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Seacoast New Hampshire

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Portsmouth Herald: City services support aging, independent seniors

(View article here.)

April 30, 2012

PORTSMOUTH — With the nation's senior population expected to increase more than 40 percent to 72 million by 2025, the projected demand on the nation's health care system is sometimes referred to as the "silver tsunami."

One change already being felt in New Hampshire is the increased need for senior home care services.

"Aging baby boomers want to remain and live independently in their own homes," said Lucille Karatzas, elder services director at Seacoast Mental Health Center in Portsmouth. "They don't necessarily expect to just go into a nursing home."

Kathleen Robinson, estate planning/elder law attorney in Portsmouth, also sees the shift.

"More elderly people are coming to me with questions regarding their care, their assets and how Medicaid works," she said. "Older people are looking for alternatives to nursing home care."

One alternative is Home Instead Senior Care in Portsmouth, whose mission is "to enable seniors to live happy, healthy and independent lives in their homes." Citing recent studies that show 90 percent of seniors prefer to remain in their homes, Lisa Ganem, co-owner of Home Instead Senior Care, said to meet future needs they "must continue advancing their level of service to ensure a higher quality of life at home is possible."

"One example is a new specialized dementia training we offer professional and family caregivers," she said. "With this new research-based approach, we promote engagement, support families and manage behaviors — honoring the experiences of seniors living with dementia."

Ganem said their services are tailored "to assist in areas that become challenging to independence," which include meal preparation, medication reminders, transportation to medical appointments and personal care. "Our caregivers often work in conjunction with visiting nurse services and with hospice," she added.

Emphasizing the importance of prevention, Karatzas cited the statewide Referral Education Assistance and Prevention program as another important resource. Offered through the state's 10 community mental health centers and managed by SMHC, she said REAP's mission is "to improve the quality of life for older adults through free preventative home- and community-based counseling and education services."

"We help elders evaluate their home for safety and things that could become issues later on — steps, scatter rugs and proper lighting," she said. "It's important to talk about safety earlier rather than later."

Robinson said legal ramifications related to aging must also be considered. "They need to consider what they can do with their assets — do they have a will, do they have a power of attorney?" said Robinson, who added many seniors initially approach her without this necessary documentation. "When families don't have these basic legal documents in place, it becomes much more complicated."

For elders wishing to remain at home, Karatzas said primary care physicians, family members and friends serve critically needed, complementary functions.

"We need the good primary care practice to oversee the whole person and not just the individual body part that's hurting," she said. "Family members should also be involved, because so many elders become overwhelmed when seeking services, or not fully understand a treatment recommendation."

Acknowledging the complexity of issues facing today's seniors, Ganem said her company's role is one intimately related to care coordination.

"We must act as a link between family, hospitals, physicians, attorneys, financial advisers, insurance companies and others," she said. "It's equally important we provide ongoing education on aging health challenges to families."

According to Karatzas, families must also recognize when living at home may not be in a senior's best interests. "For some elders, the structure and care that a nursing home provides is important," she said. "It's dangerous to say, 'I won't put my mom in a nursing home.' You don't want to make promises you can't keep."