Helping Tools for Older Pennsylvanians and Their Caregivers A Train-the-Trainer Workshop Educating older Pennsylvanians, their caregivers and others about Assistive Technology

Pennsylvania’s Initiative on Assistive Technology (PIAT) The Commonwealth’s Assistive Technology Act Program

Presenters Amy S. Goldman Associate Director – voice – voice – TTY Ann E. Dolloff Assistant Director – voice – voice – TTY

What is this? Meet someone new and start thinking!

What we ask of you today… Share YOUR expertise, knowledge and experiences Be fully present and participate Take care of yourself as needed Think creatively Have fun!

What we ask of you after today… Train at least six older adults, caregivers, or people who support them Let us know of your training efforts and any outcomes you have Call us with questions, for additional help or more information!

Pennsylvania’s Initiative on Assistive Technology (PIAT) (voice) (TTY) Institute on Disabilities, 423 Ritter Hall Annex, 1301 Cecil B. Moore Avenue, Philadelphia, PA Statewide Assistive Technology Resource Centers (ATRC)

Pennsylvania’s Initiative on Assistive Technology Accessing AT Acquiring AT Training and Technical Assistance Public Awareness and Information and Referral Coordination and Collaboration Transition

ACCESSING Assistive Technology How do I know what I need? Try before you buy – Pennsylvania’s Assistive Technology LENDING LIBRARY Learn about different devices and how they can help you - DEMONSTRATIONS

Device Demonstrations Consumer responsive – primary audience “Guided Discovery” of a device or group of devices to help make informed decisions about assistive technology Learn about how device(s) can help at home, work, or community Demonstrations are NOT meant to evaluate a person’s abilities, provide in-depth instruction, or replace the expertise of other specialists

ACQUIRING Assistive Technology How do I get what I need? Individualized Assistance to Obtain Funding for Assistive Technology Device Exchange and Recycling

Individualized Assistance to Obtain Funding for Assistive Technology 1:1 assistance to help consumers understand their funding options in order to obtain needed assistive technology PIAT doesn’t purchase devices for consumers, but collaborates with the Pennsylvania Assistive Technology Foundation (PATF) to help consumers

Device Exchange and Recycling Used (sometimes new!) devices for sale (sometimes free!) directly from and to individuals with disabilities and their families Classified Listing – Recycled Equipment Exchange Program (REEP) Online Auction – Refurbishing Program – Into New Hands

Other PIAT Activities Information and Referral: Phone and requests for help about different devices and services Training and Technical Assistance: Helping professionals and agencies increase their knowledge and skills to better provide AT services Public Awareness: General information, presentations, brochures, posters, exhibits and other outreach activities

Assistive Technology Act of 1998, as amended Authorizing federal statute that funds Pennsylvania’s Initiative on Assistive Technology Reauthorized and signed into law October 25, 2004 “AT Act” or “AT Act of 2004”

What is Assistive Technology? Devices – “Things” and Services and Support

Assistive Technology Device “any item, piece of equipment, or product system, whether acquired commercially, modified, or customized, that is used to increase, maintain, or improve the functional capacities of individuals with disabilities.” From the Assistive Technology Act (AT Act) of 1998, Older Americans Act and the American with Disabilities Act

The Scope of Assistive Technology Communication Seating and Positioning Power Mobility Manual Mobility Mobility Aids Assistive Listening Vehicle Modification Leisure and Recreation Worksite Modification Home Modification Learning Aids Environmental Controls Vision Aids Self Care/Activities of Daily Living

Low, Mid and High Assistive Technology Devices Low: Inexpensive, easily made, easy to learn, readily available, easy to replace/maintain Mid: May cost more, require some training, have special design, need power source or other support High: Higher cost, need specific training to learn, often customized

Assistive Technology Services Evaluation Acquisition Adapting/Modification Coordination of Therapies Training: Consumer – Family – Professionals Maintenance, Repair & Replacement Providing Accessible Information Technology Any service that directly assists an older adult or individual with a disability in the selection, acquisition, or use of an assistive technology device.

How do I decide what assistive technology is needed? Requires consideration of the: PERSON + ENVIRONMENT + TASK What activity does the person want to do? What skills are needed to do the activity? What skills does the person have to do activity? What supports exist to help learn a new way? Where is this activity done and under what conditions ?

How do I decide what assistive technology is needed? Need to know: Activities Assistive Technology Devices and Services Environments AND Older Adults and Their General Characteristics

Who Are Older Pennsylvanians?

Baby boomers turn 60 in 2006 Those 85 years and older are predicted to increase in number by 33% Increase in diversity of aging population Pennsylvania State Plan on Aging

Who Are Older Pennsylvanians? Estimate 19.8% of population is age 60+ Number of households with individuals 65+ is 1.3 million % of persons 65+ living alone is 30.7% Family Caregiver Alliance. The State of the States in Family Caregiver Support: A 50-State Study, Pennsylvania Profile

Who Are Older Pennsylvanians? Highest increase in the age group –South central, Southeast and Northeast PA Highest increase in 85+ age group –Counties near Philadelphia and Pittsburgh, Pike, Monroe, Perry, Montour and Potter counties Pennsylvania State Plan on Aging

Normal Effects of Aging Hearing Vision Neuro-sensory system Skeleto-muscular Intellectual functioning Social supports Influenced by genetics, lifestyle and environment

Hearing Natural deterioration Tinnitus Conversation, socialization, and communication impacted Ability may vary place to place Hearing aids often problematic

Vision Natural deterioration which increases at 65 years Driving – peripheral, night, road signs Leisure – reading, sewing, woodworking Movement and mobility

Neuro-sensory and Skeloto-muscular Systems Changes in Strength Balance Endurance Range of motion Sensitivity to temperature changes Sensitivity to pain and trauma

Intellectual Functioning Processing may take longer Long-term memory often better than short- term memory Motivation varies to learn and do things differently

Social Supports Social isolation and changes in community Friends living in alternative settings (with family, long-term care, etc.) Changes in personal mobility and transportation Rural and urban settings Proximity of family

Who Are Caregivers for Older Pennsylvanians?

Who Are Caregivers? Nationally: –34 million adults (16% of population) provide care to adults 50+ years –8.9 million caregivers (20% of adult caregivers) care for someone 50+ years who have dementia – million people (family, friends and neighbors) provide care to persons 65+ who need assistance with everyday activities –Unpaid family caregivers will likely continue to be the largest source of long-term care services in the U.S. and are estimated to reach 37 million caregivers by 2050, an increase of 85% from 2000 Family Caregiver Alliance. Retrieved 4/18/06 from:

Who Are Caregivers? Caregivers are present in 21% of US households There are an estimated 44.4 million caregivers age 18 and older who provide unpaid care to an adult family member or friend over 18 years of age. Fifty-eight percent of caregivers are between ages 18 and 49 and 42% are over the age of 50. An estimated 59% of caregivers are working full or part- time On average caregivers provide 21 hours of care per week National Alliance for Caregiving and AARP (2005), Caregiving in the U.S., Bethesda, Maryland,

Who Are Caregivers? 61% are female 83% are relatives of the care recipient 62% of caregivers are married or living with a partner Between 20 and 40% have children under 18 The average length of caregiving is 4.3 years While half of caregivers report performing at least one daily living activity for an older adult, less than one in five received formal training on how to care (unskilled) National Alliance for Caregiving and AARP (2005), Caregiving in the U.S., Bethesda, Maryland,

Pennsylvania Caregivers Estimated 1.2 million caregivers in Pennsylvania Estimated 1,316.7 million hours caregiving Estimated value of care in excess of $11,600.5 million Pennsylvania caregivers care for adults, age 65+ years, who have wide range of physical, mobility, sensory, cognitive and self-care needs, with 26% identifying a physical disability and 20% expressing difficulty going outside their home. Family Caregiver Alliance. The State of the States in Family Caregiver Support: A 50-State Study, Pennsylvania Profile

Progression of Care for Caregivers Begin with supporting of basic activities of daily living, such as cooking, cleaning, shopping Expands to include personal care activities (bathing, dressing, eating) Decision to seek supportive living environment Health decline and death Schulz, Richard, PhD, University of Pittsburgh, Health Effects of Caregiving. Looking in to the Future of Family Caregiving in the U.S., Proceedings from the White House Conference on Aging Mini Conference, June 15, 2005

Personal Cost to Caregivers 16% of caregivers indicate their health has worsened since becoming a caregiver Up to half of primary caregivers caring for someone with Alzheimer’s Disease develop significant psychological distress 40% of caregivers incur additional financial expenses for care related products services and activities About one-half of primary caregivers provide care without outside assistance whatsoever Family Caregiver Alliance,1999

Health Impact on Caregivers Level of caregiver depression increases as care recipient requires more support Increases in health risk behaviors –not enough time to exercise –decreased sleep –neglecting personal medication regimes –not seeing own physician Schulz, Richard, PhD, University of Pittsburgh, Health Effects of Caregiving. Looking in to the Future of Family Caregiving in the U.S., Proceedings from the White House Conference on Aging Mini Conference, June 15, 2005

Economic Costs to Caregivers The cost of nursing home care is beyond the means of most people Middle income families are the hardest hit. Families of people with dementing illness face a particularly severe financial burden Lynn Friss Feinberg, Shaping Legislative Policy: The Legislative and Advocacy Agenda, Family Caregiver Alliance

Caring for Older Pennsylvanians

Caring for an Older Adult Household Activities –Using the telephone –Getting around the house –Preparing meals –Housework and yard work –Laundry –Taking medications –Managing money Full Circle of Care Caregiver Website

Caring for an Older Adult Community activities –Visiting family, friends and neighbors –Transportation and travel –Shopping and banking –Church –Employment –Volunteer work –Recreation and leisure Full Circle of Care Caregiver Website

Caring for an Older Adult Daily Living Activities –Eating –Dressing –Bathing, toileting and personal hygiene –Transferring –Grooming –Walking - Moving Full Circle of Care Caregiver Website-

Caring for an Older Adult It can be difficult for a new caregiver to undertake these tasks for a loved one. Finding help through the use of assistive technology devices and services, as well as services such as occupational therapy, physical therapy, social work, in-home attendant care can make caregiving easier for both the adult and the caregiver.

Caring for an Older Adult Forty percent of caregivers report obtaining an assistive device to make it easier to care for the person they help National Alliance for Caregivers and AARP (2006). Caregiving in the U.S., Bethesda, Maryland

How AT Can Help The obvious, not-so-obvious and the downright creative use of devices!

Helping Tools for Older Pennsylvanians Demonstration Kit Open and Explore What is this? How does it work?

Lunch Over lunch, please discuss the following: Video: Case Study – Marie What AT would benefit Marie? Discuss in small groups and plan to share your thoughts at the end of lunch!

Pennsylvania’s Assistive Technology Lending Library FREE program available to older adults and Pennsylvanians with disabilities, regardless of age or disability, who would like to try assistive technology devices prior to obtaining them.

You can borrow devices that help you: Communicate with others Talk on the phone Control your environment Hear what others are saying Do everyday activities Access computers See things better and read printed materials Learn and remember Work and volunteer Participate in recreation and leisure activities

Daily Assistance / Household

CCTVs

Telephones / TTYs

Assistive Listening

Alerting / Alarm Systems

How does Pennsylvania’s Assistive Technology Lending Library Work? Obtain a loan application at Fill out application completely, with signatures Fax and Mail application to your ATRC Item is shipped to you via UPS At end of loan period (2-8 weeks), item is picked up by UPS

Training Resources Manual Handouts CD Mini-kits Lending Library Demonstration Kits Catalogues and other Resources

Ordering the Helping Tools Demonstration Kit Name of Item: Helping Tools for Seniors Inventory Number: HP-AGING-NCOA Value: $ Loan Period: 2 weeks You can also borrow a laptop and LCD projector for presentations You can include other devices on the same Device Loan Request Form

AT in Everyday Junk Mail! AT is in the eye of the beholder! Or How to find AT at home, work or wherever…

Developing Your Training Action Plan Sample Announcement and Registration Form Presentation Considerations and Needs Accessibility Evaluation

Additional Resources Pennsylvania Assistive Technology Foundation (PATF) Telecommunication Device Distribution Program (TDDP) State and National Programs and Organizations which Support Older Adults

Pennsylvania Assistive Technology Foundation (PATF) PATF is a non-profit organization that provides low-interest loans and mini- grants/mini-loans to older adults and people with disabilities to buy needed assistive technology devices and services (voice) (TTY)

Other Funding Sources Public and Private Health Insurances Office of Vocational Rehabilitation Area Agencies on Aging Employers Private Agencies Civic Organizations Telecommunications Device Distribution Program (TDDP)

Pennsylvanian Telecommunications Device Distribution Program - TDDP Provides free telecommunication devices to Pennsylvanians who have disabilities which impede independent telephone access A licensed physician, audiologist, speech pathologist or representative of a qualified State agency must certify the disability Must be 6 years or older Individual gross income of 200% of Federal Poverty level or less Must have telephone service and the ability to learn to use the telecommunications device

To Locate an AT Act Program in Another State AT Act Programs in every state Association of Assistive Technology Programs (ATAP)