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FUNDING FOR THIS PROGRAM MADE POSSIBLE BY THE INVESTOR PROTECTION TRUST, STATE OF ALASKA OF DIVISION OF BANKING AND SECURITIES AND AARP ALASKA. [ MUSIC ] [ MUSIC ] >> IN TODAY'S PROGRAM WE'LL REVIEW THE ABCS OF CHOOSING AN ASSISTED-LIVING HOME IN ALASKA. HERE IS YOUR HOST, ANN SECREST. >> HELLO EVERYONE AND WELCOME TO AARP ALASKA AND TODAY OUR GUEST IS TERESA HOLT, LONG-TERM CARE OMBUDSMAN FOR THE STATE OF ALASKA. TERESA, THANK YOU SO MUCH FOR JOINING US TODAY. >> THANK YOU FOR HAVING ME. >> IF YOU WOULD SHARE A LITTLE BIT ABOUT YOUR BACKGROUND AND HOW YOU GOT TO YOUR PRESENT POSITION? >> WELL, I WORKED IN HEALTH AND SOCIAL SERVICES ABOUT 30 YEARS AND I HAVE DONE ALL KINDS OF JOBS STARTING FROM DIRECT CARE TO CASE MANAGERS, CARE COORDINATOR AND RAN SOME PROGRAMS. THEN I SORT OF SWITCHED GEARS AND STARTED WORKING IN ADVOCACY FOR FOLKS WITH DISABILITIES. AND I DID MANY YEARS' WORKING WITH FAMILIES WHO HAVE CHILDREN WITH DISABILITIES. AND EVENTUALLY WORKED MY WAY UP TO BEING THE EXECUTIVE DIRECTOR OF THE GOVERNOR'S COUNCIL WHICH WAS MY JOB JUST BEFORE MOVING OVER TO THE LONG-TERM CARE OMBUDSMAN. >> THE TERM OMBUDSMAN, LET'S TAKE A LOOK AT THE FIRST SLIDE. IT'S A UNIQUE TERM BY ITSELF AND GOT ITS ORIGINS IN AN OLD NORSE WORD. BASICALLY MEANING, "REPRESENTATIVE." >> YES. WHEN I TELL PEOPLE WHAT I DO, THEY SAY OH, NICE TO MEET YOU, WHAT DO YOU DO? I SAY I'M THE LONG-TERM CARE OMBUDSMAN AND THEY EITHER ASK WHAT OR SKIP ON TO SOMETHING ELSE. SO THE WAY I EXPLAIN IS AN OMBUDSMAN IS A REPRESENTATIVE OF THE PEOPLE. >> RIGHT. >> LONG-TERM CARE FOR OUR OFFICE MEANS, "INDIVIDUALS WHO LIVE IN A SYSTEM OF LIVING HOMES OR NURSING HOMES." SO THE LONG-TERM CARE OMBUDSMAN REPRESENTS PEOPLE WHO LIVE IN ASSISTED-LIVING HOMES OR NURSING HOMES. >> AS YOU MENTIONED THERE ARE DIFFERENT TYPES OF OMBUDSMAN, MUNI, STATE AND LONG-TERM CARE IN YOUR CASE. >> YES. >> WHAT ROLE DOES THE LONG-TERM CARE OMBUDSMAN PLAY WHICH IT COMES TO ALASKA SENIOR POPULATION SPECIFICALLY? >> EVERY STATE HAS A LONG-TERM CARE OMBUDSMAN AND WE HAVE SIX SPECIFIC DUTIES, VISITING ASSISTED-LIVING AND NURSING HOMES AND TALK WITH THE RESIDENTS THERE. WE HELP EDUCATE THEM ABOUT THEIR RIGHTS LIVING IN THOSE FACILITIES. WE HELP THEM RESOLVE ISSUES THAT THEY MIGHT HAVE AND THAT COULD BE EVERYTHING FROM -- AND MOST PEOPLE REALLY UNDERSTAND THIS ONE. IF YOU GET UP IN THE MORNING AND YOU DON'T HAVE HOT COFFEE RIGHT AWAY, THAT IS A CRISIS AND IT'S A QUALITY OF LIFE ISSUE AND WORKING FROM ISSUES THAT MIGHT INVOLVE SUSPICIOUS BRUISES OR SOMEBODY WHEN WE VISIT THEM THEY SEEM TERRIFIED TO TALK TO US. SO WE ALSO LOOK INTO ABUSE AND NEGLECT ISSUES. AND THEN ANOTHER THING THAT WE DO IS SYSTEMS CHANGE. SO WE LOOK FOR WAYS TO IMPROVE THE SYSTEM FOR SENIORS IN GENERAL, BUT ALSO FOR SENIORS ESPECIALLY FOR SENIORS WHO LIVE IN ASSISTED-LIVING HOMES AND NURSING HOMES. >> WE HAVE A SLIDE UP AND THE OTHER TWO AREAS THAT YOU DO IS SUPPORT AND EMPOWER SENIORS TO ADVOCATE FOR THEMSELVES, WHICH IS WONDERFUL. AND PROVIDE INFORMATION AND REFERRALS TO SENIORS HAVING DIFFICULTIES WITH GUARDIANSHIP. SO YOU REALLY, TRULY HANDS-ON AND IT'S ALL ABOUT GIVING INFORMATION AND EMPOWERMENT, EDUCATION TO OUR SENIORS HERE IN THE STATE OF ALASKA. >> RIGHT. SO IF SOMEBODY IS A SENIOR AND THEY DON'T KNOW WHERE TO CALL, THEY CAN ALWAYS CALL OUR OFFICE AND WE'LL BE ABLE TO HELP THEM GET TO THE RIGHT PLACE IF IT'S NOT AN ISSUE WE'RE ABLE TO WORK ON. >> HOW DOES YOUR OFFICE DIFFER FROM ADULT PROTECTIVE SERVICES? >> SO OUR FOCUS IS ON RESOLVING ISSUES TO THE SATISFACTION OF THE SENIORS. SO REALLY WE MEET WITH SENIORS AND ASK THEM WHAT ISSUES THEY WANT US TO WORK ON? AND HOW THEY WANT US TO RESOLVE THOSE ISSUES? ADULT PROTECTIVE SERVICES IS REALLY MORE IN THE REALM OF BEST INTERESTS. SO THEY LOOK TO SEE IF SOMEBODY IS MAKING DECISIONS THAT WOULD BE HEALTH AND SAFETY? ARE THEY COMPETENT TO MAKE THOSE DECISIONS? AND SO THAT IS REALLY HOW WE DIFFER. >> LET'S TALK ABOUT-- IN FACT, YOU HAD A WONDERFUL ANALOGY, DIFFERENT FROM THE AGENCIES THAT LICENSE NURSING FACILITIES AND ASSISTED-LIVING FACILITIES HERE IN THE STATE. YOU TALKED ABOUT THE LICENSING, AND DOCTOR'S ORDERS. SO HELP ME EXPLAIN YOUR ANALOGY WHEN IT COMES TO THE RESIDENT WHO WANTS TO EAT ICE CREAM EVERY DAY? YOU EXPLAINED THAT VERY WELL. >> LICENSING HAS A DIFFERENT PERSPECTIVE, WHICH IS THE HOME OR THE FACILITY FOLLOWING REGULATIONS? SO IF YOU HAVE AN INDIVIDUAL, WHO IS DIABETIC AND THEY ARE NOT SUPPOSED TO BE EATING SWEETS BUT THEY WANT ICE CREAM AND WE VISIT THEM AND THEY SAY EVERYBODY GETS ICE CREAM OR FOR DESSERT AND WE WANT INCREASE. LICENSING'S JOB IS THE HOME FOLLOWING THE DOCTOR'S ORDER REGARDING DIABETIC CARE? AND ADULT PROTECTIVE SERVICES MIGHT COME IN AND SAY IS THIS PERSON UNDERSTANDING THE CONSEQUENCES OF THEIR CHOICE IF THEY CHOOSE TO EAT SWEETS AND ARE THEY COMPETENT TO MAKE THAT DECISION? OUR JOB WOULD BE TO GO INTO THE HOME, FIGURE OUT CAN THEY WORK WITH THEIR DOCTOR? MAYBE THEY CAN HAVE A SMALL AMOUNT? MAYBE IF THEY EAT A LOT OF PROTEIN FIRST AND THEN ICE CREAM? OR MAYBE THEY CAN PROVIDE DIABETIC ICE CREAM? THERE ARE DIFFERENT WAYS THAT WE COULD HELP RESOLVE THAT SITUATION. >> FOR A LOT OF THEM THERE IS SOME CONFUSION WITH THE PIONEER HOME SYSTEM AND ASSISTED-LIVING HOME FACILITIES. PEOPLE DON'T REALIZE UNTIL THEY ARE THERE, UNTIL THEY ARE FACED WITH HAVING TO MAKE DECISIONS, THE VARYING LEVELS OF CARE THAT IS INVOLVED. >> RIGHT. SO THERE ARE TWO TYPES OF LONG-TERM CARE. NURSING FACILITIES, AND ASSISTED-LIVING HOMES. SOMETIMES IT DEPENDS IF YOU NEED A HIGHER-LEVEL OF NURSING CARE? OR ALSO IF YOU CHOOSE TO LIVE IN THE COMMUNITY? AND HOW YOU ARE GOING TO PAY FOR IT? MOST PEOPLE DON'T KNOW, BUT MEDICARE -- SORRY MEDICARE DOES NOT PAY FOR LONG-TERM CARE. SO IF YOU PAY INTO SOCIAL SECURITY YOUR WHOLE LIFE, AND YOU ARE RETIRED AND YOU HAVE MEDICARE, MOST PEOPLE THINK THAT IS GOING TO PAY FOR LONG-TERM CARE AND IT DOESN'T. >> THAT IS A MESSAGE WE TRY TO GET OUT OFTEN. AGAIN MEDICARE DOES NOT PAY FOR LONG-TERM CARE. HERE IN ALASKA I HAVE THE SLIDE UP HERE THAT NURSING HOMES IN ALASKA, 692 INDIVIDUALS LIVING IN 18 FACILITIES THROUGHOUT THE STATE, AND YOU HAD A NOTE HERE RANGES IN SIZE FROM 10 TO 102 RESIDENTS. SO THEY ARE THROUGHOUT THE STATE ARE THE FACILITIES. >> RIGHT. OUR JOB IS THAT WE TRY TO VISIT EVER SINGLE FACILITY AT LEAST ONCE A YEAR. OUR CONSTRAINTS OF COURSE ARE TRAVEL DOLLARS. YOU CAN SEE THE COMMUNITIES ON THAT SLIDE, THEY ARE ALL OVER THE STATE. >> RIGHT. >> VERY FEW OF THEM ARE ACTUALLY ON THE ROAD SYSTEM. AND SO WE HOPE TO VISIT THEM QUARTERLY. THAT IS OUR ULTIMATELY GOAL. BUT FOR BARROW AND DILLINGHAM AND CORDOVA, OUR OFFICE IS BASED IN ANCHORAGE AND WE ONLY HAVE SO MANY TRAVEL DOLLARS. >> DO YOU RELY ON VOLUNTEERS IN MANY CASES? >> WE DO. WE ARE CURRENTLY PUSHING TO FIND AND RECRUIT NEW VOLUNTEERS, ESPECIALLY IN THOSE COMMUNITIES OFF THE ROAD SYSTEM. AND IT'S REALLY A VERY SMALL TIME COMMITMENT ON A MONTHLY BASIS. THE BIGGEST TIME COMMITMENT IS THAT UPFRONT TRAINING. WE ASK FOLKS TO ATTEND 12 HOURS OF IN-CLASS ROOM TRAINING AND SUPERVISED VISITS IN THE FACILITIES THAT THEY WILL BE VISITING. AND REALLY IT'S ONLY ONE VISIT A MONTH AND ONE HOUR OF CONTINUING EDUCATION. >> NOW WHEN YOU STARTED DID YOU START WITH EIGHT -- YOU STARTED WITH EIGHT VOLUNTEERS. HOW MANY VOLUNTEERS DO YOU HAVE NOW? >> WE HAVE ABOUT -- WE JUST GRADUATED CLASS. SO WE HAVE 36 NOW. >> WHAT IS YOUR GOAL? >> OUR GOAL IS TO GET 100 VOLUNTEERS. >> WITHIN WHAT TIMEFRAME? >> WITHIN THE NEXT FIVE YEARS. >> THAT IS WONDERFUL. SO WHAT DOES A VOLUNTEER DO? >> SO A VOLUNTEER GOES AND VISITS IN A SMALL ASSISTED-LIVING HOME AND MAYBE FIVE RESIDENTS THEY WILL TRY TO VISIT WITH EACH RESIDENT IN THE HOME. IF IT'S A LARGER FACILITY, MAYBE ONE OF THE FACILITIES THAT IS 100, THEY WILL TRY TO MEET WITH 5-10 INDIVIDUALS EACH VISIT. REALLY THEY GO AND VISIT WITH THE SENIOR, AND THEY ASK THEM DO YOU HAVE ANY CONCERNS? IS THERE ANYTHING THAT OUR OFFICE CAN HELP YOU RESOLVE? WHETHER IS IT BE SOMEONE IN THE FACILITY NOT BEING NICE TO YOU? OR THE FOOD ISN'T HOW YOU WOULD LIKE IT? JUST REALLY A WHOLE RANGE OF ISSUES. WHATEVER THAT SENIOR NEEDS HELP WITH. >> YOU HAVE GOT SOME SUPER VOLUNTEERS, I UNDERSTAND. >> WE DO. WE DO. MOST OF OUR SUPER VOLUNTEERS ARE INDIVIDUALS THAT HAD A FAMILY MEMBER WHO LIVED IN A LONG-TERM FACILITY AND HAS PASSED AWAY AND THEY WANT TO GIVE BACK AND VISIT WITH OTHER SENIORS. >> SO A LOT -- FOR MANY VOLUNTEERS IT'S A SOCIAL EVENT AS WELL. >> IT IS. WE HAVE ONE GENTLEMAN -- WE HAVE THE REQUIREMENT THAT IS ONCE A MONTH AND HE GOES EVERY WEEK. >> THAT IS WONDERFUL. SPEAKING OF ASSISTED-LIVING, ANOTHER SLIDE HERE. THERE ARE 3642 INDIVIDUALS LIVING IN 650 HOMES THROUGHOUT ALASKA. AND OF THE THOSE, THERE ARE 2400 SENIORS LIVING IN 264 HOMES. AND IT'S ACROSS THE BOARD AS FAR AS THE LEVELS OF CARE, AND THIS ALSO INCLUDES INDIVIDUALS WHO HAVE MENTAL HEALTH OR INTELLECTUAL AND DEVELOPMENTAL DISABILITY CHALLENGES. >> RIGHT. SO WE FOCUS ON VISITING EVERY SINGLE FACILITY THAT IS LICENSED TO SERVE SENIORS. BUT IF SOMEONE CALLS OUR OFFICE AND THERE IS A SENIOR WHO LIVES IN ANOTHER HOME, MAYBE A HOME FOR FOLKS WITH DEVELOPMENTAL DISABILITIES, THEN WE'LL GO AND VISIT THAT HOME. AND THEN WE ADD IT TO OUR LIST. SO THAT WE ARE VISITING THAT HOME ALSO. IT'S IMPORTANT THOUGH KNOW THAT WE'RE A VERY SMALL OFFICE, MYSELF AND FIVE OTHER PEOPLE. ONE PERSON TO ANSWER THE PHONE AND FOUR PEOPLE WHO MAKE THE VISITS. SO THAT IS A LOT OF FACILITIES AND A LOT OF PEOPLE TO VISIT, WHICH IS WHY WE'RE REALLY RECRUITING VOLUNTEERS. >> WONDERFUL. LET'S TALK BRIEFLY ABOUT THE RIGHTS THAT AN INDIVIDUAL HAS IN A LONG-TERM CARE FACILITY, IN A STATEMENT, DO YOU KEEP OR IN ANSWER TO THE QUESTION, DOES AN INDIVIDUAL KEEP THEIR RIGHTS IN A FACILITY? >> YES. SO YOU SHOULD HAVE THE SAME RIGHTS THAT YOU WOULD HAVE IF YOU WERE LIVING IN YOUR OWN HOME. SO FOR EXAMPLE, THE RIGHT TO VOTE. AND WE RECENTLY HAD A GENTLEMAN WHO WAS VERY INTERESTED IN ALL OF THE DEBATES THAT WERE GOING ON, AND REALIZED THAT HE WAS NO LONGER REGISTERED TO VOTE. SO WE HELPED HIM GET HIS VOTER CARD TO DO THAT. >> HE PROBABLY DIDN'T HAVE TRANSPORTATION. >> FIRST OF ALL HE DIDN'T HAVE AN ID CARD AND HAD TO WORK WITH THE GUARDIAN TO GET THE ID CARD AND ARRANGED FOR TRANSPORTATION WITH HIS SISTER TO TAKE HIM TO GET HIS CARD AND YOU CAN FIND IT ONLINE IF YOU HAVE ALL OF THESE PIECES. >> NOW HE IS ENGAGED. >> HE IS ENGAGED AND EXCITED FOR NOVEMBER. >> WONDERFUL. WE'LL BE BACK WITH OUR GUEST, TERESA SE HOLT RIGHT AFTER THIS BREAK. >> CAREGIVERS NEED TO KNOW THAT THEY ARE NOT ALONE. IT HAS TOOL AND INFORMATION TO HELP THEM CARE FOR THEIR LOVED ONES AND THEMSELVES. VISIT AARP.ORG/CAREGIVING. >> WE'RE BACK WITH THERESA HOLT, LONG-TERM CAR OMBUDSMAN FOR THE STATE OF ALASKA AND WE WERE TALKING ABOUT THE RIGHTS OF THOSE WHO LIVE IN LONG-TERM CARE FACILITIES AND STARTED WITH THE FACT THAT THIS IS THE HOME THAT THEY ARE LIVING IN. THE OTHER IS INFORMATION. WHEN IT COMES TO INFORMATION, WHAT TYPE OF THE RIGHTS DO RESIDENTS HAVE WHEN IT COMES TO INFORMATION? >> WELL, SO THEY HAVE THE RIGHT TO BE A PART OF THEIR PLAN OF CARE. TO PARTICIPATE IN THAT PLAN OF CARE, TO HAVE INFORMATION ABOUT THEIR CONDITION. SO IF SOMEBODY HELPS THEM GO TO THE DOCTOR AND THEY DON'T UNDERSTAND IT FOR SOMEONE TO EXPLAIN WHAT HAPPENED AT THE DOCTOR'S OFFICE? OR THEIR NEW MEDICATION, WHY THEY ARE TAKING A NEW MEDICATION? AND ALSO, TO HAVE INFORMATION ABOUT THE COST OF THE CARE THAT THEY ARE RECEIVING? SO IF THEY ARE PRIVATE-PAYING OR WHETHER MEDICARE IS PAYING FOR THAT AND MAYBE MEDICARE PAYS FOR MEDICARE PAYS FOR THAT AND WHAT THOSE ARE. >> AS FAR AS CHOICES, CHOOSE YOUR DOCTOR AND OTHER HEALTH CARE PROVIDERS AND SEEMS LIKE THERE IS -- I HAVE TO GO BACK HERE. IS THIS SOMETHING THAT IS NEW AS FAR AS RIGHTS OF THE RESIDENTS? HAS THIS CHANGED OR HAS IT ALWAYS BEEN THERE? >> WELL, SO THE CENTERS FOR MEDICAID AND MEDICARE SERVICES MAYBE IT'S THE OTHER WAY MEDICARE AND MEDICARE SERVICES, CMS. HAS COME DOWN WITH SOME EXPLANATION OF WHAT HAS ALWAYS BEEN THERE AS FAR AS PERSON-CENTERED CARE. AND SO THE "CHOICE" SECTION OF THE RIGHTS HAS REALLY BEEN RE-EMPHASIZED AND EXPLAINED BETTER. SO PEOPLE HAVE THE RIGHT TO CHOOSE OUT OF A COUPLE OF PLACEMENTS AND NOT JUST THE PLACEMENT THAT IS PRESENTED TO THEM. SO THE FACILITY THAT THEY MIGHT GO TO. THEY HAVE THE RIGHT TO CHOOSE A ROOMMATE. WE'RE NOT REALLY SURE HOW THAT IS GOING TO PLAY OUT IF THERE IS ONLY ONE SPOT IN A HOME? I'M NOT REALLY SURE HOW IMPRACTICALITY THAT IS GOING TO WORK. THEY HAVE THE RIGHT TO CHOOSE WHEN THEY GET UP, WHEN THEY GO TO BED. WITHOUT CONSEQUENCES. QUITE OFTEN WE'LL FIND SIGNS IN ASSISTED-LIVING HOMES IF SAY YOU ARE NOT UP BY 8:00, AND YOU MISSED BREAKFAST, YOU DON'T GET BREAKFAST. >> WOW. >> NOW IT'S VERY CLEAR THAT YOU GET BREAKFAST. >> YOU MENTIONED ACCESS TO FOOD AND THERE IS NO RESTRICTION? >> WELL, THE SAME ACCESS YOU WOULD HAVE HAD LIVING IN YOUR OWN HOME. YOU ARE PROBABLY NOT GOING TO COOK A MEAL AT 3:00 A.M., BUT YOU COULD GET A PIECE OF CHEESE OR GRANOLA BAR OR HOT MILK OR SOMETHING. >> RESPECT AND DIGNITY. >> THIS IS A BIG ONE. TO BE TREATED WITH RESPECT. THEY ARE SENIORS, THEY ARE OUR ELDERS. AND NOT JUST -- BY STAFF, NOT JUST ANOTHER JOB THAT THEY ARE DOING. >> RIGHT. >> OR SOMEBODY WHO IS IN THEIR WAY, ESSENTIALLY. >> RIGHT. >> CAUSING THEM TROUBLE, OR HASSLES. AND NOT TO BE RESTRAINED. WITH WE DON'T SEE THAT VERY OFTEN ANYMORE. IT USED TO BE YOU WOULD SEE A LOT OF PEOPLE WITH DEMENTIA RESTRAINED TO A CHAIR. THAT REALLY DOESN'T HAPPEN ALL THAT MUCH AS FAR AS PHYSICAL RESTRAINTS, BUT WE'RE SEEING A LOT OF PEOPLE WITH DEMENTIA THAT ARE BEING RESTRAINED WITH DRUGS. SO THOSE ARE ISSUES THAT WE WOULD HELP RESIDENTS AND FAMILIES UNDERSTAND. >> PRIVACY, THIS IS VERY IMPORTANT. THAT AN INDIVIDUAL CAN BE ABLE TO CLOSE THEIR DOOR. >> RIGHT. AND WITH THE NEW CMS REGULATIONS THEY ARE ABLE TO LOCK THEIR DOOR, WHICH IS A NEW PIECE TO THIS; THAT THEY HAVE THE RIGHT TO HAVE VISITORS WHENEVER THEY CHOOSE. I THINK THERE WILL BE SOME PLAY OUT AND IT HAS TO BE REASONABLE, CAN'T THROUGH A PARTY AT 3:00 A.M. AND WITH VISITS WE INSIST OUR VISITS ARE PRIVATE, BUT PRIVATE VISITS WITH FAMILY AND FRIENDS, AND PRIVACY SURROUNDING YOUR CARE. SO THAT THEY ARE NOT TAKING YOUR BLOOD PRESSURE OR MAYBE A BLOOD DRAW FOR SOMEBODY WHO HAS DIABETES AT THE TABLE IN FRONT OF EVERYONE. >> OH, MY, YES. >> ONE OF THE BIGGEST CONCERNS IS THE ISSUES AROUND CONFIDENTIALITY. ALASKA, I LIKE TO SAY IS THE BIGGEST SMALL TOWN STATE. EVERYBODY KNOWS EVERYBODY AND IF YOU SHARE A FEW SNIPPETS IN A TOWN, SOMEBODY IS GOING TO KNOW WHO THAT PERSON IS. ONE OF THE THINGS THAT WE'RE SEEING HAPPEN MORE AND MORE IS A BREACH OF CONFIDENTIALITY THROUGH SOCIAL MEDIA. A STAFF PERSON MIGHT BE TAKING A PICTURE OF THEM DOING SOME WORK AND INCLUDE PEOPLE WITHOUT THEIR PERMISSION. >> RIGHT. >> SO WE'RE REALLY WORKING HARD TO STOP THAT PRACTICE. >> NOW HOW DOES THE RIGHTS -- DO THE RIGHTS DIFFER FOR INDIVIDUALS WHO ARE LIVING IN AN ASSISTED-LIVING -- WE WENT OVER THE RIGHTS AS PUT TOGETHER BY CMS IN LONG-TERM CARE, BUT DO THE RIGHTS DIFFER FOR THOSE IN ASSISTED-LIVING? >> WELL, THEY DO. THEY HAVE AN ADDITIONAL RIGHT TO BE ABLE TO ADMINISTER THEIR OWN MEDICATIONS. SO THAT IS REALLY THE BIGGEST DIFFERENCE. >> ALL RIGHT. THE OTHER QUESTION IS DOES YOUR OFFICE PROVIDE TRAINING FOR THOSE WHO WORK IN ASSISTED-LIVING AND NURSING HOMES? >> WE HAVE. WE HAVE DEVELOPED THREE SPECIFIC TRAININGS BASED ON THE COMPLAINTS THAT WE GET OFTEN. THE FIRST ONE SEEMS A BIT UNUSUAL, BUT IT'S REALLY IN RESPONSE TO HOW AND WHEN TO CALL 911. THERE WAS SOME UNINTENDED CONSEQUENCES FROM A FEE STRUCTURE THAT -- FOR FACILITIES WHO WERE CALLING THE TROOPERS OR EMERGENCY PERSONNEL FOR BEHAVIORS. SO IN ANCHORAGE, IF YOU CALL MORE THAN EIGHT TIMES AND IT'S NOT A MEDICAL EMERGENCY, THEN THEY START TO FINE YOU. WELL, THE UNINTENDED CONSEQUENCE OF THAT WAS THAT STAFF WERE HESITANT TO CALL 911. AND SO WE HAVE HAD SOME PEOPLE PASS AWAY BECAUSE THEY WERE TRYING TO GET A HOLD OF THE ADMINISTRATOR. AND THEN WE ALSO HAVE AN ISSUE WHERE SOME OF THE STAFF WHO WORK ARE NOT ABLE TO GIVE APPROPRIATE INFORMATION TO THE EMERGENCY OPERATOR ABOUT WHAT IS GOING ON AND SO WE'LL GO IN AND DO A TRAINING IN THE HOME WHILE THE STAFF ARE THERE WORKING. WE ALSO PROVIDE A TRAINING OF HOW TO WORK WITH INDIVIDUALS WHO HAVE DEMENTIA, ESPECIALLY AROUND BEHAVIORS. AND THEN THE LAST ONE S REALLY AROUND WAYS TO PREVENT FALLS. >> GOOD. >> FALLS ARE THE WAY SENIORS ARE INJURED MOST OFTEN. >> YES. LET'S TAKE A QUICK LOOK AT THE ABCS OF CHOOSING AN ASSISTED-LIVING HOME IN ALASKA AND WE HAVE THE URL AND TOLL-FREE NUMBER FOR PEOPLE TO CALL THE DISABILITY RESOURCE CENTER AT 877-625-2372. WE'RE NOT GOING TO GO THROUGH THE ENTIRE LIST, BUT HAVE YOU CHOOSE A COUPLE OF THE KEY LETTERS. >> OKAY. >> BY THE WAY, THIS LIST IS ON YOUR SITE. >> YES. >> THAT IS IMPORTANT. >> IT'S A WONDERFUL LIST. SO I'M GOING TO HAVE YOU CHOOSE SOME OF THE ALPHABET SOUP HERE. >> THE FIRST THING TO KNOW IS THAT CERTAINLY ANYONE CAN CALL OUR OFFICE OR THE ADRCS. BECAUSE THERE IS 650 CHOICES FOR ASSISTED-LIVING HOMES. AND SO IT CAN BE A DAUNTING CHOICE. AND WE CAN'T MAKE RECOMMENDATIONS, BUT WE CAN TELL YOU THE NUMBER OF COMPLAINTS THAT WE HAVE HAD ON A PARTICULAR FACILITY. WE CAN HELP YOU NARROW DOWN THE LIST TO WHICH FACILITIES ARE NEAR WHERE YOU LIVE? MAYBE WHICH FACILITIES SPEAK SPANISH? WHICH ARE MULTI--LEVEL HOMES? WHICH ONLY TAKE WOMEN OR MEN? WE CAN HELP YOU NARROW DOWN BY THOSE CHOICES. ONCE YOU HAVE DECIDED THAT YOU ARE GOING TO LOOK AT A COUPLE, ABSOLUTELY ALWAYS VISIT. VISIT THE HOMES. IT'S REALLY IMPORTANT. MAKE SURE THAT IT'S A LICENSED HOME. THAT IS REALLY IMPORTANT. AND WHEN YOU VISIT CHECK -- ASK TO SEE THE MENU? IS THAT SOMETHING THAT YOUR FAMILY MEMBER WOULD LIKE TO EAT? ASK TO SEE WHAT IS THE STAFFING? IF THERE IS FIVE PEOPLE IN THE HOME? IS THERE STAFF AT NIGHT? DO THEY PROVIDE TRANSPORTATION TO MEDICAL APPOINTMENTS? THAT IS AN IMPORTANT PIECE. SO TALKING TO THE ADMINISTRATOR, MAKING THOSE VISITS. BUT THEN, ALSO, FIND A REASON TO GO BACK AND HAVE AN UNANNOUNCED VISIT, JUST TO SEE WHAT IS HAPPENING WHEN THEY DON'T KNOW WHEN YOU ARE COMING. >> I LIKE KINDNESS, IF STAFF IS KIND AND GENTLE? >> YES, IT'S IMPORTANT, MAYBE ON THE UNANNOUNCED BUSINESS THAT YOU LOOK AT INTERACTIONS BETWEEN THE STAFF AND RESIDENTS? DO THE RESIDENTS SEEM HAPPY? DO THE STAFF SEEM HAPPY? THOSE ARE IMPORTANT THINGS TO LOOK AT. >> WONDERFUL. AND AS YOU SAID, TALK TO THE RESIDENTS, IF POSSIBLE, THEIR FAMILY MEMBERS AND ARE THEY PLEASED WITH THE HOMES? GOOD ADVICE. LET'S TALK VERY BRIEFLY ABOUT THIS TOPIC OF ABUSE, NEGLECT AND EXPLOITATION, IF WE COULD. SOME OF THE AREAS I THINK IT'S IMPORTANT FOR PEOPLE TO KNOW THE DEFINITIONS OF WHAT IS "ABUSE ?" AND WHAT IS NEGLECT AND EXPLOITATION? IS IT SOMETHING THAT YOU TRAIN YOUR STAFF FOR? >> WE DO. A LOT OF REPORTS FROM ABUSE OR NEGLECT COME FROM STAFF WORKING IN THE HOME OR FAMILY MEMBERS OR FAMILY MEMBERS OF SOMEBODY ELSE OR INDIVIDUALS THAT CALL THEMSELVES. OR WE FIND THEM ON OUR FACILITY VISITS. REALLY ABUSE CAN BE PHYSICAL ABUSE, BRUISES ON THE CORE OF THE BODY OR VERBAL ABUSE. SO SOMEBODY BEING EXTREMELY DISRESPECTFUL AND WE SHOW UP AND SOMEBODY SEEMS WE AFRAID. WE TRY TO GET TO THE BOTTOM OF THE WHAT IS HAPPENING THERE. >> TELL US ABOUT YOUR CASELOAD? >> WE SERVE THE WHOLE STATE. WE HAVE A SMALL STAFF OF SIX. AND WE SERVE ALL OF THOSE FACILITIES. SO WE ARE REALLY LOOKING FOR VOLUNTEERS WHO CAN GO OUT AND ESPECIALLY IN THOSE COMMUNITIES OFF THE ROAD SYSTEM. WE'RE LOOKING, FOR EXAMPLE IN CORDOVA AND WE'RE LOOKING FOR TWO PEOPLE, IN A SMALL COMMUNITY WE WANT SOMEONE TO HAVE A PARTNER AND SUPPORT. OR BARROW OR DILLINGHAM, THERE IS A LOT OF THE FACILITIES OUT THERE. >> WHAT IS THE TIME COMMITMENT FOR AN INDIVIDUAL? >> SO AS WE SAID BEFORE, THERE IS A BIG UPFRONT TIME COMMITMENT IN THE TRAINING, BUT REALLY IT'S 3-4 HOURS A MONTH. >> AS FAR AS LONG-TERM CARE OMBUDSMAN, HOW DOES ALASKA COMPARE TO THE LOWER 48 CASELOAD-WISE AND STAFFING-WISE? >> FOR THE LARGEST GEOGRAPHIC STATE, BUT WE'RE ALSO A VERY SMALL POPULATION STATE. SO WE'RE A LITTLE BIT DIFFERENT THAN OTHER STATES IN THAT WE HAVE EXTENSIVE TRAVEL COSTS. IT COSTS US A FAIR AMOUNT, YOU KNOW? $1200 TO GO TO BARROW FOR ONE VISIT. SO THAT IS WHY WE'RE REALLY TRYING TO RECRUIT VOLUNTEERS IN THOSE COMMUNITIES. >> WHAT IS THE MOST SATISFYING PART OF YOUR JOB? >> I THINK WHEN YOU SEE THAT YOU HAVE MADE A DIFFERENCE FOR SOMEBODY. YOU HAVE BEEN ABLE TO GET THAT HOT COFFEE IN THE MORNING. WE RECENTLY HAD A CASE WHERE A GENTLEMAN WHEN HE WOKE UP IN THE MORNING WANTED HOT COCOA. >> WHAT KEEPS YOU UP AT NIGHT? >> WHAT KEEPS ME UP AT NIGHT IS REALLY THINKING ABOUT HOW WE'RE GOING SERVE THIS HUGE -- THEY CALL IT THE SILVER TSUNAMI, THE BABY-BOOMERS WHO HAVE NOW AGING. WE KNOW THAT WE'RE GOING TO NEED TO DOUBLE THE AMOUNT OF THE CARE THAT WE HAVE NOW. AND I JUST DON'T SEE NATIONALLY OR IN OUR STATE BEING ABLE TO BUILD TWICE THE NUMBER OF FACILITIES AND PAY FOR TWICE THE NUMBER OF CARE. SO I REALLY WORRY ABOUT HOW WE'RE GOING TO SERVE ALL OF THESE FOLKS? AND I KNOW THAT IT'S GOING TO HAVE TO END UP BEING A CHANGE IN OUR SYSTEM OF CARE. HOW WE CARE FOR FOLKS. >> I WANTED TO PUT UP HERE YOUR CONTACT INFORMATION, THIS SLIDE. YOUR PHONE NUMBER IS THERE AND TOLL-FREE AND WITH THE QUOTE THAT YOU SHARED TO THE WORLD YOU MIGHT BE JUST ONE PERSON, BUT ONE PERSON YOU CAN BE THEIR WORLD. >> RIGHT. SO IF YOU HAVE A SENIOR IN A FACILITY, GO VISIT THEM. IF YOU DON'T, CALL US AND VOLUNTEER AND WE'LL SET YOU UP AND YOU CAN MAKE A DIFFERENCE FOR SOMEBODY. >> WONDERFUL. THANKING OUR GUEST TERESA HOLT LONG-TERM CARE OMBUDSMAN FOR THE STATE OF ALASKA. THANK YOU, TERESA FOR JOINING US TODAY. AARP IS A NON-PROFIT, NON- PARTISAN ORGANIZATION WITH MORE THAN 87,000 MEMBERS IN ALASKA. AARP IS DEDICATED TO ENHANCING THE QUALITY OF LIFE FOR ALL AS WE AGE. WE LEAD POSITIVE SOCIAL CHANGE AND DELIVER VALUE TO OUR MEMBERS THROUGH INFORMATION, ADVOCACY, AND SERVICE. THANK YOU FOR WATCHING AARP ALASKA. [ MUSIC ] [ MUSIC ] FUNDING FOR THIS PROGRAM MADE POSSIBLE BY THE INVESTOR PROTECTION TRUST, THE STATE OF ALASKA DIVISION OF BANKING AND SECURITIES, AND AARP ALASKA.