Event ID: 1487887
Event Started: 1/21/2010 2:51:00 PM ET
Please stand by for realtime captions.

Good afternoon everybody. Who do I have on the call?

Jane from Iowa.

This is Lisa and Nancy and her brick.

And Sandy and Debbie from my out -- Wyoming.


Roger from Texas.

Carol Williams from North Carolina.

Julia Beam from Colorado.

Can you say your first name?


Thank you.

Anchorage Alaska.


Paddy black and Sheila Simmons from Kansas.

Amy from Michigan.

Bonnie from Memphis Tennessee.

Who else?

Susie Miller from Nebraska.

Amy Peterson from Illinois.

Great. Thank you so much.

Kathy Adams from Maine.

Can't Wiseman from North Dakota. -- Kent.

Memphis Tennessee.

Suzy Stewart from Louisiana.

Mary Alice from South Carolina.

Eric from Illinois.

Carole Rossick says: Carole Rossick from Massachusetts is logged onto the conference

Dennis Welton says: Dennis Welton and Jennifer Cunningham from Jackson, Tennessee

Carole Rossick says: Carole Rossick from Massachusetts is logged onto the conference captioned

Brandie Stevens from Lincoln Nebraska.

Lisa, it is Carla.

Hello Carla.

Rick, this is Brian from RSA.

Hello Lisa.

Or whoever set high.

It is Lisa.

I am not sure if I can be heard. It is a little Bonnie.

Jan from Oregon.

Hello Jan.

Rob Oliver from disability rights the network in Pennsylvania.

Hello Rob.

We will just wait another few seconds before we get started.

This is Rob with RSA.

This is Nancy. There seems to be a lot of extra chapter on the line. If you want to meet your line, it is a star six and if you have questions, it is pound six.

This is Pat Casey from Laramie Wyoming.

Did you hear me?


Thank you.

I think we are going to go ahead and get started I'm going to step away for a few seconds so I can start the recording and we will get started.

Good afternoon everyone and thank you for joining us for today's call titled keeping seniors in their home. Today we have a panel of four speakers that will share information on what their state have been doing in this area. We have from the Michigan disability rights coalition, Amy Sterk and Jane K. from the Iowa program in assisted technologies and from Wyoming we have Sandy and from the wind assisted technology resources along with depth of running from the Wyoming geriatric education Center.

Carole Rossick says: folks, please say your name before making your comment or asking your question - i am following this on the conference captioning site and reading what transpires thanks

And a reminder I sent out yesterday, you guys saw a link for the hand out. Hopefully you'll have those available, if not, the link is a reminder e-mail that I sent out yesterday. As well, just a reminder to everyone, to meet your line, press star six and two as needed, -- unmute, count six. To start off, we are going to have Jane give us information on some of the work she has done with the state of Parkinson's Association in providing training at a local level to support groups about assistive technology, specific to Parkinson's and how they worked on a DVD and it is now available through the website as well as another training program they have for training contractors and remodelers a universal design has been made available to community colleges on trade programs as well as work they have been doing with AARP so I'm going to head it off today.

Good morning from a cold and icy Iowa. Basically, if you remember I jumped on senior issues a little bit before everybody else or before it was cool, as the saying goes. I want to really quickly share five programs with you. The first is universal design and has a booklet. That was provided in the hand out e-mail, or PDF and you are welcome to use on your website. We originally printed that booklet. We provided over 50,000 of them across the state and now, we can't afford to reprint them so just make it available online and use it as a resource and a large number of our training, both consumers are very happy with it and we have a large contingent of contractors that like to use it, which is one way it is designed, to go room by room to someone thinking about remodeling or building a new home, to think about what they can do a different cost breakpoints. It was the lead interactivity we did about five or eight years ago now but on Mother's Day, we had an insert, eight page insert into our one big Sunday newspaper, we basically have to in our state and it was featured later in the week -- as a secondary insert. It continues to be a focal point of a lot of our activity to get people to think about that. That is the UD booklet. And secondly, let's talk about, start talking about how we are addressing things and the program for assistive technology cannot be the only water bearer on these projects. We started negotiating and working with collaborating, with different types of partners or cooperating, depending on how much we were together. Over the last are, we worked with the stay Parkinson's Association and provided local level training to the support groups about assistive technology to help develop the content that they wanted and presented it. This was so popular that the state association wanted to work with us on a DVD that they can hand out and provide the information by the website. That is being developed right now, except unfortunately, today was going to be a major filming day and all of our consumers who volunteered to do it, are not able to travel. To the filming site and the film crews are not able to get to the houses they are supposed to film from. That is available, we will either. At this point, the stay Parkinson's group is so excited about this that they want to run up the flagpole of national and have national use it as a dissemination. It is topic specific to Parkinson's. It is using them to help develop the content, what they are interested in and actually the vast majority of it is they are dying paying for it. We're just paying for the technical assistance being provided in the development of in the content of the assistive technology part of it. It has been a great example of nurturing of a collaboration, doing some awareness and training act committee and they are taking the lead to pay the dime and the time to get the information out and those of you who heard me, and national meetings know that is a main goal of Iowa, we can't pay for everything and we can't be the only people putting the message out there the next similar type of program we are working with an Iowa AARP, the Johnson County is one of the AARP livable community projects so we are working extensively in that County and subcommittees to provide technical assistance awareness and training and working with them to have assistive technology inserted into their main topical community activities. This is going to give us material information that we can share across the state, once it is developed. Again, we are providing the technical assistance in the direction that they are the group carrying a heavy load of water.

The first one is the housing committee which I've actually been on for about three years now. One of our success is that I can actually do a code change in my report next year, is that they got the visibility goes accepted by the lead town in Johnson County. At the last meeting last week, the code people from the three other communities said they would be following said as their coats came up for review. And related to that is all the training and awareness that goes along with the contractors. Last year we got the home builders Association to sponsor, basically three universal design homes in the Parade of homes with all kinds of awareness materials and that was rather interesting because when I stood up or set up and volunteered and raise my hand, I said I will help do this and was almost kind of dreading it because of the amount of work it was going to take, he home builders Association of two of the home builders basically said no, Jane, we will do it. It is our job to do it. You have given us the material and information and we will do it. So that is really great.

The home show, same type of thing, there was a model they are in teaching and training on it. So here is her organization again, but it has taken me years to develop that collaboration so they own it, it is their project had they are doing it with technical assistance. Another of the Johnson County livable communities is a fall prevention. We started working on those types of topics. They are doing all kinds of fall prevention. How modification in a tea is one thread a bit but I'm having that opportunity to get into some display they are doing, electronic information, and feature article in the newspaper. Transportation, again, by working for Johnson County, it has given me the entr&é;e into our state car that program where there are a doing one-on-one assessments of people. Probably more what we would call a demonstration level where they are helping people in their own cars, look at the assistive technology that will keep them safe drivers.

BSafe driver AARP education program are kind of tied together but again, by offering some technical assistance of the carpet program and others additions, they are doing what we call demonstrations and awareness activities and I'll have to do that anymore. Actually today we just talked about doing a local cable TV training program on that which then becomes available all the time. This is just another community and state-level program that allows me to get a lot of information out without having to be all of my time and energy. The next thing I would like to talk about is the Iowa contractors network. This is a project that we have been working on for over 10 years in Iowa. We provide her own training for Iowa contractors. We do not certify them, per se, and offer a certificate of completion. And help them learn how to market, help them market themselves and things like that.

We work closely with the Iowa home builders Association on the but Iowa decided to set up our own contractor training because most of our remodelers in Iowa and a large number of our contractors do not belong to the national home builders Association, they are too expensive and they don't get their money out, in their opinion, they are words not mine. So they are not eligible to take the certified aging in place a specialist program are the caps program although we have helped make that available at least annually, if not twice a year in our state, it is just a majority of the people who do the work can't get, aren't eligible to take the training. We have been doing that in our trainer also does that in the community college home trades program. All of the trade program an Iowa are building, universal design homes or visible homes at least and are using those were awareness activities. Our next step is, right now we are in the midst of converting that training to five online modules. Through a public health initiative, we are working with public health. And living well with the disability project to do that. There'll be five online modules when that is done. Yesterday I would have had to say for but we figured it had to figure out the money for all five of them late yesterday afternoon. There is an overview and general home universal design and accessibility. And implications for home design. Ramps, bathrooms, and workplace.

We hope to be other ones and follow up on that the right now we decided to go and try and online, we know there are limitations in dealing with the tradespeople on this. But we can't afford necessarily to keep doing in-person trainings on this, even will partner with the community college trade programs to help sponsor it, we are reaching to view is too much work. We are going to try the online and see what happens and we had input from contractors on this, we are trying to make it very, even though it is online, we are trying to make a contractor family and realizing these contractors may not have been real academic to start with. So it is a trial under a funded project to see if that will happen. Windows are available, anybody across the nation can take those, including family were consumers, any type of service provider besides the contractors. When that is available, I will let you know, it is just not ready. The final thing I want to talk about real quickly before I pass it along to Amy, these small changes big difference project.

I should mention that the Iowa contractor trainer is working with the Wisconsin Tech and she can go there and do some training also so they just started kind of looking at her work up there to greet small changes, big difference.

I started this way back when. What I think we were still the original with three years of funding. And many of you have replicated that project. It was originally started as a way to do a awareness activities across the state to consumers. To get the information, the research-based information down to the consumer and the people that really helped the elderly stay in her own home. They don't go to the rehab Association meetings, big don't go to the research-based tom modification meetings, that is not worthy service providers govern area agencies on aging. This is a project we started many years ago and has been replicated in many other states. But I am not that active in small changes anymore. I know not all of our agencies have continued to do it, but more than half of them still do it in some shape and form of awareness activities. Michigan is much more active in it right now. I'm going to pass off to Amy for Michigan right now. To let her talk about small changes, big differences.

Thank you. We are very happy to one of the state that has taken Iowa's lead and back in the original act, we started small changes big differences after hearing about it from Iowa and now we have a new and revised program but we are sharing. We have kids at locations around the state. With low cost 80 for community living and Lisa has posted our presentation for all of you to take and use it as you would like to present the information. All of the devices and the kids cost less than $100. We also present research that shows that interventions increase functional independence, decreased hospitalization, decreased nursing home stays and prevent falls. The workshops are really interactive. We have gotten the most positive feedback and evaluations of any training we have ever given. With the workshops. We are training nurses and social workers were care managers with waiver agents and area agencies on aging around the state and we also do training for seniors, nursing home residents and staff. The devices cover key categories cooking, baking and dressing, memory, mobility, recreation, environmental control. When we go out and present with small changes big differences we also provide our exchange user program and alternative financing programs and those kids are then used for demonstrations and they promote their demonstrations using the kit. When we are doing demonstrations using the long-term small changes big differences small kid, we work with centers for Independent living around the state. We are part of a process that acquired funding for Center for Independent living staff to help people transition out of nursing homes in our state and the staff that do transitions also provide demos of these small changes devices when necessary, for people in the transition process. We also just started using the ATA peak pressure on the 18 for community living to promote those demonstrations in training.

We have also been very deeply involved for more than 10 years in the deinstitutionalization movement out of nursing homes in Michigan. We were part of the real choice systems change grants and the remedies to the Olmsted lawsuit in Michigan that developed single point of entry throughout our state and we were on the ground with developing the manual for standards for support coordinators for single point of entry and we included promoting assistive technology and learning about assistive technology as key components of the supports coordinators job. We also implemented training to the single point of entry to include and support consumer led models and real person centered planning that included assistive technology. We also were involved in a pilot at the single point of entry. We helped write a grant to fund the position that would do prevention using assistive technology and we have helped fund a position, a full-time occupational therapist actually that went out to people's homes and help them identify assistive technology that would work for them. We also developed a curriculum on how to help people transition out of the nursing homes and I think Lisa has a link to that. We did the training around the state and also trained our nursing home. They were trained in transition and how to make referrals for centers for Independent living to help people get out of the nursing home and also how to help people acquire assistive technology both in the nursing home and in the transition process. We also helped push for in the housing area, what is known as PA 182 in Michigan. We found that finding accessible housing was a real problem in helping people transition so under PA 182, new units, new homes a funded through our state Housing Authority are to be designed under type of the dwellings which I guess is short of universal design.

We also worked on the collaboration, I guess was how we defined under the grant reporting persistence to increase funding for our waiver programs for two years in a row during devastating ongoing devastating budget crisis in Michigan. And also in helping people access housing, we were at with our public Housing Authority at the state level and around the state to change their definition of homelessness so it included people living in nursing homes so they could transition out with access to specialized vouchers. We also have separate money to promote and advocate for long-term care reform so we persist the page in our state Olmstead coalition and our Gov.'s task force on long-term care. Which was a result of Michigan's Olmsted lawsuit. As part of that work we have assisted in writing successful grant to CMS included cash and counseling and a real choice of systems change. As part of the ongoing collaboration of the state level, we will be partnering this year at the off the -- office of services for the aging, these small changes kid in all the senior centers in our state and I'm very hopeful about that but that might not happen but that is what they are interested.

We also used see grant from the former ATP program to farm zero, actually our partners formed zero step which is now urgent certification program for builders, it sounds a similar to what is going on in Iowa. Promoting universal design as a adjunct to certified aging employee specialists. This year, I will be presenting at the Michigan affordable housing conference to raise awareness about assistive technology using these small changes big differences kit. I think that about covers it. I am guessing Wyoming is next.

Thank you Amy. This is handy. -- Sandy. I am going to briefly overview some of our work and give this to Deb Flemming from our Wyoming geriatric education Center because it is a partnership that some of you may not have thought about. Probably our stronger work in aging is because of our partnerships with Agricola the and are aging and disability resource Center. For a DRC, dad and I were the co-GIs on that. We helped develop at work closely with our project, our nursing home transition program and with the financial for a tea. Specifically for seniors we developed a video of transitioning into a disability which is a vision disability and that has had actually great reviews and we continue to disseminate data. Barry was handing me a postcard that we just got on that, thanking us for that work. Our geriatric education Center, I would like to introduce to Deb Flemming and she is the director of that and she can tell you a little bit about what the education centers do and also some of the work towards fall prevention and rehabilitation that has gone on in Wyoming

Thank you Sandy. We have been very fortunate to be mentored and assisted by the Wyoming Institute for disability while we are housed within their suite of offices here and has given us an opportunity to really farm that nexus between disability and aging around a lot of education for students and an some of the programming. I wanted to talk a little bit about fall prevention, that was one of the topics that was suggested to us. Today a little bit about some of the work we have done what that. First in describing the issue of calls and then talk about a conference that was held last May in Cheyenne, does the Wyoming conference on aging are pulled together several partners to do a session for that. And then a very specific program that we have, of the northern part of our state that is a partnership between a rehab hospital and a state-funded assisted living center. First of all, to talk about fall prevention, just to make you aware, there are so many resources for information about this, AARP is another important partner for us and they have all kinds of materials they have a caregiver checklist and just go to the website and you will find all sorts of resources for consumers and for professionals. Also look at the CDC website, they have information about preventing falls among older adults and some of the statistics I will be giving you a run information from the CDC. We also have, in our country, a fall prevention Center of excellence and I was not aware of that until he started looking into this. You can look at stop the falls.word. Stop all start work. -- Stop. Word. They are doing incredible work there the ball present -- preventive Center for excellence. National Institute on aging, you're not familiar with them as a resource, they have the age of pages and they are a 1 to 2 page handout, on a variety of topics but they do have one that is called falls and fractures so I invite you to take a look at that. There is a CDC, and you can go to the national Center for injury prevention and control website at CDC, they have sent it to fall prevention documents and in looking through these, some of these statistics are pretty startling. The unintentional falls are a threat to the lives independence and health of adults 65 and older. Every 18 seconds and older adults is treated in emergency departments for a fall. I just think that is stunning. Every 35 minutes, which is about how long this has been going here, someone dies as a result of their injuries. I think it is such a crisis in this country and we are probably not recognizing it as such. Among older adults, 60% of fatal falls occur in the home. Many of those are preventable. The education that we can do around that fall prevention, how to improve the environment, how to look for the risks within the home. We had a handout that was quite graphic. It was a picture of a home and came tiny 14 risk factors within this picture and circle them. They were all very common things that many older adults have in their homes and don't even recognize them as they fall risk. So 60% of the fatal falls occur in the home of 30% in public places. Again, that is where the government entities and cities and towns need to be taking a look at that and only 10% and healthcare institutions. We often think that is where most of these they don't falls happen in nursing homes and hospitals. One out of three adults, 65 and over, falls each year. That is amazing. 103 is going to have some kind of bothered out of those that fall, 2030% suffer moderate to severe injuries. Older adults are hospitalized for injuries five times more than injuries from other causes. It is the big one. That is the one we should be focusing our attention on. More than two thirds of injury reported deaths after age 85 are related to false and annually, those admitted to hospital after a fall, only 50% survived. So about a 50% death rate from those false. -- False. -- falls.

The problem is also big in nursing homes and I know they are very aware of this and trying to make a lot of changes to improve the incidence of falls . Nursing home residents account for 20% of deaths from falls although the limit of the 5% of 65 and older. So atypical nursing home with a new hundred beds reports 100 to 200 falls every year. Those of the reported false. I know there are many balls that are underreported. There are also a high incidence, I suspect and assisted living centers who have less strict reporting requirements. 75% of residents in nursing homes fall each year. They fall more than once on an average 2.6 times a year. And about 35% of all injuries occur among residents who cannot walk. These are people who are in nursing homes or are pretty much in bed and they still have falls issue.

Talking about some of the partnerships that we have engaged in the way to the conference on aging, we listed the help of our University of Wyoming family of medicine residency program and one other -- today presentation on the influence of medication and vitamin supplements on a risk and prevention of falls. That is an important thing to take a look at. What kind of world is medication and the use of vitamin D, other vitamins that can have an impact. We then called up VBA. We have a nice VA Hospital in Cheyenne. It is a fairly large one. They have a very active fall prevention program there. And they sent a multidisciplinary team to the conference. They provided us with a general toolkit and they talked about their fall prevention efforts on the extended care unit and in their recreation therapy, we had licensed clinical social worker and a restorative aide, and actual rehab unit. And by Randy Wigle who is a professor here at family consumer sciences and talked about agri-ability and I think Sandy is going to talk more about that in the -- minute and Mary, who is also the Rue, who did a demonstration of many a T. devices that can assist people in fall prevention.

One of the things that the VA team talk about a different ball risk assessments. I'm not going to go into detail is the just to give you an idea, of the range of different scales to assess a fall risk. There is a marked fall scale, behind her, two of those skills, be tied up and go test, which is one of many physicians use their offices for the multidirectional reach test, the balance has comedy for squared step test and how environmental assessment is another important assessment. Let me just describe quickly, the shortest one, easiest to administer and this is one that you often see an assessment in a doctors office, the get up and go test. Basically all the involved is having someone sit in a straight back chair and asked them to get up without using the armrest as they can. The standstill momentarily, walk forward 10 feet, turn around and walk back to the chair and turn and be seated. And it is impressive what can be determined from just that simple quick test. They will be looking for the sitting balance, how people can sit in a chair and maintain a balance. The transfer from sitting to standing, the patient stability and walking and the ability to turn without staggering. And the balance ability of an individual.

We have, as I said, up in the northern part of the state, we have the got to rehabilitation center. It is a small rehabilitation center, it has been there for a number of years and is located next to the hospital. This is located in Hot Springs County called that because they are famous for their Hot Springs, where people come from all over the state to bask in the warmer waters there. Located near the rehabilitation center is the Wyoming pioneer home. This is unusual for a state to have its own assisted living center because it is based on a sliding scale. People can come from all over the state and regardless of their income level, they are accepted as a revenue resident and a welding pioneer home. They form a collaborative effort to provide a screening process when people went to the assisted living center, the staff of the Wyoming pioneer home doing fairly extensive balance and fall risk assessment and then they work with the therapist at the rehab center to get them into a wellness program. They will actually come and pick them up from the hospital every day and take them over for their strength training classes. Access them using the balance of system and do whatever needs to be done. So they get it right from the very beginning of figuring out if people are at high risk and intervening with that kind of prevention work. At the hospital, they have what is called the biotech system, SD, and this is a piece of equipment, I imagine it is fairly expensive but you stand on this thing and it is designed to improve the balance, increase agility and develop muscle tone. And assist -- it is an excellent tool in that field of fall prevention. It is also available to people. It shows what can be done in a very rural area. Utilizing the resources that are there and the expertise and working together in a partnership. They have substantially reduced the falls that occur within the assisted living center. They have had far either -- for fewer hospitalizations have been able to track the data over time since they started with the partnership and I think it is a model that could be used in a lot of other locations and that is about it. Sandy said I was supposed to talk a little bit about geriatric education Center so I will fill -- throw in a quick pitch and be quiet. The lambing geriatric education Center has been at the University of Wyoming since 2007. These centers are located all across the country. There are 40 of them. We are one of the newer ones. They were established and they are funded by the health resources services administration to provide education and training for health professionals, both future health professionals many are students or the University but also to provide continuing educational for health professionals out in the field. So that is it in a nutshell. Give a listen. -- Thank you for listening.

This is Sandy. I will summarize that we have had to rely on collaboration. Much as Jane has said, you can't do it all. We certainly are still at the AP 101 stage in Wyoming. Trying to educate people. We're using our collaborators to do that. And are port and a lime at what the lambing geriatric education Center. And looking towards health and prevention as much as rehabilitation. And then using assistive technology for support and independent living after. And I think that is all he has to say in Wyoming.

All right. That, does anyone have any questions? For our group? To unmute it is pound six.

This is Nancy. Sandy, could you talk a little bit more about your partnership with Agricola he? -- Aggregate ability?

Sure. We are just finishing our first goal, our first term of an aggregate would he project. Our AP program prior to this one worked on some submissions of we have never been successful with. So we partnered with Cooperative extension, that is a mandate. And we partnered with them and we were successful. And the way we were to does far, we did submit an application for a second round. The way we set up is that the base of the program is actually here in our AP program and that is through Mary monkeys. She does all the and take calls, referrals and a general request, they have not gone through Cooperative extension and also for office we handle most of the conferences and demonstrations of things, some of the trainings are coordinated here. But the more formalized education stays in Cooperative extension and although we are involved with that, we have contracted occupational therapist who do the on-site assessments. They go and do that but they are in other areas of the state. Basically, it within the AP program where the base, the public face of aggregate ability. The hell?

Yes it did. Thanks.

Are there any other programs on the call that are using these small changes big differences kit? Other than Michigan?

Maybe they need to be dusted off.

This is Jane. I don't know, I do know of several states, again, they roll them out a long time ago and they are using them in a small part of it are a certain way. I know Pennsylvania and Georgia are using them in a certain way. And these types of things. The problem is we can only do so much with limited awareness.

Marsha Willoughby says: Where can the kit be bought?


The kits are not put together to purchase. I can provide you with a list and maybe Amy, can provide, each day personalized as the exact devices that are in them but I can shed a logo with you and had to put them together and those types of things.

I believe our list is up on the website.

Lisa, this is Helen and Alabama.


Just listening to you guys, I don't know if we piggyback off of someone or not, but I am looking at a brochure that I design, several years ago, this was back in the 90s. Late 90s and early 2000. Actually, I adjust it as a 21st-century seniors. We have this model from someone but we partner with the &� ; la Bama area agencies, AAA's and these Department of Senior services here, the collaborative project and we came up with a kit of items at that particular time, the items were no more than $20 each. But they were low-tech items and we had about 30 items in the kids and we had several kids that we left with the Jabar AA, AAA offices and it was train the trainer modules. We would love to update, go back and revisit that an updated but I would like to see another video because the video we were using at the time in our kids was the use of assistive devices by older person with disabilities. That was very old. I think it was a buffalo or something, years ago. If that has been updated and anyone knows of any videos with seniors and low-tech devices for safety and independence in their home, I will love to have a copy of that.

Again, with the Parkinson's project we have found that a lot of the older groups want specified information and we have worked with arthritis, we have a -- we have worked with Alzheimer's, our most recent effort has been with Parkinson's, but they are general but they won't be really, specific to whatever the topic is, fall prevention and it next and tucks it a little bit versus the generic one is for everyone.

Nobody is disabled but they all want to be special.

Carole Rossick says: This is Carole Rossick with a question for Amy about the small changes big differences program and my question is, do you include information on how to make home modifications for people with hearing loss and deafness - there are a number of assistive listening devices, telecommunications, alerting devices and signaling systems that can be incorporated into a home and modifications that can be made to make the acoustics and lighting more suitable

We do have some devices that address hearing loss and our kids. We have, the alarm clocks with vibrating alarms and things like that. We also have the emergency alert devices that have readouts and notifications for people with hearing loss. We don't really have terms of environmental modification devices in a kid. Maybe -- kit. Maybe six or seven. We do have partnership with the hearing loss Association of Michigan who have their own kids. -- Kids. They are going around and doing presentations specific to hearing loss. They do demonstrations as well.

And Iowa we had some beginning information on it, our older world population especially has noise induced hearing loss issues and so you are dealing with older Iowa farmers and you have to come in through the back door.

Honestly, we have recreation devices for assisted living with television and things like that so we try to go in the back door starting with recreation.

We have some and actually have increased and what we are dealing with, very much along the lines of what she was talking about. We kind of comment -- come in through the front door, or the white door type of deal and come around through it that way, but we have used again, several types of awareness activities, either with small changes big difference or other activities to get that information out. Now, recently, we were requested, actually something that they can come together about and that is the World War II veterans and now the veterans coming back from Iraq. It is a common issue that they both have noise induced hearing loss from war that is affecting their relationships.

That is a great end.

That is an end. I wait for the end and then go for it.

Again, not knowing the funding. It is a huge, and Iowa, our veterans hearing support is huge. They will pay for everything and anything at the veteran just comes in. It is kind of a real no-brainer that we are doing awareness and had the answer and the funding for it.

I have a question for some of the other programs. What are you guys doing in this area? Are you doing anything similar? Are you taking a different approach?

This is Kathy from Maine. I cannot for some information on what we have been doing in Maine. I am an OT and I am with the state main site. I just pulled up our website. Back in 2005, we created six publications, very short publications, geared towards promoting information around assistive technology for seniors. The six information guides are titled tools and ideas for easier loading. They are on our website and we just have done a revision of them and they are going to print, we are doing a sizable reprinting them but there are six information guides. I have used them extensively across the state with managers and family care giving trainers through our area agencies on aging. We only have five AAA agencies in Maine so they are pretty accessible. Actually, I just very recently did a webinar for the caregiver coordinators across the state, to bring them back to focus on our assistive technology resources and I used these as six information publications to focus that group. That is something you might want to look at on our website in the publications section and we are Maine and CIT.org. -- Main CITE.org. The publications are on our site.

Thank you Kathy.

Does anyone have any additional questions before we wrap it up?

This is data -- Debbie and Wyoming. I just wanted to toss this out to the group and probably you are all involved with this but just to make a point of whatever program that you are working with, or whichever health professionals, you need to stress the importance of the home visit. We try to take a real interdisciplinary approach to that, but only with taking our young resident physicians out of homes and having them do a house call but also involving nurses, therapists, social workers and pharmacist. And for people to have that recognition, that is a whole different person, that consumer at home versus the patient that they see in the 15 minute office visit. Not only to encourage folks to do that but also to make those home visit some unstructured so they look for the environmental issues and have a checklist of the home environment so those are very meaningful visits so that is just my plug for that. I think there is so much to be learned about a person when you see them in their own environment.

Actually I would like to piggyback on that, the research we have done and the, when you're in a homeless so when you need to start with what they want to use 84. What is interesting to them. One of the articles that I used for my presentation said only about half of 80 is actually used. The rest of the my closet and I've been told that people think that half might be less than half. We really focus on talking with people about what is important to them and what do they want to be able to do and starting using 18 air. And building upon it and not just saying I had a T. for these three things.

Also, this is Jane. I have also found very much what you are saying, but if you can get them to accept 180 device and it works for them, they will do others.


To the person from Maine to the website again please?

Mains site -- MAINECITE.ORG

Okay. Thank you. You any other comments? -- Any other, question mark all right. -- Thank you very much to Jane, Amy, Sandy. Thank you for taking the time to share what you have been doing. Thank you for giving the participants some good ideas to think about and with that, have a great afternoon.

Thank you Lisa.

Thank you.

We appreciate it.

[Event concluded]