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Male voice: Brought to you this afternoon by Witt Brothers Market across from the First National Bank of Wyoming in Wyoming and

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by Buchanan Service Firestone South Governors Avenue, Dover. Jack's comments are not necessarily those of the sponsors or of this station.

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[Guitar solo from "Classical Gas" by Mason Williams] Rick Gettis: And a pleasant "Good afternoon" to you on this Friday afternoon, 17th day of January, 1986.

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I'm Rick Gettis. This is the WKEN Speak Your Peace program. And we have a guest with us this afternoon to discuss issues surrounding the

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elderly in the First State. And our guest is the Director of the Division, and that is Eleanor Cain,

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and we'll be talking with her today about everything virtually that relates to the elderly. And if you have questions, 674-1234

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is our Speak Your Peace number. And certainly at any time we'll entertain your question. Don't wait too late though.

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If you wait until the end of the program, that's when everyone else seems to wait. And on occasion we end up not able to get to everybody's question.

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So call early if you have a question, or if you think there's something you might want an answer to, and we'll try to get

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an answer for you, okay? 674-1234. We'll tell you a little bit later about what's coming up the beginning of next week.

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We will have guests next week as well. Some interesting programs I think coming up. Mrs. Cain, welcome to Speak Your Peace. Eleanor Cain: Good afternoon, Rick.

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Nice to be here. RG: Tell me first of all about the, a little bit about the demographics in Delaware. We're hearing all over the nation that

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the number of elderly are increasing, and becoming a greater percentage of the population as well as numbers. How do we stand in Delaware?

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Are we along with that same trend? EC: Well, we're along with that same trend. In fact, percentage wise, we have more older people

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living in Delaware than the national percentage. Those persons over the age of sixty right now in Delaware is almost

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sixteen percent of our population. And in fact, the older population, as it is nationally, is growing faster than any other segment

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of our population. Here in Delaware, when we received our 1985 estimates, just at the end of this past year, we now have in Delaware

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ninety-seven-thousand people over the age of sixty. And between the time the 1970 census was taken and the 1980 census, our population over sixty grew by thirty-five percent.

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And we expect another twenty-five percent growth at the turn of the decade, 1990. And I could go on into the year 2000 and beyond.

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But I think the most interesting thing about that is that when I talked about those percentages, the total population in Delaware

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only grew by five percent between 1970 and 1980, and they expect about a seven percent growth between 1980 and 1990. Of course, those are only estimates.

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So you can see about that population. And the oldest of the old, the seventy-five to eighty, are the fastest growing of all.

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And the last time the census was taken, it was like forty-two percent of that population was over the age of seventy-five to eighty. And of course, both you and I know

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of people who are in their eighties and nineties. And in fact, it's not even unusual anymore to hear about someone who has arrived at the age of one-hundred.

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RG: Now for Delaware's purposes, then, sixty is the defining age. EC: For the Division of Aging. And what defines that

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is the Older Americans Act. The Older Americans Act, which was passed by Congress in 1965, and primarily those are the dollars

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that come to Delaware through the Division of Aging, and the age is targeted for those sixty and above. RG: In a lot of areas, they're attempting

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to move ages back as far as the ages for receiving retirement and so forth. Do you foresee in the future because of

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the fast-growing population in this age category of sixty and above, that there will be a move to define the elderly as maybe

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sixty-five and older, as opposed to starting at sixty? EC: Well, they're talking about that now. And of course right now,

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they, Aging, you know, has different ages. Our services are for those sixty and above. If you are interested

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in subsidized housing, it's sixty-two. Medicare begins at sixty-five. So it just depends on where the cash comes from as to

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what age you can apply for a certain program. But what they should do is everybody get together, and they have one age. I'm not so sure that

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in the future that the Older Americans Act, which is the dollars that come into the Division of Aging, that they will not increase

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the age from sixty to sixty-five. RG: I see. So you think that's on the horizon? EC: Well, for one thing is that, let's take for instance,

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our senior centers. We are finding people older who are going into senior centers and nutritions. And where

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the nutrition sites are every year. Where at one time we saw a lot of people in their early sixties, now most of the people that we see

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in the nutrition program are into their seventies. And I think that this is characteristic of people, some of them working part-time, who are in their sixties.

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People are more active than what they used to be. And they really are not entering the programs

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at the early age of sixty any more. RG: Another area, speaking of the financial aspects, has to be Gramm-Rudman.

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Now, there's much concern in the State today. Mr. Golding expressing some concern about what's happening, and some dismay at the way

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it was handled by the Congress. But as far as your particular Division is concerned, Aging, will you expect to see major cuts,

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or loss of services because of Gramm-Rudman, as far as what you know at this point? EC: Well, I'm very concerned about Gramm-Rudman. You know

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the Older Americans Act is the only categorical program left. And in the past when the other programs, domestic programs have received cuts,

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we have been very lucky that we have not gotten any cuts. But we haven't gotten any increases either since 1981.

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So you know what's happened to the money that comes into the Division. If Gramm-Rudman goes, becomes effective, we will have the same cuts

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that they're predicting for all the domestic programs. Somewhere between four and five percent. I have had an opportunity

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to personally talk with the Commissioner on Aging. And she is hoping that during the first year that she will be able to take that cut in

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the discretionary money that she has available in the Administration on Aging. If that's true. And she's able to do that,

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then the first year we will not expect any cuts in our nutrition and social service program. The second year, that's a different story.

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If she's not able to do that, use the discretionary money that goes to the Administration on Aging. Then of course, we are

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going to have to look at the services that we provide here in Delaware. Our goal is to help those individuals

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closest to institutionalization, the most frail. That will still be our goal. And of course, our programs

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will be for those individuals. And we will have to take a look at all that. RG: I see. Do you expect any serious loss of programs?

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I suppose that like any other department or agency, if you face serious cuts in programs that you feel are necessary,

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then you can certainly go to the State and ask for State funding in those particular areas. Do you envision that happening?

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Do you think that is your budget so bare-bones now, for example, that a four percent cut that we're talking about, or five percent,

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that it may mean that serious services would be lost by elderly, or significant elder populations in this State? EC: Well, first of all,

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the State has been very good to us anyway, in our budgets over the last few years. And as far as the future, even this year, FY87 coming up.

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And of course, I'm waiting for the Governor's recommended budget, but the Division of Aging did apply for some extra funds

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for a social services and nutrition. Not because a cut backs, but because we haven't received additional federal dollars, and mainly

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because the aging population is growing. And as I said when I talked about the demographics, the population over seventy-five and eighty

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that we're finding more homebound people all the time. People who are leaving the hospitals earlier than they used to,

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who really need support at home. Families are giving most of the support. And what we're doing really is helping families care for

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their older relatives out there with the nutrition and social service programs that we currently have.

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RG: I see. Some people say, and I suppose there are those that wish to see other programs that maybe aren't available.

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But they say that things aren't being done for the elderly in the State. How would you answer that? Are things done?

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Certainly, I think to most people they can see a lot of programs, the model maturity centers. Some areas like Dover have the bus services,

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the nutrition programs, on-site programs for nutrition. There seem to be many, many things out there,

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but some still say that nothing is really being done for the elderly. EC: Well, I think there's a lot being done for the elderly.

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And not only through the State agency, but also through the private agencies and the volunteer agencies. Yes, we have gaps in service.

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We all know that. And the Department of Health and Social Services, which the Division of Aging is part of, is working towards filling some of those gaps.

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We wrote the Long-Term Care Plan the department did about five years ago, and that was the blueprint for the future as to what those gaps are.

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And we have made great progress in helping to fill those. One, for instance, is in the whole area of housing.

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Housing is a problem for older people. And last year the General Assembly passed a bill that started a counseling, housing counseling program

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within the Division of Aging. And I now have staff on, and have been on since fall, and they're in the process

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of developing some new housing options out there. For one thing, most of our older people in Delaware live

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in their own homes and most of them even own their own homes. And what we found is that so many people who are older people have large homes,

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maybe three, four, or five bedrooms. They now live alone, most of those being women, because women live longer than men.

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And they're finding it difficult to keep that home up with the energy cost, and the maintenance and the repairs. Or maybe they need more healthcare

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because they may be seventy-five, eighty, eighty-five years of age. We're looking into developing a home-sharing program where an older person

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can share a bedroom, or two, with another older person or two. They can help with some of the expenses in the home. Naturally, the would

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charge them for it, for the use of that. But we're also looking at a home-sharing program where they can share a room,

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let's say with students at Wesley College or Delaware State College or the Delaware Technical and Community College.

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That the students can pay a nominal fee. But just as important is they can help the older person with chores, shoveling snow. I think it snowed here in Kent County

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just last week. Raking the leaves in the fall. As we grow older, sometimes we have to give up our vehicles that were used to

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driving ourselves to the grocery store, to the drugstore, having someone take us once a week, to put in the screens and the spring

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and the storm windows in the fall. Things that we find it more difficult to be able to do as we grow older. That is a program that we are

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now in the process of designing. And there will be counseling with that so that the matches are just as good as

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we can possibly make them. We're also looking into a home equity conversion program. You know, there are

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millions of dollars tied up in home equity. And all of that money is sitting there. And we don't have access to it. Across the country now,

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they are beginning to develop a home equity program where let's say at the age of eighty, you need repairs to your home,

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you need to pay for more healthcare within your home, and you do not have the current cash-flow.

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We're trying to work out a program where you can take the equity in your home, let's say, over a period of ten or fifteen years, and you can receive from a lender

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a monthly check that would help you keep that home in repair, and also to pay for some of the care that you need in that home.

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And we have to think that way because of the diminishing federal dollars out there. It's true that people are applying more

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to the State to help pick up some of those programs. But you know, it's all of us are applying to the State,

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not just the Division of Aging, but also the other agencies within State government. And I'm not just so sure how much the State

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will be able to do as time goes on. So we're having to look at creative ways. We're trying to look at the community as a whole,

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not just programs that we're developing within the Division of Aging, but looking at the private community, the volunteer sector.

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Somebody talks about volunteers, that women are going back in the workforce and that's very true. But look at all the people who are retiring.

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What a wonderful way for those individuals to contribute to their community. They've got a lot of knowledge,

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a lot of experience. And as a community, I think that we can work these problems out. But it has to be the community to do it.

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RG: There are a lot of programs. Counties have their offices, at least Kent County has an Office on Aging. As you mentioned, some private

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organizations, and so forth around the State. What specifically is the Division of Aging charged with doing? What is their responsibility as far

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as the elderly are concerned by statute in this State? EC: Okay, by statute the Division of Aging is responsible

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for planning and coordinating services for older people, and advocating with other agencies within State government, local government, and the private sector

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for the needs of older people. RG: I see. We've heard in this country that there has been a big influx of,

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at least we're hearing more about it, maybe there's not a big increase, but elderly abuse of elderly people. Is that then something that

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your department, Division would be looking into? EC: Yes. We're very, naturally we're very interested in all of those problems.

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And we have several programs that address that. The Division of Aging has the Adult Protective Service Program. That was a piece of legislation that

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was passed by the General Assembly in 1982, I have social workers, upstate and downstate, for all adults. Anyone over the age of eighteen who may be

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abused, exploited, or neglected, social workers will go out and investigate the case. If it is indeed an Adult Protective case,

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then of course the case work is done, whatever that may be. We also have the Nursing Home Ombudsman Program

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that is mandated to us through the Older Americans Act. And we contract the Ombudsman Program out where there is

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someone who will investigate complaints from residents, family, staff of all of our long-term care facilities

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throughout the State. And we are very much on top of those problems. I think here in Delaware that we're

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very lucky with our nursing homes. We have some very fine nursing homes in Delaware. And there's a lot of training that's being done

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on patient rights within the nursing homes. My Adult Protective workers are out in the community. They're working with the police departments,

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the hospitals, and all other agencies where there may be community abuse. Unfortunately, most of the abuse that they

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find is with older people. About seventy percent of our statistics show us that the abuse that is called into our agency,

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is with people over the age of sixty-five. And of course, that's a reason why Adult Protective Services happens to be in the Division of Aging.

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RG: I see. What types of specific programs does the State offer for the elderly? And I guess basically what many of the elderly are concerned with,

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I guess are those types of programs that are involved with help with food, with medicine, with housing-- EC: Well, one of our largest programs,

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of course, is the nutrition program. And that is both congregate and home-delivered. And the project here

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in Kent County is Modern Maturity Center. And there's a site at Modern Maturity Center. There is one in Milford at the Milford Senior Center,

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one of the Harrington Senior Center. There's one at Peach Circle in Smyrna. There's one in Kenton. I think those are the five that

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we have in Kent County. There is also a home-delivered meals program. The home-delivered meals program will deliver a hot meal to

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any older person who is unable to leave their residence and attend a congregate site each day. And some provision is made

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for a weekend if the older person does not have someone who can prepare a meal for them on Saturday and Sunday.

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RG: Now, some of the elderly have complained about the congregate centers themselves. They have said, for example,

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that they see many people that are well able to afford the cost of that meal that's provided. That are since they're

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generally asked to make a donation as to what they feel they can afford or putting in extremely small amounts, nothing to even come close

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to paying for the cost of the meal. Is that a problem? Is that a problem with the system? EC: Rick, I'm really glad that you mentioned that

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because I'd like to talk about that for a couple of seconds. First of all, it is not a free program. That is that is a misconception. It is on a

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donated basis and we ask for the minimum donation to be seventy-five cents. Now some people can give more than that. And then there are people

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who cannot give that. That money that is donated stays with the food program and can be used only to buy food.

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Without those donations, we will not be able to continue the program as we currently are. We have raised the minimum donation just this summer from fifty cents to seventy-five cents.

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Each meal that goes on the table costs us about three dollars. Now if I go into a site, I pay three dollars.

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Or if you were to go into one. The older people, it's whatever they feel that they are able to give.

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And believe me, we really need the donations because the donations are a part of their contract and we have to rely on those.

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And without them, the food program will have to be cut back. RG: Well, some might say why not, as the schools do,

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require information to be filled out to determine the status of an individual and whether they qualify to pay seventy-five [cents], a dollar,

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two three, whatever it might be. Why not something like that as opposed to totally come in and pay what you feel you can pay?

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EC: Well, first of all, the Older Americans Act is not a welfare program. It's available for all people over the age of sixty.

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Because I firmly believe that there is no one who is going to any nutrition site or senior center unless they really need

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the fellowship and the companionship of that program. And loneliness has nothing to do with how much money you have.

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There are many people who are in the nutrition sites because they have lost a spouse or because their friends have passed away and they need to make

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new companionships out there. And there's no better way to do it than to attend one of those programs. That's the reason that

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there is not a means test taken. But if you have the means, if you have the income, we ask you to donate as much as you can

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towards that three-dollar meal out there. Because if the donations drop off and if people are only putting in nickels and dimes,

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or twenty-five cents or so forth, then there's no way that we're going to be able to keep the program going at the level that it is now,

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and even increase the level. Because we should be looking for new sites to open, and enlarging the program. When I talked to you

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about the the demographics. Now, there are people in Delaware who cannot give, and those people are just as welcome.

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And there is no one who will be turned away because they can not put into the basket, or the envelope, or however

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the donation is collected, because we do have poor of people in Delaware. And in fact, twelve percent of our older people

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over sixty right now are living below poverty. And we've got about thirty-six percent of our population in Delaware over sixty

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who are trying to survive, and I'm using the word "survive," on an income below ninety-two-hundred dollars a year. RG: That's sad. ED: And that's pretty difficult

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to do when you're trying to live in your own home. RG: You're expressing some concern that if the donations aren't there

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and a reasonable level, there may be problems. Programs have obviously been ongoing for number of years now. Are you experiencing problems?

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Or you foresee with the current level of donations that there maybe problems? There must be if you had to raise it from fifty to seventy-five cents--

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EC: I have a problem right now. The problem right now is that we're not able to feed everybody who really and

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truly needs the program. We have people who are waiting for a home-delivered meal, who might have been discharged

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from the hospital and there is absolutely no way that we can go and give them a meal. People come and go off the programs, so of course, that opens up

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from time to time. But there isn't any more money. That's really what it boils down to. And right now, I have

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tightened the management of the programs and we put more controls on, more accountability. And between that and

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the donations that, for people who can donate, I'm hoping to be able to keep the program at the level that it is now. And of course, I would like

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to be able to increase it. RG: I understand there was recently charges of discrimination brought, at least against one of the centers.

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That they were discriminating against, I guess, a racial basis is the way I understood it. I understand that may have been resolved. But is that a problem in the State?

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ED: I don't have any problems whatsoever in any of my nutrition sites. All of the nutrition sites are open to anyone regardless of race.

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All of our nutrition sites are integrated, both black and whites. And we have never, ever had any problem that way.

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And in fact, I get quarterly reports out there. My minority count is way up. And I'm very pleased

00:22:30.230 - 00:22:39.110

with the numbers of people who are truly needy and who participate in the program, regardless of their race.

00:22:39.110 - 00:22:48.360

And that information, when that hearing was held here in Dover, was, it was unfounded. RG [softly]: I think just totally unfounded.

00:22:48.360 - 00:22:52.580

[louder] We're talking with Eleanor Cain, the Director of the Division of Aging for the State of Delaware. Now we'll quickly remind you,

00:22:52.580 - 00:22:57.890

674-1234 is our number. If you do have questions about programs for the elderly, or want to talk with Mrs. Cain,

00:22:57.890 - 00:23:03.770

the phone lines are open. We'd be happy to entertain your calls at this time. 674-1234 is the number.

00:23:03.770 - 00:23:10.900

Mrs. Cain, I guess another area that we'd like to to touch on is the area of medical help. And recently, I guess,

00:23:10.900 - 00:23:18.350

when I say recently, a couple of years ago I guess, one of the offshoots of the DuPont company, there was a case settled in Florida

00:23:18.350 - 00:23:23.300

and so forth that provided certain help to the elderly in the State of Delaware. Exactly what's going on with

00:23:23.300 - 00:23:30.110

that now? Is it still available? Is it available to people in Kent and Sussex Counties? And on what basis?

00:23:30.110 - 00:23:35.670

EC: Oh, yes. That's the Nemours clinic. RG: Right. And it was in the Nemours Foundation that you're referring to.

00:23:35.670 - 00:23:45.600

And the Nemours Clinic is very active and is open every day. In fact, I believe it's six days a week in Wilmington.

00:23:45.600 - 00:23:52.850

There's transportation that is provided from the senior centers here in Kent County and also Sussex County that

00:23:52.850 - 00:24:01.770

transport people to Wilmington. and they've also done some contracting with some private doctors here in the two lower counties.

00:24:01.770 - 00:24:11.360

The program is a pharmacy program, for one, and it's like a co-payment. And there's also an eye-care program and a dental program.

00:24:11.360 - 00:24:19.010

And I believe that it is a dental program that they are now contracting with some of the private dentists in Kent and

00:24:19.010 - 00:24:27.880

Sussex County because, so that older people can go to a dentist very near where they live. Some people, of course,

00:24:27.880 - 00:24:34.310

are not able to ride the two hours, let's say if you live in Sussex County, to Wilmington, and then another two hours back again.

00:24:34.310 - 00:24:42.020

And then maybe have to wait for seven or eight people before you can even return home. And the Nemours Clinic

00:24:42.020 - 00:24:48.770

has made some provisions for that. Also in the pharmacy area, there are certain drop-off points where you can

00:24:48.770 - 00:24:56.120

take your prescriptions and they will be picked up and then sent to Wilmington, and filled, and then back down again

00:24:56.120 - 00:25:01.790

in a very, very short period of time. So the Nemours Foundation has made provisions that they can, where they can serve

00:25:01.790 - 00:25:14.720

people throughout the State. They also have provided a grant to Visiting Nurse Association for certain kinds of help, nursing help in the home.

00:25:14.720 - 00:25:25.100

And that also is on a State-wide basis. So there the help that they had provided through the Foundation has been very, very helpful to a lot

00:25:25.100 - 00:25:32.310

of older people living here in Delaware, especially in those three areas of pharmacy, eye-care, and dental care. RG: Now, I would assume that people that

00:25:32.310 - 00:25:39.560

want information that your agency, although you don't administer the program, it's administered by the Nemours Foundation. I guess that to you still provide,

00:25:39.560 - 00:25:46.370

act as a clearing house to channel elderly to these types of programs that the Nemours Foundation may offer and that other people may offer

00:25:46.370 - 00:25:52.250

in the State? EC: That's right. I mean, for any information that any older person would want on any service, they could call

00:25:52.250 - 00:25:57.430

our offices. We have an office in Wilmington, which is on the grounds of the Delaware State Hospital,

00:25:57.430 - 00:26:04.600

where most of the administrative offices of the Department of Health and Social Services are located. And then we also have an office in Milford,

00:26:04.600 - 00:26:11.970

which is at the Milford State Service Center. And you call either one of those offices and receive any information that you want.

00:26:11.970 - 00:26:18.650

We also have a guide to services for older Delawareans too, and that not only has the services that are provided

00:26:18.650 - 00:26:26.990

through the Division of Aging, but also other services that are provided regardless of how and what way to older people in the State.

00:26:26.990 - 00:26:35.570

And in fact, the brochures are available at any senior center or nutrition site throughout the State. RG: I see. Eleanor Cain is our guest.

00:26:35.570 - 00:26:46.560

Speak Your Peace. Do you have a question? Female voice: Yes, I'd like to ask Mrs. Cain. What is considered below the poverty level for an older person who is a widow? Or who are a widower?

00:26:46.560 - 00:27:00.250

EC: I don't have the exact figure with me, but it's somewhere around forty-seven-hundred dollars a year. Female voice: And it's my understanding that they were trying, they were planning to keep

00:27:00.250 - 00:27:11.930

older people in their homes as long as they could. You know, say for instance, you have a small mobile home, would you help people live in it as long as they can? They stay in their own homes?

00:27:11.930 - 00:27:18.500

EC: Doesn't make any difference whether your home is a mobile home. It's still your home and we are interested in

00:27:18.500 - 00:27:29.630

helping you stay there as long as possible. Female voice: It isn't a big home. It isn't as though you have a lot of rooms to heat and everything. EC: That's all right. Yeah.

00:27:29.630 - 00:27:41.390

Older people can stay as long as they can in their on homes? EC: That's absolutely right. Female voice: Well, I'm glad to hear that. And now repeat that again for the four-hundred? EC: It's about forty-seven-hundred dollars.

00:27:41.390 - 00:27:49.280

I don't have the exact figure with me, but it's about forty-seven-hundred. Female voice: All right. Thank you. RG: Okay, thank you for calling. 674-1234. The number if you have

00:27:49.280 - 00:27:53.810

a question for Mrs. Cain, the Division Director of the Division of Aging for the State of Delaware,

00:27:53.810 - 00:28:01.640

if you're interested in programs for the elderly or have comments about them. Our phone lines are open. 674-1234 is the number to call.

00:28:01.640 - 00:28:08.040

Mrs. Cain, earlier you outlined some programs, things that I guess that you think, or that will be coming up for the elderly in the State.

00:28:08.040 - 00:28:14.460

What do you see as the major concern? It seems that many people talk about this pharmaceutical area. The medicine versus

00:28:14.460 - 00:28:22.070

the food question that seems to continually arise even though we have the the nutrition sites in the State. Is there anything that is going to be done

00:28:22.070 - 00:28:31.600

on that score in the future? EC: On the pharmacy? RG: On the pharmacy issue, yes. EC: Well, the pharmacy issue. The Nemours Foundation picked up that program,

00:28:31.600 - 00:28:39.980

which we are very grateful for, and they have raised the criteria once. And if there is a need and they feel that there's that need

00:28:39.980 - 00:28:48.050

because of it being expressed by people living in the community, then I'm sure that they will take under consideration again

00:28:48.050 - 00:28:56.590

the possibility of raising the income eligibility for their program. RG: I see. But right now do you have an idea what that might be?

00:28:56.590 - 00:29:02.940

EC: It's somewhere in this little book that I have here in front of me. Okay? RG: Okay. We'll suffice it to say that it is in the book on aging

00:29:02.940 - 00:29:07.190

that we referred to. EC: It is in the book on aging. That's right. RG: If you'd like to check that or you can certainly call the number

00:29:07.190 - 00:29:14.020

if you're interested in the programs administered by the Nemours Foundation as to what the criteria for income may be.

00:29:14.020 - 00:29:20.060

What do you see as the most significant problem facing the elderly in the State of Delaware in the coming years?

00:29:20.060 - 00:29:27.470

EC: Well, first of all, I think the most pressing thing is income. If we had enough income, we would be able to purchase services.

00:29:27.470 - 00:29:35.910

So income is very, very important. And the other is healthcare. And under healthcare we can put a lot of things. We can add

00:29:35.910 - 00:29:49.610

home health, along with medical care, and that whole long-term care system that we talk about out there. Adult daycare is part of that.

00:29:49.610 - 00:30:00.790

Keeping our people healthy. We can do that through prevention. There is a program nationally that has been sponsored by the Administration on Aging

00:30:00.790 - 00:30:07.820

and the Public Health Service. And the Division of Aging and the Division of Public Health are working towards a promotion

00:30:07.820 - 00:30:14.850

prevention program. Trying to keep our older people healthy through proper nutrition, through exercise,

00:30:14.850 - 00:30:26.330

through safety in their home. Those are some of the ways that we are beginning to move and work in that whole prevention area.

00:30:26.330 - 00:30:34.040

Of course, it's not just older people that they're talking to that about, but also to all of us trying to keep us healthy.

00:30:34.040 - 00:30:39.800

RG: Are there significant numbers of elderly falling through the cracks, for example on Medicare? We understand that they

00:30:39.800 - 00:30:47.180

continually seem to be raising here over the last few years the the deductibles on Medicare payments. And obviously it is separate

00:30:47.180 - 00:30:53.600

from the Medicaid program, which is the welfare type of program, So do we have significant numbers of people having difficulties

00:30:53.600 - 00:31:02.600

with this continuing increase in the deductions and deductibles of Medicare? EC: Well, every time that there is a tightening of the Medicare program,

00:31:02.600 - 00:31:07.900

of course, that's more of a burden on the pocketbook. And because they either have more of a deductible.

00:31:07.900 - 00:31:16.940

And if you have any kind of a medical problem where you're hospitalized or need more physician care or what have you, and

00:31:16.940 - 00:31:24.830

the deductible is raised and the other benefits, of course, that's more of a burden to the older person. And they feel that.

00:31:24.830 - 00:31:32.570

They definitely feel that. Those who are on a limited income, and there are hundreds and thousands of older people out there

00:31:32.570 - 00:31:42.290

who are on a limited income. And it's difficult for them because they're no longer in the workforce. Many of them are not even able to work,

00:31:42.290 - 00:31:51.390

even if they were able to because of age and because of some sort of a chronic, possibly a health problem that they have.

00:31:51.390 - 00:31:58.450

So they're limited. And every time that these programs are cut, it's a major effect on them, because they have nowhere to turn.

00:31:58.450 - 00:32:05.350

RG: How about the transportation problem? Delaware is not known for mass transit, especially in the lower two counties. Is that a significant problem?

00:32:05.350 - 00:32:11.790

Is it an increasing problem in the State and will there be anything to address that problem of the elderly? EC: Well, it's a problem.

00:32:11.790 - 00:32:20.380

There's no doubt about that. Of course, it's more of a problem in rural areas than it is in the city. Of course, the city people don't agree

00:32:20.380 - 00:32:25.000

with that because the buses may stop running at six o'clock at night and they can't go anywhere.

00:32:25.000 - 00:32:32.410

But it is a problem, because as you get older many times you have to give up your automobile.

00:32:32.410 - 00:32:40.060

And in order to get access to any kind of service, medical service, social service, you have to have transportation to do that.

00:32:40.060 - 00:32:47.220

And of course, we are fortunate in Delaware because we do have DAST. And along with DAST, we also have right here in Dover.

00:32:47.220 - 00:32:55.470

We have the Dover Surrey. And I think that's thanks to the City and revenue-sharing that provides for that. So we do have

00:32:55.470 - 00:33:06.000

transportation that's available, but it can always be increased. And we can always probably try to better coordinate the transportation that

00:33:06.000 - 00:33:11.910

is available out there. And I know those kinds of meetings are going on all the time. Most of the senior centers,

00:33:11.910 - 00:33:20.760

if not all of them, have a vehicle. Some of those vehicles are coming from the Department of Transportation through money that is made available to Delaware.

00:33:20.760 - 00:33:31.170

And we have encouraged the senior centers and the housing complexes in Delaware to apply so that we can have some transportation,

00:33:31.170 - 00:33:39.580

not just for medical appointments, but also for shopping. And everybody likes to take a ride out in the country once in a while too.

00:33:39.580 - 00:33:46.410

RG: And we mentioned earlier the question of some people that say that there's very little being done for the elderly by the government.

00:33:46.410 - 00:33:50.900

There are also those on the other side of the coin that say that the government is spending way too much.

00:33:50.900 - 00:34:00.570

That in fact, we're getting into cradle-to-the-grave care of people. We jump right in at the beginning of life and want to see

00:34:00.570 - 00:34:06.450

them right through to the end. And some feel that that's a burden on the society. How would you answer that?

00:34:06.450 - 00:34:12.900

Is it a burden trying to provide the programs for the elderly on the taxpayer? Will it become a greater burden

00:34:12.900 - 00:34:20.060

with the expected cutbacks? EC: When people talk about all the money that's being spent on the elderly, they're also including Social Security.

00:34:20.060 - 00:34:28.560

And of course, Social Security is something that they've paid into, and that they're entitled to. Of course, as when I

00:34:28.560 - 00:34:35.830

talked about the demographics, when you have got a declining birth rate out there, and you've got more older people. You see you have to have more workers

00:34:35.830 - 00:34:42.900

in order to provide for the Social Security payment for one individual. And in fact, I don't

00:34:42.900 - 00:34:48.630

have those figures in front of me, but that will increase as time goes on. The one thing that we don't want to get into is pitting

00:34:48.630 - 00:34:56.550

the youth against the aging. That's why it's important for us to work as a community. And the older people don't want

00:34:56.550 - 00:35:05.100

to have the youth pitted against them. The older people themselves are very, very concerned about the youth of today. And most of them are

00:35:05.100 - 00:35:12.600

grandparents and they're very supportive of that. And that was very much under discussion when they were

00:35:12.600 - 00:35:20.940

talking about Social Security cuts, about how the older people felt. So there's a lot of sensitivity out there and we

00:35:20.940 - 00:35:27.480

don't want to get ourselves into that battle. RG: Rather than the State or federal government spending a lot of money to keep people

00:35:27.480 - 00:35:34.830

out of some of the institutions, would it not be better to offer more incentives, tax incentives to families

00:35:34.830 - 00:35:40.590

to take care of their own elderly. Certainly not everyone has a family to fall back on. So obviously some of

00:35:40.590 - 00:35:46.280

these programs would be needed, but would we not be better off to encourage that the families themselves take care of the problems

00:35:46.280 - 00:35:54.870

of those that are older in the family? EC: Well, there was a bill introduced last year in the General Assembly. It was not passed,

00:35:54.870 - 00:36:04.080

either by the House or the Senate, that did provide for a twenty-five-hundred dollar tax credit to people who would care for an older relative in their home.

00:36:04.080 - 00:36:12.720

And of course, criteria would have to be set up for that, and also, what would we talk about income. But that is something that we should think about.

00:36:12.720 - 00:36:20.820

But more than that though, families need support services out there. There's a lot of data on that,

00:36:20.820 - 00:36:30.150

that it really is not the tax credit, the tax incentive for the family, but it really is the services for them. There are more and more older people

00:36:30.150 - 00:36:36.180

living with their families all the time. And what families need is some sort of a respite care in case they themselves

00:36:36.180 - 00:36:44.370

have an emergency, or the family wants to go away for a weekend or for two or three days. The adult children are the ones that they're

00:36:44.370 - 00:36:51.590

referred to as the sandwich generation. They've got children in college, older parents that they're helping to care for,

00:36:51.590 - 00:37:00.360

and here they are at midlife, let's say, and they're sandwiched in there trying to help provide for both.

00:37:00.360 - 00:37:05.910

So what they really need is a support out there. There are a lot of support groups that have sprung up

00:37:05.910 - 00:37:14.690

throughout the State, in fact fifteen or twenty, where families who are caring for older relatives can go and meet on a regular basis

00:37:14.690 - 00:37:23.220

to get some help as to relate what some of the problems are, how can they better care for them, and then support from one another.

00:37:23.220 - 00:37:30.270

That has been very, very important. And those support groups are springing up all over the State and they're very,

00:37:30.270 - 00:37:37.620

very well-received and very well-attended. Respite care. Now that's a program that we started in a very small way,

00:37:37.620 - 00:37:46.080

the first of the year, and we have one contractor throughout the entire State. And what I'm talking about emergency or for a weekend away.

00:37:46.080 - 00:37:55.860

We're going to see how that works. Adult daycare happens to be another program which is respite for families. In many families now with

00:37:55.860 - 00:38:03.540

both husband and wife working and trying to care for, let's say, a mother or a father. And it does take both husband and wife

00:38:03.540 - 00:38:09.630

to work and sometimes the older person need supervision. Adult daycare can be just the answer for that.

00:38:09.630 - 00:38:20.070

Where the individual who is frail and who needs supervision and monitoring of medication can go to a daycare program every day

00:38:20.070 - 00:38:28.350

and still return home at night, and on weekends and holidays, be part of the family and part of the community.

00:38:28.350 - 00:38:38.880

It's important for us to design programs such as that for families. We're getting ready to develop our State plan for the next three years.

00:38:38.880 - 00:38:48.630

Beginning in October of 1986 is when the new plan will become effective. And the State plan is a plan which is signed every three years

00:38:48.630 - 00:38:58.270

by the Governor of the State, which is actually our contract with the Administration on Aging. And right now we are beginning to design

00:38:58.270 - 00:39:05.880

that plan around the issues of older people and their families living here in Delaware. This morning I was at the area

00:39:05.880 - 00:39:13.560

Advisory Council on Aging here in Kent County and we were talking about that because it's very important for me

00:39:13.560 - 00:39:22.530

to hear from the older people in Delaware and their families exactly what the issues are and how we should address those issues

00:39:22.530 - 00:39:29.700

over the next three years. In Kent County today we were talking about a couple of community forums because I really want to hear

00:39:29.700 - 00:39:37.470

from the people and I thought that the best way to do that would be to ask the advisory councils if they would host community forums.

00:39:37.470 - 00:39:47.920

We haven't had any in Delaware since 1981, pertaining to the aging. And the advisory council today has set up two community forums for Kent County.

00:39:47.920 - 00:39:55.880

One is going to be held at the Modern Maturity Center on the 25th of February at ten o'clock in the morning.

00:39:55.880 - 00:40:05.100

The other one is going to be held on the 26th of February at Milford Senior Center at ten o'clock in the morning. And these two forums are not

00:40:05.100 - 00:40:14.160

just for people who attend those senior centers, believe me, they are for the community. We're interested in families attending,

00:40:14.160 - 00:40:25.200

people in our academic institutions, nursing home staff and administrators, just the general public. People who have neighbors

00:40:25.200 - 00:40:33.660

who are growing older and who see what some of the problems are. Because if I don't hear from the community as to what the issues are,

00:40:33.660 - 00:40:41.400

then I'm not so sure that that plan is going to be drafted to the real needs and the concerns of

00:40:41.400 - 00:40:52.980

the aging community here in Delaware. And I'm hoping, Rick, that you'll be able to announce those forums as the month goes on and into February

00:40:52.980 - 00:41:04.500

so that the Kent County community will really help the Division of Aging during the spring address the needs that the older people have and

00:41:04.500 - 00:41:11.310

how we can better meet those needs over the next three years. RG: Eleanor Cain is our guest today, Speak Your Peace. Do you have a question?

00:41:11.310 - 00:41:24.210

Female voice 2: I would just like to ask. I wonder if, of course we know the needy have the care, and so on, but the ones who are not in need and so on, if the children. Now do they inherit

00:41:24.210 - 00:41:33.180

after their parents are recipients? I wonder about that. And I thank you. RG: Hold on just a minute. Hold the line Let's just make sure she has your question.

00:41:33.180 - 00:41:40.770

EC: I'm not sure what she means. RG: You're asking about-- Are you still there? No, apparently not. So I guess we'll have to sort of guess.

00:41:40.770 - 00:41:47.760

I kinda think what she was asking is if people that are not, I guess, totally needy, not passing a needs test

00:41:47.760 - 00:41:52.230

for some of these programs. I think she was asking do the children inherit the property, even though the State

00:41:52.230 - 00:41:56.910

at some point in time has been providing some sorts of assistance to them. EC: Well, the State does not have

00:41:56.910 - 00:42:03.600

any lien on your property at all. I mean, the property belongs to you and it's in your name. Now if she's talking about

00:42:03.600 - 00:42:10.150

home equity conversion. Okay. You will be taking the equity out of your home.

00:42:10.150 - 00:42:18.260

And of course, you know, with our homes and our savings and so forth are really put aside to care for ourselves anyway.

00:42:18.260 - 00:42:28.260

And even if it takes all of it, because there's nothing that says that we are to leave our children are home. And I'm sure that our children would

00:42:28.260 - 00:42:35.550

want us to use what income we have to take care of our self, and to have a good quality of life. I'm quite sure of that.

00:42:35.550 - 00:42:40.650

RG: I know one thing that some people are looking into, and I think the University of Delaware through the Extension Program

00:42:40.650 - 00:42:48.270

had a discussion on that a week or two ago, and that was the Sale Lease Back where an elderly person may sell their home and they say most generally and

00:42:48.270 - 00:42:53.580

most favorably, usually to children or close relatives that they'd sell their home to that individual and

00:42:53.580 - 00:43:02.700

retain in the contract of sale an agreement to be able to lease that residence for their entire life. The youngsters get, of course,

00:43:02.700 - 00:43:07.560

the benefit of the tax breaks on the home and so forth. The elderly people, of course, get a place to stay and

00:43:07.560 - 00:43:15.240

have the income to be able to use for other things that they need. EC: Well, Sale Lease Back is one of those options under the home equity program.

00:43:15.240 - 00:43:23.160

Yes. And some children are purchasing the home, as you just said, and it works out very well that way.

00:43:23.160 - 00:43:29.300

RG: What about the area of legal help for the elderly? We hear the elderly are many, many times victimized

00:43:29.300 - 00:43:34.800

by scheisters that come in. Home repairs have been a big one. There have been a number in the area, from time to time, that are

00:43:34.800 - 00:43:40.980

victimized by people who come in and say, "We're an investigator for the bank and we want you to draw your money out and give it to me because we think

00:43:40.980 - 00:43:49.140

someone there is stealing money." And all types of scams of this nature and types of contracts that the elderly sign and then realize later

00:43:49.140 - 00:43:57.990

that maybe they made a mistake and sometimes it's late. But are there legal help provided? Is there legal help provided the elderly

00:43:57.990 - 00:44:05.400

in the State by your division? ED: Yes. That can be a very serious problem, as you know. Well, aside from our division,

00:44:05.400 - 00:44:14.220

there is also the Division of Consumer Affairs. And the Division of Consumer Affairs plays quite a role in that.

00:44:14.220 - 00:44:19.680

And any older person who feels that they have been schiested or that they don't have a bona fide contract,

00:44:19.680 - 00:44:27.990

can contact the Division of Consumer Affairs for help. The Division of Aging does fund a legal services program

00:44:27.990 - 00:44:35.180

for the elderly through Community Legal Aid. And there's an office here in Kent County, in Dover as a matter of fact.

00:44:35.180 - 00:44:42.810

We have an attorney that works between Kent and Sussex County, and there are also several paralegals. Any kind of a legal problem whether

00:44:42.810 - 00:44:53.190

it's Social Security, Medicare, Medicaid, landlord-tenant, help in drawing a will, or whatever. That help can be

00:44:53.190 - 00:45:00.810

received from Community Legal Aid. RG: I see. So even on civil matters? EC: Even on civil matters, yes. RG: Usually I think Legal Aid,

00:45:00.810 - 00:45:07.710

it's difficult to get that unless you're elderly then. Is that correct? EC: Well. RG: Because I think Legal Aid in this State by and large doesn't do a lot in the civil area,

00:45:07.710 - 00:45:12.960

but you're saying that there's a specific program for the elderly in that way. EC: There's a specific program, and we fund that through the Division of Aging. Yes.

00:45:12.960 - 00:45:22.210

RG: And that's age sixty-- EC: Yes. That's age sixty. RG: Okay. Speak Your Peace. Do you have a question? Female voice 3: Yes. I wonder if in case a person is living by themselves,

00:45:22.210 - 00:45:47.900

and you may get to the point you can't take care of yourself. Is there enough nursing homes that, on the spur of the moment, you could get in? And do they have any idea what it would cost? And if you have Medicare and Blue Cross, they talk of cutting those down.

00:45:47.900 - 00:45:58.520

What are the options? EC: Well, first of all, Medicare does not provide for long-term care in a nursing home. Female voice 3: Yes, I-- EC: And neither does Blue Cross.

00:45:58.520 - 00:46:06.780

Medicare is only for short-term in a nursing home. Some people feel that if they have Medicare and Blue Cross

00:46:06.780 - 00:46:14.310

then they'll be able to stay in a nursing home forever. And that's not really true. As far as emergency beds,

00:46:14.310 - 00:46:21.630

sometimes there's a bed available and then many times all the beds are taken and there isn't an emergency bed.

00:46:21.630 - 00:46:32.760

But there is home care available. There are a lot of home care agencies where a nurse or a home health aide or a homemaker can come into your home

00:46:32.760 - 00:46:41.640

and take care of you until you were able to be admitted into a nursing home. A lot of times, you may

00:46:41.640 - 00:46:50.100

be in a hospital, an acute hospital before you would even have to go to a nursing home. So provisions are made there. Female voice 3: What would it cost for--

00:46:50.100 - 00:47:02.770

EC: A nursing home is very expensive. The average cost is probably around fifteen to sixteen-hundred dollars per month. Female voice 3: If a helper comes in your home,

00:47:02.770 - 00:47:11.910

what do you pay them, I mean, to help you? EC: Okay. If you were to call one of the agencies that the Division of Aging contracts with

00:47:11.910 - 00:47:21.350

it would be on a donation basis. What they would do is they would tell you how much the service is costing you each hour. Female voice 3: Oh okay.

00:47:21.350 - 00:47:31.530

EC: And they would ask you, what could you contribute towards that rate. Female voice 3: Okay. Thank you very much. RG: Thank you for calling. Speak Your Peace. Do you have a question?

00:47:31.530 - 00:47:48.880

Female voice 4: Rick, I'd like to ask Mrs. Cain two questions which I've been concerned about. And one is how would she go about, I've been concerned because I realize that the meals are very important to so many of the aged people

00:47:48.880 - 00:48:13.400

And if they're not putting enough money in, what would be your plan to impress them that it is needed? That would be the first question. The second question, which I've been quite concerned about, is the matter of fact about a doctor's visit in the home of the aged person who is exceptionally ill?

00:48:13.400 - 00:48:27.710

I mean, seriously ill and couldn't even get out of bed. Do they have plans to have home visits by doctors like we used to do years ago? EC: I'm afraid that that's a thing of the past.

00:48:27.710 - 00:48:35.850

There may be some doctors that will still make a house call. I'm sure that there are. As you know, that in

00:48:35.850 - 00:48:45.960

most cases the physician either want you to come into the emergency or have someone bring you into his office. But there are some that do make house calls.

00:48:45.960 - 00:48:57.930

As far as the meals program. The meals program, of course, is a priority program and one that I think that the community

00:48:57.930 - 00:49:05.730

here what would look at as a priority, especially the home-delivered meals part of it. For people who really do need

00:49:05.730 - 00:49:19.140

help in getting their food, but are able to live at home. Female voice 4: Well, I was just interested in it because I noticed in the Maturity bulletin once in a while they do stress the fact

00:49:19.140 - 00:49:29.520

that everyone should contribute. And I think really that they should. EC: Yeah, I have to have that, we have to have that money. You know, if people can

00:49:29.520 - 00:49:39.360

give a dollar or a dollar-and-a-half towards a meal I really encourage them to please contribute that much, because there are people who can't. Female voice 4: Yeah, that's true. I--

00:49:39.360 - 00:49:47.660

EC: There are people out there that can't even give the seventy-five cents and I don't want them to stay away because they can't. Female voice 4: No, no.

00:49:47.660 - 00:49:53.700

EC: Because they're the people that really need the food. Female voice 4: Oh yeah. EC: Who can't go out and buy it. Female voice 4: That's right. EC: But you know, you can't get

00:49:53.700 - 00:50:00.330

a meal out in a restaurant as good as that for that little bit of money. Female voice 4: Oh no, I recognize that. EC: And I'm not so sure that you can even go

00:50:00.330 - 00:50:11.010

to the grocery store. Female voice 4: And fix it yourself. EC: And fix it yourself for that amount of money. Female voice 4: I was just concerned. Those were just two concerns that I had. And I just wanted to ask about it.

00:50:11.010 - 00:50:17.520

RG: Okay. Female voice 4: Thank you. RG: Thank you for calling. 674-1234 is our number. We have about fifteen minutes remaining in today's program.

00:50:17.520 - 00:50:22.380

If you have a question for Mrs. Cain. She is the Director of the Division of Aging for the State of Delaware.

00:50:22.380 - 00:50:28.410

So if you have a question about programs for the elderly, now is the time to call to get an answer from the person right at the top

00:50:28.410 - 00:50:36.620

in the State on that particular topic. 674-1234 again. The Speak Your Peace number. Mrs. Cain, another area I'd like to just sort of

00:50:36.620 - 00:50:44.010

get away just a moment from, I guess, elderly issues directly. To ask you about the Hay Study. We've asked the various

00:50:44.010 - 00:50:51.210

representatives that have been on recently, some of the other division directors, there's some great concern from some of the directors in the State as to this study

00:50:51.210 - 00:50:58.200

and what some of the recommendations seem to have been at this point coming from personnel. Mr. Voshell mentioned the other day

00:50:58.200 - 00:51:03.960

from Motor Vehicle that one-hundred-forty out of one-hundred-eighty-nine employees in his department may be sort of at their peak so that

00:51:03.960 - 00:51:12.250

they would be basically facing a situation of getting less in the future of any raises that were passed along by the Legislature.

00:51:12.250 - 00:51:16.930

And that would seem to be a morale problem should that occur. What about in your division? Are you going to face

00:51:16.930 - 00:51:23.520

problems with positions in your division in that same area? EC: Well, in my division, of course, everyone has had an opportunity to look

00:51:23.520 - 00:51:31.400

at the report that we receive from the State personnel through the department. And there has been a great deal of concern.

00:51:31.400 - 00:51:39.660

I think that what we must remember is that that study is only a draft at this point. It's not in final form. And that I know

00:51:39.660 - 00:51:48.540

the Department of Health and Social Services is, I feel, doing an excellent job of informing us. We had the State Personnel Director and

00:51:48.540 - 00:51:57.810

her staff at our staff meeting last week that Secretary Eichler called, and she explained it to us in detail. She asked for some additional information

00:51:57.810 - 00:52:06.710

from us as far as classifications that we feel that there should be some changes made and why. We had that opportunity for input.

00:52:06.710 - 00:52:17.670

Secretary Eichler is also making provisions, through his support staff to hold meetings at our own staff meetings with our staff so that we can clear up

00:52:17.670 - 00:52:26.120

any misconceptions or answer any questions at any of the staff have. The department is also going to have some meetings.

00:52:26.120 - 00:52:32.760

There's going to be several held right at the State Hospital. They're going to have them I think at DHCI, Delaware Hospital for

00:52:32.760 - 00:52:43.590

the Chronically Ill in Smyrna. So our particular department, through the Secretary, is doing everything possible to work

00:52:43.590 - 00:52:55.940

with the report and the State Personnel Director made it very clear to us the other day that they are looking for input, and

00:52:55.940 - 00:53:05.470

that hopefully they will get this all worked out before anything goes into effect. RG: Okay. Speak Your Peace. Do have a question? Female voice 5: Yeah.

00:53:05.470 - 00:53:17.370

I was wondering if you had a bountiful harvest, and you wanted to donate some of the food, if there'd be any way the Modern Maturity Center or someone could can it for the program

00:53:17.370 - 00:53:28.200

that you were talking about? EC: We are not allowed through federal regulations to accept canned food. That is done.

00:53:28.200 - 00:53:39.990

That is not, that does not come through some professional canning company. They can accept all of the raw food,

00:53:39.990 - 00:53:50.640

like tomatoes and cucumbers or anything such as that. But we cannot accept home-canned or home-prepared foods into the program

00:53:50.640 - 00:54:01.660

because of the liability for food poisoning. I do know that Community Action in Sussex County used to have a cannery in Laurel

00:54:01.660 - 00:54:11.010

at the Laurel State Service Center. And I'm not sure what the status of that is currently. But any kind of raw food

00:54:11.010 - 00:54:18.270

that you would like to donate from a bountiful harvest would be greatly appreciated in all of those senior centers.

00:54:18.270 - 00:54:26.360

Not just for the nutrition program, but also for seniors to be able to have in their homes. Female voice 5: Can you take it to the senior center then?

00:54:26.360 - 00:54:37.560

EC: You can take it to the senior center. Yes. Female voice 5: Where is it? EC: Where do you live? Female voice 5: West of town. EC: West of Dover? Female voice 5: Mm-hm. EC: Well, the Modern Maturity Center

00:54:37.560 - 00:54:48.240

is on Greenhill Avenue, which is East Dover. Female voice 5: Where would that be? RG: All right, you know where the Dover Post is? Female voice 5: Yeah, just about. RG: Yeah, it's right back behind the Post.

00:54:48.240 - 00:54:58.320

Female voice 5: Oh okay. RG: Right down that side-street-- EC: But that would be a wonderful gift. Female voice 5: I have given to them at different times, but I lost track of where they were

00:54:58.320 - 00:55:08.120

this last time. So I was wondering. EC: They're on Greenhill Avenue. Female voice 5: All right. Thanks a whole lot. EC: You can find their number in the telephone book.

00:55:08.120 - 00:55:14.610

Female voice 5: All right. Thank you. RG: Okay. Thanks for calling. 674-1234. We have, as I said, about ten minutes remaining in today's program.

00:55:14.610 - 00:55:19.710

If there are topics or issues concerning the elderly you would like to bring up on today's show, so hurry to do so

00:55:19.710 - 00:55:28.260

if there's something you want to comment on or a question that you want to ask concerning the elderly, 674-1234. Mrs. Cain, we've talked a little bit

00:55:28.260 - 00:55:35.670

about transportation, about medical care, about the nutritional needs of the elderly, a little bit about the legal aspect,

00:55:35.670 - 00:55:42.370

but two more areas I guess that sort of border on the legal and the medical area, since someone did bring up

00:55:42.370 - 00:55:50.220

questions about the homes, nursing homes. In other parts of the country, this has been a real touchy issue. In some, there have been religious homes that

00:55:50.220 - 00:55:57.270

have been established that have required that an individual sign over their home and possessions to the home in order to live

00:55:57.270 - 00:56:03.220

there, to pay the bill. And after so doing, they were supposed to be guaranteed to be able to stay in that home,

00:56:03.220 - 00:56:10.590

I guess, for the rest of their life. Unfortunately, some of those homes end up closing down, having disposed of the property

00:56:10.590 - 00:56:18.210

of the individual and now the individual is out on a limb. No more home, no more assets, and no place to stay now.

00:56:18.210 - 00:56:25.110

Is the State of Delaware policing or your department policing these homes in the State to make sure

00:56:25.110 - 00:56:32.580

that those types of nursing homes don't open up in the State of Delaware and don't bilk the elderly in that manner? EC: Well, first of all, you cannot

00:56:32.580 - 00:56:38.160

open up a nursing home in Delaware, just because you decided you want to open a nursing home. You have to go through a certificate of need,

00:56:38.160 - 00:56:46.410

and Health Planning is totally responsible for that. For instance, right now they have accepted letters of intent

00:56:46.410 - 00:56:56.790

from some of the nursing home industry and you have to have very, very specific plans laid out, and it goes through a board.

00:56:56.790 - 00:57:07.820

It is a long process. Delaware does not have that kind of home where people are bilked of their belongings, and they have been put out on the street.

00:57:07.820 - 00:57:16.660

And I am thankful that I can say that. But it is a long process. I couldn't go out here in Dover right now and buy a piece of land

00:57:16.660 - 00:57:24.870

and started building a nursing home. Not unless the State gave me permission to do that, and then it would be according to certain specifications.

00:57:24.870 - 00:57:31.500

RG: I see. Now after the Certificate of Need is given, does someone, your office or someone else in the State, continue

00:57:31.500 - 00:57:40.410

to monitor, especially the financial standing of these homes, to make sure that they are going to be able to deliver these services to the elderly in the future?

00:57:40.410 - 00:57:47.070

Or after the Certificate of Need is given, are they pretty much left on their own with the exception of the Health and Safety checks,

00:57:47.070 - 00:57:58.320

that may be conducted? EC: Well, if they accept Medicare or Medicaid, those are State and federal programs. Yes, they are audited, financially.

00:57:58.320 - 00:58:06.090

And of course you just mentioned, license and inspection that comes through the Division of Public Health are responsible for

00:58:06.090 - 00:58:15.200

the licensing and the inspection of those homes to make sure that they're sanitary and that they meet all of the Public Health codes

00:58:15.200 - 00:58:23.910

as they apply to nursing homes. And of course, the nursing home Ombudsman that I spoke about is the individual who goes into those homes

00:58:23.910 - 00:58:33.630

and who does staff training as far as patient rights, visits with the patients, and the staff, and the administrators.

00:58:33.630 - 00:58:40.110

And it's all of those forces working together there. RG: I see. Another area that I'd like to touch on too,

00:58:40.110 - 00:58:46.230

and I know it tends to be a bit of a controversial area. But now in many parts of the country and the world,

00:58:46.230 - 00:58:52.380

there's a movement afoot and there has been really for some time in this area of life with dignity. Meaning basically we're

00:58:52.380 - 00:58:59.940

talking about euthanasia. The point where an elderly person who is extremely ill, and critically ill, decides

00:58:59.940 - 00:59:07.590

that "I don't want to go on. I don't want to have tubes and be kept on respirators artificially and all this stuff." That life is not worth that.

00:59:07.590 - 00:59:13.620

That's not life, that's existing. What about in the State of Delaware? Can the elderly, do they have an option in the State of Delaware currently?

00:59:13.620 - 00:59:20.910

Or will your office be working in that direction in the future to allow people once they've reached a certain point to make the decisions?

00:59:20.910 - 00:59:29.310

No artificial life-support. EC: Well, Delaware passed the Death with Dignity statute several years ago. And the Division of Aging,

00:59:29.310 - 00:59:36.850

with the Attorney General's office at that time, designed the Living Will and those living wills are available in our office.

00:59:36.850 - 00:59:48.600

And believe me, we send them out by the hundreds. It's a Will that you sign, and you have to have several witnesses.

00:59:48.600 - 00:59:56.010

The witnesses cannot be members of your family. And what it basically says is that when you get to a,

00:59:56.010 - 01:00:06.660

if you should ever get to a certain stage physically, that you do not wish to have any life-support. RG: What about a step farther? What about

01:00:06.660 - 01:00:15.870

euthanasia for people that are in agony and pain but who are in such pain, but yet they really are not on life-support? EC: Well, there is not any bill that has been

01:00:15.870 - 01:00:23.270

passed in Delaware. And right now, I don't see that there is going to be any bill passed in Delaware any time soon.

01:00:23.270 - 01:00:32.940

That is a very, very controversial issue. And believe me, I don't want to get into it. [RG laughs] RG: Okay. Speak Your Peace. Do you have a question?

01:00:32.940 - 01:00:44.880

Female voice 6: Yes. You were mentioning about people giving their money, and then these homes folding, and I was wondering if that, how would that apply

01:00:44.880 - 01:00:53.550

to these places that sell you an apartment and they're supposed to take care of you for the rest of your life,

01:00:53.550 - 01:01:02.690

and then after thirty months, they own the apartment. Supposing they fold in about thirty-six months, what would happen to you then?

01:01:02.690 - 01:01:09.690

That would come under the same category, wouldn't it? And I know we have those in Delaware, because I saw one of them.

01:01:09.690 - 01:01:16.170

EC: You're talkin about a life-care community. I think is what you're talking about? Female voice 6: Yes. EC: And a life-care community is where you

01:01:16.170 - 01:01:23.700

can buy like a cottage or an apartment. And when you're no longer able to stay there, you move on into another level of care, and they follow you right straight

01:01:23.700 - 01:01:32.400

through to nursing care. And you do buy your own property. There's a contract. Delaware has not had any

01:01:32.400 - 01:01:40.650

that has folded. Female voice 6: Well, I know. These people that I saw are very, I mean they are not the kind that would fold.

01:01:40.650 - 01:01:51.040

But after the [inaudible] you can't expect anybody. They may not be planning to fold, but they could just be losing their money.

01:01:51.040 - 01:01:58.140

EC: True. That's true. Female voice 6: And then what would happen? That's what I was wondering. EC: Well, the people who are living in these life-care communities

01:01:58.140 - 01:02:05.040

are investing a small percentage of their money. Most of your people in life-care communities have got a great deal of money,

01:02:05.040 - 01:02:12.710

and it is a serious problem if that were to happen, that's for sure. And it has happened in some parts of the country,

01:02:12.710 - 01:02:20.150

where some of the life-care communities have not been successful. Female voice 6: Those apartments are beautiful, but they're very, very expensive.

01:02:20.150 - 01:02:24.230

EC: That's true. You're absolutely correct. Female voice 6: Okay then. I was just wondering. RG: Okay.

01:02:24.230 - 01:02:29.430

Female voice 6: All right, thank you. RG: Okay, thanks for calling. Well, we're running near the end of the program. Mrs. Cain, let's again mention, you have

01:02:29.430 - 01:02:35.470

coming up a forum here in the State of Delaware, at least in Kent County on you said the 25th of February,

01:02:35.470 - 01:02:43.710

where the elderly, where family members, friends, interested people in the community, can come forth at that forum. A ten o'clock, I believe you said it was,

01:02:43.710 - 01:02:49.700

the Modern Maturity Center on Greenhill Avenue, and discuss issues pertinent to the elderly in the future.

01:02:49.700 - 01:02:56.730

Now the importance of that is that, I believe you mentioned, the State, your division, is preparing a three-year plan which will serve

01:02:56.730 - 01:03:05.640

almost as a contract between our State and the Department of Aging nationally. EC: That's right. RG: So you want input, and are offering people

01:03:05.640 - 01:03:10.800

that opportunity to provide input as to what they think the problems are and how they should be addressed in this State.

01:03:10.800 - 01:03:17.640

EC: Because our office is responsible to develop that plan. And I need the input from this Kent County community,

01:03:17.640 - 01:03:22.830

either at the forum on the 25th of February at the Modern Maturity Center or the one the following day

01:03:22.830 - 01:03:31.830

on the 26th at the Milford Senior Center, which is on Walnut Street in Milford. RG: Informal, I assume. They wouldn't have to call ahead or to request a time to speak?

01:03:31.830 - 01:03:37.920

EC: No. All they have to do is be there at ten o'clock and you'll be hearing more about that

01:03:37.920 - 01:03:43.290

from the people here in Kent County as to how they're going to set that up. RG: And I would assume again people that can't make it,

01:03:43.290 - 01:03:50.130

or for some reason would choose not to speak in public, could probably address in writing their feelings or comments?

01:03:50.130 - 01:03:52.150

EC: I would be happy--