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The way we access healthcare in the United States is changing rapidly. For seniors, their families, and medical providers, these changes can be challenging to understand. On Wednesday, June 18th, the Los Angeles Jewish Home hosted a training session to help geriatric social workers and nursing home administrators gain insight into California's Coordinated Care Initiative, or CCI. The initiative is being implemented across the state to integrate medical, behavioral and long-term care services for individuals who receive both Medicare and Medi-Cal, known as dual eligibles, and those with Medi-Cal only. The training session was opened by the Jewish Home's CEO-President Molly Forrest, who welcomed the attendees and spoke briefly about the Home and the impact of healthcare reform on seniors. Denny Chan, staff attorney for the National Senior Citizens Law Center, provided an overview of CCI. He reviewed the major changes brought about by the initiative, with the major difference being the integration of Medicare and Medi-Cal benefits into one managed care plan. "Most dual eligibles will have the option to join Cal MediConnect, which currently is offered through five managed care plans in Los Angeles County," he explained. When a person with dual eligibility receives notification that they must make a choice, they have three options: Opt-in (choose a Cal MediConnect plan)Opt-out (choose an alternative, such as a PACE program)Do nothing, which means the individual will be passively enrolled into a Cal MediConnect plan as chosen by the State. PACE, one of the alternatives to Cal MediConnect, is currently available at the Jewish Home's Grancell Village Campus. The Brandman Centers for Senior Care (BCSC) is a Program of All-inclusive Care for the Elderly, or PACE. The program offers adult day healthcare, including medical care, activities, physical therapy, meals, transportation and other personal services to seniors who are eligible for admission to a nursing home but have elected to remain safely in their own homes. Mari Abrams, director of marketing for BCSC, spoke about PACE and the benefits of participation.The training session came to an end with a lively question and answer session. What could be a difficult and dry subject was made understandable and even enjoyable by the speakers and their presentations.For more information about the Brandman Centers for Senior Care, please visit their website at www.brandmanseniorcare.org.

The Los Angeles Jewish Home’s annual Volunteer Recognition Luncheon was held on May 27th and May 28th on both Eisenberg and Grancell Village Campuses. Attendees enjoyed a delightful lunch catered by our very own dietary department as well as an exciting performance by entertainment extraordinaires Wendy and Rik. The dazzling duo performed classic songs from the Beatles, Barbara Streisand, Frank Sinatra, Carole King, Sonny and Cher, and Neil Diamond.Over 350 community and resident volunteers were honored for their contributions to the Jewish Home community. One volunteer in particular was honored for her extraordinary dedication to giving back to the Home and its residents. The special honoree, Susan Fien, was presented with the Howard Kayton Memorial Volunteer Service Award. The beautiful crystal statuette featured the Jewish Home logo and a quote from Sukkah 496: “The whole value of a good deed lies in the kindness that inspires it.” Many members of the Home’s administration were present. CEO-President Molly Forrest, chief operating officer Larissa Stepanians, senior vice president Ira Schreck, EV administrator Douglas Tucker, JEKMC administrator Ilana Grossman, and Taper administrator Kathleen Kennings-Glass were just a few of the staff members who gave thanks.Expressing appreciation for the volunteers, Molly Forrest noted “When I hear you have collectively completed more than 50,000 hours of volunteering, it must have been a miracle. You all are definitely following the 5th commandment of honoring thy father and mother.”Similarly, RCFE activities director Caryl Geiger offered an earnest thank you. “Our community is run so smoothly because of you. From the bottom of my heart, I thank you for all that you do.”Administrator Ashley Teal commented on the importance of volunteers at the Home. “From the time spent showing movies daily, to the hours of manning the Nosh Box, you’re making a giant contribution to the Home. The small ways you give back to your community are actually the pillars that make it work. We couldn’t do it without you!”The Home’s beloved Rabbi Elman then described his admiration for the volunteers. “Because I’m going to be retiring this year, a lot of people have been asking me what I plan on doing when I retire. The answer I give them is: ‘I don’t know.’ But there really is one thing I do know. I look around at this room and take each and every one of you as inspiration. Instead of living a lazy life, you stand on your feet and live a life of giving. You make the Home a better place. So I know that when I retire I will do my best to be like all of you. Thank you for all that you do and as the old saying goes, ‘Give and you will receive.’”Please click here to view photos from the 2014 Volunteer Recognition Luncheon.For more information on volunteer opportunities at the Jewish Home, please contact director of volunteer services Stacy Orbach at (818) 757-4442 or [email protected], or visit our website at http://www.lajh.org/volunteer/.

For years it's been recommended that everyone 65 and over get the one-time "pneumonia" shot (Pneumovax, or PPSV23). Pneumovax helps to prevent invasive, and deadly, complications of pneumococcal pneumonia, the most common kind of pneumonia. Unfortunately, it didn't have much benefit in preventing pneumococcal pneumonia itself. However, a new vaccine called Prevnar 13 (PCV13) does significantly prevent pneumococcal pneumonia. This should greatly reduce pneumonia in the senior population.The current recommendation is that everyone over 65 receive two pneumococcal vaccinations. First, at 65 or older, Prevnar 13, followed in 6-12 months by Pneumovax. If the person has already had Pneumovax after the age of 65, they should just get Prevnar 13 (at least a year after the Pneumovax). If the person had Pneumovax before 65, they should wait several years, then get Prevnar 13 followed by a second Pneumovax (but making sure the second Pneumovax is at least five years after the first Pneumovax and one year after the Prevnar 13).This means that everyone over 65-70 should have at least two pneumococcal vaccinations and maybe three, depending on their age when they received the first Pneumovax. This is complicated but should result in a substantial health benefit. Seniors should expect their primary care doctor to be order these vaccinations for them. If you have any questions, do not hesitate to ask your doctor.The other vaccinations everyone should have are Zostavax (shingles shot) one-time (but not if you have problems with your immune system), and tetanus every 10 years, with one of these being Tdap — tetanus, diphtheria, pertussis. And, of course, influenza vaccinations every year are a must.Remember, an ounce of prevention is worth a pound of cure, and vaccinations are one of the best forms of prevention.

For the Jewish Home, helping to maintain employee health and wellness is a priority. This encompasses wellness of the body, mind, and spirit. Urban Zen, a program recently added to the many healthy activities offered by the Home for employees, is quickly gaining popularity.Urban Zen was created by visionary designer Donna Karan. As her husband, Stephen, battled lung cancer, he was very aware that his caregivers — doctors, nurses, other medical staff, and family members — seemed to be even more stressed than he was. He asked Donna to do something for caregivers. "The hope was that, by helping caregivers, it would create a ripple effect that would benefit patients as well," explains Susan Jefferson, a certified Urban Zen therapist at YogaWorks and facilitator of sessions at the Jewish Home. "Seeing your caregiver crumble can create a great deal of stress in someone who is ill."Stephen's request led to the conceptualization of Urban Zen, a holistic healthcare practice created to give people another option for treating pain, anxiety, nausea, insomnia, constipation, and exhaustion. This practice combines five techniques — yoga, Reiki, essential oils, nutrition and contemplative care, such as meditation — and is often used as a supplement to conventional care. Urban Zen uses movement, reflection, visualization, and sensory stimulation as tools to help participants achieve a state of Zen, or calmness.Urban Zen incorporates some of the basics of yoga, in particular focus on breath and use of restorative movements. "As we begin each session, we evaluate three main components: the levels of pain, anxiety, and insomnia the employees may be dealing with at that time," says Susan. Based on need, essential oils are recommended to help alleviate those problems, followed by some gentle movements and a body scan, which helps you to become more mindful of your body and how it feels.The benefits of Urban Zen can be experienced at any age. "Everyone's body, whether young or old, recuperates and restores better when there is balance between the body, mind, and spirit," Susan explains. "Healthcare workers put the concerns of others first, often without taking time to focus on their own needs." Urban Zen can provide the time, space, and tools to slow down and look inside.Sharon Ginchansky, vice president of human resources, explains why it was important to bring Urban Zen to the Home's employees: "We want to help our employees be healthy and happy. A big part of promoting employee wellness is lessening their stress levels, and Urban Zen is an excellent way to do this." She adds, "Taking a few minutes out of our day to focus on our own well-being can help us recommit to the work at hand and bring a sense of inner peace. Urban Zen is a great de-stressing practice because it can be as simple as inhaling fragrant oil or focusing on breathing."Through ongoing research surveys, people who participate in Urban Zen classes report greater relaxation, a renewed sense of peace and calm, reduction of aches and pains, clearer thinking, and better sleep and digestion. "The best part is you can take what you learn in a session and use the techniques on your own to help prevent symptoms from recurring," says Susan."Urban Zen provides a wonderful break from my work stressors," says Debbie Fishel, a regular member of the Grancell Village employee group. "The relaxation techniques I've learned help get me through the rest of the week." Dr. Rick Smith notes that sometimes it's difficult to make time to attend, "but I'm always glad I did."

World Allergy Week is an annual initiative of the World Allergy Organization (WAO). This year, World Allergy Week falls on April 4th-April 10th. During this week, WAO partners with its member societies to raise awareness of allergic disease and related disorders. WAO also advocates for the provision of training and resources in the diagnosis, management, and prevention of these diseases and asthma, which are rising in prevalence around the world. While allergies affect people of all ages, they can have a large impact on the lives and health of seniors. Allergy symptoms, such as a congested nose, an irritated throat, and a dry mouth can be extremely dangerous to a senior who has pre-existing cardiovascular or lung problems. Pollens can also aggravate existing medical conditions such as heart disease and COPD. That is why allergies in the elderly should be treated as rapidly and aggressively as possible Seniors with pollen allergy need to be particularly careful using over the counter or prescription medications for their symptoms. The anti-histamines that help minimize the effects of allergies are not recommended for a lot of seniors. That is because they can interact with other medications and increase blood pressure. In addition, the sedating quality of anti-histamines increase a senior’s risk of falling, and could cause a dangerous condition where the person cannot urinate. Other side effects include confusion, drowsiness, dry mouth and eyes, and dizziness. Rather than prescribing antihistamines for the seniors suffering from seasonal allergies, a doctor will often prescribe a nasal steroid or some form of topical medication. The following are some simple tips for you to consider: Use the air conditioner. Keeping the windows closed helps to prevent pollens and molds from entering the house.Don’t hang clothing or linens outside to dry. Instead, use the clothes dryer or hang them indoors to dry.Keep an eye on pollen levels and plan outings for days when pollen counts are projected to be the lowest. There are several free services that will also alert you when pollen counts reach high levels. They include The Weather Channel, The American Academy of Allergy Asthma and Immunology, and Pollen.com.Wear sunglasses when you are outside. That can prevent pollen and other seasonal irritants from getting in to your eyes. A hat also helps prevent it from getting in to your hair and working its way on to your hands and clothing.Wash your hands after being outdoors. And make sure to shower as soon as you come in from working or spending any significant amount of time outside. Throw the clothes you were wearing in to the laundry. That can help prevent pollen from being spread around your house.Many nutritionists believe that foods that help fight inflammation can help relieve some of the symptoms of allergies. Those include apples, walnuts, flax seed, ginger, leafy green vegetables and foods rich in vitamin C. However, as mentioned previously some people are allergic to these foods. It is important to realize seniors often have multiple chronic health problems, and it can be hard for a doctor to separate a potential allergy from their ongoing diseases. A caregiver or family member who suspects that their elderly loved one may have allergies should bring their concerns to their loved one's doctor, and suggest to the doctor allergy testing or treatment. Dr. Noah MarcoJewish Home Chief Medical Officer

Skirball Hospice, a program of the Los Angeles Jewish Home, provides compassionate end-of-life care, enabling individuals and families to overcome fear and discomfort, to cope with loss, and embrace the experience and value of each and every day of life. Hospice care recognizes the needs of patients who choose to remain where they live, outside of the hospital, so they can be surrounded by loved ones when hospitalization is no longer expected to cure their illness. Skirball Hospice provides the support that allows someone to spend the last stages of life in a loving environment, comforted by friends and family, and free from discomfort. While the use of hospice services has increased over the years, many people are still uncertain about the type of services available through a hospice program and when end-of-life care can be accessed. Some people are still unaware that hospice care exists. Lack of knowledge and understanding about hospice programs may lead individuals and family members to make less than optimal decisions at a very important time. Let’s take this opportunity to dispel some of the most prevalent myths about hospice, according to the National Hospice and Palliative Care Organization: MYTH: Hospice is where you go when there is nothing more a doctor can do.FACT: Hospice is care designed for patients with a life-limiting illness. Hospice is not where you go to die; hospice professionals are trained to assist patients in living their lives fully, completely, and without pain until the end of their lives. MYTH: To be eligible for hospice, I have to be in the final stages of dying.FACT: Hospice patients and families receive care for an unlimited amount of time, depending upon the course of the illness. There is no fixed limit on the amount of time a patient may continue to receive hospice services. MYTH: Quality care at the end of life is very expensive.FACT: Medicare beneficiaries pay little or nothing for hospice. For those not eligible for Medicare, most insurance plans, HMOs, and managed care plans cover hospice care. MYTH: If I choose hospice care, I have to leave my home.FACT: Hospice care is provided wherever the patient may be: in their own home or the home of a family member, a nursing home, or an assisted living facility. Hospice is also provided in in-patient units, VA hospitals, and some correctional facilities. MYTH: Families are not able to care for people with life limiting illnesses.FACT: Family members are encouraged, supported, and trained by hospice professionals to care for their loved ones. Hospice staff is on call to patients and their families 24 hours a day, 7 days a week, to help family and friends care for their loved ones. MYTH: Hospice care is only for cancer or AIDS patients.FACT: Fifty percent of hospice patients are diagnosed with conditions other than cancer or AIDS. MYTH: Hospice is just for the elderly.FACT: Hospice is for anyone facing a life-limiting illness, regardless of age. MYTH: There’s no hospice in my area.FACT: Less than one percent of Medicare beneficiaries live in an area where hospice is not available. MYTH: After the patient’s death, hospice care ends.FACT: Bereavement services and grief support are available to family members for up to one year after the death of a patient. At Skirball Hospice, this support is available for thirteen months. The Jewish Home’s Skirball Hospice is the only Jewish sponsored hospice in the Greater Los Angeles area. Skirball Hospice supports and assists families and caregivers with compassion and expertise with an integrated team, including physicians, nurses, rabbis, medical social workers, registered dietitians, and certified home health aides. Individuals and families have the option to specifically request Skirball Hospice for end-of-life care. For more information, please contact Skirball Hospice at (877) 774-3040 or www.skirballhospice.org.

What is Home Health? Jewish Home Care Services – a home health program of the Los Angeles Jewish Home – is a full suite of doctor-prescribed restorative services completed in the individual’s home. Medical care, social services, and more are provided according to a personalized plan of care jointly developed by the referring physician, the person receiving care, the caregiver, and others. What services does Home Health provide? Skilled nursingPhysical, occupational, and speech rehabilitation therapiesMedication infusionPain managementWound careVaccinationHome safety assistanceBathingDressingGroomingEatingExercising Who needs Home Health? Adults over 19 years of age in the Greater Los Angeles area.Adults who have health problems and need careful monitoring and the support of medical professionals in the comfort of their own home.Adults who can learn how to better manage and monitor their conditions, preventing future hospitalizations.Adults who will benefit from therapy services to improve their strength and overall health so they can safely navigate their environment.Patients who are returning home after surgery and need care, training, or assistance with health conditions, medications, and therapy.Patients who have complex treatments that require the use of medical equipment and/or medication monitoring.Patients who are recovering from accidents or injuries, and whose caregiver could manage their care when educated by a professional home health staff.Patients and caregivers who want peace of mind knowing that an experienced healthcare worker will be there when needed.Patients who are under the care of a physician who determines the medical necessity of the care and the provision of service by a skilled nurse and/or therapist.Millions of Americans with acute, chronic, or exacerbated diseases, conditions, and disabilities, such as Alzheimer's disease, heart disease, heart failure, stroke, kidney disease, respiratory disease and lung conditions, diabetes, or musculoskeletal conditions, such as arthritis. How can I get Home Health care? For more information about Jewish Home Care Services, please contact Karine Keshishyan, Home Health Administrator, 818.655.0411, or [email protected].

While the media is known for portraying sex as something meant for only the young and beautiful, more and more seniors are finding a gratifying sex life is attainable and enjoyable at any age. Seniors who frequently engage in sexual activity enjoy the benefits of boosted immunity, lower blood pressure, pain relief, and better sleep. Through these intimate encounters seniors strengthen the physical and emotional connection with another person, combating feelings of isolation, depression, and loneliness. Sex can also enhance one’s mood, self-confidence, and overall health. Seniors who engage in sexual activity regularly tend to be happier, healthier, and more satisfied with life For many, sex gets better with age and experience. In the latter years of life, we tend to become more patient and attentive to our partner’s needs. Additionally, by this stage in life most people have learned what brings them the most pleasure, and are more inclined to share this information with their partners. Another great benefit of having intercourse after menopause is that there is no need to worry about an unwanted pregnancy; however, sexually transmitted diseases (STDs) pose a risk to all who engage in sexual activity, no matter their age. The Centers for Disease Control reports only 6% of adults over the age of 61 use condoms in sexual encounters. STDs are often left undiagnosed in aging adults and can complicate pre-existing medical conditions. In order to prevent the spread of these dangerous diseases, seniors should always practice safe sex. While sex can be pleasurable and beneficial at any age, seniors may experience many physical changes and medical issues that make it more difficult. Changing hormone levels, illness, chronic pain, and disability can greatly affect a senior’s satisfaction and performance in the bedroom. Additionally, drugs, alcohol, and some prescribed medications can lead to sexual problems such as decreased libido, erectile issues, and delayed orgasms. Feelings of depression, anxiety, stress, and insecurity may also affect one’s ability to perform sexually. "Seniors should feel comfortable discussing their sex life with their healthcare providers." says Dr. Noah Marco, chief medical officer of the Jewish Home. "Senior sex is natural and healthy, and most doctors are comfortable and experienced with helping their patients maintain an active sex life. Clinicians can diagnose and treat STDs with simple exams and tests. Doctors can also suggest ways to improve one’s sexual experience, and prevent sex-related injuries and accidents. Because of physical changes caused by aging and some diseases, seniors (both men and women) will often need to be prescribed medication in order to have intercourse. Remember, your healthcare provider’s goal is to help you maintain all the things that you enjoy doing so don’t be hesitant if one of the things that you need help with is your sex life."

When most of us hear the words "vaccination" or "immunization" we automatically think: oh, that's for kids. It's true: young children receive several vaccinations as they grow up and prepare to attend school, including measles, mumps, chickenpox, polio, tetanus, diphtheria, and pertussis, or whooping cough. Influenza, or flu, shots are administered yearly beginning as young as six months. The bad news is…getting older doesn't mean you no longer need those shots! Throughout our lives we can be susceptible to catching many diseases just by coming into physical contact with someone who is ill or breathing air that is carrying germs from a sneeze or cough. We all know the importance of sneezing into a tissue or the crook of our arm when we have a cold and washing our hands frequently — all the time. These simple actions can help prevent transmission of illness from person to person. For some diseases, however, an immunization is necessary to help keep you healthy. As we get older, our age, job, lifestyle, travel, or health conditions can put us at risk for acquiring vaccine-preventable diseases. According to the Centers for Disease Control (CDC), here are the immunizations adults should receive to help prevent them from getting and spreading serious diseases that could result in poor health, missed work, medical bills, and not being able to care for family: seasonal flu (influenza) — All adults need this vaccine every year. It's especially important for people with chronic health conditions, pregnant women, and older adults.pneumococcal — There are two types of vaccines that are necessary to help fight pneumonia and its complications in seniors. The first is Pneumovax, which is given once. The second is Prevnar 13, which is also a one-time vaccine and should be given one year after receiving Pneumovax or vice versa. Tdap (whooping cough) and Td (tetanus and diphtheria) — Every adult should get a Tdap shot once if they did not receive it as an adolescent. All adults need a Td booster shot every 10 years. Herpes zoster — Zostavax is a one-time vaccination; however, since it contains a live Virus, some people should not take it. Be sure to check with your doctor to see if you are up to date on your immunizations and make a plan to follow up yearly. Regular visits can help insure you and your doctor are doing your most to protect your health…and you can improve your chances of living a healthy life at any age.

September is Healthy Aging Month. Here are 6 things you can do to maintain your health as you age. 1. Keep movingWant to maintain a healthy body and mind? Exercise! Doctors recommend you get at least two and a half hours of exercise a week. Belong to a gym? Go! How about a daily brisk walk with a friend or family—or the family pet—which bolsters both your heart and lungs? Practice yoga or tai chi to improve balance and help prevent falls. Dance or do yardwork. The point is, keep moving. 2. Eat rightRemember what your parents told you: eat lots of fruits and veggies. Beans and other high-fiber foods are excellent for digestive and heart health. Feeling lethargic? Eat iron-rich foods such as spinach, beans, dried fruit, and meats. Want a snack? Stay away from processed sugar foods. Try nuts, dried fruit or trail mix. And remember, September is still harvest season, so check out your local farmers market. 3. Get your sleepLike they say, sleep is the best medicine. If you have trouble sleeping, talk to a sleep specialist. And take cat naps. Healthy Aging® magazine reports people who take naps are 37% less likely to die from heart disease. 4. Be socialThere's a link between having active social ties and living a longer life. Spend time with family. See old friends and make new ones. Surround yourself with positive people who make you happy. Continue your old hobbies and find new ones you can do with your friends or alone. 5. Keep learningIt's never too late to learn something new! Learn how to paint, sculpt, or play a musical instrument. Take history or computer classes. Study archeology or architecture. Learn whatever interests you. Remember, when you learn, you grow. 6. Spend wiselyCreate a budget. It's important to know where your money is going. And reducing your expenses can help reduce stress in your life. Plus, the money you save can go toward activities you enjoy: traveling, hobbies, sports…whatever makes you happy and keeps you moving. Celebrate Healthy Aging Month this month… and every month!