by Matilda Charles

There’s a movement afoot that, if it gains traction and becomes law, could affect many of us. Researchers have once again studied the ramifications of increasing the age of Medicare eligibility to 67. The purpose, of course, would be to save the government money.

Here are a few of the things the study discovered from the records of more than 200,000 seniors:

Overall medical spending dropped by a third when seniors switched to Medicare because the government pays providers less than private insurers.

While the government will save money, actual health-care spending will go up. A previous 2011 study concluded that while the government would save $5.7 billion (in 2014), seniors age 65 and 66 would have increased costs out of pocket of $4.5 billion. The current study agrees.

A Congressional Budget Office looked at the potential government savings in 2013, and concluded that the government could save $19 billion between 2016 and 2023.

Seniors generally would stay with the same health-care providers, who will get less money for the same services, probably 30 percent less. Those providers will continue to see existing patients because they’ll be dealing with volume in the number of patients.

So what does this mean to us? Seniors would need to spend two more years on private insurance. To keep employer-provided insurance, we’d need to stay employed for two more years.

If we were planning to retire and have Social Security as all (or at least part) of our income, we’re not likely to be able to afford the high cost of medical insurance, as it seems to go up each year as we get older.

(c) 2016 King Features Synd., Inc.

by Cate Kortzeborn- Medicare’s acting regional administrator for Arizona, California, Hawaii, Nevada, and the Pacific Territories

My mom, 88 stubborn years old, still lives on her own in a big house with a cat that loves to get underfoot. Because I work in healthcare, I have an all-too-vivid recognition of the perils that can befall someone in her situation.

POLST stands for Physician Order for Life-Sustaining Treatment. It’s a document that makes your treatment wishes known to doctors, nurses, emergency medical technicians, and other healthcare providers. Too often, people near the end of their lives get treatment they don’t want. These treatments may not help them live longer or better, and sometimes can cause pain.

Also, family members sometimes have their own ideas about what types of treatment their loved ones would want. POLST makes sure your family members and caregivers know exactly what life-saving treatments you do and do not want.

POLST is different from an advance healthcare directive. An advance directive allows you to choose the advocate you want to speak for you if you’re incapacitated, and provides a general guide to what treatment you want. POLST is different because:

• POLST is a signed medical order that your healthcare team can act upon, whether your advocate is there or not;

• POLST indicates your exact wishes about certain medical treatments.

Although it’s a good idea for all seriously-ill people to have both an advance directive and a POLST, any adult, especially if she or he is unmarried, should have one or both.

You can find the POLST form online or at your primary care provider’s office. Your provider can explain the different options on the form to you. The POLST must be signed by a licensed healthcare provider and by you.

Once signed, the POLST becomes part of your medical record. It stays with you all the time. If you’re at home, put it near your bed or on your refrigerator. If you’re in a hospital, nursing home, or assisted living facility, it’ll be in your chart or file. If you’re moved between locations, your POLST goes with you.

POLST forms vary by state and focus on three types of interventions. For each, you can chose whether or not to have something done or choose a level of intervention.

• Resuscitation (person has no pulse and is not breathing):.

• Medical intervention (person has pulse and/or is breathing):

• Artificially administered fluids and nutrition: This is a way of feeding a person through a tube either in his/her nose or through the skin into his/her stomach.

To find the POLST website in your state, where you can get more information and download forms, go to www.polst.org.

More information on advance directives can be found at: https://medlineplus.gov/advancedirectives.html.

You can always get answers to your Medicare questions by calling 1-800-MEDICARE (1-800-633-4227).

by Lori Harasta

Howard was only 41 years old and was suffering from the advanced stages of esophageal cancer when he was admitted into Livingston’s compassionate hospice care. Within days his pain was under control and he was comfortable enough to leave the house, be with friends and even enjoy a beer. Although he was on hospice care, he was living what appeared to be an ordinary life again.  When the end finally came, his passing was pain free.

Many people think that being on hospice means lying in a bed, barely conscious. Howard’s story proves that is not the case. Hospices are all about providing a comfortable lifestyle for those in their final stages of life. There are many hospices out there that people use such as the Hospice Cincinnati. People want to be happy in their final moments and this is one way to do it. Many of his final moments were anything but ordinary, and they would not have been possible without the help of hospice.

Howard’s experience is not unique. The mission of hospice is to provide specialized care for end-of-life patients and their families.  Hospice care supports living one’s life to the fullest with dignity regardless of how much time remains. They provide support and also give high quality care through professional doctors, and healthcare lighting and equipment.

November is National Hospice and Palliative Care Month.  Here are some of the common myths of hospice that need to be put to rest:

MYTH: Hospice care means leaving home.
FACT:  Hospice is not a place. In fact, hospice services can be provided to a terminally ill patient and his or her family wherever they are most comfortable, or wherever they consider “home.”

MYTH: Hospice means forgoing all medical treatment.
FACT:  With hospice, the focus changes from cure to comfort.  The hospice provider will assess the needs of the patient, deciding which medications and equipment are needed for maximum comfort.

MYTH: Hospice means strangers care for you.
FACT:  Livingston Memorial Visiting Nurse Association strives to educate and support family members to serve as the primary caregivers for an end-of- life patient.  The hospice team comes alongside the family and consists of doctors, nurses, aides, social workers, therapists, volunteers and chaplains, and are available 24/7.

MYTH: Hospice care ends when someone dies.
FACT:  Bereavement support  services that deal specifically with grief and coping after the loss of a loved one are available at no cost for up to a year after someone dies.  In addition, Livingston has bereavement support groups for the general public in various parts of Ventura County.  For more information, visit the website at http://lmvna.org/calendar/index.html

MYTH: People on hospice are in bed, waiting to die.
FACT: Hospice enables special moments and memories at the end of a life that would otherwise not happen.  Howard called hospice because he wanted to live his life to the fullest with dignity, restoring a quality of life that he may have otherwise lost to invasive treatments and surgeries.

Hospice makes more meaningful moments possible.

The California Assisted Living Association (CALA) has announced that Sarah Perez, Memory Care Program Manager with Cypress Place Senior Living in Ventura, has received the organization’s prestigious Outstanding Department Director award at their Fall Conference & Trade Show in Rancho Mirage. CALA chooses recipients of these awards based on their commitment to providing outstanding, quality care and service to residents in the Assisted Living communities where they work. Perez received her award on October 24, 2016.

According to executive director Steve Spira, “Sarah may think no one is watching, but we at Cypress Place can see that excellence and superlatives are simply silent badges she wears every day.”

Perez began working at the community 13 years ago as a caregiver, and is currently in charge of the memory care Vibrant Life program.

Co-workers and family members say that Perez’s greatest talent lies in the fact that she really “knows” residents and takes cues from them to create personalized, engaging activities. She noticed on a recent outing that residents were expressing concern for homeless individuals, so she organized a group to craft blankets for them. She also organized the “Yahtzee Girls Club” after many residents told her they like to play dice games.

This creativity extends to individual residents as well. One resident was continually talking about his WWII experience. Perez worked with his wife to create a slide show of his military life and hold a celebration of his service. Her philosophy of care is, “When residents are laughing and engaged, they’re not experiencing fear or trepidation.”

“This is a well-deserved award for Sarah, and we are thankful she is part of the Cypress Place team assisting our residents in such a loving and dignified manner,” said Spira.

If you are considering nursing home care and you have Medicare, you can begin your search at http://www.medicare.gov. You can find many links that can help you gather information about Medicare- and Medicaid-certified nursing facilities and long-term care options in your state.

To compare the quality of nursing homes in your area that are Medicare- or Medicaid-certified, visit the Medicare Home Compare page and type in your zip code. (Information on Nursing Home Compare isn’t an endorsement or advertisement for any nursing home and should be considered carefully.)

To look at or print a copy of the booklet “Medicare Coverage of Skilled Nursing Facility Care,” click on “Forms,help & Resources” at the top of the Medicare home page and select “Publications.” You can also call 1-800-Medicare (1-800-633-4227) to find out if a free copy can be mailed to you. TTY users should call 1-877-486-2048.

Creative Cooking
Get excited about the joys of the table and getting processed foods out of the pantry, cooking clean fresh food with the added benefits of improving ones health with simple foods that taste better and is easy on the budget. $20 Material/food fee due to instructor at first class.
Class 7433   Thur.  2-4 pm 11/3-11/17       $80

Beauty for the Budget Minded Senior
Define color for wardrobe, using cosmetics that you already have to the best advantage. Using what you have well also look at skincare, makeup and your look/style while keeping $$$ in your wallet.
Class 7423    Thur.  1-3 pm 11/17   $10

Ventura Avenue Adult Center 550 N. Ventura Ave. 648-3035
Ventura Council of Seniors monthly meeting November 16 at 9:30 am at Silvercrest
750 S. Petit  647-0110

For more senior programs and classes go to http://www.cityofventura.net/adult.

The Alzheimer’s Association Ventura County Regional Office invites caregivers to their Fourth Annual Empowering the Caregiver Resource Fair. This free event will be held on Saturday, November 5th from 9 a.m. to 2 p.m. at Oxnard Family Circle located at 2100 Outlet Center Drive, Ste. 380, in Oxnard.

Come learn about options of care for your loved one, the latest update on Alzheimer’s research and other information for caregiver support. Vendors will present information about their services and answer any questions.

James P. Sutton, M.D. of Pacific Neuroscience Medical Group will be the keynote speaker.  Michael Williams with Grey Law, Michael Malone with EdwardJones and Dean and Ayesha Sherzai, both MD’s with Cedars-Sinai Medical Center will also be presenting.  Respite care will be generously provided onsite by Oxnard Family Circle and lunch provided by AlmaVia of Camarillo.

Space is limited and registration is required for this free event. Contact the Alzheimer’s Association office at 494.5200 or [email protected].

A Beach Community

Sinking are surfers that move over the tide but rise with faith on their boards to throw them beachside….the seagulls squawk to see a wave challenging their flight off a swell to explore schools of fish where children behave….Ventura’s a beach sandy to a pier like a picture held together by stained glass and a wooden square..

Jeffers

Is this what replaced the RAP?

Council often asks citizens, “Where have you been for the past months or years” and “why is this just now coming up”   I ask this question of this new process and first test case under it .

If we are going to have good Design Review or Planning Commission folks, aren’t we micro managing to have council second guess them and staff after their many meetings with and investment by developers

This also begs the issue Neal Andrews raised and City Attorney  Greg Diaz affirmed about councilmembers fine legal  line on expressing personal opinion / support or opposition on projects?

I think we all agree that something is broken in this process.  We have been trying to fix it for many years.  I hope we all agree that Uncertainty is the  worst thing of all for anyone considering new development in our City.

Is it time to reconsider this New Call Up Rule?

Mike L Merewether-Ventura

Residential Allocation Program (RAP)

On April 13, 2015, the City Council voted to create a residential allocation program (RAP)to accomplish three goals:

• Provide the City Council authority and discretion over the housing types, pace of growth, and quality of residential development
• Thoughtful allocation of limited City resources and services, such as water, land, sewer, and transportation, to ensure that high priority residential projects are developed in appropriate areas
• Ensure a range of housing types that accommodate all income levels, from executive estates to affordable housing units
  

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City Council

Several months ago, the Pierpont Community Council (PCC)passed a resolution wherein a request was made by the Pierpont Community Council to the City to effect a temporary moratorium on the issuance of new permits for Short-Term Rentals.  We wish to thank the Council for recognizing our resolution and bringing it forward for consideration this evening.  The majority of Short-Term Rentals occur in Pierpont and, therefore, impact our membership.

To be clear, the Pierpont Community Council has not taken a position either way on the existence of the practice itself, as there are Pierpont property owners on both sides of the issue.  We have, however, concluded that there should be a “time-out” on the issuance of new permits so that the City can further review 1) its legality, 2) the code itself, and 3) code enforcement measures that are in place.  We strongly urge that you rule in favor of a temporary moratorium.

Thank you,

Dan Scully, President PCC

Breeze: Because two City Council  members were recused from this decision and one was not present it was not possible for the City Council to vote on placing a moratorium but they instructed staff to prepare further information for their consideration. City officials plan to hold two community meetings to get input on the rentals and then have a group of stakeholders meet various times after that. The group will return with recommendations to the council in four to six months.

Those who can make you believe in absurdities can make you commit atrocities.
 ~ Voltaire

by Phil Chandler, Owner of Right at Home of Ventura County, Home Care Agency

Many individuals with serious chronic illnesses find that meeting and discussing their illness at support groups provides comfort and tips in dealing with the disease. The Breeze will be highlighting local support groups for several different conditions in the coming weeks.

As we age, many of us will experience vision loss. In fact, the National Federation for the Blind estimates that 5.5 million seniors in the United States are blind or visually impaired. There are many causes of vision loss with age, including Macular Degeneration, Glaucoma, and Diabetic Retinopathy.  There are medications that can slow the progression of vision loss due to these diseases, but it cannot be reversed.

Fortunately, we have resources right here in Ventura County to help people adapt their lifestyles to low vision. The Braille Institute has a regional office in Santa Barbara that sponsors several low vision support groups throughout Ventura County. Locally, a group meets at the Ventura Townehouse at 4900 Telegraph Rd from 10AM to 11AM on the first Tuesday of the month. There are also numerous other support groups throughout the county.

The topics for each support group are selected by its members – there may be a presentation on tips for navigating your house and using appliances, using an ipad, or an overview of the changes in Medicare. One support group had a presentation by UCSB students who were working on devices to help people with low vision.  Other times, they may discuss coping with the emotional impact of vision loss.

In Camarillo, the Lions Club sponsors a bus to take people to the center in Santa Barbara, where they teach independent living skills. There are also academic courses taught by volunteers, many of whom are professors from UCSB. A diverse curriculum is offered – including ceramics, computer skills, languages, and disaster planning to name a few.

Brenda Birdwell, the Braille Institute’s Field Service Manager serving Ventura County, said “The mission of the Braille Institute is to empower people with low vision to lead fulfilling lives”. There are a wide variety of services that the Institute provides. The Institute can send a consultant to your home to do an in-home assessment. With each visit they try to help the participant master one major objective, from navigating the kitchen to using the phone. There is training available on orientation (where you are relative objects around you) to use of a white cane. An extensive library of talking books are available as well.

For more information on these support groups and services for those with low vision, call Brenda Birdwell at 682-6222 ext 8304, or see http://brailleinstitute.org/santabarbara.

“I’ve been homeless for 15 years.  No one has been nice to me until now!”  “Joe” broke down and cried when David Cates, RN for Livingston Memorial Visiting Nurse Association gave him a sandwich, a sleeping bag, and a goodie bag filled with water, band aids, face wipes, fruit bars and applesauce.

David works with the CATCH (COPD Access To Community Health) Program, a grant-funded initiative, implemented through the Ventura County Health Care Agency (VCHCA). Livingston is the only healthcare agency that is partnering with VCHCA.  It is a free-of-charge program designed to improve health outcomes for Medicare and Medi-Cal patients diagnosed with COPD (Chronic Obstructive Pulmonary Disease).  COPD is a group of lung diseases that block airflow and make it difficult to breathe. It includes emphysema, chronic bronchitis, and severe asthma.

Livingston has three nurses on the CATCH Team.  70% of the patients David sees are homeless. Every Tuesday the CATCH Team meets to do a preliminary assessment and plan of care for the list of patients under the guidance of Program Director Sandra Tovar and Pulmonologist Dr. Chris Landon.  The nurses are equipped with pertinent patient education materials and pulmonary function assessment tools as they go out to meet the patients.  For the homeless, the meeting could be at the One Stop Center (which provides medical and behavioral assistance, housing options, employment assistance, etc.) a parking lot or along a river bed.

A lung function test is done.  Smoking cessation counseling is offered.  Nurses review medication and teach about proper use.  They provide diet counseling and refer patients to services according to their needs.  As David says, “Education is the biggest thing we do.”

Joe has diabetes.  David showed him how to read the label on a can of peaches to warn him about the high sugar content.  He swapped the peaches for an apple.  With a little bit of education, Joe’s blood sugars have stabilized.

The goal of the CATCH program is not just to reduce emergency visits and hospitalizations, but to improve the quality of life for patients through smoking cessation classes and support, improved medication regimen, nutrition counseling and emotional support.