Aging in Place at Hunterdon County of New Jersey
“I’ve heard from attorneys that only 10% of the population ended up not needing long-term care of some sort. While the preference is to stay home, sometimes assisted living is your home,” said Janet Kuebler, owner of Right at Home Somerset and Hunterdon Counties. “So aging in place can also be in an assisted living.”
Janet and her husband Carl Kuebler brought Right at Home to the area about a decade ago, providing in home care and assistance to the elderly and people with disabilities. In late June, Janet joined Joe Peters in his 55+ Radio show to talk about senior services and support available in Somerset and Hunterdon Counties, dementia and Alzheimer’s care services her office offers, as well as tactics to help seniors age in place.
Listen to the show here:
Community Services for Older Adults in Somerset and Hunterdon Counties
Joe began the show addressing a number of senior services and support available in the community. The Hunterdon County Department of Administrative Services for example has a Senior Center that provides an outlet for senior residents to remain active. The center hosts health and fitness classes, outdoor activities, health and wellness lectures, computer classes, as well as dine and chat events for the 60+ denizens.
Seniors who no longer drive can request rides from the Hunterdon County LINK transportation system for specialized medical appointments at a small fee. The LINK also runs bus routes connecting Raritan Township and Flemington Borough.
Home bound seniors may benefit from Meals on Wheels in Hunterdon, a non-government organization that delivers nutritional, individually packaged meals to elderly and people with disabilities. Meals on Wheels not only assists participants to maintain and improve their health, its volunteer drivers also serve as a “safety check” on them.
Hunterdon Helpline is another “safety check” service available in town. Seniors can sign up for scheduled “check-in” and “medication reminder” calls. Free “telephone assurance calls” are made by Hunterdon Helpline everyday between 8am and 9pm. If a participant cannot be reached within an hour of the scheduled call, Hunterdon Helpline would send someone to check and see if the senior is okay or need some help.
Alzheimer’s, Dementia or Forgetfulness?
According to the 2016 Alzheimer ’s Disease Facts and Figures report released by the Alzheimer’s Association, 170,000 people aged 65+ in New Jersey are diagnosed with Alzheimer’s disease. It’s also the 6th cause of death in the United States. As the baby boomers are approaching their 70s, Janet and her staff members devote much of their time advocating for Alzheimer’s awareness.
Janet and her team also offer training sessions in rehab and assisted living facilities to help healthcare professionals, caregivers, friends and relatives of the elderly understand what a dementia (and Alzheimer’s, which falls under the umbrella of dementia) patient is going through.While many people may think “forgetfulness” comes with age, Janet encourages the audience to take a health assessment to look at their cognitive abilities if they are concerned. “There is a difference between maybe forgetting and putting your keys in the fridge versus thinking the keys belong in the fridge, or not knowing what the keys are for. You need to look at what the forgetfulness is,” says Janet. “An assessment at the medical center will indicate if there is any mild cognitive impairment. Then you can put a plan of action into place.”
The training simulates the experience of a patient with degenerative brain disease. “We impede your senses – changing your hearing, what you are seeing – and ask you to complete tasks with those impediments,” explains Janet. “You have to complete five tasks within 7 – 10 minutes.
We prepare you beforehand and there is a discussion afterwards. The discussion is important as many participants became emotional and felt a lot of guilt once they realized what their loved ones were going through.
Janet recalled her personal experience of caring and seeking help for aging loved ones, “you really don’t know what you don’t know until you have an emergency.” She decided to get training to learn more about geriatric care management. She is now a Certified Senior Advisor, a Certified Dementia Practitioner, and a Mental Health First Responder. “I want to make sure that no one has the deer in the headlights look when something happens. Raising awareness and educating the public is something that I do a lot. ” She also has a pet therapy dog available for visits.
Alzheimer’s Care at Home
Families may be distraught when their loved one is diagnosed with Alzheimer’s or dementia. Patients need to have others around them at all time as the disease progresses. While it may sound harsh, family caregivers can feel “chained” to a loved one who suffer from the illness.
Janet said families should seek help for a loved one with Alzheimer’s or dementia sooner than later. “When they are used to having someone around, they don’t become so dependent on the spouse or the family caregiver. They also wouldn’t become upset when someone comes in to care for them as the disease progresses,” Janet explains.
Professional caregivers and nurses use a number of tactics to handle things that bother people living with Alzheimer’s or dementia. They look for physical causes for an issue to work on a strategy. For example, many patients suffer from sundowning - a psychological phenomenon that emerges as the disease worsens - and become more agitated, professional caregivers would find out what triggers the agitation.
“Sundowning is usually triggered by what happened in the past and how the patients’ lives were run. It might be a certain point of time,” Janet elaborates. “We usually find an activity that they can do to stop the agitation. For some, meal preparation can help with the agitation. We have them use safe cutter knives so they can chop veggies to help get dinner ready. We may ask them to fold laundry as the activity.”
If the patient is a “wanderer” – someone who might try to elope from home or an apartment in an assisted living – Janet said that decorations and disguises may help keep him / her contained. “You can do things beyond just putting an alarm to the door,” says Janet. “If you put a black doormat in front of a door, a lot of people with Alzheimer’s or dementia would think there is a hole. They would not step into it and that’s the stopping point. Although I would say giving them an activity to refocus them is still the best.”
Preparing for Aging in Place
Permanent legal residents of the U.S. become eligible for Medicare when they turn 65. While Medicare covers a number of home health care services, Janet said most home care services are covered by private pay or long-term insurance. Some people may opt for reverse mortgage to pay for care services as well. However she remarked that her agency participates in a few Medicaid waver programs through the State of New Jersey, and suggested interested parties to contact her for more information.
Janet urged people to familiarize themselves with what Medicare covers and what home care services are – in case there is a need, at least they would have some knowledge of who can offer help.