Aging in Montgomery County (MD)

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Steve L.:

Good morning. My name is Steve Lorberbaum. I’m the owner of Assisting Hands Home Care Potomac, and welcome to What’s your plan? Today, we are incredibly fortunate to have Odile Brunetto, who’s the Chief of the Aging and Disability Services, to talk to us today about the hot topics that are going on in Montgomery County that impact seniors. Assisting Hands Home Care, we take care of people in their homes. We provide aids to help with social isolation and help folks who need a little extra help with activities of daily living and companionship, but that’s a very small piece. Odile has got all the rest of it, and it is ginormous. So Odile, welcome, thank you very much for joining us today.

Odile B.:

You also welcome. Good morning everyone on the line. It’s a pleasure to be with all of you. Thank you so much for inviting us.

Steve L.:

Yes, so Odile, just briefly, I saw earlier the list of things that your department is responsible for, and it is staggering in its breadth and scope. So if you could give us a two-minute rundown on what Aging and Disability Services covers and sort of the highlights.

Odile B.:

Sure, I’m delighted to do so, thank you so much. So Aging and Disability Services belong to the greater Department of Health and Human Services, and we work on a daily basis with our colleagues across the whole entire department. But obviously, in Aging and Disability Services, we focus on personal disabilities of all ages, and of course, older adults and their family members, and so we are organized, if you wish, into three major groups.

Odile B.:

We have one group that focuses on the needs of persons with a developmental disability and their family members. We have one group that focuses on both traditional social services for persons with disabilities in older adults. And then we have another group that is for the area agency on aging that either part of the national network, focusing on the needs of older adults, over the age of 60, and their caregivers. And so across in our programs, we aim to assist a person with disabilities, older adults, their caregivers in staying at home, engaging in the community, being as safe as possible for as long as possible, and providing an array of services that eligible persons can select to enrich their lives, and again, focusing on safety and health.

Steve L.:

Got you, and I will put in a plug for Aging and Disability Services because that is a one-stop-shop phone number. If there’s virtually any question that someone has related to aging and resources available in the county, that’s the number. I use it all the time and I refer it out to clients and their families because really, they seem to know it all, which is fabulous.

Odile B.:

Thank you for sharing that information with the audience, yeah. And the number is 240-777-3000, and it’s called the Aging and Disability Resource Unit. We have a team of eight full-time program specialists with the supervisor, and they are truly the expert at connecting anyone who calls to the services that are needed for the person or the family to do good. So this team, I’ve been fortunate to be working with us for many, many years. We are having very much stability in the staff, and so that is why it is so wonderful because they really do know the community, the resources.

Odile B.:

But in the private sector, the nonprofit sector, of course, within our government system, they knew the rules for eligibility, which as you know, sometimes change twice a year. They are really on top of the game. We have two and four years on the team who are bilingual, Spanish, English. However, everybody on the team is able to reach any language. As you know in Montgomery County, we also fortunate to have residents who come from all over the world to be with us in the schools over 170 languages are spoken. And so our staff connects that school with telephone or different languages because we have a language line. And so the program is open Monday through Friday from 8:30 AM to 5:00 PM. However, on Tuesday, Wednesday, Thursday, they are open until 7:30 PM. So people can get on the phone, talk to a live person, 240-777- 3000. Thank you so much, Steve.

Steve L.:

Great. So let me ask you this, I mean, we all move on in our lives, and we have programs and agendas, but something like the COVID pandemic really spotlights, I think and highlights the deficiencies, the things that we didn’t even think about. What are the things that really have come to the fore that we learned, we need to do a better job at? Or maybe you’re already addressing them.

Odile B.:

Thank you so much. So when we started in this pandemic, close to a year ago, in terms of the mechanics of our programs, obviously, a lot of what we do in Aging and Disability Services is in people’s homes. We go to someone’s home, or we go to somebody who resides in the assisted living facility, or we go to a senior center. So once the face-to-face activities where are no longer safe, and we have to stop doing that, for many of our programs, that was a new challenge. Because we as county employees, at that point in time, we didn’t have the right equipment. We didn’t have cell phones, and laptops, et cetera, to be able to work from home. So it took us a few weeks to get that done, but fortunately, now we are very well equipped and we can work remotely.

Odile B.:

Obviously, way back when you may recall, you couldn’t find a mask, you couldn’t find this famous PPE, personal protective equipment, and so, but we didn’t have any of that, so we had to just plug it all in, and just like everyone else, waiting for the supplies were about to come our way. So having said that, we have some programs that are mandated and need to continue regardless of a pandemic to provide these services, and one of our programs is the adult protective services. We call it APS in short, and this is when someone in the community reports to us their concerns. It’s a serious concern if that is a person with disability or an older adult who is at risk of abuse, neglect, self-neglect, exploitation. And so we receive the call, and our staff, of course, investigate the situation, goes into the homes. Despite the pandemic, we are continuing to do our face-to-face work. Really, people are using their equipment, and respect the social distance, et cetera.

Odile B.:

So another situation that we have seen is that, especially at the beginning of a pandemic, our clients were very resistant to welcome us into their homes because the seniors were so afraid of the virus. So again, fortunately, a couple of months later, especially now that we have the testing that is available regularly for folks, as well as you can see on the map, people now are welcoming us back into their homes to provide services. Another challenge has been with our long-term care facilities. We have one wonderful program that is sponsored by the federal government. We have supplemental funding from the state and the county that is called the Long-Term Care Investment program. That program is operated by a small team of county staff and a wonderful larger team of the trained and certified volunteers. Our team of county staff consists of eight persons, and our volunteers were absolutely awesome, right now, we have about 25 of them.

Odile B.:

And their job is to assist residents and families, problem-solve, whatever is concerned in their day-to-day lives in a nursing home on the assisted living facility. And so before COVID, obviously, our staff and our volunteers were going into each of the facilities on a daily basis, multiple facilities on a daily basis. Just to put a reminder, we have 34 nursing homes and 200 sums assisted living facilities in the county. And we are a large geographical area, so the staff and volunteers were driving up and down and visiting all the sites on a daily basis.

Odile B.:

Of course, we stopped altogether in March last year. And recently our service statistics, and that was really heartbreaking to see that, this year due to the pandemic, we have conducted half of the visits that we do last year for good reason. And it has been really challenging to do the work remotely, because obviously when we call or do a Zoom call, we’ve already done in the facility, we have to depend upon the staff person to do the connectivity.

Odile B.:

And as you well know, the staff members are super busy, many of them themselves were sick, and the staffing was a huge challenge in the facilities, conducting the work of the long-term care investment remotely has been extremely challenging. In the fall, the governor allowed an outdoor visit. We arrange, we schedule weather permitting. So this really has occurred, but again, it is a challenge to do this outdoors. And clearly right now, with the cold weather, and the snow, and all of that, that is not happening.

Odile B.:

However, the good news this very day, this morning, the first email I opened was from the governor’s office indicating that they would allow inside the facilities visit effective March the 1st. Assuming of course, that there is no COVID positive test in the facilities, and the nursing homes continue to have their supplies of PPE, and that they continue to do all of the communicable disease precautions for the residents and the staff.

Odile B.:

So looking forward to the vaccine in place as the new residents, the staff has been a priority now in many, many states. So once the vaccine kicks in, there is light at the end of the tunnel with us being able to go back in the facilities, and of course, for the family members who have been not able, that it’s going to be such a relief to be able to finally go see your loved one in the facility, give them a hug finally, and we connect because the social isolation has gone both ways for the residents as well as the family members.

Steve L.:

So one of the things that the county is being on is Age-Friendly and Dementia Friendly programs. How do your departments intertwine with those county initiatives to create awareness for dealing with folks with dementia? Spotting it, trying to educate people that you can’t argue or fight with someone with dementia. And that’s one of the largest things that we see in-home care that a husband of 40 years is yelling at his wife because she thinks something is red when it’s blue. And it really doesn’t matter what color it is, but it’s just the way it is. It’s that feeling of trying to convince people that they’re wrong, so they acknowledge they have dementia which just can’t happen. Are there any special programs or tips that you can share that might involve dementia training and awareness?

Odile B.:

Absolutely. Steve, you’re absolutely right. So we have two initiatives, one is called Aged Friendly Montgomery County and the other one is called Dementia Friendly. So let me start first with the Dementia Friendly. This is an international movement that started in Great Britain and then came over to the United States. The goal of this program is exactly what you’re talking about, to assist families and persons living with dementia, to adjust as best as possible, and enjoy a safe and healthy life.

Odile B.:

We have supports obviously, and so the Dementia Friendly initiated in Montgomery County, started in 2015, and we have a second county, the State of Maryland, Prince George’s County was the first and we have a second. We partnered with all of the departments in the county government, and one very, very important partner is the police department. They do have a special program when the person wanders off and is lost in the community, and the family is not able to find them. This program is for safety terms. It has no cost, so family connects to us, this is no cost, whatsoever. And the person who has dementia receives a special device that can be activated remotely. And so when the person wanders off and is lost, and the police department is notified, the police department can activate that and find the person.

Odile B.:

I was on a call two days ago with the officer who is in charge of this program, officer Laurie Reyes, who’s just been a fabulous lady. And she says that on a weekly basis, between five and eight persons get to wander off a week from their family, and the police department is contacted. So we urge anyone to enroll in this program, because again, better be safe than sorry, better be prepared and have this service, which again, available at no cost. And also the police officer who is responsible for this program, establishing the relationship with the family and the person with that dementia, so that we try to prevent these types of problems to occur.

Odile B.:

But when they do occur, we have a system in place to rectify the situation. So I spoke of the Dementia Friendly initiative, we also have a series of training for family members, some of us training online. Nowadays, of course, we have caregiver support, and we also have the training for businesses, because as you know, the person who lives with dementia, go to a dentist, they go to a hairdresser, go to a restaurant, et cetera. And so we have 24 of those businesses in order to have them interact, communicate successfully with the person with dementia.

Odile B.:

Exactly as you say, there’s no point in arguing about X, Y, and Z, and part of the conversation, describe the person move on to something else. And so again, we’ve partnered very much with the Alzheimer’s Association. We have support groups for family members. We have special programs for people who have been recently diagnosed with dementia to help them understand the disease, adjust to what is going to change their life. So that is a part of Dementia Friendly.

Odile B.:

And again, we have lots of information on the website. You can connect anyone who’s interested, just call us again at 240-777-3000, and we’ll do that warm connection with the person in need. The Age-Friendly Montgomery initiative started also in 2015, and it’s again, an international movement that was started by the WHO, the World Health Organization, to assist countries to plan for the current and future population of older adults.

Odile B.:

Everyone is very much aware of this work for the older population. In our county right now, as you know, we have a budget, a little over a million persons who reside in our county. 16% of our population are over the age of 60. Every year, over 9,000 residents in our county turn 65 and are eligible for Medicare. So we clearly in each group for continuing to work or a residence as well over the age of 60.

Odile B.:

So this initiative from WHO here in our nation is organized under the umbrella of AARP. And so for the community to belong to the Age-Friendly initiative, you have to go through the straight application process, provide documentation, conducted a needs assessment, and organize with multiple partners. So here in the county, we have a lot of advisory groups for the Age-Friendly Montgomery. All of the departments of the county government like fire, police, library, recreation, et cetera, along with key partners into the community, with their nonprofit or for-profit, we meet every quarter to focus on where we are, where we want to go and how are we going to get there?

Odile B.:

We are organized by 10 workgroups. We’re extremely active in employment, safety, communication, health and wellness, community-based services, et cetera, globe tourism, et cetera. And so we focused on all of these topics, and again, we develop a plan. We report about the progress we made, and move forward in developing an additional plan. So one example has to do with financial exploitation, as we’ve mentioned before. So we have a group focusing on that issue. We read through the financial exploitation of older adults is growing at a rapid pace.

Odile B.:

Right now, 36% of the cases that have reported to us in adult protective services, focus on financial exploitation. So we partner with the state attorney’s office, with the police department, with the medical profession to engage as many persons as possible to identify what we call red flags of abuse and report to APS. The state attorney’s office has been very successful in prosecuting criminals who have done these horrible crimes against older people. So that has been something that has been very much at the forefront of our Age-Friendly Montgomery initiative.

Odile B.:

Another one has to do with what you talked about with many older adults, from the older generation, do not have access to computers, or if they do, they do not get very comfortable in using them. So we have had a huge partnership with a program called the OATS, O-A-T-S, Older Adults Technical Services. And they have developed this fabulous program for the senior planet that teaches older adults how to use their cell phone, your laptop, your tablet, et cetera.

Odile B.:

And so clearly back in the days, all of these classes were face-to-face. We had small groups of older adults who attended in class in person. We had classes in Spanish, and in English, and now all of these have moved online, and they are now even doing more business than before. Because really now, when you are in the Zoom situation, meeting thousands of people, you are not limited to how many chairs you have in the meeting room. So their business is really booming. They are very successful. All of these classes are three, and we really encourage anyone to take advantage of that. They have classes also in multiple languages which is fabulous.

Odile B.:

Also, during the summer months, we were able to engage a group of young folks. They were called the COVID core, and they worked from July to October, and of course, we have young people who were trained and vetted by the county government. And we would match one-on-one an older person who needed hands-on help with a younger person who could provide that guidance, and they were doing that on the telephone. So most of the adults do have a telephone, and so that was really very successful. Regrettably, the funding stuff at the end of October, which we are all looking forward to, I’m thankful to sponsors when we started this program, but it was just a win-win.

Odile B.:

I know the school system is very interested in this, and we’d like to see how we could do this together. And the public schools would actually give credit to the students, the old schooler, or the high school would gain credit for doing this kind of warm, warm, warm teaching with all the adults that needed the hands-on help. So those are some of the examples. We have lots of information on our website. And another program, I want to point out is something we called Engage at Home. When the pandemic shocked all of us a year ago, we had one of our wonderful staff members who are in charge of the caregiver program, who put together all of these YouTube videos.

Odile B.:

So that is not too difficult to access. You just need to go on, YouTube and all the videos that have placed there are all vetted. They’re all safe, the information you can trust and, and there’s information for caregivers, the exercises, health, nutrition, and there’s just incredible wealth of resources. And again, this is done in partnership with the libraries, with the recreation department, and it has been so successful. We have tens of thousands of people logging on every single day to get information and also get up to obtain. We have this program that’s supposed to engage at home.

Steve L.:

Well, in fact, I, well, put in a plug for myself. I am a participant in one of the videos that we did on home care, and how to hire home care assistance, whether they be through an agency, or registry, or private. And the other thing is, I’m on the task force for the home and community-based services. And one of the things I think we’re really proud of from last year is the brochure we put out to educate people on how to hire someone to come into their home, and explain the differences between hiring a private caregiver, or using a registry, or using an agency. And it’s very easy to read, very easy to use, and I think it just shows the work of the age-friendly task force that they really are responding to the needs of the community, both in engaged at home and in the task force, all of them individually.

Odile B.:

Absolutely, and again, thank you, Steve, for joining the task force. I think that is a perfect example of working together, partnering between the public and the private sector, and listening to the concerns of the residents when we can move forward and provide services, and we sort it with the council right on and help the family. And by the way that the guide that you are referring to is available in print, and also online, and also in nine different languages. So thank you for your work on that.

Steve L.:

That was really hard for me to translate it into all those other languages.

Odile B.:

Yes, it took close to a year. It was quite a job. Some of the resources I want to point out are always still that come from the State Department of Aging. But now, I’m Department of Aging, they have this wonderful list of again, no costs that is called Senior Call Check, and so people can register at no cost. You have to be a Maryland resident, 60 years old and over. And once you register, they would provide you with a daily phone call. The phone call is made by a computerized call center. So the call center will call the older adult, check on them, and after three calls, if the older adult does not answer the phone, then the system is going to call a backup person that has been designated ahead of time by the older adult. And this has proven to be valuable, especially for older adults who live by themselves.

Odile B.:

In our county, we have 34% of our older adults who live by themselves. And so it is very reassuring to the older adult, as well as to their family members that every day, even on the weekend, a call will be made. And if there is no answer, then a backup person will be contacted. Again, this is provided at no cost, and the number is 1-866-50 CHECK. 1-866-50 C-H-E-C-K for the check. So we urge everyone to enroll in this program, and also the program can disseminating information via the telecoms system. So for example, where there is a snowstorm that is being predicted, the system can call and say, “Hello, it was like that we are expecting winches of snow in two days, make sure you got your medication and milk in the fridge, et cetera.” So that is very helpful.

Odile B.:

Now, the horizon from the Department of Aging is related to durable medical equipment. As you know, many times in life, we needed to access a walker, or crutches, or wheelchair. And so the Department of Aging is putting together this gigantic project of durable medical equipment loan closet, and they have started to receive donations in a centralized location in Prince George’s County.

Odile B.:

The equipment that is donated is being sanitized and repaired. And the goal is, in a few months, to be able to have types of satellite locations, will have to schedule where the items are going to be transported for people who once need to borrow them. And so in Montgomery County, we are working right now with two sites. One is one of the churches in Silver Spring, and the other one is in Rockville senior center. So these two facilities right now are interested in becoming satellite sites, whereby people could come and pick up items that they would need. So this is really exciting and it should come pretty soon.

Steve L.:

Perfect. Well, I’m mindful of your time, and we may have time for a question or two before we have to sign off. Any questions that we didn’t answer? Okay, well, I’ll assume that we-

Claudia:

I’m sorry.

Steve L.:

Oh, go ahead.

Claudia:

Hi, Dr. Brunetto. How are you? This is Claudia from [Home and help for life.

Odile B.:

Oh my goodness, Claudia, fresh from the phone. Thank you for being on the line. I haven’t seen you for a long time. It’s good to hear your voice.

Claudia:

I’m doing okay. So from my home for life perspective, thank you for all that you do, by the way, for the villages that I’m sure you’ve never mentioned that a while ago, but she also works as well. A lot of work, she does at the villages. So from the British perspective, I’m getting a lot of casual emails from my seniors. They desperately trying to seek how they can get assistance to register for the vaccine. Is there any program that we can collaborate on to assist them?

Odile B.:

Thank you so much, Dr. Warren. Thank you for this, Claudia. Really, a lot of older adults are very concerned about that. So obviously, the confusion is there, eight different ways people can try to register for the vaccine. We have the pharmacies, we have the mass vaccination sites organized by the state, we have the hospitals, and then we have a local health department.

Odile B.:

So the local health department, we have a website where people can register. And if people do not have access to the website, that is perfectly fine. There is a telephone line, just spoke clearly with respect to the assistant. So, anyone who needs help, we were just doing a public county public health call. Please call 240-777-2982, 240-777-2982. This is the phone line for everyone who needs help pre-registering for the county public health vaccination. Right now, public health received about 30% of the available vaccines in the State of Maryland.

Odile B.:

So 70% of the vaccine are given by the state to pharmacies, hospitals, and mass vaccination sites, and again, the local public health who receive 30% of the doses. So again, I encourage anyone, 240-777-2982. Now, for the online registration, people don’t have to do it themselves. A family member, or friend, or neighbor, anyone can assist someone who has difficulty doing it themselves online. And the online question also asked, do you need assistance with transportation? Do you need assistance with ambulation? So please make sure that when people registered, they informed us that what is needed to make sure that they can successfully obtain the vaccine.

Steve L.:

All right. Well, thank you again. I’m mindful of everyone’s time. Odile, we can probably spend a day with you.

Odile B.:

That’s great. I love it.

Steve L.:

So many things to talk about, because when I think about that, I didn’t even get to ask you about respite programs of the villages, or food insecurity, or transportation challenges, so maybe we’ll have time to get on your calendar again in the future. I do want to thank you for coming today. It was fabulous. Again, this was Odile Brunetto, the Chief of Aging and Disability Services. And my name is Steve Lorberbaum, I’m the owner of Assisting Hands Home Care, and I thank you all for joining today.

Odile B.:

You’re welcome. Thanks to you until next time.

Steve L.:

All right. Goodbye, all.

Odile B.:

Bye-bye. Thanks for joining. Bye-bye. Be safe.

Steve L.:

Thank you.

Odile B.:

Be safe.

If you would like to schedule an appointment to discuss your Alzheimer’s and Dementia care needs or to set up a free in-home evaluation with one of our nurses, call us today in Potomac (301) 363-2580, MD at (301) 363-2580, or VA at (703) 556-8983. We are located in Reston, VA, (703) 556-8983.