We will attempt to hear you thru the two way speaker and if we can’t hear you, we will call your phone.  If you do not answer your phone we will send help.

Geriatric Care Advocacy and Management

Nancy Ruffner, NAVIGATE NC, [email protected] 919.628.4428
Q: What are the families asking about, what are the challenges, “Top 3”, etc?
A: Folks are asking: How to pay for care, how to have discussions, how to find solid services among the onslaught of information online, where do I even begin, “we are out of town/state, but our parents are in Cary. What to do..?”
At the two FUMC panels specifically the questions were: How do I get my parents to open up, to talk with me about finances? What do I do if they won’t talk, or won’t consider help? What about medical alert necklaces? How do we choose the right provider, how do we know they are qualified? Discussion centered on medication management, fall prevention, legal documents that need to be in order or developed. Home health or Home Care? Long Term Care policies, how to find, how to choose, how to plan. Discussion of evaluation of the home (for falls) and for future. Taking Care of the caregiver.

What is the best advice you ever got on planning for aging that you use today?
 “ASSEMBLE YOUR TEAM”.  Determine who will be on your team, who will be needed. An Advocate will have vetted resources to refer, can do so or teach you how to interview and choose.
Q: What is the difference between an Advocate and Geriatric Care Manager?
A: Advocates work with more than the geriatric population. At NAVIGATE NC we help families to navigate the challenges that normally come with aging or with chronic disease.
We are private pay, and that is for a reason: so we will work for you. Not for insurance, not for hospitals, not for medical groups. YOU.
We will press, push, we “show our teeth”. Yes, we educate and inform and counsel…but we go to bat, will take your matter further…
Q: How do I “vet” or choose the right provider?
A: Memberships in professional organizations (who have checked US!).  If licensed, check with that Board (nurse, attorney, general contractor, and exterminator). Look for evidence in the community (volunteerism, civic group memberships, Boards). Interview them (Advocates will teach you how). Ask for references, even check BBB. (On my professional organization’s directory ( there is a great listing of How to Choose an Advocate and How to Interview an Advocate.
Vet us! If we are worth our salt we’ll tell you how, it’s part of our Advocacy.
Pharmacy Home Delivery – Health Park Pharmacy
Steve Adkins, 919.847.7645 [email protected]
The following is an excerpt from our Blog on Medication Management that Steve influenced. Management – Help Your Loved One Get Organized
Why is managing medications so important? Personally, we had never thought about whether or not our parents were taking their medications as ordered. After his stepdad Jack’s first stroke, Tim and I stayed with his Mom during those first frightening days.
During this time, I noticed that there were a numerous medication bottles throughout their home. With Mom’s permission, I collected all the medication bottles and sorted through them. There were over five dozen medications- over half of them were expired. The oldest medication was 15 years old! We realized that Jack had not been taking his medication correctly which was a major factor that led to his stroke.
Where do you start if you want to help a loved one get organized?
With permission:
1. Do a clean sweep – collect medications from all parts of the home. Remember to check kitchen and bathroom cabinets and drawers, pockets of clothes (especially robes), purses, the car, etc.
2. Check the expiration date for each medicine. Place expired medications off to the side or into a box to keep them separate.
3. Review the current medication list or create one if there isn’t one. Include the person’s drug allergies and today’s date on the list.
4. Review the medication list and compare it to those medicines you have collected. Start with the prescription medicines.
5. For each prescribed medicine: Check the pharmacy label on each prescribed medicine on this list. Each should include: the name of the medicine, the dose prescribed, how many tablets/capsules/ml to take, how often to take it, the reason the medicine was prescribed, and special instruction, if any. Is a refill needed? When was the last refill? (This can help determine if too many or too few are being taken).
6. Add over the counter medications and supplements that are taken on a routine basis to the list. Are there enough on hand?
7. Use one pharmacy for your medicines. If some medicines are mail ordered, be sure to let your local pharmacist know about them. Pharmacists will watch for medication interactions.
8. Consider the use of a pillbox(es). There are various size boxes, some have alarms you can set as a reminder to take the medicines. The pillboxes keep the medicines organized. It also makes it simple to see if doses were missed.
9. Consider using a pharmacy that will prepackage the medicines into blister packs- at no additional charge. Some pharmacies will deliver the medicines to the home, at no charge as well including Health Park Pharmacy and Hayes Barton Pharmacy. Check out and for more information on these services.
10. Help your loved one fill the pillboxes each week or buy more than one so you can do more weeks at the same time.
11. Check each week- are the medicines being taken? Are the same doses being missed each day? Consider the use of timers or other reminders if needed.
Taking medicines as they are prescribed is essential for good health. Talk to your healthcare professional if there are concerns or questions about any medicine.
Have you been able to help a loved one organize their medicines? What did you do? Please share your experiences and what worked for you and your loved one.
Estate Planning and Special
Devan Culbreth, Attorney at Law [email protected] 919-948-7633