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When someone comes home from a stay in the hospital or nursing facility, the last thing they want is to be readmitted. Options Counseling helps people obtain the resources they need to stay at home.

Programs and services abound to support older adults’ choice to live at home for as long as possible – so many, in fact, that the maze of guidelines and applications can become overwhelming. How can you find what’s available, and how do you know which services are right for you?

Chris ChagnonChris Chagnon, Community Options Resource Specialist“There’s no cookie cutter solution for everyone,” says, Chris Chagnon, community options resource specialist at LifePath. Chris assists elders age 60 and older, people with disabilities of any age, and caregivers with Options Counseling, a free service that provides information and support to consumers, family members, or caregivers who make decisions about service options. “I sit down with that individual and find out their needs and their goals, and we go from there. It all goes back to providing individuals with information: how to access resources to provide either themselves or their loved one with the best care.”

LifePath has two community options resource specialists, who can meet with you in the setting of your choice. “They’re welcome to come to the office, or we can meet in a public area somewhere - wherever it’s convenient for them,” says Chris, and he can also meet in a hospital, rehab, or nursing facility. Whenever possible, Chris encourages meeting at home “because I get to assess their environment as well as their situation and may be able to make a recommendation regarding their home setting.”

Some questions that Options Counselors may review with an individual include:

  • Is their home safe? Are they safe in their home?
  • What are their activities of daily living, and how do they perform these activities? Are they safe with these or do they need assistance?
  • How do they do their housekeeping, their shopping, their meal prep, their laundry?
  • If they don’t have a car, who provides transportation?
  • If they don’t have the ability to perform some of these tasks, who does it for them?

“If we find out they immediate needs,” says Chris, “we can set them up with services if they would like them. It really reduces a lot of fear and anxiety for people to realize they can remain in their home, which is huge to them. That’s typically the most important thing - to remain in their home - and the services we provide can do that for them.”

For more information, contact LifePath at 413-773-5555 or 978-544-2259 or send us an email.

No matter your age, expanding your mind through learning is always a worthy pursuit, and in this season of new year’s resolutions, there’s never been a better time to try your hand at something new. Thankfully, in our “knowledge corridor,” local resources abound for educational opportunities.

Greenfield Community College

Greenfield Community College (GCC) offers many options targeted to learners who are over age 50 – though the following programs are open to people of all ages.

Senior education in Western MassYou're never too old to learn, whether outside of a classroom or in one.One option is the "Senior Symposium," a collaborative effort between GCC and area residents to provide a way to continue your education in a format that best suits your needs, interests, and resources. Inspired by the motto, “you’re never too old to learn something new” these two-hour programs take place from 2 to 4 p.m. at the John Zon Community Center (35 Pleasant Street, Greenfield, MA 01301), individual sessions are only $10 per person, and a full season pass to all eight presentations can be purchased for $70, which includes a $10 discount. Financial assistance is always available.

The first workshop in the early 2019 series will be “The Common Pot: Native Writing and Native Spaces in the Connecticut River Valley,” led by Professor Lisa Brooks on Thursday, February 21. According to the website description, Professor Brooks will demonstrate “the ways in which Native leaders – including William Apess – adopted writing as a tool to reclaim rights and land in the Native networks in what is now the northeastern United States.”

Additional presentations include:

  • Thursday, February 28: “King Philip and the Renegade Skaters Of Warren Falls” with Wesley Blixt
  • Wednesday, March 6: “Architecture and Place: The Details of Eighteenth-Century Connecticut River Valley Dwellings” with Eric Gradoia
  • Wednesday, March 20: “Fungi Foraging & Forest Mushroom Farming in the Foothills of Franklin County” with Paul Lagreze
  • Thursday, April 4: “The Story of the Buffalo Soldiers” with Alyssa Arnell
  • Wednesday, April 10: “Marijuana in Massachusetts” with Bob Mayerson
  • Tuesday, April 16: “Notes from a Contemporary Art Curator” with Amy Shannon Halliday
  • Wednesday, May 1: “New England Takes Flight: 100 Years of Aerospace History” with Amanda Goodheart Parks

New this year are “Senior Workshops,” which are six-session programs and cost $125 each:

  • “The Non-Fiction Film” will be led by Helen von Schmidt & Carolyn Anderson on Mondays, March 11 through April 15, from 1 to 3:30 p.m.
  • “Butterfly Biology and Wonderful Wildflowers” will be led by George Locascio on Tuesdays and Wednesdays, May 28 through June 12, from 10 a.m. to 12 p.m.

According to the website, the butterfly and wildflower course “begins with classroom lecture-based learning and hands-on laboratory experience identifying plant herbarium specimens and pinned insect specimens. We then move our skills outdoors to conduct plant and insect field identification at three different sites.”

To learn more, call Mark Rabinsky, director of workforce development and community education, at 413-775-1611 or find registration links and full descriptions here.

Five College Learning in Retirement Program

Another local college-learning program for older people is through the “Five College Learning in Retirement Program.” There is a $125-$250 membership fee, but an assistance fund is available. A catalog with the spring 2019 offerings is available on the Five College Learning in Retirement Program website. Most seminars run for ten weeks and start in late February. Locations vary but are all handicap accessible.

A sampling of seminar topics in spring 2019 include:

  • “Dealing with Dying & Death” with Jeanne Ballantine
  • “Techniques of Memoir Writing” with Dick Bentley and Nancy Denig
  • “Victorian Britain” with James Harvey
  • “The Lure of Mars” with Martha Hanner and Dorothy Rosenthal
  • “1800’s Massachusetts Architecture” with Linda Honan
  • “Appalachian Food” with Katy van Geel and Nina Scott
  • “Language and Evolution” with Kathy Campbell

For more information, visit the Five College Learning in Retirement Program website or call 413-585-3756.

Categorical Tuition Waivers

If you’re interested in obtaining an associate or bachelor’s degree or enrolling in a certificate program, consider tuition waivers for seniors. The Massachusetts Department of Higher Education’s Office of Student Financial Assistance offers Categorical Tuition Waivers, including those for people over the age of 60; additional qualification requirements apply. Contact the financial aid office at the institution you are attending or plan to attend for application requirements or deadlines. You can also call the Office of Student Financial Assistance at (617) 391-6070 to obtain more information.

MassHire Franklin Hampshire Career Center

The recently renamed MassHire Franklin Hampshire Career Center offers job search strategy workshops and skills training to support vocational goals for those in Franklin and Hampshire counties. Call 413-774-4361 or visit MassHire Franklin Hampshire Career Center online.

Additional education resources for older people

Finding financial assistance for college as an older adult

If you’re currently working, your employer may offer college education assistance. You typically do not need to pay federal income tax on the first $5,250 of assistance, and many employers will cover expenses for studies that are not directly related to your work. Websites like Fastweb.com and FinAid.org help students find fellowships, grants, and scholarships, including those available to older students.

Free and low-cost massive open online courses

Websites that offer free or mostly free “massive open online courses” (MOOC) taught by instructors from elite universities include Coursera.org, Edx.org, and Lynda.com. GCC offers economical, online classes for $10 per credit, and hundreds of workshops are available to choose from online at GCC.

Part 3: Expanding the options

The alternatives to opioids we have now don’t work for everyone’s pain. More non-opioid, non-addictive treatment options could help reduce the number of opioids prescribed each year.

Healthy Living LifePath winterThe Healthy Living program at LifePath is offering several workshops during the 2019 winter season, including a free Chronic Pain Self-Management workshop that helps people build self-confidence to assume an active role in managing their chronic pain. Particpants explore the cause of pain; distraction and relaxation techniques; dealing with difficult emotions, stress, fatigue, isolation, and poor sleep; appropriate exercise; strategies on healthy eating, weight management, and nutrition; pacing activity and rest; and more. The next six-week Chonric Pain Self-Management workshop series starts on February 14 at North Quabbin Recovery Center. Learn more about this and other Healthy Living workshops.Recently, the National Institutes of Health (NIH) launched the Helping to End Addiction Long-Term (HEAL) Initiative to address the shortage of effective medications for chronic pain and other issues contributing to the opioid crisis.

Some of the research funded by HEAL will focus on understanding how chronic pain develops. A better understanding of how acute pain becomes chronic could reveal new treatment targets.

Researchers funded by HEAL also hope to learn how to predict who will develop chronic pain from acute pain. This information could be used to guide early pain management, Oshinsky explains. HEAL will fund research into new treatments for opioid misuse and addiction as well.

More options for pain management could help doctors better personalize pain treatment. “It could be a little more like precision medicine, where you try to identify what flavor of pain the patient has, and then match the treatments we have available to the needs of that patient,” explains Dr. David Williams, an NIH-funded pain researcher at the University of Michigan.

Read Part 1 of this series.

Read Part 2 of this series.

Learn about the Chronic Pain Self-Management Program at LifePath.

Article adapted from the NIH October 2018 News in Health.

 

Pam OddyAttorney Pamela OddyThe topic of funerals is not the most pleasant one to discuss; however, the idea of a prepaid funeral is gaining more prominence especially when it comes to spending down one’s assets in order to become eligible for MassHealth. To not count toward the asset limit for these programs, the prepaid funeral arrangement must be “irrevocable,” that is, it cannot be changed. There is no “lookback” period for the purchase of a prepaid funeral.

It is always a wise choice to prepay a loved one’s funeral if that loved one (for example, a spouse or a parent) enters a nursing home for permanent placement. If a spouse is the one who must enter the nursing home on a permanent basis, it makes good sense to prepay the funerals of both spouses (i.e. the one who is in the nursing home as well as the spouse who remains in the home). Prepaying both funerals may become part of the spend down for MassHealth eligibility. Although it is a sensitive topic, I have found the area funeral directors to be quite helpful in guiding people in choosing funeral arrangements. I counsel my clients to be sure to have the funeral director include in the prepaid funeral the cost of minister/priest/rabbi as well as the cost of multiple death certificates.

In addition to prepaying the funeral, one may establish a burial fund account with a local bank. The total amount that can be deposited into this account is $1500. This expenditure is also an allowable one for MassHealth eligibility and may become part of the spend down. One may ask the question: why set up a burial fund account if the funeral is already prepaid? Theoretically, the burial fund account may be used to pay for a funeral luncheon and flowers and various extras that fall outside the parameters of a funeral. This account may not be touched until the person’s passing or else all of the money in the account becomes countable toward the MassHealth asset limit.

Prepaying a funeral will serve to take the burden off your loved ones because you will be the one making the decision as to what you want as well as which funeral home directs the arrangements. It will also settle any disagreement as to what you want and what your family members want for you; for example, you may want to be buried, but your family, if the decision were left to them, might have you cremated. If the funeral is prepaid, then the choice is already made, you have covered the expense and saved your family the financial burden and you will receive the funeral that you paid for.

The topic of funerals is not one any of us look forward to discussing but it is becoming increasingly important in any advanced planning.

The views expressed in this column represent general information. To address your particular and specific needs consult your own attorney. If you need help with referral to an attorney, contact the Franklin County Bar Association at (413) 773-9839 or the Worcester County Bar Association at (978) 752-1311. Elder law resources may be found through the National Academy of Elder Law Attorneys, Massachusetts Chapter, at massnaela.com or 617-566-5640.

Community Legal Aid (CLA) provides legal services free to people age 60 and older for civil legal matters with an emphasis on access to health care coverage (MassHealth and Medicare) and public benefits as well as tenants’ rights. A request for legal assistance can be made by phone at 413-774-3747 or toll-free 1-855-252-5342 during their intake hours (Monday, Tuesday, Thursday, and Friday from 9:30 a.m. to 12:15 p.m. and Wednesday from 1:30 p.m. to 4:15 p.m.) or any time online by visiting www.communitylegal.org.

Part 2: Opioids are not always needed

Opioids are often prescribed for acute pain. Acute pain is short-term pain, the kind experienced after an accident or an operation. But other drugs may be just as effective for acute pain, even after surgery, explains Dr. Dena Fischer, a dental health expert at the National Institutes of Health (NIH). Some of these drugs, like acetaminophen or ibuprofen, don’t require a prescription.

People may think that prescription drugs work better for acute pain. But that’s often not the case, Fischer says. Using something other than an opioid first can be especially important to manage acute pain in fields such as dentistry, she adds.

Many people receiving opioid prescriptions from dentists are teens or young adults who have never been prescribed an opioid before.

“Research is starting to tell us that people who receive an opioid prescription as a teenager have a tendency to continue to take opioids for non-medical purposes in the long term,” Fischer says.

Healthcare providers who decide their patient needs an opioid are now being encouraged to give only a few pills at a time. People who receive shorter prescriptions are less likely to misuse their pills by taking more than prescribed or taking them after the pain is gone. This also cuts down the chance that the pills could be taken by others.

When pain is chronic

Managing chronic pain is more complicated than treating acute pain. More than 25 million people in the U.S. alone live with chronic pain, which is pain that lasts more than three months.

Many things can cause chronic pain. For example, Oshinsky says, a muscle that was damaged in an accident may heal relatively quickly. But if a nerve was also hurt, it can continue to send pain signals long after the body has repaired the muscle.

Other types of chronic pain are driven by brain changes, explains Dr. David Williams, an NIH-funded pain researcher at the University of Michigan. When these changes happen, the brain continues to perceive pain even though the injury has healed.

For people with this type of chronic pain, sometimes called central pain, opioids and some other kinds of pain medications can actually make the pain worse.

CounselingTalk therapy may be able to help people with chronic pain.Research has shown that talk therapies, such as cognitive behavioral therapy, can help many people with chronic central pain. These types of therapies “emphasize behaving in different ways or thinking in different ways that alter the perception of pain,” Williams explains. “Pain is a combination of a sensory and an emotional experience.”

Cognitive behavioral therapy can also help people with chronic pain manage related health problems, such as problems sleeping, feeling tired, or trouble concentrating. This can increase quality of life for people with chronic pain. It can also have overlapping effects.

“Pain processing and sleep and thinking and mood all share the same neurotransmitters in the brain,” Williams says. “So, by improving something like sleep, you’re also improving pain.”

Non-opioid drugs can help some people with chronic pain too, Oshinsky says. Many of these drugs were first developed to treat different health conditions, such as seizures, depression, or anxiety. But they can also change the way the brain processes pain.

Some people benefit from devices that stimulate the nerves directly to block pain signals from reaching the brain, Oshinsky adds. Different devices can work on different parts of the nervous system, from the nerves in the skin to the spinal cord.

People with certain types of pain have also been shown to benefit from exercise, acupuncture, massage therapy, or yoga.

Read Part 1 of this series.

Learn more about research into additional pain treatment alternatives to opioids in Part 3.

Learn about the Chronic Pain Self-Management Program at LifePath.

Article adapted from the NIH October 2018 News in Health.