Earlier this year I was fortunate to be able to attend the 27th annual conference of the National Association of Professional Geriatric Care Managers (NAPGCM), along with our Director of Care Management, Susy Murphy. This year the meeting took place in the vibrant, revitalized city of New Orleans. The choice of this location was particularly poignant since our association had planned a conference in New Orleans in 2005, just two weeks after Hurricane Katrina. Of course that meeting had to be postponed, and as an organization we mobilized to assist our members in New Orleans. It was wonderful to be able to return to New Orleans and see the city alive with visitors, food, and music.

I have been an active member of NAPGCM for over twenty years, having served in various roles on the national board and committees. When I attended my first conference in 1989, there were 200 members; and now we have over 2000. I always leave the conference feeling full of ideas and inspiration. This year's conference was especially rewarding for me, as I was the recipient of NAPGCM's annual Adele Elkind award.   

Debra receiving the Adele Elkind award from prior award winner Mary Lynn Pannen

Named after one of our organization's founders and visionaries, this honor is given to one member each year who has been selected by a group of peers for extraordinary contributions "of service and commitment to the profession of geriatric care management and to NAPGCM." The recipient's name is kept secret until it is announced with great fanfare at the conference. I was surprised and thrilled to be chosen.   

Over the years I have grown increasingly committed to NAPGCM as the source of quality assurance and community education about geriatric care management. I have always enjoyed my work on the Board and on committees, and find my fellow members to be smart, creative, energetic, and generous professionals. It is a true pleasure to work with them to benefit the field of care management and the clients we serve.

One highlight of this year's conference was a gripping presentation by Dr. Richard Deichmann, Chief of Medicine at Memorial Hospital (New Orleans), about his hospital's experience responding to Hurricane Katrina. This included his own heart-wrenching decision to separate from his wife and children in order to help lead the perilous evacuation of the hospital patients. In addition to his insider account and photographs, Dr. Deichmann discussed lessons learned and the importance of preparing for emergencies. I have returned from this year's conference with renewed resolve to help our clients and families prepare, as best we can, for any emergency situations that might affect our area.

NAPGCM is also becoming increasingly active at the regional level, holding local conferences and supporting community activities related to eldercare. In addition to the recent national conference in New Orleans, I was pleased to attend the 2011 MidAtlantic Geriatric Care Managers' conference in Philadelphia this past month. This meeting featured several outstanding speakers, including presentations on Alzheimer's Disease research trends, dementia care strategies, and bridging cultural differences in working with caregivers from other countries. It was wonderful to get together with my local care management colleagues from the DC/MD/VA area, as well as our chapter members from Pennsylvania and downstate Virginia.

My visit to the Louisiana conference reminded me of some very special memories from New Orleans before Katrina, when my father accompanied me there for a short vacation before a previous NAPGCM conference in 1997. My Dad had a great love of New Orleans, which he had last visited during WW II and shortly after. Dad had a prized collection of menus from his visits, and when we went to eat at Commander's Palace or Galatoire's, he would pull out the old menu and ask if he could "still get a shrimp cocktail for 29 cents?" This evoked great laughter and repartee, along with a few private tours of the famous kitchens. All we did on that vacation was eat and talk about where we were going to eat or where we had eaten. It was delightful. My father died four years after that trip, and I was so pleased to have shared those special memories with him.

I hope you enjoy this issue of our newsletter, and if you ever have a chance, go on down to New Orleans to enjoy that fine city!

Debra Levy 

EXTENDING HUMAN LIFE EXPECTANCY    

 As humans age, we accumulate damage to our cells, tissues, and organs.  Theoretically, the human lifespan can be extended in various ways: by reducing the rate of aging damage, replacing damaged tissues, and/or by working at the molecular level to repair or rejuvenate deteriorated cells.  Even if all this was achieved, however, individuals would still be susceptible to accidental or intentional death by trauma or infectious diseases.

Scientists agree that the goal is to slow aging and stave off age-related diseases rather than simply to extend life at its most infirm.  Various factors contribute to an individual's longevity including gender, genetics, diet and nutrition, hygiene, exercise, access to health care, and crime rates.  Average lifespan is lowered by child mortality, which is often linked to infectious diseases or nutritional deficiencies.  Mortality in later life is often increased by vulnerability to accidents and age-related chronic diseases such as cancer and heart disease.  Expected lifespan can be extended by good diet, exercise, and avoidance of hazardous behaviors such as smoking.   

Life expectancy has been increasing slightly each year as treatment strategies and technologies improve. Ironically, even though treatment of childhood diseases accounts for the greatest growth in life expectancy, by the year 2050, the world's population of persons aged 60 or above is expected to exceed the population of children under 14 for the first time in human history.  U.S. life expectancy increased from 77.4 years in 2002 to 78.2 years in 2010.  Recent increases in lifestyle-related diseases such as obesity, diabetes, hypertension, and heart disease may slow or reverse this trend in the developed world.

While some goals of increasing individual lifespans may seem fanciful, we should remember that technological advances over the past 100 years have far exceeded expectations. Robert Freitas of the Institute for Molecular Manufacturing, a non-profit nanotech group in California said that "There are many, many different components of aging and we are chipping away at all of them."  Future advances in nanomedicine may aid life extension through repair at the cellular level of many processes thought to be responsible for aging.  Already scientists are able to use patients' own cells to create and implant bio-engineered bladders to treat bladder diseases.

There are differing opinions of the value of some dietary supplements touted to be life-extending. Clinical studies have shown that beta-carotene supplements and high doses of Vitamin E actually increase mortality rates. There is not yet any scientific consensus supporting claims that any dietary supplements actually decrease mortality.

Until researchers have cured all disease, some bodies are being cryopreserved (frozen at sub-zero temperatures). Advocates of cryopreservation believe that human bodies can be stored just after death at extremely low temperatures to minimize tissue deterioration.  However, no mammal has yet been successfully cryopreserved and brought back to life.

Some raise moral or ethical objections to scientific attempts to extend life, opposing, for example, the use of human stem cells in life extension research. Opponents also state that life extension will increase the demand for Earth's limited natural resources and that retirement ages will need to be extended so that there will be sufficient people working to support retirees.

While efforts to extend human life remain an important part of scientific research, it is clear that the issue is complex both procedurally and intellectually. Those who provide services to seniors would generally agree that maintaining quality of life must be a crucial component of efforts to increase the quantity of years on earth.

GETTING TO KNOW SUSAN I. WRANIK   

President of GROWS  

Now we want to introduce you to Susan I. Wranik, who has stepped up to the plate to serve as the volunteer President of GROWS, Montgomery County's "Grass Roots Organization for the Well-being of Seniors." GROWS is a long-standing organization of professionals who serve area seniors.  Many of us have been attending its monthly meetings for over 25 years, and have watched this association evolve to become a large and very effective voice for Washington area seniors.

The President of GROWS is Susan I. Wranik, MS MA CCC-SLP, a Board Certified Speech-Language Pathologist with over 30 years of experience in the communication field, first as an interpreter and translator for the Italian Embassy and later as a professional speech pathologist. She brings a dynamic, energetic, and inclusive approach to the leadership of GROWS.

In her own words:

"Communication is my passion.  My goal for GROWS:  to make the organization a force with which to be reckoned.  When legislation or decisions regarding seniors come down the pike, I want to be a voice for them and mobilize them to speak for themselves.  This is why I am encouraging more seniors to become involved, why I want affiliate organizations to join forces, collaborate - not see each other as competitors, but as strategic allies, and why I emphasize the 4 association objectives:  ADVOCACY-EDUCATION-COMMUNITY OUTREACH-NETWORKING.  There's something for everyone: the larger the membership, the louder the voice and the greater the power." 

Susan also said that "Nothing riles me more than people saying "you can't do that" to which I reply:  'Just watch me!  I learned that from my parents growing up in the Midwest and reinforced it with the Italian Navy.  And THAT's what I want for GROWS, that "just watch me" spirit.

This spirit shows clearly whenever Susan, with her bright smile and convincing voice takes the podium at GROWS. Susan follows a long-standing tradition of dedicated professionals who have given their time and energy to serve as leaders of GROWS. We are grateful for all who have served in this role, and feel excited to participate as Susan brings her background as a linguist, translator, author, speaker, educator, and clinician to her position as GROWS President.  

 

Mr. B. was born in California, the older of two sons. His first five years of life were uneventful, however in his sixth year he contracted encephalitis which left him paralyzed on the left side, with rigid muscles and slurred speech. In subsequent years, his family relocated to the East Coast to seek treatment for his symptoms, but by and large the treatments did not alter the course of the disease.  

 

Nevertheless, Mr. B. completed his college education. He worked as a federal employee for 30 years and retired in 2001 due to his disability. Mr. B. became wheelchair dependent but traveled the United States and abroad, and for most of his adult life he lived independently in his home. The change in his physical function did not impact his desire to be part of his community. After retirement, he became a volunteer at the National Zoo, and remained active, dining out and interacting with his neighbors and friends.

 

At age 62, Mr. B. was referred to Debra Levy Eldercare Associates (DLEA) after being hospitalized for the third time in six months. The repeated hospitalizations, for recurrent respiratory infections, were in part caused by poor discharge follow-up. Mr. B.'s family contacted our geriatric care management practice because they were concerned about his deteriorating condition and ability to live independently in his own home. Prior to his hospitalizations, Mr. B. was living in his own condo with assistance from a home health aide.  

 

After a lengthy hospital stay, the family wanted help in ensuring a good discharge plan and support for Mr. B. The hospital recommended permanent nursing home placement, but, as the client wanted to return to his own home, the DLEA Care Manager (CM) identified a nursing facility with a strong rehabilitation program. Despite a discouraging prognosis, the Care Manager hoped that Mr. B would recover enough to leave the nursing home.

 

At the rehabilitation facility he continued to gain strength through participation in physical and occupational therapies. With advocacy by his CM, Mr. B "graduated" to a more rigorous rehabilitation program in an acute rehabilitation hospital. The CM obtained a custom fitted electronic chair to promote his independence. When his hospital rehab program was complete, the CM helped Mr. B find a supportive Assisted Living community for a short-term stay while he continued to regain more function, and hopefully would return to his condo. A senior community was identified that was close to Mr. B's home and which offered excellent social and recreational programs, as well as access to a neighborhood community center, shops, and restaurants. Fortunately, the community agreed to allow Mr. B's two cherished cats to live with him.

Mr. B has resided in his new community for almost a year now and has decided, on his own, to sell his condo. He considers his new community "home." The CM, in collaboration with the community staff, helped Mr. B take on a leadership role as head of their Men's Club. He participates in many community activities, and is well known for his intelligence, his positive attitude, and his care for his fellow residents.  

Recently, Mr. B. experienced a minor health issue. With the support of his CM he navigated well through the hospitalization and a short-term nursing home stay, and ultimately made his way "home" again. Today, he is happily choosing furniture for his apartment, tending to his cats and being active in as many social activities as he can fit into his schedule. His CM visits regularly to assist with doctors' appointments and to provide oversight of his care. We feel very pleased to have been able to help this determined gentleman, despite his disability, to stay independent, and maintain his quality of life. There's nothing a care manager likes more than to share in a client's well-earned success story!