The coming year may be the 'Year of the Family' - Florida Department ... [PDF]

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Volume 8, Number 11 / November, 1998

PUBLISHED BY THE FLORIDA DEPARTMENT OF ELDER AFFAIRS • E. BENTLEY LIPSCOMB, SECRETARY

The coming year may be the ‘Year of the Family’

Bulletin Board From time to time, Elder Update focuses its attention on topics that are of particular interest to Florida’s elders. This month, we have devoted four pages to coverage of issues related to Medicare Plan Choices. Inside this issue, you’ll learn about some of the new healthcare options that soon will be available to Florida’s Medicare beneficiaries. You’ll also find out what the Florida Department of Elder Affairs is doing to make information on Medicare changes available to concerned elders. *** As we refine our subscription list, we have learned that a few readers still are receiving duplicate issues of Elder Update. We apologize for this inconvenience. If you are receiving duplicate issues, please remove the mailing labels from all of the issues you receive and send them to us, making sure to mark the ones you want deleted from our records. You can send them to Database Manager, Elder Update, P.O. Box 10118, Tallahassee, FL 32302. *** Over the past year we have prepared several special issues of Elder Update, each dealing with a health problem of particular interest to Florida’s elders. October’s issue concentrated on Parkinson’s disease; June’s issue gave valuable information on strokes; March’s issue took an in-depth look at Alzheimer’s disease; and a special supplement released in October 1997 told of the battle against osteoporosis. If you would like to order any of these special issues for Continued on page 7

By Dave Bruns /Elder Update correspondent was a very good year 1998 for Florida state government, fiscally speaking: A booming economy brought in about $2.5 billion in new tax revenues and the Legislature didn’t have to raise tax rates. Early in the legislative session, it appeared that government programs aimed at elders would share some of the good fortune created by record tourism profits, booming international trade and a fast-growing job market. But by the session’s end, Florida legislators had allocated a total of $93 million to elder-related programs, according to E. Bentley Lipscomb, Florida’s secretary of Elder Affairs. That’s about 4 percent of the new funding, while seniors make up 24 percent of the state’s population. Meanwhile, education and children’s health programs garnered about $1.3 billion worth of new funding. Hometown projects favored by legislators totaled at least $260 million. The remaining $960 million went for

other state programs — criminal justice, economic development, etc. Clearly, Florida’s electorate and government reacted to Gov. Lawton Chiles’ challenge to make 1998 the “Year of the Child.” Speaking to elder groups around the state, Lipscomb is calling on senior organizations, elder-service agencies and older people themselves to change directions slightly in 1999. Florida should make 1999 the “Year of the Family,” Lipscomb said

— creating a statewide sense of urgency about supporting families as they help loved ones through day-to-day challenges at both ends of the life spectrum. Lipscomb’s call — unveiled at the mid-August Florida Council on Aging “State of the State” speech, is leading a rising chorus of calls from other state leaders on the importance of preparing Florida for a graying future. In candidate forums, public hearings and other events during the 1998 election season, candidates and voters have focused on questions that stem from the massive demographic change overtaking Florida’s society due to aging. The state’s 60-plus population is rising slightly faster than the overall population, but the 85-plus population rose four times faster than the overall population in the first seven years of this decade. Demographers call it the Longevity Revolution because the rising numbers are fueled by increasing life expectancies. Continued on page 4

A health-care storm is buffeting Florida’s elders By E. Bentley Lipscomb /Secretary, Florida Department of Elder Affairs

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n early October, Hurricane Georges ravaged the Florida Keys with wind gusts of up to 170 mph. The storm’s damage made international news: The costs to rebuild could exceed $300 million. Just a few days later, elder Floridians were hit with another kind of storm — a slow-motion collapse of Medicare HMO coverage that will leave an estimated 60,000 elders scrambling to find new health-insurance policies by Jan. 1. Shockingly, the financial impacts on elders in Florida actually could

exceed the damage caused by Hurricane Georges. Even worse, this financial storm isn’t over. First, more Medicare HMOs may follow the example of eight major insurers who have canceled Medicare coverage in 25 counties effective Jan. 1. Also, deep cuts in Medicare home health-care financing may leave 35,000 elder Floridians without home care this year alone. More than 70 home healthcare agencies (commercial enterprises, not government agencies) have closed

in the last few months, and some families whose elder loved ones have lost home-health services are frantic with worry. Both the HMO nonrenewals and the home health-care cuts share one cause: Unforeseen consequences of strict new Medicare regulations resulting from Congress’ Balanced Budget Act of 1997. Elder Floridians believe strongly in balancing the federal budget. But I can’t believe that Congress intended to balance the entire budget Continued on page 5

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NOVEMBER 1998

ELDER UPDATE

Not all neighbors provide a friendly welcome By Constance B. Sanborn (Editor’s note: We continue trying out potential new columnists to go along with some of our regular columnists. This month: Constance B. Sanborn.) hen we moved to the rural W community of DeFuniak Springs in Florida’s Panhandle, it was not necessary to tell people where we were from. Our Boston accent always gives us away. Everyone we met was extremely helpful, and we had come prepared with a list of our “needs” and “wants.”

The first Realtor that took us out found just the home that we had hoped we might find — situated on a lake, with lovely old trees and lots of mature shrubbery for me to try to capture in watercolor. For Tom, there were pine trees to shelter what he hoped would be some new varieties of camellias. He’d need a greenhouse to shelter the new blossoms from bees so he could do his own pollination, and he’d need to expand the irrigation system, but there were minor problems. One problem might not be minor.

Your Comments Are Important to Us! Elder Update recognizes corporate members of the Elder Floridians Foundation, Inc. Such recognition does not constitute an endorsement by the Department of Elder Affairs of the products or services offered by corporate members. POSTMASTER: Send address changes to: Editor, Barry Ray Database Manager, Bonni Singer ELDER UPDATE Elder Update (USPS 403-710/ISSN Department of Elder Affairs 1060-4545) is published monthly by P.O. Box 10118 the Department of Elder Affairs. Tallahassee, Florida 32302 4040 Esplanade Way Periodicals postage paid at Tallahassee, FL 32399-7000 Tallahassee, FL

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Constance B. Sanborn lives in DeFuniak Springs with her real-life husband of 52 years, Floyd.

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red maples. Constance B. Sanborn Then lend themselves to both spring and fall paintings. We had one planted well away from the lake and, we hoped, from the view of our neighbor. However, within two weeks, it had literally disappeared, and I didn’t scream — I cried. Our neighbors to the west were also transplants, and were so delighted with what we were trying to do with the property that they told Tom that as soon as he had his new dock and water system in, they would help him with the “other” neighbor. Later, we entertained everyone who had helped with our remodeling with a cocktail and barbecue party, and flew a “Welcome” flag off the end of the dock. Two days later, Tom was dead, and there was a posse out looking for our neighbor. He had cut off the two pilings that extended furthest into the lake, and when Tom strolled out there before breakfast to view the rising sun, the dock tipped and he fell, striking his head. It was a mortal wound. Who would think that a beaver could be so vicious.

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Before we agreed to purchase, both our Realtor and the builder we talked with said our nearest neighbor to the east could present problems. Both of the preceding owners had trouble with him, and since we would be new to the area as well as new owners of the property, we might not be alert to what could cause our neighbor to take offense. We just laughed and bought. Yes, we had been told that our neighbor was a fifth- or sixthgeneration and that the family had controlled development all that time — but we are certainly not unreasonable people, and only wanted to “remodel” about four acres. I had my heart set on adding some bald cypress to the waterfront, so even before the greenhouse and irrigation system were installed, I got my wish. Two mornings after the two 10-foot trees had been planted by a horticultural firm, I looked out my bedroom window to the waterfront — and they were nothing but stumps. My scream of rage may have wakened some of the dead in the cemetery a mile down the road. Tom persuaded me that we would just “take our lumps” and pretend indifference. Later, perhaps, we could replace them. I’m also inordinately fond of

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he mission of the Department of Elder Affairs is to maximize opportunities for self-sufficiency and personal independence of Florida’s elders and to plan, advocate and administer programs and policies that assure accessible, responsive and comprehensive services and long-term care.

ELDER UPDATE

NOVEMBER 1998

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The Customers Always Write Dear Editor, I read with much interest the September letter from Linton of Jacksonville, in which he stated that at 67 years of age he had decided against Viagra. When God created Adam, I doubt that Adam was told he would be able to perform until the day he died. Since that time, man has searched for the fountain of youth without success until Pfizer introduced Viagra in early April 1998. At the age of 75, I was elated when my urologist, Dr. Stanley K. Sujka, enlisted me in the Viagra protocol program, which I now know had the illustrious Robert Dole in the program. During the past three years there had been a decrease in sexual performance, and I am happy to report that Viagra renewed the performance with a vengeance. Thank you, Dr. Sujka and Pfizer, for the renewed enjoyment. Since I have lived 75 years, I have witnessed many changes in my lifestyle. At the age of 39 it became apparent that I needed glasses. I can also remember the days of only caressing, which at that time was all that was available, long before the sexual revolution. Viagra has made it possible that I not return to those days until I am ready to give it all up. I trust that this will enlighten any person who is interested in an active life, regardless of age. Ralph, Orlando Dear Editor, You have from time to time published articles on how Medicare and Medicaid are being defrauded by health care providers, and you asked those

receiving health care to ask for itemized bills and to carefully go over these bills to see if any charges were made for services not received or needed. I was recently admitted to a local hospital for a simple inguinal hernia operation. I went to the hospital at 7:30 in the morning and came home that afternoon. In due time I received a bill for $2,933, of which Medicare paid $2,396.40 and I was billed for $586.60. I asked the hospital for an itemized bill for the charges. The itemized bill contained 40 entries ranging from $3 for “Blade #15” to $713 for the operating room. Many of these entries have names I cannot identify and others have names I recognize but have no idea if they were needed or if I received them. I have no idea of what a fair price for most of these entries would be. From the above I have concluded that most patients, like me, are not able to examine these bills and tell if they contain fraudulent entries. So it’s difficult to know whether Medicare should get these itemized bills and have their experts review them and make their own decisions on whether they contain fraud.

through “up coding” or billing for services the individual never received. Hospitals are much less likely to commit such illegal acts. Our advice is to ask your Medicare carrier/intermediary to review the claim if you think fraud is involved. Dear Editor, Just wanted to tell you how much I enjoyed “Those Fateful Trips to the Outhouse” by Lois Erisey Poole in your July issue. It was hilarious and brought back many memories. We were fortunate enough to have had toilet tissue. On one of my trips, I encountered a copperhead curled up on the floor! Olive, Jacksonville Dear Editor, This letter is to request that you publish the phone number for the U.S. Department of Veterans Affairs in St. Petersburg (1-800/827-1000). I am a veterans counselor with Orange County and see people each day who are not aware of the benefits that they may be entitled to from the U.S. Department of Veterans Affairs. Many of these people are World War II veterans or their widows. There are many benefits avail-

Calvit, Caryville (Editor’s Note: First of all, you are to be commended for being an informed consumer who doesn’t accept medical claims at “face value.” Unfortunately, there are no easy answers for those who have questions about specific charges on their itemized bills. We can tell you that most fraud against Medicare is from individual doctors or providers, either

able to these people, but they are simply unaware of them. What they need to know is that each county in the state of Florida has an office to help veterans and their surviving spouses to obtain benefits from the U.S. Department of Veterans Affairs. Usually this office is listed in the blue pages of the phone book under County Government, “Veterans Service Office.” By calling 1-800/8271000, they can be told the number of the office in their county if they can’t find it in the phone book. They should call their local office and go by to talk with a counselor about benefits to which they may be entitled. J. Darrell Duncan Veterans Counselor Orange County Government

Florida Power PICK-UP

is available in both Braille and on cassette tape for people with print disabilities. To order your copy, call 1-800 /226-6075

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NOVEMBER 1998

ELDER UPDATE

Florida Guardianship Association ‘grows’ guardians By Erika Hill /Special to Elder Update hen many people hear the W word “guardian,” they picture elderly people being exploited or scammed, thanks to the negative connotation it often carries in news stories. But participants in the Florida Guardianship Association’s Annual Conference, held Aug. 28-29 at the Hyatt on Sarasota Bay, gained a new appreciation for the valuable work guardians do. This year’s theme was “How Does Your Guardian Grow?” The conference provided educational and networking opportunities for those involved in the daily lives of Florida’s elder population. Taking part were guardians (both family members and professional), lawyers, nurses, financial planners, care managers, insurance compa-

‘Year of the Family’ Gradually, Lipscomb said, Florida’s business, governmental and community leaders are recognizing that the Sunshine State is leading the nation into an aging future. In fact, both political parties’ nominees for governor also have called for increased emphasis on elder-related programs, especially those intended to keep frail elders in their homes and communities rather than in long-term care facilities. Both Lt. Gov. Buddy MacKay, the Democratic nominee, and GOP nominee Jeb Bush have called for even stronger efforts to support families caring for elder loved ones, to give seniors more options to remain out of nursing homes and to prepare Florida for the Longevity Revolution. Such an increased emphasis would be a sharp shift from the priorities adopted by budget-makers in the 1998 legislative session. Out of the $93 million devoted to elder-oriented programs, about $79 million was devoted to the Medicaid nursing-home program, according to the Legislature’s budget committees. Programs devoted to keeping frail

nies, state officials, probate judges and a host of service providers. The conference opened up with a “Hot Topics” round-table forum, which proved very popular. Participants were given the opportunity to listen to and ask questions on subjects such as mentoring to new guardians, Medicaid waivers, assisted care living facilities (ACLFs), funding for indigent wards and Do Not Resuscitate Orders (DNROs). The Florida Guardianship Association is dedicated to ensuring that guardians are well-educated and trained to take care of the wards the courts have entrusted to their care. To that end, workshops at the conference were packed with topics ranging from “Protectcontinued from page 1

elders in their homes and communities, and supporting families struggling to care for those elders, got about $11 million, Lipscomb said, while legislators devoted $4 million to programs intended to attack elder abuse, neglect and exploitation. Expressed in terms of percentages, home- and communitybased elder programs got less than one-half of 1 percent of available new funding. Lipscomb called on Florida elders to study these issues independently, decide for themselves what approach the state should take and make their views known to their legislators. Whether Florida seeks to prepare for the Longevity Revolution by supporting families and keeping elders independent and active — or if it decides to spend money on paying for extensive long-term care programs in large institutions — is the citizens’ choice, Lipscomb said. But Florida cannot afford to blunder into the next century without an informed, comprehensive debate on the social changes that the Longevity Revolution is creating, he said.

ing your Ward from Improper Discharge” to “Preventing Abuse, Neglect and Exploitation.” The association also held its annual membership meeting, which included the election for at-large seats on the board of directors. Updates were given on last year’s legislation on the public-guardianship bill and the 40-hour education requirement. There also was a “changing of the guards” — the association’s outgoing president, Knyvett Lee, was succeeded by Michael Connors. The conference concluded with an “Ask the Judge” session, in which participants received answers to questions solicited in advance from three probate judges.

Among the questions asked were: Should a guardian “spend down” assets to qualify for Medicaid? And is it legal to create a trust to pay for guardian services in the event the ward becomes indigent? Coming away from the conference, one was left with the impression that even though there are a few bad apples in the profession of guardianship, they can’t be allowed to overshadow all of the good thousands of other guardians do. Participants left the conference having received some great training to enhance and expand their guardianship skills. And most of them also left full from the “Death by Chocolate” grand finale!

ELDER UPDATE

Q:

I am 68 years old and I have heard that Medicare will cover bone-density measurement for beneficiaries at risk for osteoporosis and other bone abnormalities. Is this true? How may I obtain more information concerning osteoporosis and bone-density testing?

Yes, it is true. Beginning July 1, 1998, Medicare A: started covering bone-density tests when a patient’s condition warrants it. Beneficiaries should consult with their doctors about whether and when they might need one of these tests. In the past, bone-measurement coverage was decided by the many regional contractors that process Medicare claims, resulting in wide variation across the country. The new law makes sure that all beneficiaries who need this testing, no matter where they live, will be covered.

NOVEMBER 1998

Questions & Answers For more information about osteoporosis and bone-density testing, call the Mid-Florida Area Agency on Aging’s Center for Aging Resources toll-free number, 1-800/262-2243, and request a copy of “Osteoporosis and Its Treatments.” There is no charge for this information. I recently received a flyer in the mail about Q: insurance. It stated that all you get from Social Security when your spouse dies is a lump-sum death payment of $255. Is this true? Are my husband and I paying 7.65% in taxes for this small sum of money?

A:

Many insurance companies emphasize Social Security’s lump-sum death

payment of $255 to scare people into thinking that’s all that people get from Social Security. While it’s true that Social Security has a lump-sum death payment of $255, Social Security provides much more to the survivors of a deceased worker — protection equivalent to a $322,000 insurance policy for an average family. And for an average family, the Social Security disability program is equivalent to a private disability insurance policy worth more than $200,000. In addition, of course, Social Security provides retirement benefits that last as long as you live — and the benefits increase each year with increases in the cost of living.

A health care storm is buffeting Florida’s elders on the backs of frail, needy elders. That approach isn’t right, it isn’t fair and it isn’t going to help the taxpayer in the long run. In fact, cuts in Medicare HMO coverage and cuts in Medicare home health care — intended to save money — may have just the opposite effect. Elders who lose home-health coverage may not be able to remain in their homes and communities, being cared for by their loved ones. They may have to be surrendered to care in nursing homes, where the cost to taxpayers can be 10 or more times as high as home- and community-based services. If that occurs, Florida’s Medicaid nursing-home budget will see a new round of explosive growth. Longterm care costs already have risen 1,000 percent in less than 20 years. Many individuals will be financially devastated by the impact of the loss of HMO coverage. Most elders who join Medicare HMOs enjoy full or partial reimbursement for the cost of prescription coverage, which typically costs $1,500 or more per year. Also, Medicare HMOs cover the full cost of services, while

regular Medicare calls for copayments for some kinds of services. Beneficiaries who belong to “regular” Medicare frequently purchase Medicare supplemental insurance policies (often called Medigap policies) to protect themselves — and the

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most frequently purchased Medigap policy costs an average of $1,300 for a typical 65-year-old Floridian, with the cost rising radically as age increases. For people older than 65, or those who live in high-cost areas Continued on page 12

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For a free estimate of the benefits you may be eligible for, call the Social Security Administration at 1-800/772-1213 and ask for a “Request for Personal Earnings and Benefit Estimate Statement.” I am 68 years old and made out a will several Q: years ago. However, I have heard that I can avoid the expense of probate by creating a revocable living trust. Is this true, and what is a living trust? A revocable living trust is created by the trustor A: while he or she is alive. The trustor names himself or herself as the beneficiary. The trustee then assumes the task of managing the trust for the beneficiary according to the conditions of the trust document. A living trust also can be used to manage the financial assets of older people who still may want to control their financial affairs while they are competent. It also provides for someone else to manage their affairs should they become incompetent. A living trust can remain in effect after death and thus can Continued on page 10

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New surgery may help degeneration of the eye A researcher at Johns Hopkins University in Baltimore has developed a surgical technique that may restore sight in some people with age-related macular degeneration, the most common cause of blindness in people over the age of 55. Blindness occurs from bleeding vessels underneath the retina at the back of the eye, which delays images to the brain. The procedure developed by Dr. Eugene de Juan has restored some sight in 20% of patients, he reported in the American Journal of Ophthalmology. Surgery involves moving healthy retinal tissue away from the underlying bleeding area so it can again transmit light images to the brain.

Reverse mortgages gaining in popularity In the next five years, one in four eligible elder households is expected to seek a reverse mortgage, according to a Fannie Mae research project. A reverse mortgage allows homeowners ages 62 and older to turn their home equity into cash payments. The findings were reported in Reverse Mortgage, a quarterly publication of the National Reverse

NOVEMBER 1998

Mortgage Lenders Association. The research divided elders into six categories: • Maintainers: Middle-income elders who would use a reverse mortgage to maintain their current lifestyle and financial independence. • Enhancers: Lower-income elders who are not as well off in retirement as they expected to be and who would use a reverse mortgage to improve their lifestyles. • Money wise: Upper-income elders who are financially sophisticated and would use a reverse mortgage in financial planning. • Maybes: Lower-income, conservative elders who may or may not use a reverse mortgage. • Last resorters: Upper-income elders who are better off financially than they expected and would consider a reverse mortgage only as a last resort. • Haters: Middle-income elders who have a negative view of reverse mortgages and would never consider them.

Three Florida communities win Claude Pepper awards The Claude Pepper Foundation has picked the town of South Palm Beach, the city of Marianna and the city of Pembroke Pines as

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ELDER UPDATE

recipients of the 1998 Claude Pepper Florida Cities Awards. The three communities were chosen for their outstanding programs benefiting elders in the spirit of the late U.S. Sen. Claude Pepper. Following are the categories and amounts of awards, with a brief description of the winning programs: • South Palm Beach: $10,000 award for communities with a population less than 5,000. The town was recognized for the Community Affairs Advisory Board, a program that provides a variety of activities centrally located within walking distance for elder residents of South Palm Beach. Activities include medical seminars, cultural series, entertainment and social events. • Marianna: $12,000 award for communities with a population between 5,001 and 20,000. The city was recognized for the Marianna Police Department Police Care, a program that provides daily contact with the city’s elders to ensure their safety and to provide assistance to those in need. • Pembroke Pines: $15,000 award for communities with a population over 20,000. The city was recognized for the Focal Point Senior Center & Residential Towers, a program that provides affordable housing, access to core social services at a residential site, recreational, medical and informational services to elder residents. It was Sen. Pepper’s belief that elder Americans are “the greatest natural resource of our country.” His work to strengthen laws protecting the rights of elders made him a hero to millions of Americans.

deafness, hearing loss, a speech impairment, or deafness and blindness. They loan, free of charge, text telephones (TTYs), large visual-display TTYs, Braille TTYs, volume-control telephones, voice and/or hearing-carry-over phones, and audible, visual and tactile ring signaling devices. To qualify for the devices, the individual must be a Florida citizen and must be certified as having deafness, hearing loss, a speech impairment or deaf-blindness by a physician, licensed audiologist or speech pathologist, hearing-aid specialist, deaf service center director, state certified teacher for people who have a hearing loss or speech impairment, or appropriate state or federal representative. For more information, call 1-800/ 222-3448 (voice) or 1-888/447-5620 (TTY).

Equipment available for those with hearing, vision problems

Protecting your annuities

If you have a complete or partial hearing loss that limits or precludes your use of a regular telephone, you may be interested in the work of Florida Telecommunications Relay Inc., or FTRI. FTRI is a private, not-for-profit organization that administers a statewide Specialized Telecommunications Equipment Distribution Program for people who have

New hours for Medicare Part B The Beneficiary Customer Service Department for Medicare Part B has announced a change in its hours of operation for telephone inquiries. If you wish to call the office, the new telephone hours are 9 a.m.-5 p.m. Monday through Thursday, and 8 a.m.-12:30 p.m. Friday. The Automated Response Unit (ARU) hours are 7:30 a.m.-5:30 p.m. Monday, and 7:30 a.m.-6:30 p.m. Tuesday through Friday. If you have any questions, the Medicare Part B office encourages you to call. If you live in Florida, you may call 1-800-333-7586. If you live in Jacksonville or outside of Florida, you may call (904) 355-3680. Many annuity owners lose more than 50 percent of their annuity when it pays off at death. But a new booklet, “Annuity Owner Mistakes,” by retirement and estate planning specialist Allan Roth, can show you how to preserve your annuity. To get your free copy and help protect your funds, call 1-800/765-7302 and the booklet will be mailed to you immediately.

ELDER UPDATE

NOVEMBER 1998

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A Haven for Caregivers Bradenton’s West Side Club helps share the burden

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velyn has been married to Ed for more than 55 years. His decline was so gradual that he had full-blown dementia before he received a diagnosis. Carole has been married to Smitty for more than 61 years. Smitty has had Alzheimer’s for five years, and his condition continues to worsen. His requirements for care are complicated by long-standing problems with emphysema. Carole has considered moving him into a nursing home. What keeps both of these ladies going is a program called the West Side Club, operated by Neighborly Senior Services of Manatee and located at Christ United Methodist Church in Bradenton. The West Side Club is open three days a week from 10 a.m. to 4 p.m. and offers socialization and group activities in a safe, supportive environment. The site is sponsored by the Department of Elder Affairs FAVOR program, the Wilson-Wood Foundation Inc., the Brookdale Foundation, and United Way of Manatee County. The program recently moved to a new location, which was celebrated with a community-wide open house. Those attending were entertained by the Astro-Notes, a local band of elder musicians. Site coordinator John Driscoll and a dedicated group of volunteers keep participants busy and involved. A favorite activity is early-morning socialization time, a time set aside for visiting with club friends, having morning coffee or juice, and reading the paper. Table games, indoor golf, bowling, outside walks, and an “ugly tie” contest are just some of the many activities participated in over the past few months. “John has a wonderful rapport with both caregivers and club members,” said Dawn Harlock, director of the FAVOR program. “He knows how to work with each

Members of the West Side Club join arms as they participate in a watermelon-seed spitting contest.

participant to bring out the best of their abilities.” Respite gives the caregiver time to rest and relax, visit with friends, go to the doctor, or just go shopping. This may not seem like a very big break to some, but it means a lot to someone who now finds it impossible to leave the house because of his or her duties as a full-time caregiver. Not only does respite benefit the caregiver, but it also greatly benefits the individual with Alzheimer’s disease. “At first he was reluctant to go, as is normal, but now he comes home singing and a delight to be with once again and … keeps asking when he is going back,” stated Evelyn in a letter she wrote to the West Side Club. The West Side Club has been in operation since 1996, and has been able to expand the program thanks to the enthusiasm of caregivers and participants and the tenacity of staff in seeking out new funding sources. The program recently expanded from two to three days a week after a generous donation from Rosanne Spendley, a Pennsylvania resident whose father is a participant at the club. She was thrilled when she noticed the positive change in his personality after he started attending. The program has been able to

add transportation to the list of services it offers with the addition of a van that is partially funded by Manatee County. Support-group meetings also are offered, with complimentary care available. Programs such as the West Side Club allow elders with Alzheimer’s disease to stay in the community longer. They also contribute to the mental and physical health of caregivers who often have a “36+ hour day” of caregiving. “The West Side Club is important to me because I personally do not want to put my mother in a nursing home unless there is no other alternative,” said Rose Marie. “It is also important to my mother because she is able to interact with her peers.”

It was billed as an ugly-tie contest, but the hats were equally suspect.

For more information about the West Side club in Bradenton, call 941/748-6974 (administrative office), or call the West Side Club at 941/727-3664.

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yourself or your organization, please write, once again, to Database Manager, Elder Update, P.O. Box 10118, Tallahassee, Fl 32302. Make sure you say which issue or issues you would like to receive, and the quantity of each. *** Often our readers send us information for publication in an upcoming issue of Elder Update, then are disappointed when the item doesn’t appear. One big reason for this is our tight production schedule. To illustrate: We began working on this issue of Elder Update about eight weeks ago so that there would be enough time to write and edit all of the stories, find any art we needed, have a graphic designer assemble the issue, have the issue sent to a printer, and then have the printer send it to a bulk-mail company, which in turn mails to you. What that means for you is this: If you have a time-sensitive item, such as an event that you’d

like to publicize in our Calendar of Events on a specific month, you will need to send it to us about eight weeks prior to the month in which the issue will come out. *** CORRECTION In September’s issue, the man pictured along with Charles Wiggins’ “It Seems Like Only Yesterday” column is not Mr. Wiggins. The man pictured is Ralph DiSanto, and his photograph should have appeared with a story on SHINE Heroes on a separate page.

Charles Wiggins

Ralph DiSanto

We apologize to both gentlemen for the mix-up.

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NOVEMBER 1998

ELDER UPDATE

Holidays can be a time of joy — and depression By D’vorah Mitchell /Elder Update correspondent

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eneath the tinkling music, colored lights, and endless trays of sweets lies the flip side of upcoming holiday festivities — feelings of loneliness, depression and grief. Although holiday depression is not a problem for all elders, they are a little more prone to it than other age groups because of their life circumstances, says Tallahassee psychologist Russell Mavrides. “A lot of people experience holiday depression

after a significant loss in their lives.” Elders are bombarded with images from the media of families celebrating the holidays together, and may feel empty because they cannot be with their own family for some reason. Some elders may remember past holidays and think of the current season with a sense of loss and sadness. That feeling of loneliness can lead to depression, hopelessness, and a sense that life is hollow.

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lorida Lifestyle Radio,” an hour-long show featuring news and information of interest to elders, is now heard in 21 markets throughout Florida. One of the regular segments of the program features Department of Elder Affairs Secretary E. Bentley Lipscomb, who interviews guests and discusses issues of importance to elders. Here is a list of Florida’s Radio Network stations that carry the show. Air times vary from community to community, so call the station that is listed for your area to learn the exact day and time.

Dade City / Zephyrhills - WDCF-AM (1350) 352/567-1350 Daytona Beach - WNDB-AM (1150) 904/257-1150 Englewood - WENG-AM (1530) 941/474-3231 Eustis / Leesburg / Lady Lake WKIQ-AM (1240) 352/357-1240 Fernandina Beach - WYHI-AM (1570) 904/277-0630

Holidays are a time for remembrance and a time for thinking about the future. Elders may be nostalgic for the past, disappointed about the present, and dismal about the future because they long for the past and think that there are not going to be many more holidays for them, says Mavrides. Holidays can be “a reminder of what’s missing, a reminder of a loss in that person’s life.” Holiday depression can be caused by many things; among them, the death of a spouse or sibling, lost contact with friends, limited finances, isolation from the community, illness, or taking care of an ailing spouse. It’s common for elders who experience some form of loss to have periods of depression, and there are times when those feelings are appropriate, says Mavrides, who points out that it’s important to let them express themselves. Being a good listener will help more than telling a depressed person to just cheer up. “When they start expressing these feelings of sadness and loneliness, you don’t want to cut them off too quickly. Let them open up. Empathy is key.” While there are times when holiday depression is appropriate, it should be kept in check. If someone continues to be down, expresses feelings of hopelessness, is without much appetite or energy, isn’t sleeping well, is withdrawn from socialization or is reluctant to get out of bed or leave the house, then the depression should be treated more seriously.

Milton / Pensacola - WEBY-AM (1330) 850/623-1330 Ocala / Gainesville - WOCA-AM (1370) 352/732-8000 Orlando / Daytona Beach / Melbourne WWNZ-AM (740) 407/661-1900 St. Augustine - WFOY-AM (1240) 904/829-3416 Sarasota - WTMY-AM (1280) 941/365-0521 Tallahassee WTAL-AM (1450) / WTAL-FM (105.7) 850/671-1450 Tampa / St. Pete - WHNZ-AM (570) 813/522-6397 Winter Haven - WSIR-AM (1490) 941/295-9411 Zephyrhills - WZHR-AM (1400) 352/576-1350

Building on Success… Drawing on Creativity… Capitalizing on Innovation… Serving our Customers… Florida Power & Light Company Florida Power & Light Co. is a corporate member of the Elder Floridians Foundation, which partially underwrites Elder Update.

Holiday depression usually passes, but if it worsens, consult a family physician, psychologist or psychiatrist. “When somebody starts showing a pattern of worsening depression, it could represent an underlying medical illness,” Mavrides said. For most people, minor holiday depression can be battled with some lifestyle adjustments. Here are some tips to help manage the holiday blues: • Volunteer to help others in need. Helping others can fill the emptiness that you feel and ease depression, and it can also improve someone else’s holidays. Check in with the United Way, Salvation Army, or a local nursing home, hospital or homeless shelter. Human contact can ease depression. “If you want to feel good about yourself, go out and help someone else,” Mavrides said. • Make sure you get plenty of rest and regular exercise. Stress and depression are easier to manage when regular cycles of sleep and exercise are maintained. Even getting out for a walk will help with the stress. “If you’re active, you’ll do better during the holidays,” says social worker Bill Perry. • Look out for free activities. Try something new. It can be refreshing to celebrate the holidays in a new way. You may want to get involved with the activities at your local church or place of worship. You may want to look into helping out with a community dinner or go to one. Call up your local senior center or Area Agency on Aging for activities. It’s important just to get out of the house. “Be as active and involved as possibly can,” Perry said. • Spend the holidays with your friends. Talking to someone can help relieve depression. If a friend is spending the time alone, a visit from can help both of you enjoy the holidays more. “It’s much easier if you have some human contact,” Mavrides said. “It softens the blow.” If you would like more help or information dealing with holiday depression, please call the Florida Psychological Referral line: 1-800254-5219.

ELDER UPDATE

NOVEMBER 1998

Does it make any differQ: ence whether you drink alcohol by itself or with meals?

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start eating healthfully while young?

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On the contrary, healthy eating can begin offering A: protection at any age.

I’ve started using tofu in Q: meatless meals. If I don’t use the whole package at one

Diet plays a major role in many of the stages that cells go through as they develop into cancer. Even if certain pre-cancerous cell changes have already occurred, eating plenty of fruits and vegetables, for example, can provide nutrients and other substances that could block the development of damaged cells into cancer. And switching to a high-fiber balanced diet has been shown to decrease the development of colon polyps that can lead to cancer in some people. One exception to diet’s effectiveness at any age is breast cancer, which can be most successfully prevented by health eating habits before puberty.

The most important factor in the risks associated with alcohol consumption relate to the amount you drink, and not when or what you drink. Some researchers are investigating whether consuming alcohol with food will not only slow its absorption into the bloodstream, but will do less damage than alcohol consumed on its own. This makes some sense from a physiological point of view, but until separate guidelines for alcohol consumed with and without food are devised, try not to exceed the one (for women) and to two (for men) drink maximum recommended.

meal, how long will the leftovers keep and what can I do with them?

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Congratulations on expanding your usual food choices with an eye to good nutrition. As you find more tofu dishes that you enjoy, you will probably learn many uses for leftovers. It can be used in a stir-fry with any combination of vegetables, or crumbled up with ricotta or cottage cheese in a dip or casserole. Once you open the store package, as long as you change the water in its dish each day, tofu will keep in the refrigerator for up to a week. It also freezes well if you wrap it thoroughly; defrost it by letting it stand in a pan covered with boiling water for 10 to 15 minutes. Tofu’s color is a bit different after freezing, and its texture is a bit chewier and more sponge-like, but it is quite safe to eat. Since new dietary recomQ: mendations call for limiting red meat to three ounces per day, is it healthful to eat a much larger portion only once or twice a week?

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The importance of moderate meat consumption to good health has been demonstrated by many reputable stud-

by Karen Collins, M.S., R.D. ies. Those studies, however, don’t allow us to differentiate between small, frequent use and occasional, greater meat consumption. As long as your total red meat consumption averages out to no more than three ounces per day, having more some days and less on others is probably reasonable. It is possible, though, that our metabolic processes can handle specific substances in meat only up to a certain level. Consuming large amounts of meat at one time in excess of that level could then increase certain health risks, but further research is needed. Is it true that drinking Q: soft drinks can make your bones start to dissolve? No. However, research does A: suggest that drinking excessive amounts of soft drinks may affect bone strength, especially when calcium consumption is low. Large amounts of phosphorus from soft drinks, chicken and fish can affect the hormones that deposit calcium in our bones. Since bone mass normally increases only until the age of 25 or 30, there is some concern that limiting bone mineral deposits during this time may increase risk of osteoporosis (weakened bones). Some studies have suggested that a high intake of carbonated soft drinks may pose such risks, but more research is definitely needed. Studies also have suggested that the effects of soft drinks could be different in children and adolescents than in older adults, but that is not certain either.

Meanwhile, it makes good sense to drink soft drinks in moderation. They should not be a replacement for the water we need for good health, nor the milk we may need to get adequate calcium. I’m trying to include more Q: beans in my meals, but gas is a real problem. What should I do?

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Dried beans, including kidney, pinto and garbanzo beans, are nutritional powerhouses featuring the fiber, vitamins and protein that might otherwise be low in your diet if meat portions are reduced or eliminated. The culprit behind the gas you experience after eating dried beans is a carbohydrate our intestinal tracts have trouble breaking down. Many pharmacies carry enzymes that when taken by pill or sprinkled on bean dishes before eating will break down the carbohydrate. These products help some, but not all, people who have gas problems with beans. Some people find that they handle home-cooked beans, soaked in large amounts of water and well-rinsed, better than canned beans. Some people seem to adapt to eating beans by gradually increasing the amount of beans in their diet. Until you adjust, dishes can be changed to use vegetable or grain products (such as brown rice or bulgur) for part of the bean portion. effectively lower risk of Q: Tocancer, do you have to

“Nutrition-Wise” is provided as a public service by the American Institute for Cancer Research (AICR). Questions for this column may be sent to “Nutrition-Wise,” 1759 R St. NW, Washington, DC 20009. Karen Collins, M.S., R.D., does not respond to questions personally. AICR also operates a tollfree hot line that offers advice about nutrition and health. The number is 1-800/843-8114; it operates weekdays from 9 a.m. to 5 p.m. Eastern time.

Presbyterian Retirement Communities PICK-UP Presbyterian Retirement Communities is a corporate member of the Elder Floridians Foundation, which partially underwrites Elder Update

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NOVEMBER 1998

ELDER UPDATE

Protecting your home — and your nest egg By Mary Alice Ferrell, P.A. /Special to Elder Update (Editor’s note: Welcome to “Legal Tips from Florida’s Elder Bar,” a new monthly column offering information on legal matters pertaining to elders. If there is a specific legal topic you’d like to see covered, please write us at Elder Update, 4040 Esplanade Way, Suite 152B, Tallahassee, FL 32399-4000.) hile home is where the heart is, W it’s also where many older Floridians hold a majority of their net worth. Home ownership plays a symbolic role in American culture. Worries about losing their home, or being unable to pass the home and its value on to their heirs becomes a serious concern to individuals as they age. Under Florida law, homestead property enjoys favorable protection when it is managed correctly. Unfortunately, many people misunderstand the role of the home in longterm-care, financial and estate planning. It can be easy to make costly mistakes that irrevocably change both lifetime and post-death planning. Knowledge of a few simple concepts can be helpful in planning. “Homestead” is a word used to describe the real property and structures that we own and upon which we live. The extent of homestead property is carefully limited under the Florida Constitution: one-half acre within a municipality, 160 acres outside a municipality. There are additional limitations that may affect the extent of a homestead determination. Homestead protection from creditors comes from the Florida Constitution, not from a legislative act. Here’s how it works: If you own homestead property as defined under the constitution, that property cannot be sold during your lifetime to pay creditors or judgments that may be obtained against you. After your

death, if the property passes via your will or through intestacy to your heirs (rather than a friend or charity), those heirs also will receive the property free from the claims of creditors. The value of the property is not limited; the property will enjoy protection from creditors whether it is worth $20,000 or $2 million. Individuals who are engaged in financial, estate and/or long-term-care planning must be very careful when dealing with the homestead exemption from creditors. In general terms, here are a few important factors to consider: • Retaining title to your home may allow you to pass it on as an inheritance to your family members. • Under Florida law, one spouse cannot sell or mortgage homestead property without the written consent of the other spouse. If the other spouse is incapacitated, you will need a valid Durable Power of Attorney, or the appointment of a guardian, to complete the sale or mortgage. • Your surviving spouse will be entitled to live in the homestead for life, even if the home was in your name alone and you attempt to leave it to your children or others under your Last Will and Testament. • The lifetime transfer of homestead property may have adverse gift- and estate-tax consequences. • If you leave your home because you need to live in an assisted living facility or nursing home, your home does not lose its homestead status, and still enjoys the same protections from creditors before and after death. • Homestead property is not a countable asset for purposes of determining Medicaid eligibility; transfer of the property may result in unintended penalties or ineligibility. • A title insurance company may not accept the language of a “storebought” or “Internet” Durable Power

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re you worried that an elder relative or friend may be the victim of abuse? You can report known or suspected cases of abuse by calling the State of Florida’s hotline at 1/800/96 -ABUSE (962-2873)

of Attorney for purposes of selling homestead or other real property. • The constitutional protection from creditors is different from the $25,000 homestead property tax exemption, a law that encourages home ownership.

Homestead law can be complex, even for experienced lawyers. To protect your home and to accomplish your lifetime and estate planning objectives, you should seek the advice and counsel of an attorney before making any disposition of your home. If you don’t have an attorney, you can call The Florida Bar Lawyer’s Referral Service at 1-800/342-8011 for the names of elder law attorneys or estate planners in your area. Mary Alice Ferrell, Esq., is a board-certified elder law attorney practicing in Sarasota. She is chair-elect of the Elder Law Section of The Florida Bar, which has more than 1,100 members.

Questions & Answers

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avoid probate and provide for an orderly means of managing an estate without the interruptions, delay or expense caused by probate. For more information about wills and living trusts, call the Mid-Florida Area Agency on Aging’s Center for Aging Resources toll-free number, 1-800/262-2243 and request a copy of “Wills and Living Trusts.” There is no charge for the publication.

which could include pensions, Social Security and interest. You would be paying property taxes and condo maintenance fees, which tend to increase, and making the down payment would reduce the amount of ready cash as well as interest income you might receive from it. Another concern is that once you own the property, the job of making the repairs and replacements shifts from the landlord to you. These could include large capital items such as air-conditioning units, a range or refrigerator. Make sure you have, or set up, ample cash reserves to cover these possible costs. Even though you like living in that condominium as a renter, how does it compare with other condos in purchase value? Particularly with condos and town home communities, market values can differ widely, causing you to lose money if you decide to sell.

Q:

My husband and I are both in our 70s and have been renting since we moved to South Florida three years ago. We now have the opportunity to purchase the condo we’re in but wonder if we’re not too old to be doing this again, especially taking on a mortgage. What should we do? If purchasing the condo will help you meet your objectives, such as securing your living arrangements for the future, then go for it. And add to that pluses such as tax benefits, pride of ownership and potential appreciation. But as with any major purchase, you need to weight the potential obstacles as well. You must be able to qualify with a lender based on your income,

A:

Do most people retire at Q: age 65, or do they retire early and get reduced benefits? Approximately three out A: of four workers today take a reduced Social Security benefit so they can retire before age 65.

THE CHANGING FACE OF MEDICARE Beneficiaries have their work cut out for them By Andy Lindstrom/Special to Elder Update et ready, Florida seniors. G Medicare is changing again. The good news is, you don’t have to. But if you want to take advantage of the new options, say a number of experts in the field, comparison-shopping has never been more complex or confusing. Consumer information from the Health Care Financing Administration (HCFA), which administers Medicare, is difficult to use and understand, claims Consumer Reports magazine in a special September survey of health care in America. There’s little evidence that agency officials will be able to handle the confusion the new options are bound to create, the popular shopping guide contends. “I don't see how any of this is going to help me,” says Bobby Trammell, a disabled Lakeland citrus worker who takes $400 per month worth of medications, paid

for by his HMO, for complications following four surgeries for a broken back. But, he says, “my Medicare-affiliated HMO is pulling out December 31, and I don’t see anything in these new programs to take its place. I’m just going to be completely out of luck.”

Al Propp, Polk County's coordinator for SHINE (Serving Health Insurance Needs of Elders), says the county soon will lose the last of its four Medicare HMOs because insurers and doctors can’t agree over medical fees. Until that issue is resolved, dozens of people such

as Trammell, who he advises, have nowhere to turn for their health needs. “Now they’re bringing out some new programs that they haven’t even explained to us,” Propp says. “And we’re supposed to tell our seniors what they should do. Right now, we’re as much in the dark as everybody else.” Nancy-Ann Min DeParle, HCFA national administrator, doesn’t have an answer for dilemmas faced by people such as Trammell. As for others who are satisfied with their present Medicare benefits, “You don't have to change anything,” Min DeParle says. “The choice is yours.” At this point, Min DeParle and others concede, Medicare has a solid track record of satisfying most elders by delivering its service either as a traditional fee-for-service policy with an optional Medicare supplement — that is, you pay a premium, Continued on next page

HMO pullouts will limit options in some areas By Dave Bruns /Elder Update correspondent

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he course of future Medicare reform — a planned transition to managed care to contain rising Medicare costs and help balance the federal budget — was in serious doubt by early October as Medicare health-care insurers across the country announced plans to stop serving as many as 300,000 older Americans. The impact on elders will be enormous. The typical elder will lose an average of $100 per month or more in prescription-drug coverage benefits that are provided under many Medicare HMOs but not under regular Medicare, plus cover-

age for eyeglasses and hearing aids. Many also will be forced to purchase so-called “Medigap” Medicare supplemental insurance policies. Costs for the most popular Medigap policy run about $1,500 per year for 65-year-old nonsmokers in Central Florida. Persons older than 65, smokers and South Florida residents can expect much higher costs. The bottom line for tens of thousands of Florida elders: As much as $2,700 to $3,000 per year in extra out-of-pocket expenses for health care — a quarter of the average elder’s pretax income.

In Florida alone, elders could see a loss of from $400 million to $500 million in such benefits as lower insurance costs and higher outlays for prescription medicines and other federal cuts in home health-care coverage, according to initial estimates, said E. Bentley Lipscomb, Florida’s secretary of Elder Affairs. But the impact on state government, on the managed-care industry and on the future of Medicare reform also will be significant, state officials predicted. Congress had expected to save billions toward balancing the federal

budget and controlling future Medicare costs by shifting millions of elders to managed care. Until the pullouts that began in September, more than 720,000 older Floridians were members of Medicare HMOs. Medicare officials were poised to begin signing hundreds of thousands of other Medicare beneficiaries up for managed-care plans as of Jan. 1, 1999, under the new Medicare Plan Choices program. With HMOs pulling out of Medicare managed care, federal officials raised concerns that elders would be unwilling Continued on next page

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The Changing Face of Medicare cover a deductible and co-pay a percentage of the doctor's bill — or by way of an HMO in which one monthly payment covers everything. But that’s all about to change. Thanks to spinoff from the federal Balanced Budget Act of 1997, Congress has decided to implement changes to Medicare with the expressed goal of cutting costs and saving a system that some argue won’t be able to pay its bills within the next three years. One result: Medicare in January will add the possibility of a whole range of options to original Medicare and Medicare HMOs for some of Florida's 2.6 million covered elders as one of five pilot states nationwide. Under the umbrella title of Medicare Part C (also known as Medicare Plan Choices), each of the future choices is most easily identified by its acronym: HMO with a point-of-service option, PPO, PSO, PFFS and MSA. The first three are new wrinkles on the old managed-care concept. Both PFFS and MSA aim at bringing private insurance companies into the Medicare picture. In a nutshell, an HMO with a point-of-service option allows you to visit doctors outside the Medicare-approved network, but this only works if you have Medicare HMO coverage in your area. A PPO (preferred provider organization) means that you have joined an organization that the state has licensed as “a risk-bearing entity” for the comprehensive range of Medicare services. Finally, a PSO (provider-sponsored organization) is a group of doctors or hospitals who organize for the same purpose. As for the two private options, an MSA (medical savings account) allows you to buy an insurance policy with an annual deductible up to $6,000 and coverage of Medicare-eligible expenses after the deductible is met. A PFFS (private fee-for-service plan) means that your health-insurance policy comes from a private insurance company that has contracted with Medicare to assume the risk for your coverage.

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Simple? Not exactly. A real headache for confused elders to sort out? You bet. It’s made more complex by the fact that several of these options are available only if some entity outside government decides to offer them. A PSO, for instance, has low premiums, low co-insurance and no deductible. You might have some coverage for prescription drugs, but you still have to go through a primary-care physician for referrals, and your network providers may be limited by a shortage of specialists. A PPO, on the other hand, often cuts out that primary-care gatekeeper. But non-network health professionals charge higher fees, as is also true in those point-of-service HMOs. Most expensive of the new plans is PFFS. Almost a throwback to health insurance before Medicare, its only apparent benefit is that it usually covers a minimum of everything Medicare plans offer and might attract the more upscale doctors who won’t work for Medicare. “Only the wealthy who can pay the full cost of their care should consider this option,” says Consumer Reports, opting even more strongly against an MSA as what it calls “a $6,000 gamble against an insurance company that you will stay healthy.” Without getting too bogged down in the fine print, an MSA means the government will pay a private insurance company for your policy. Then you cover your own bills up to the deductible, after which your insurance picks up the Medicare-eligible amount. The catch: The doctor can charge any fee he wishes, enrollees can’t sign up for a Medigap plan, and a limited number of people can qualify for eligibility for an MSA (only 390,000 slots are available in the United States for this demonstration project). Hazel Hayes, associate state coordinator for the AARP/VOTE program, says that Medicare is already a bewildering and complex program to many of the seniors she

serves. Now, she says, depending on where enrollees live and what is available there, they may have all the Medicare options or — particularly in rural areas — only a few. (In fact, in many parts of Florida, none of the options are currently available.) “It will be a challenge for beneficiaries to learn the difference between the options and choose one that meets their needs,” says Hayes. Among the most difficult options seniors face, says SHINE coordinator Al Propp, is the question of prescription drugs. “Most people are in HMOs for two specific reasons, both monetary,” Propp says. “One, they don't have

HMO Pullouts

to pay up to $200 a month for a Medicare supplemental policy. Two, they save … on medications. And let’s face it, these people take medications.” Elders served by the state Department of Elder Affairs take an average of three prescription drugs, says Dave Bruns, communications director for the department. It’s not unusual for frail elders to take more than the average, he says. And since classic Medicare doesn’t pay for such costs, an HMO often does. Then again, Consumer Reports says, HMOs nationwide are beginning to cut back this benefit. Whether the new options will be any better, it continues, remains a question. So, with all of the lingering questions, what should a person do at this point? It’s time to go back to school and do some homework, says E. Bentley Lipscomb, secretary of the Florida Department of Elder Affairs. “Education is the key,” says Lipscomb. “We recognize that Medicare Plan Choices presents a challenge to beneficiaries to learn new information about Medicare and health insurance, but I know Florida’s elders are up to the task. Our SHINE volunteers will be there to help, by providing information and assistance so older Floridians can make truly informed decisions.”

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to sign up for the managed-care programs to be announced under Medicare Plus Choice. HMO executives had mounted an intensive lobbying campaign to convince the Clinton administration not to implement cuts in Medicare payments. Shortly after federal officials announced that they had rejected HMO requests, the pullouts began. Florida was hit especially hard by the HMO pullout from Medicare. In a spate of announcements in September and early October, eight health plans announced they would cease operations in 25 counties, mostly in Central Florida and along the Atlantic’s Treasure Coast.

Counties known at press time to be affected by at least one HMO nonrenewal included Baker, Brevard, Citrus, Clay, Gilchrist, Glades, Hendry, Hernando, Highlands, Indian River, Lake, Manatee, Marion, Martin, Monroe, Nassau, Okeechobee, Orange, Osceola, Polk, Sarasota, Seminole, St. Johns and possibly Volusia. Health plans affected include Aetna, Avmed, CIGNA, Florida Hospital, Humana, Prudential and United. Residents of nine counties will be left with no HMO coverage at all; five counties will have only one HMO. Residents of at least one county, Polk, will be left with no HMO at all.

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Department of Elder Affairs Is Ready To Help Y

ou have questions? We will help you get answers! The Florida Department of Elder Affairs, in partnership with the area agencies on aging and the elder helplines, has been gearing up to ensure that Medicare beneficiaries receive the information they need about Medicare Plan Choices and other changes resulting from the Balanced Budget Act of 1997. Florida’s elders can receive assistance in a number of ways:

• SHINE counseling More than 600 trained SHINE (Serving Health Insurance Needs of Elders) counselors are available statewide to provide one-on-one counseling and assistance in local communities. If you want to arrange for SHINE services, simply call the local Elder Helpline number or 1800/96-ELDER (1-800/963-5337). SHINE is active in more than 50 counties across Florida. In counties where there is no active SHINE counseling program, elders will be referred directly to the SHINE office in Tallahassee.

• Internet access Do you want the most current information on Medicare Plan

Choices and other changes resulting from the Balanced Budget Act? Do you enjoy surfing the Net? If so, visit our DOEA Web site at http:// www. state.fl.us/doea/. The DOEA Web site can link you to the national HCFA (Health Care Financing Administration) site for detailed information on Medicare Plan Choices plan options.

• Educational presentations SHINE counselors are available to make educational presentations on the changes in Medicare to community and civic groups at senior centers, mobile home parks, condominium complexes, churches, synagogues and other locations. Speakers will provide information on the new Medicare preventive benefits, new managed care options that may be available over the next few years, and important dates to remember. SHINE can work with the Medicare carriers, intermediaries, and peer review organization to schedule and plan large public forums. In addition, SHINE volunteers are available to provide information at health fairs and senior fairs. For access to the local SHINE education

and outreach team, please call the Elder Helpline at 1-800/96-ELDER (1-800/963-5337) or the SHINE office in Tallahassee (850/4142060). Please call early to reserve a date, as we are expecting high demand for SHINE speaking services over the next few months.

• Additional resource materials Though the new Medicare handbook (“Medicare and You”)

provides detailed information on the changes in Medicare, some elders may seek additional resource materials to help them make more informed choices. If you want to read more about Medicare Plan Choices, contact your local SHINE program (through the Elder Helpline) or the SHINE office in Tallahassee (4040 Esplanade Way, Tallahassee, FL 32399-7000). DOEA Secretary E. Bentley Lipscomb says the department is committed to helping elders make sense of the “new” Medicare. “We’re going to do everything within our power to ensure elder Floridians get the answers and information they need to make informed decisions about Medicare and their health care options,” Lipscomb said. “Our goal is to provide beneficiaries and their family members and caregivers with accurate and timely information about the changes in Medicare, so they can make appropriate plans for their future health care needs. When elders have questions, we want to give them answers and personal attention, not an automated phone system.”

KEY CHANGES IN MEDICARE New Preventive Benefits • Annual screening mammograms • Annual pap smears • Colorectal screenings • Flu and pneumonia vaccinations • Bone density measurements for high-risk individuals • Diabetes outpatient self-management training and blood glucose monitors and testing strips for insulin and non-insulin-dependent diabetics • Annual prostate cancer screening tests (effective Jan. 1, 2000) Note: Some preventive benefits are covered at 80 percent, and others are covered at 100 percent.

Options Under Medicare New options will include the following: • Original fee-for-service Medicare (with or without Medicare Supplement) • Medicare Managed Care • Health Maintenance Organization (HMO) • Provider-Sponsored Organization (PSO) • Preferred Provider Organization (PPO)

• HMO with point-of-service option (POS) • Private fee-for-service plan (PFFS) • Private contracting with physicians • Medical Savings Account (MSA) • Religious Fraternal Benefit Society plans (RFB) Note: Many of the new options are not available throughout Florida. Over the next few years, if more providers contract to provide services, these options may be available to more of Florida’s Medicare beneficiaries.

Important Dates to Remember: • November 1999: Beginning of phase-in for annual coordinated enrollment period • November 2003: Effective date for annual coordinated enrollment period (beneficiaries must select Medicare plan choices in November for following year) For more information, read the “Medicare and You” handbook or contact your local SHINE counselor.

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SHINE counselors have worked hard to get ready for Medicare blitz By Barry Ray /Elder Update Editor

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ll over Florida, Medicare beneficiaries are receiving their Medicare handbooks in the mail and reading about the new health-care options that may be available to them. One thing is for sure: They will have plenty of questions. The good news for them is that the Department of Elder Affairs is prepared to answer those questions. Through the SHINE (Serving Health Insurance Needs of Elders) program, the department has trained volunteer counselors around the state to answer phone calls and even pay home visits to people who need help sorting through the Medicare paperwork. That training began in midSeptember, when eight SHINE senior volunteers attended a comprehensive “training the trainers” seminar on the Medicare changes in Orlando. “It was very intense,” said Boris Edelman of Lake Worth, a SHINE counselor since its inception in 1993. He said the two-day training seminar involved “giving us a complete rundown on everything that pertains to Medicare, health-maintenance organizations … and all the options under Medicare Plan Choices.”

From left, Department of Elder Affairs/ SHINE staffer Marsha Ryan helps counselors Arnold Abrams, Boris Edelman and Harold Barnes with their training.

Edelman said that after the eight underwent training with Elder Affairs/SHINE staffer Marsha Ryan, they took turns giving the presentation that would be used to teach other SHINE counselors. “Those trainers who were observing then critiqued the presentations given by others — and let me tell you, we weren’t easy on each other.” The eight who received the first round of training then had the responsibility of training more than 600 other SHINE counselors across the state on the fine points of Medicare Plan Choices.

All were confident that SHINE’s counselors would be ready once the phone calls on Medicare started pouring in. “We think we’re going to be inundated with calls,” said Edelman, but “I think our counselors will be welltrained enough to handle the volume.” Several counselors said that if they received calls from confused or worried Medicare beneficiaries, the first point the counselors would emphasize is that no one has to change their Medicare coverage if they don’t want to. “I’d tell them if you’re already on

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HINE (Serving the Health Insurance Needs of Elders) is a free insurance counseling program designed for elders and their caregivers. Highly trained volunteers assist elders with their health insurance questions. If you need assistance with Medicare, Medicaid, or health-related insurance, a SHINE volunteer counselor can help. Call 800/963-5337 for the SHINE site nearest you. SHINE has counselors in the following counties:

ALACHUA BAY BRADFORD BREVARD BROWARD CALHOUN CHARLOTTE CITRUS COLLIER DADE DESOTO DUVAL ESCAMBIA FRANKLIN

FLAGLER GADSDEN GILCHRIST GULF HARDEE HERNANDO HIGHLANDS HILLSBOROUGH HOLMES INDIAN RIVER JACKSON LAFAYETTE LAKE LEE

LEON LIBERTY MANATEE MARION MARTIN MONROE NASSAU OKALOOSA ORANGE OSCEOLA PALM BEACH PASCO PINELLAS POLK

PUTNAM SANTA ROSA SARASOTA SEMINOLE ST. JOHNS ST. LUCIE SUWANNEE SUMTER VOLUSIA WAKULLA WALTON WASHINGTON

H E R O E S Medicare, you can keep what you’ve got,” said Harold Barnes of Lady Lake, a SHINE volunteer for two years. “If you’re interested in any of the other providers, get information from them, compare plans as best you can, and then come in to a SHINE counseling site for advice.” Hard work, lots of travel, and no pay — what do the SHINE volunteers get out of this? Bob Herman, a five-year member of SHINE who lives in Fort Walton Beach and is chairman of the training committee, explained what motivates him: “It’s hard to explain it, but when you help a frustrated elderly person who’s got doctor bills, paperwork from Medicare, a lot of them have transportation problems — and that’s not even the worst of it — and we take the time to actually go to them if need be and sit down and take all the time to go through all this paperwork and sort it out, we’ve made a friend. It’s amazing the number of people who want to pay us or something. Just the relief that comes over these people — I’ve even gotten phone calls from some of these people’s children from out of state thanking us. It just makes you feel good.” Edelman said SHINE can use more help. “We’re always looking for volunteers,” he said. In addition to Edelman, Herman and Barnes, the other SHINE volunteers involved in the Medicare “training the trainers” session were Gisela Oeffen of Deltona, José Colón of Casselberry, Arnie Abrams of Boynton Beach, and Ed Lundquist of Largo, who was assisted by his wife, Loretto. Unable to attend was Barbara Rudd of Stuart, who subsequently received her training. If you’d like to become a SHINE volunteer, or if you’re seeking the SHINE site nearest you, call 1-800/96ELDER (1-800/963-5337).

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NOVEMBER 1998

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ELDER HELPLINE

Florida Elder Helpline Directory (County-by-county listings)

A Starting Point

Alachua ..........1-800-262-2243 Baker.................904-259-1388 Bay ....................850-769-3468 Bradford ........1-800-262-2243 Brevard..............407-631-2747 Broward ............954-714-3464 Calhoun .............850-674-4163 Charlotte ............941-637-8019 Citrus .............1-800-262-2243 Clay....................904-284-5977 Collier................941-774-8443 Columbia........1-800-262-2243 Dade ..................305-670-4357 DeSoto ...............941-494-5965 Dixie ..................800-262-2243 Duval .................904-798-9503 Escambia ...........850-432-1475 Flagler ............1-888-252-6110 or 904-437-7222 Franklin .............850-697-3760 Gadsden.............850-627-2223 Gilchrist .............800-262-2243 Glades................941-946-1821 Gulf....................850-229-8466 Hamilton ........1-800-262-2243 Hardee...............941-773-6880 Hendry...............941-983-7088 Hernando .......1-800-262-2243 HighlandsAvon Park .........941-452-1288 Lake Placid .......941-465-1199 Sebring .............941-382-1288 Hillsborough......813-273-3779 Holmes ..............850-547-2345 Indian River.......561-569-8555 Jackson Marianna ..........850-482-5028 Graceville..........850-263-4650 Jefferson ............850-342-0271 Lafayette .........1-800-262-2243 Lake ...............1-800-262-2243

1-800-96-ELDER ( 800-963-5337 )

Information and referral is available at your nearest Area Agency on Aging or Elder Helpline. The Elder Helpline is the starting point if you are seeking information about aging issues, looking for an aging service provider, or wanting to volunteer. Elder Helplines are called by different names in different communities; for example, Senior Connection (Broward County) or Age Link (Lee County). You can contact the Elder Helpline nearest you by calling either the county number listed below or the statewide helpline number, 1-800-963-5337, Monday through Friday, 8 a.m. to 5 p.m. Florida Area Agencies on Aging (Listings for Area Agencies on Aging)

NORTHWEST FLORIDA AREA AGENCY ON AGING 6500-B Pensacola Boulevard Pensacola, FL 32505 850-484-5150 (Escambia, Okaloosa, Santa Rosa, and Walton Counties) AREA AGENCY ON AGING OF NORTH FLORIDA, INC. 2639 N. Monroe St., Suite 145-B Tallahassee, FL 32303 850-488-0055 (Bay, Calhoun, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Leon, Liberty, Madison, Taylor, Wakulla, and Washington Counties) MID FLORIDA AREA AGENCY ON AGING 5700 S.W. 34th St., Ste. 222 Gainesville, FL 32608 352-378-6649 1-800-262-2243 (Alachua, Bradford, Citrus, Columbia, Dixie, Gilchrist, Hamilton, Hernando, Lafayette, Lake, Levy, Marion, Putnam, Sumter, Suwannee, and Union Counties) NORTHEAST FLORIDA AREA AGENCY ON AGING 590 S. Ellis Road Jacksonville, FL 32254 904-786-5111 1-888-242-4464 (Baker, Clay, Duval, Flagler, Nassau, St. Johns, and Volusia Counties) TAMPA BAY REGIONAL PLANNING COUNCIL AREA AGENCY ON AGING 9455 Koger Blvd. Hendry Building St. Petersburg, FL 33702 727-577-5151 (St. Petersburg) 813-224-9380 (Tampa) (Pasco and Pinellas Counties)

WEST CENTRAL FLORIDA AREA AGENCY ON AGING 5911 Breckenridge Pkwy., Suite B Tampa, FL 33610 1-800-336-2226 or 1-813-623-2244 (Hardee, Highlands, Hillsborough, Manatee, and Polk Counties) SENIOR RESOURCE ALLIANCE 988 Woodcock Road, Suite 200 Orlando, FL 32803 407-228-1800 (Brevard, Orange, Osceola and Seminole Counties) AREA AGENCY ON AGING OF SOUTHWEST FLORIDA 2285 First Street Fort Myers, FL 33901 941-332-4233 (Charlotte, Collier, DeSoto, Glades, Hendry, Lee, and Sarasota Counties) AREA AGENCY ON AGING OF PALM BEACH/TREASURE COAST, INC. 8895 N. Military Trail, Suite 201-C Palm Beach Gardens, 33410 561-694-7601 (Indian River, Martin, Okeechobee, Palm Beach and St. Lucie Counties) AREA AGENCY ON AGING OF BROWARD COUNTY 5345 N.W. 35th Ave. Ft. Lauderdale, FL 33309 954-714-3456 (Broward County) ALLIANCE FOR AGING 9500 S. Dadeland Blvd., Suite 400 Miami, FL 33156 305-670-6500 (Dade and Monroe Counties)

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Lee.....................941-433-3900 Leon ..................850-921-5554 Levy ...................800-262-2243 Liberty ...............850-643-5613 Madison.............850-973-2006 Manatee .............941-742-5818 Marion ...........1-800-262-2243 Martin................561-283-2242 Monroe..............305-292-4520 So. Florida ........800-273-2044 Nassau Fernandina ......904-261-0701 Westside ...........904-845-3332 Okaloosa ...........850-833-9165 Okeechobee.......941-462-5180 Orange...............407-897-6464 Osceola..............407-897-6464 Palm Beach in-county..................930-5040 out-of-county ....561-547-8677 Pasco in-state..............800-861-8111 out-of-state .......813-576-1533 Pinellas ..............727-576-1533 Polk ...................941-534-5320 Putnam...........1-800-262-2243 Santa Rosa .........850-626-5823 Sarasota North ................941-955-2122 Englewood........941-475-4056 North Port.........941-475-4056 Seminole............407-897-6464 St. Johns .........1-888-252-6110 or 904-794-0740 St. Lucie.............561-465-1485 Sumter ...........1-800-262-2243 Suwannee ..........904-364-5673 Taylor ................850-584-4924 Union .............1-800-262-2243 Volusia...............904-253-4700 Wakulla..............850-926-7145 Walton ...............850-892-8168 Washington ........850-638-6216

If you need information about, or referral to, a service provider outside the state of Florida, call the national Eldercare Locator Service at 1-800-677-1116. An information specialist is ready to assist you Monday through Friday from 9 a.m. to 11 p.m. EST. For people with Telecommunication Devices for the Deaf (TDDs), all Elder Helplines, as well as the Eldercare Locator Service, can be accessed through the Florida Relay Service at 1-800-955-8771.

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7 ORLANDO — The public is invited to the Alzheimer Resource Center’s Sixth annual educational conference on Alzheimer’s disease. This year’s theme, “A Symphony of Caring; A Song of Hope,” will address topics relating to the family and the community as they meet the challenges of caring for those with Alzheimer’s disease. Beardall Senior Center, 800 S. Delaney Ave. Registration deadline is Oct. 30. Call: 407/843-1910.

10 JACKSONVILLE — The Florida Council on Aging hosts a Legislative Breakfast, offering an opportunity to educate area legislators regarding the needs of older persons and how they

A health care storm such as Southeast Florida, the costs are dramatically higher. The bottom line for elders dropped by one HMO and unable to join another: annual cost increases of $2,700 or more (sometimes much more) per year. With the average elder in Florida on a fixed income, these costs can represent a whopping 25 percent of his or her annual income. If this hemorrhage of healthcare coverage for Florida’s elders continues, the long-term consequences will be extremely serious not only for those individuals affected but for the state as well. Elsewhere in this issue, Elder Update brings you a look at the New Medicare, a comprehensive program of managed care choices that may save you money and help sustain the nation’s largest elder health-care program into the next century. The Medicare Plan Choices program was a major part of a bipartisan initiative to “save Medicare” by cutting costs. But the cost savings depend on elders’ willingness to join managed-care programs, assuming that there are programs to join. As we go to press, in Citrus, Gilchrist, Highlands, Marion, Monroe, Glades, Hendry, Okeechobee, and Polk

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ELDER UPDATE

Calendar of Events benefit from the programs created and funded by legislation. Mary Singleton Senior Center, 150 E. 1st St. 7:30-9 a.m. Call: 904/630-0998. LAKE WORTH — The Palm Beach County Medication Education Task Group, in cooperation with the Area Agency on Aging’s Advisory Council, is sponsoring a free “Check-Up For Your Medicines Day” from 9 to 11:30 a.m. at the Mid-County Senior Center, 202 N. H St. Bring your medicines or a list of medicines and speak with a pharmacist about any questions or concerns you may have. Please call Joaquin continued from page 5

counties, managed care coverage will no longer be an option for 17,000 individuals who had been covered. All the HMOs offering coverage in those counties have chosen to pull out as of Jan. 1, 1998. In Baker, Indian River, Lake, St. Johns, and St. Lucie counties, only one HMO remains — the others have all pulled out. Florida elders were more willing than most to join managed-care plans. That’s why 28 percent of Floridians on Medicare had joined managed-care plans, almost twice the national average. But in the wake of the Medicare HMO nonrenewals, managed care may be a very tough sell. And that leaves Medicare’s future financial stability even more up in the air than it was before the Balanced Budget Act. No one can doubt that balancing the federal budget is a necessity for America. But the latest plans to implement the Balanced Budget Act could end up balancing the budget on the backs of frail, elder Americans. Considering that elders are the ones whose hard work and sacrifice built the country in the first place, they shouldn’t have to bear that burden.

Etcheverry at (561) 586-6102 for a reservation.

13 PENSACOLA — Band leader Jim Miller and the legendary Jimmy Dorsey Orchestra will perform with singer Nancy Knorr. Doors open at 6:30 p.m., concert starts at 8. National Museum of Naval Aviation, NAS Pensacola. Call: 850/453-2389 or 1-800/327-5002. GAINESVILLE — The North Central Florida Chapter of the Alzheimer’s Association will hold its Fifth Annual Caregiver’s Conference from 8:30 a.m. to 8 p.m. at the Florida Farm Bureau, 5700 SW 34th St. Topics will include legal issues, new medications to help with management of memory, behavioral changes through the course of the disease, and activity suggestions for Alzheimer’s patients. Call: 352/372-6266.

15-20 FORT WALTON BEACH — Elder Services of Okaloosa County is sponsoring the second annual “Festival of Trees.” Kickoff is a Wine and Cheese Party from 3 to 5 p.m. on Nov. 15; sales of handcrafted items will take place from 10 a.m. to 7 p.m. Nov. 16-20 at 207 Hospital Drive. Call: 850/833-9165.

MONDAY PALM HARBOR — Al-Anon family group, providing support for friends and families of people affected by someone else’s drinking. Each Monday. 8 p.m. St. Alfreds, 1601 Curlew Road. Call: 727/5486811.

WEDNESDAY JENSEN BEACH — Free bloodpressure check for elders. Second Wednesday only. 8 a.m.-noon. Log Cabin Senior

Center, 2369 NE Dixie Highway in Langford Park. Call: 561/334-2926. WINTER PARK — Meeting of the Orange County Chapter of the Florida Society of Registered Nurses, Retired, Inc. Third Wednesday only. 11:30 a.m. Golden Corral Restaurant on State Road 436, south of Curry Ford Road. Call: 407/677-7309 or 407/658-4634.

THURSDAY BOCA RATON — The National Association of Retired Federal Employees, Boca Raton Chapter #647. Second Thursday only. 1 p.m. Boca Community Center, 150 H.W. Crawford Blvd. Call: 561/3950542 or 561/499-5456.

FRIDAY LONGWOOD — The Alzheimer Resource Center announces the formation of a new Alzheimer’s support group. First Monday only. 10-11:30 a.m. Orlando Regional Behavioral Healthcare Group, Longwood Business Center, Building 715, Suite N, State Road 434. Call: 407/843-1910. SUNRISE — Meeting of the National Association of Retired Federal Employees, Broward Chapter #1698. Second Friday only. 9:30 a.m. Nob Hill Recreation Center, 10400 Sunset Strip. Call: 954/726-0489.

SATURDAY ST. PETERSBURG — Al-Anon family group, providing support for friends and families of people affected by someone else’s drinking. Each Saturday. 8 p.m. Pasadena Presbyterian Church, 100 Pasadena Ave. Call: 727/548-6811.

REUNIONS WHO: 4th Infantry (IVY) Division Association, Florida Chapter. WHEN: Nov. 6-8, 1998. WRITE: Edward J. McEniry, 3936 Sail Drive FR-13, New Port Richey, FL 346525750.

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Social Security: One way or another, we must keep it strong for future generations

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YEARS! 0 2

By Bobbe Taffel on’t panic. Social Security has D been the United States’ most successful program for 60 years. There is no reason to suppose that it will not continue to be there for our children and grandchildren. This year, the Social Security fund is expected to have a $101.4 billion surplus. However, since demographics change, it is estimated that some adjustments will Bobbe Taffel have to be put in place, slowly, in order to insure solvency beyond the year 2034. Some remedies that have been put forth may dismantle Social Security. Others will not, says the National Committee to Preserve Social Security and Medicare. Among suggestions made by a private group with a governmental name (the National Commission on Retirement Policy, whose members include lawmakers, economists and business executives,) is that Social Security contributions be place in individual retirement accounts. Commonly known as “privatization,” this plan would leave the choice of investing the funds to the individual contributor. Prior to the enactment of the Social Security Program in 1935, this is precisely what the working person had to do to secure his or her retirement. Except that now, Social Security funds will include the contributions made by his or her employer. This was fine for higher-income earners, but for those who earned barely enough to support their families, or less, living with their children in old age or in poverty was what they had to look forward to.

Workers, who are neither familiar with the stock market nor have time to study it, will have to depend on stock brokers, stock market publications or managers of mutual funds to help them with investments. According to Sheila Poole of the Palm Beach Post (Sept. 6, 1998), Lee Jenkins, an Atlanta broker, said “workings of stock trading remains a mystery to most individuals.” In any case, those with higher incomes will have more money to invest and will, therefore, get a higher return on their money than those earning lower incomes, which may put some retirees on the welfare rolls. Women and minorities, who are most likely to work in lower-paying jobs, will probably suffer most. As of January 1998, the average monthly Social Security benefit for retired workers is $765; for the disabled, it’s $722. Everybody loses when the stock market goes down. The stock market’s slump of September 1998 is a case in point. “We have wallto-wall worries; the market is replete with uncertainties,” said Allen Ackerman, chief market strategist of Fahnestock & Co., reported Robert D. Hershey Jr. of The New York Times. “The ups and downs remind us that Social Security is not there as a hot venture-capital fund,” wrote E.J. Dionne Jr., political columnist for The Washington Post. “It is a prudent social insurance that provides a decent minimum for retirees. It’s there especially for those who don’t earn enough to save, who lack private pensions, who suffer unexpected misfortunes or who make unlucky, mistaken or badly timed investments.” On Aug. 16, 1998, the media reported that Great Britain’s 10year experiment with privatization

of their social-security program is a failure. As reported in The Wall Street Journal, “Britain’s pension industry is reeling from the financial fallout of a decade-old government-backed program that led millions of Britons to opt out of their public- and company-sponsored pension plans and invest the money themselves.” The National Committee to Preserve Social Security and Medicare suggests other ways to meet the anticipated problems of Social Security. Among them are “bringing newly hired state and local government employees under the Social Security system … changing from 35 to 38 years the period of work an individual’s Social Security benefits are calculated upon … slightly increasing the Social Security payroll tax in the year 2048.” A suggestion, made by some and frowned upon by others, is to continue deducting the Social Security payroll tax beyond the $65,000 cap, but at a lower rate. For example, the first $65,000

would be taxed at the prevailing rate. All money earned above $65,000 would be taxed at perhaps one-quarter of 1%. This, say the opponents, would turn the Social Security system into a welfare program. Not so, say the proponents. It would no more be a welfare program than the income tax. With the income tax, the more you earn the more you pay. But individuals who pay higher taxes do not have better roads to drive on than those whose taxes are lower. Neither is their postal service any better, or the bridges they cross any stronger. Taxes, high and low, are for the common good. So too the Social Security payroll tax. Continuing to contribute beyond the present cap would not make it less so. Whichever method is selected, all agree that Social Security benefits must and will be secure for future generations.

Happy Birthday from the White House! nterested in requesting a personal birthday greeting from the White House for an elderly friend or family member? The only Icriteria is that the individual be at least 80 years old. To request a card, write at least one month in advance of the anniversary date to:

Greetings Correspondence White House Washington D.C. 20500 Requests can also be made by calling the White House’s comment line at 202/456-1111

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Broward County The Alzheimer’s Family Center in Margate needs volunteers who can offer three to four hours one day a week to sit with an Alzheimer’s patient. “On-call” volunteers are also needed for temporary assignments. Call Rochelle Donohue at 954/9717155.

Dade County The District XI North Long-Term Care Ombudsman Council is seeking volunteers that want to make a difference for the residents of long-term care facilities in North Dade County. Call 305/623-3601.

Hillsborough County The District VI Long-Term Care Ombudsman Council is seeking volunteers who are interested in maintaining safety, welfare, and the rights of residents in nursing homes, assisted living facilities and adult family care homes. Consumer advocates, minorities, physicians and dietitians encouraged to apply. Call Martie Daemy at 813/871-7185. *** The Arthritis Foundation, Tampa

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ELDER UPDATE

Volunteer Help Wanted office, is looking for volunteers to be trained as support group leaders and aquatic leaders and/or instructors. The support group and aquatic leaders would be working with people of all ages afflicted with any of the many types of arthritis in Hillsborough and Polk Counties. Call Jan Kuehnert, development director, or Sally Treaster, patient services coordinator, at 813/914-7903.

Leon County The Department of Elder Affairs is seeking volunteers to be trained to provide telephone health insurance counseling at the department’s headquarters in Tallahassee. Telephone counseling is needed for people living in Florida counties without a SHINE (Serving Health Insurance Needs of Elders) program and for those researching a move to Florida from another state. Potential volunteers need to be above to commit 3-4 hours a week

following training and orientation. For more information, call Louise Engle at 850/414-2080.

Orange County Seniors First Inc. needs volunteers to deliver Meals on Wheels to homebound elders one day a week. Call 407/292-0177, Ext. 240. *** Vitas, a hospice care program, is seeking volunteers willing to work with terminally ill patients and their families in a variety of capacities. Call 407/475-2641.

Sarasota County Sarasota Memorial Hospital has a wide variety of volunteer opportunities, including openings in Central Transport/Discharge Services, Early Birds escorts, the Emergency Care Center Information Desk, the Gift Shop, the Intensive Care Open Heart Reception Desk, Oncology, and Surgery Transport. For more information, call Karen Sharp,

Coordinator of Placements, at 941/917-6277.

North-Central Florida Santa Fe Community Care has numerous openings for their Elder Blind Services Program that covers the following counties: Marion, Columbia, Bradford, Union, Dixie, Gilchrist and Levy. Staff make home visits to older blind adults to teach them skills for successful and enjoyable independent living. Call 1-800/ 737-2669.

Southwest Florida The Foster Grandparent/Senior Companion Programs of Southwest Florida (Lee, Collier, DeSoto, Hendry and Sarasota counties) have paid volunteer positions available. Seniors provide tutoring and mentoring services to children with special needs or assist frail, often homebound, elders to remain independent in their homes. Volunteers must be 60 years of age or older and meet income stipulations to qualify for the hourly stipend and mileage reimbursement. Call Nida or Judith at 1-800/332-5346 outside Lee County, 941/332-5346 within.

Prudential Health Care PICK-UP

Prudential Health Care is a corporate member of the Elder Floridians Foundation, which partially underwrites Elder Update.

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Tools, office aids and random stuff By Tom McMullen /Elder Update correspondent

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he World Wide Web is one of the most fascinating explorations in human history. There is no end to the materials that can be gleaned there. Each day my work involves me in searches on the Web for information on a great variety of subjects. One of my Elder Affairs colleagues may want to know more about grandparenting or statistical data on a range of census figures. It is possible to access library collections of many kinds, and I often access my local public library to see if they have a book I need and to know whether it is available. I also keep a collection of bookmarks (aliases) that are sorted into folders by subject or context. The sites below are some of those that have come from my “Office Aids” folder and are among the most useful parts of my tools. I would encourage you to check them out and add some to your own bookmarks. In the process, be sure to look at the other links that are available on each Web site. There are endless connections to other tools. http://work.ucsd.edu:5141/cgi-bin/http_ webster?whatever — This is a hypertext gateway to Webster’s Revised Unabridged Dictionary (1913) … very handy for looking up words. Each word is defined, then examples are given, together with explanatory notes following. Very useful in clarifying the nuances of words. Simply type in the word (in the entry box) and click on the “Look up definition” box.

http://www.thesaurus.com/cgi-bin/htsearch ?config=roget&words=whatever — Roget’s Thesaurus has long been the standard for word searchers. http://www.interest.com/hugh/calc/ — Hugh’s Mortgage and Financial Calculators is a page of links to an amazing collection of tools for working with tax, amortization, IRA figures, mortgages, stocks, and many others.

http://machaut.uchicago.edu/cgibin/WEDT1. sh?word=whatever — The Wordsmyth English DictionaryThesaurus. Presented by Robert Parks and the ARTFL Project at the University of Chicago. A fascinating variation on the dictionarythesaurus concept. http://www.m-w.com/cgibin/dictionary? book= Dictionary&va=whatever — WWWebster Dictionary offers a thesaurus and pronunciation key. http://www.m-w.com/info/info.htm — Language Info Zone is “a collection of online resources to help you track down definitions, spellings, pronunciations, synonyms, vocabulary exercises, and other key facts about words and language.” This site is particularly handy since it contains links to many other useful tool sites.

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Broward County police officers learn warning signs of dementia By Kelly Silva /Elder Update correspondent a fairly common scenario. Iandt’sPolice are called to the scene find someone wandering, confused, disoriented. Questioning produces little information and a lot of frustration. Is this person being uncooperative? Is he under the influence? Or is he suffering from dementia? Determining the answer has become easier for some Broward County police officers following a training program provided by

A L Z H E I M E R ’S N E W S the Memory Disorder Clinic of North Broward Medical Center. The Memory Disorder Clinic is one of 11 that comprise Florida’s Alzheimer’s Disease Initiative Project. Each clinic offers diagnosis, treatment and clinical drug trials for patients, and

Could a virus be behind Alzheimer’s? t is presumed that many of the Itoday, major chronic diseases we face such as Alzheimer’s, arthritis and multiple sclerosis, are caused in some way by the immune system reacting to foreign “invasion” that then leads to attack of the body. It’s been frustrating because it’s not clear what the source of the foreign material is. But a study recently reported in the Journal of Neurology shows even stronger evidence that, for Alzheimer’s disease at least, the culprit is a virus. By comparing brain tissue of 40-year-olds who died from an

HIV infection with those who didn’t, researchers found that the plaques that are characteristic of Alzheimer’s disease were present in those with HIV and not in those without HIV. Does this mean that one or more of certain viral infections over a lifetime could cause Alzheimer’s disease? Is it one particular virus? And, if identified, can we treat it or prevent it with a vaccine? Those are the questions that remain to be answered. (Written by Dr. Allen J. Douma, co-founder of iVillage’s Better Health and Medical Network on the Internet.)

IF YOU WOULD LIKE A COPY OF THE MARCH ISSUE OF ELDER UPDATE, WHICH INCLUDES A 12-PAGE SPECIAL SECTION ON ALZHEIMER’S DISEASE, WRITE TO:

Database Manager Elder Update Department of Elder Affairs P.O. Box 10118 Tallahassee, FL 32302.

training and support for caregivers. “We felt there was a need for law enforcement officers to learn how to recognize dementia and be educated about the services available to deal with it,” said Shelly Greenberg, R.N., clinic coordinator of the Memory Disorder Clinic. Many times, officers are called upon to help someone who appears lost, confused or combative. An officer may spend hours trying to get the person safely back to where they belong — only for the situation to repeat itself again and again. An unenlightened officer might deduce that the person is on drugs or even mentally ill, and then proceed to take them to jail or the local mental institution. These actions only exacerbate the dementia sufferer’s symptoms of confusion, anger and anxiety. These are some of the unfortunate occurrences that the Memory Disorder Clinic plans to curtail with its training for police officers. One goal of the training is to teach officers behavior management and communication techniques found to be successful with dementia sufferers. Dementia is a disease, and those afflicted with it should be handled very carefully. Oftentimes, they are not aware that they are causing a disturbance, but are simply lost or confused. A great deal of patience and a skilled approach can make determining the person’s identity and where he lives a painless procedure. Another important goal of the training is to give officers information on what resources and agencies are available to help dementia sufferers, such as the Wanderer’s ID Bracelet Program or companies that can install alarms on doors preventing dementia sufferers from wandering. “We initially have scheduled

training sessions for 90 officers,” said Sgt. Steve Lerman of the Fort Lauderdale Police Department. “We’re going to open the class to our people, but if other agencies in the area have some interest, we can accommodate some of their training needs as well.” The training began on Oct. 1. This is the second law enforcement agency in Broward to receive training from the Memory Disorder Clinic. Coral Springs police officers received training after the department’s Community Involvement Unit contacted the clinic. From December 1997 to May 1998, Ms. Greenberg and the clinic’s staff trained 176 employees of the Coral Springs Police Department. The training proved very useful to Coral Springs police Officer Lisa Jo Faircloth recently when she responded to a call from a health care worker. “When I got there it was kind of chaotic,” said Faircloth, who walked in to find a man dancing around his wife’s dead body. “The husband had dementia, and the only care they had was a nurse who came in twice a week. The wife (who was the caregiver) had made breakfast and had then had a heart attack. She wasn’t supposed to pass away.” Thanks to the classes, Faircloth knew what to do. She was able to calm the man and get him the help he needed within an hour. “The best thing about the program is that I know the people are going to be helped, and that’s very important to me,” Faircloth said. “I felt good when I went home knowing the gentleman was in good hands.” For more information about the Police Program or any other training events, call the North Broward Memory Disorder Clinic at 954/786-7392 of the Department of Elder Affairs at 850/414-2060.

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Housedress brings back memories of an earlier way of life By Ann MacConnachie

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oes anyone remember the housedress? I hadn’t seen one in years until recently as I thumbed through a catalog and came upon a picture of a familiar-looking garment. It was a shapeless, sleeveless cotton print loosely belted and adorned with two handy patch pockets. The kind mothers used to wear when I was a child. In the preWorld War II Ann MacConnachie era, respectable women did not wear jeans or shorts to work around the house and yard. They wore housedresses. Upon seeing this picture, visions of my mother immediately came to mind. A proud lady who tried to maintain an image of refinement, she would not want to be remembered wearing a housedress. Even in a housedress she wore the proper underpinnings — a one-piece foundation, slip, bloomers and lisle hose. Over it all was a bib apron. Housework was clearly beneath her. She had been a schoolteacher before her marriage and had not expected to do the drudge work of a typical housewife. Becoming a mother sealed her fate. There was no choice. In our middle-class neighborhood mothers stayed at home and did housework wearing housedresses whether or not they had an aptitude for domestic life. It was a full-time job, their lot in life. I recall Mother in a housedress on hot summer days hanging out the laundry to dry, scrubbing the kitchen floor, washing windows, ironing shirts, canning fruit, stuffing a turkey and weeding the garden. When the honk of the huckster’s truck was heard from the street, she and the neighborhood women emerged from their houses wiping their hands on their aprons and gathered at the curb to select produce for the evening meal. It was a

welcome break and an opportunity for a bit of socializing, much as women once gathered at the town well with their water jugs. Mother was careful not to be seen outside of the neighborhood wearing a housedress, or even at home in the afternoon. The dirty work was done in the morning so that she could transform herself into the lady of the house by afternoon when we children arrived home from school and Dad from work. She was by then carefully groomed and wearing a modish street dress. Only her hands gave her away. Her scant leisure time was spent reading Better Homes and Gardens or listening to the soaps on the radio. “The Romance of Helen Trent” promised that romance could begin at 40 or even beyond. Sometimes she mended socks or hooked a rug in the evening. Dining out was the rarest of occasions. In those Depression years a woman was judged by her ability to stretch a dollar, to keep up appearances, to set a good table. She had no money of her own for discretionary spending. She sewed her housedresses on a treadle sewing machine and cut down Dad’s old suits for children’s coats. I can only guess at Mother’s feelings because she didn’t complain. Feelings were not discussed. Anger was not discussed. Duty was everything. We were more fortunate than some neighbors who lost jobs until Dad became seriously ill. Then, the whole responsibility fell on her; two children, an invalid husband and a frail mother-in-law to wait on. After Dad died she became a widow, a single parent and a nurse. There was no longer a reason to dress up. The housedress was the uniform of the day and night. Her philosophy was “Keep on keeping on,” which she did until her nest was finally empty. Then, she chucked the housedress and began a career at Eastman Kodak Co. Although my initial musings regarding the housedress were tinged

with scorn, feelings of respect and admiration for those women who wore them soon prevailed. Gleefully, I ordered the housedress from the catalog. It’s a shapeless, sleeveless cotton print with handy patch pockets and a loose belt. Worn without the underpinnings of my mother’s generation, it is surprisingly cool and a practical, “retro” fashion statement. I wouldn’t trade places with women of that era for anything, but it would be nice if a huckster came by with fresh produce. The author lives in Cape Canaveral.

It seems like

Only Yesterday Please write and share your stories with us. Send your submission, with your phone number and a photo of yourself to: Editor, Elder Update 4040 Esplanade Way Tallahassee FL 32399-7000

Wyeth Ayerst PICK-UP

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NOVEMBER 1998

ELDER UPDATE

Put on your walking shoes and discover the real Florida If you’re a Florida resident, how much do you know about where you live?

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here’s history in your back yard and you’re probably unaware of it. For example:

• What pioneer woman supposedly grew the first pound of coffee in the United States? • What house has a heart, club, spade, and diamond carved into its facade? • Where is the church with the wrong name? • Where is the “house that rhymes”? • What landmark hotel caught fire while Marjorie Merriwether Post and “Unsinkable” Molly Brown were in the lobby? • Where did Jackie Robinson play baseball’s first racially integrated game? • How did a Space Coast city get its name from a game of dominoes? • Where is the “City Beautiful”? • What church is a memorial to a woman who died during childbirth? • In what Panhandle city was the first Christmas in America supposedly celebrated?

All of those questions are answered in author Roberta Sandler’s new travel book, “Guide to Florida Historical Walking Tours.” Sandler says she wrote the book “to introduce residents and visitors to the Florida that exists beyond beaches, golf courses and Early Bird dinners. This is the Old Florida of fascinating pioneers, from freed slaves and Civil War officers to tycoons and plantation owners; the Old Florida of stately homes turned into museums and hotels; the Old Florida of Victorian and Greek revival mansions, as well as bungalows and cracker houses.” The 288-page book’s selfguided walking tours spotlight 32 historic neighborhoods throughout Florida, their historic inns, restaurants, attractions, and commercial and residential landmarks. These are perfect destinations for people who enjoy traveling and who’d like to visit lesser-known Florida. To do research for her book, Sandler drove through 42 of Florida’s 67 counties, acquiring a sense of each area’s history

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ON THE INTERNET http://www.state.fl.us/doea/doea.html

along with the beautiful scenery. “Imagine the bravery of 19thcentury homesteaders who fought mosquitos, swampland, and Indian uprisings, or the boldness of barons who built railroads and resort hotels, or the adventurous spirit of Civil War veterans who

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carved cities out of wilderness,” Sandler says. How and where they lived are threaded through each of the book’s self-guided walking tours. Sandler, 55, is a New York native who moved to Florida in 1984 and now lives in Wellington, a suburb of West Palm Beach. She says she’s hopeful that readers will use her book as a tool to help them discover the real Florida. “Beyond its natural beauty, Florida is full of other treasures, and you can’t appreciate them until you see the Old Florida ... the Florida that, fortunately, has been preserved and is waiting to be visited.” “Guide to Florida Historical Walking Tours” is published by Pineapple Press. It’s available at most bookstores, but can be ordered toll-free at 1-800/PINEAPL (1-800/746-3275).

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http://www.m-w.com/book/ writref/writref.htm — This Merriam-Webster Writer’s References site is a gold mine of useful word tools. It has punctuation and style, rhyming, spelling, and abbreviation guides.

For the web sites, simply type the bold-face address into your address box and or . Then make bookmarks of those you wish to keep. Next time you won’t have to type all of these characters again.

http://www.dna.lth.se/cgi-bin/ kurt/rates/rates?USD+ALL — Kurt Swanson has constructed a program which provides foreign exchange rates for the U.S. dollar and other currencies. It is updated daily at 23:00 (Swedish Time).

*** I am planning more columns on elders whose work involves computers and/or the Internet. If you are among those people, please contact me at mcmullent@ elderaffairs.org . Let me know what sort of work you do and how you accomplish the necessary tasks. Comments and suggestions are welcome, and assistance is available. (Contact Tom McMullen by e-mail at the address above or [email protected]).

Email: ask-a-geologist@octopus. wr.usgs.gov — If you have questions about matters geological, send e-mail to the U.S. Geological Service. One of their scientists will try to find answers. (In your e-mail program, type a message and use the boldface address above.)

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MEDICARE/MEDICAID FRAUD Medicare fraud has become one of the nation’s fastest-growing crimes, according to the FBI and other authorities. In Florida alone, the tab is estimated at $1 billion annually, roughly a tenth of the state’s total Medicare billings. Who suffers when Medicare is defrauded? You do — because it’s your tax dollars that end up in the pockets of swindlers, and it is these frauds that have prompted Congress to propose reductions to Medicare. Here is a recent news story related to Medicare and Medicaid fraud:

SHINE counselor uncovers scheme involving his own mother’s bills ohn Walker, SHINE (Serving JElders) Health Insurance Needs of local coordinator for Volusia County, knows he has an excellent, well-trained group of counselors to work with in his area. One of his counselors recently surprised him with a tale of fraud that stretched from Volusia County north to Binghamton, N.Y., west to Yuma, Ariz., and back to Panama City, Fla. SHINE counselor Fred Kurtz

shared the following story with Walker, who relayed it to the SHINE staff in Tallahassee: Kurtz’s mother had just celebrated her 90th birthday with friends in a nursing home in Yuma when she was stricken and died. It fell to Kurtz to review, organize, and make sense of his mother’s medical paperwork and bills. He noticed several very similar charges being billed numerous times to different

Medicare carriers. The same bills were being sent to Jacksonville, Binghamton and Yuma. Something seemed wrong. Kurtz contacted the Medicare Fraud unit in Jacksonville and told them his story. Within a short period of time, he was put in touch with Special Agent Chris Bonner from the Daytona Beach FBI office. Less then a year later, Kurtz got a letter from Marcia Smith, investigator with the Program

Safeguards unit of Medicare in Jacksonville, advising him the provider had been “successfully prosecuted and convicted of fraud.” The conviction carried with it a stiff fine, court-ordered restitution, and suspension from the Medicare/ Medicaid programs for the provider. Congratulations to Fred Kurtz on pursuing questionable practices when it might have been easier just to let it go.

Understand your new Medicare options

By Lois Herron AARP Florida State President

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eginning in 1999 and beyond, the federal government will be offering new options for health insurance coverage under Medicare. If you choose, you’ll be able to enroll in any of the new coverage options in your area that may include managed care options. You can also choose to stay with “original” Medicare — the feefor-service program that has existed since 1966. It’s up to you. Medicare is a complex program and can be hard to understand.

Comparing original Medicare to the new options can be difficult. Original Medicare is the only coverage option available to everyone on Medicare. The other options may or may not be available in your area. Under original Medicare, you can use almost any doctor, hospital or health care provider in the country and your provider is paid for each service you receive. You will have some out-of-pocket expenses for your care. But if you have Medigap (supplemental insurance) or retiree insurance from your former employer or union, it will fill many of the gaps in your Medicare coverage. In Medicare managed care, one of the several new options, the government pays a fixed amount of money to your health plan to provide all of your care, no matter how few or how many services you use. Some plans will cover added benefits such as prescriptions or eye care. But be warned, these added benefits may change from year to year. Managed care options may include health maintenance organizations (HMOs), provider-sponsored organizations

(PSOs) and preferred provider organizations (PPOs). In addition to managed care options, some of the other Medicare options, where available, may include provider-sponsored organizations, preferred provider organizations, medical savings accounts and private fee-for-service plans. Everyone should take the time to compare plans. On the surface, cost comparisons look easy, but there can be hidden costs. Before you make any Medicare choice, ask yourself what’s important to you in a Medicare plan. Will the plan you choose meet your needs? How much will you have to pay for your health care? If you change plans and later want to switch back to original Medicare, will you be able to get the same supplemental coverage again? Think about the tradeoffs that exist with the added benefits of certain types of coverage. For example, with managed care, you can save money for medical services, but you generally must receive coverage only from providers named by the plan.

And if you enroll in a new Medicare option and give up your Medigap or retiree health insurance, you may not be able to get the same coverage back if you change your mind. Remember, if you’re satisfied with your current Medicare coverage, you don’t need to do anything. As long as you have Medicare parts A and B, you can always switch to another plan later. If you do consider changing Medicare options, don’t rely on information solely from the plan. Get additional information from HCFA (the Health Care Financing Administration — the federal agency that administers Medicare) and from people and organizations you trust. AARP has a new publication that can help you more clearly think about your Medicare needs, understand the terms used by health care providers and better understand your Medicare rights. AARP’s “Making Medicare Choices” is available free of charge by writing to AARP Fulfillment (EEO 1261), 601 E St. NW, Washington, DC 20049. Please request Fulfillment Number 016747.

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NOVEMBER 1998

ELDER UPDATE

THE HOT DOG GRANDMA When you need money, you get a job — even if you’re over 90 By Nick Sortal /Special to Elder Update POMPANO BEACH — Rose Resciniti has experienced most of the things a woman living 94 years would expect. She had a sturdy marriage, raised two children and fussed over six grandchildren, 14 great-grandchildren and four greatgreat-grandchildren. But this year has brought a description unknown to her first 93 years: full-time employee. Shoppers hungry for a quick bite stop by her hot dog stand inside a Pompano Beach Publix. With a noticeable quiver in her arms, she pulls out a Boar’s Head Finest, carefully applies a little mustard or onions, and pockets another dollar for the grocery chain. “Never in my life did I think I’d be doing something like this, but I love it,” says Rose, who works five days a week, 9 to 5. “God has been good to me.” She started working because she had to. Her husband of 67 years died Sept. 15, 1991. Cancer had finally eaten him away. Cancer had also taken their nest egg; her life savings amounted to $3,000. But as he was dying, her husband coached Rose about finances. He had always been the provider, running a truck company in New York. Rose had never worked a day in her life outside the home, or even written a check. “I knew I had to go get a job,” she says. “My mind was set. What I really like is that I earned it. I’ll work until God takes me.” She started at Publix in Sea Ranch Lakes six years ago, offering shoppers food samples. She couldn’t get more than three days a week, though, and moved on to the Publix on Atlantic Boulevard east of Federal Highway. “She has more energy than I do,” says store manager Gary Lanzafame. “She liked getting close to the customers, so we set her up and let her go for it.”

Ninety-four-year-old Rose Resciniti is a favorite of coworkers and customers.

Rose sells about 200 hot dogs a day. After her salary and the hot dog overhead, Publix breaks even. The stand is there as an incentive for those $100-a-trip shoppers choosing a grocery store. Until recently, Rose had to wake up at 4 a.m., take two buses from her apartment in Pompano Beach and walk two blocks to make it to work by 9. But now a Samaritan named Vinnie Calamita gives her rides. “I used to do the same thing for my mom and for my aunt,” says Vinnie, 71. He met her while buying a hot dog. “I do it because I admire what she’s doing at her age.” It’s difficult to say who likes the 5-foot-2, 87-pounder more: the customers or her fellow workers. The time clock is right above her hot dog stand, and she jokes with all the employees as they punch in. On June 29, she was called into the office. “I was wondering why, because I knew I hadn’t done anything wrong,” she says. When she opened the door, her co-workers yelled “Surprise!” There was a big cake (from the store’s bakery, of course), balloons and “more flowers than I’d ever seen” for turning 94. As for shoppers, she is the perpetual grandma.

“One day they had someone else working there, and my 9-yearold wouldn’t get a hot dog,” a woman said on a recent Saturday. “She said she’d only buy one from Miss Rose.” This day, mother and daughter left with two hot dogs each. Rose visits her sister, who’s in a nursing home with Alzheimer’s, on her days off. Two grandsons also work for Publix. One is a district manager

in Lake Worth and another is a delivery driver. “She needed to do something after her husband died, and I suggested Publix,” says Bob, the district manager, who fondly remembers Sundays visiting grandma for homemade ravioli and Italian pastries. “From there she did it all on her own. That’s the way she is.” And she has learned how to handle the $300 or so a week she earns. The bills come in one day and her payment goes out the next. She saves money on clothes by making her own, and her rent will go down next month when she moves into a smaller apartment. The Social Security rule helps, too. People over 70 who work get to keep their full Social Security benefits. Rose likes that rule. “Now, if I just didn’t have to pay income tax,” she says. “I work hard for my money.” This story was reprinted with the permission of the Sun-Sentinel of Fort Lauderdale.

NOVEMBER, 1998

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