senior citizens

Many older adults live alone, can't get out of the house, and have no family nearby. This can cause frustration, anxiety and just plain loneliness.

And that's where the “Volunteer Home Visitors Program” comes in.

Run by Catholic Charities of Western New York, this outreach program has been in place for several years in Genesee County and, according to coordinator Jim Morasco, is now getting started in Orleans County after three years of existing in the form of the “Friendly Phones Program” (which has volunteers check in on seniors by phone rather than by visitation).

The program is run through the Office for the Aging in both counties; it is funded by the Muriel Marshall Fund in Genesee County and by a private funder in Orleans County. Available to adults 60 and older, it matches each senior participant with a volunteer who will come into his or her home to provide company and to socialize.

"It's generally for an hour," Morasco said. "When people sign up, they give us times that are convenient for them. We try to match them up with volunteers who have that time frame open."

Coordinators attempt to look not only for time frames convenient for both volunteers and seniors, but also for hobbies and interests that they might share.

Morasco stressed that the program does not entail hospice work -- bathing, driving to appointments, or similar responsibilities – although referrals can be provided for such things.

“(We work in conjunction with) just about anybody that works with people -- anyone with a connection to the elderly,” Morasco said. “So for example, say we go into someone’s home and they need something fixed. We can call Community Action or the Office for the Aging, both of whom have a handyman program. Not long ago, we helped a woman whose furnace stopped working at the beginning of winter get a new one through the Veterans Association.”

The main purpose of the “Volunteer Home Visitors Program” is to foster friendships.

"It's to break up the monotony of being alone," Morasco said. "I always say to people, 'Think about how busy you are when you're younger. You always have something to do, and you probably have a family. And then when you get older, sometimes they move away. People pass away. And all of a sudden you're frail, you can't go out, you can't drive, and nobody's around anymore.' That's where a lot of folks find themselves."

He described these home visitations as "socialization, and also wellness."

"You get to know people, and sometimes they start to look like maybe they need some help. I went into the home of a person I was visiting once and found her lying on the floor. Who knows how long she would have been there if she hadn't had that visit?"

In Genesee County, 52 seniors are signed up for the program at this time. There are 41 volunteers, and six people are on a waiting list. Orleans County currently has around 20 volunteers, about evenly matched with senior participants.

Morasco said he sees both seniors and volunteers benefitting from the home visits.

"A lot of (senior participants) say they look forward to their visitor or their caller," he said. "And the volunteers tell me that they get just as much out of this, if not more, than the seniors. When you give, you receive."

For more information, call Catholic Charities at 343-0614, ext 23.

Photo courtesy of Danette Weaver.

One elderly person commits suicide every 90 seconds, according to a statistic provided by the Genesee County Mental Health Association.

That's why they are helping the Genesee County Suicide Prevention Coalition to host an upcoming pair of workshops featuring Eric Weaver (pictured). He's the executive director of "Overcoming the Darkness," a Victor-based organization dedicated to providing education about and help for people with mental illnesses.

"Suicide Prevention in the Elderly" is the title of the workshops, which will take place Tuesday at ARC's Community Center, at 38 Woodrow Road in Batavia. There will be a workshop for providers from 12:30 until 4:30 p.m. and another one for friends and family members from 6 until 8 p.m.

Both are free and open to the public.

Caregivers, family and community members who attend either workshop will be equipped to help elderly individuals in danger of suicide by learning how to:

• Understand risk factors;
• Recognize warning signs;
• Learn how to have a discussion with the person if they suspect suicidal thoughts; and
• Learn about local resources available to help with prevention, managing risk factors and coping in the wake of a suicide.

According to Sue Gagne, of Genesee County Mental Health, people age 65 and older have a higher suicide rate than any other age group.

She believes the main contributing factors to be "financial concerns, concerns about managing the aging process, health concerns and loss of independence."

Millie Tomidy, also of Genesee County Mental Health, described the Genesee County Suicide Prevention Coalition as "a group of people from various professional backgrounds as well as individual community members who are alarmed by the prevalence of suicide and want to do something about it."

"The ripple effect from one death can devastate the entire community," Tomidy said. "The goal of the coalition is to educate in order to prevent future suicides, but also to have a unified response plan in place if (a suicide) should occur."

Weaver, a survivor of a mental illness himself, is widely recognized for his educational talks and training seminars for professionals, family members, churches, workplaces, community groups, schools, hospitals and other audiences.

The mission of his business, "Overcoming the Darkness," is to "reduce stigma, increase understanding surrounding the many challenges of mental health related issues, create a culture that openly discusses the topic of mental illness, suicide and suicide related behavior, and above all proclaim that there is hope and that a level of recovery is available to everyone, so that individuals and families will no longer need to suffer in silence" (from the Web site).

For more information or to reserve a space, call 344-2611.

Photo from www.overcomingthedarkness.com

This entry concludes Sunday's article on the comments of Victor DeSa, M.D., who spoke to senior citizens at Batavia's First United Methodist Church last week.

Please remember, this is a summary of DeSa's presentation and does not necessarily reflect the views of The Batavian:

Medicare, Medicaid and senior services

By requiring insurance companies to expand coverage, the new health care law will drive costs up, according to DeSa. The government has told consumers that these costs will be offset by subsidies for people making less than $80,000 per year.

These subsidies will be coming, in part, from a $500 billion cut from Medicare -- and that's where senior citizens and others eligible for Medicare should be concerned.

But this is not the only problem. Both Medicare and Medicaid, which DeSa called "the original two public options," have met with disaster. Medicaid has already failed, and Medicare is on the brink of failure.

"The government has no idea how to handle the rising costs. Their idea of handling the costs is to take a machete to (the programs) and cut."

The result is the "doctor fix," a 21-percent cut in doctors' reimbursements. This could be disastrous in a system where the cost of providing services is already greater than what the doctors receive in compensation.

For that reason, many doctors no longer accept Medicare. The Mayo Clinic in Arizona has already determined that because of the new health care legislation, it will no longer deal with the program.

"So Medicare patients are going to have fewer and fewer choices of who is going to take care of them."

With fewer doctors available, waiting periods will increase. So the direction Medicare is taking presents seniors with a double disadvantage.

The government "carved the 21-percent doctor fix out of the bill" in order to avoid upsetting America's seniors, but that doesn't mean they've addressed the cost. They are simply pushing it to the side and will have to deal with it later.

"Six months down the road, they have to still come up with a fix for this 21-percent cut that they are going to make on Medicare payments to the doctors."

So that's the story with Medicare and Medicaid. As far as insurance for retired citizens goes, people who worked in the public sector should be okay (although DeSa said it's not impossible that this could change, because "anything is possible" with what the government is doing), but people in the private sector should be concerned.

What to do?

When asked how we can change the course we've taken, DeSa answered: "We've got to kick out the guys who did this."

He appealed to the power of senior citizens -- which he became two years ago -- who are "feared in Washington because we vote."

Many seniors were suspicious when the government said that $500 billion had to be cut from Medicare to cover health care.

"If they really addressed costs the way we asked them to do, a person making $40,000 a year be able should be able to afford health care coverage without subsidies, don't you think?"

Failure to address the problem of cost in the current system was one of DeSa's main critiques of the health care bill. He said that in looking for alternative plans, we need to look for one that does address them.

Counting the costs 

There are three main factors driving health care costs:

1) Overuse

Back in the old days, when there was usually only one doctor in town and he had to go to patients' homes to treat them, people only went to the doctor when there was something really wrong.

Now, with easy access to medical examination and treatment, people will go to the doctor -- and even to the emergency room -- whenever they have a minor health concern.

"We have to change that if we want to truly address the cost of health care."

But it's not just patients -- doctors sometimes overuse the system, too.

"I hate to admit it, but there's greed in every profession. There are bad apples in every bunch, and you've got to admit it."

2) The fact that people have insurance in the first place

Strange as this may sound, this can be a problem.

"Insurance is like a credit card, but you don't have to pay every month. So there's no incentive for you to be prudent with the costs. You don't even want to know what the cost is, you just want the health care."

DeSa believes that while insurance cannot be eliminated altogether, people should reduce their dependence on it. For health purposes, they should only turn to insurance in times of emergency.

Generally speaking, the way people take care of this part of the cost is by having "skin in the game."

"If you shop around for a car or a house, why shouldn't you be able to shop around for a doctor? Especially in this day and age, with the Internet and everything."

3) Liability

"Everything from a Band-Aid to a heart valve has a mark-up depending on the risk."

In other words, the more dangerous the a product or its failure can be -- and, therefore, the greater the likelihood of a lawsuit -- the more expensive the product.

Because the liability cost is factored into the price of the product itself, "the little guy gets it in the neck every time."

DeSa fully supports the patient's right to sue when a doctor has done something wrong or is incompetent, but he also believes that the whole liability issue should be looked at when considering the cost.

Government out, skin in (the game)

Costs are going down for procedures that are not covered by insurance (Lasik surgery is one example). The reason?

Competition.

"Costs come down if there are market forces in place."

DeSa saw this in his native India, which had a socialized health care system until the early 1990s.

When he was studying at Jabalpur University in the mid '60s, the Indian government had total control of health care and sent all competing forces out of the country.

The effect of this was what DeSa called a "brain drain."

"The best and the brightest (doctors) were all leaving the country."

He sees the same thing happening here in Western New York, where there is a serious shortage of doctors.

"Over 80 percent (of young doctors surveyed at Western New York teaching institutes) say they'll train here, but they're not going to stay in New York to work. We are known as one of the most heavily taxed and over-regulated states in the country."

Our response to this situation should mirror the response taken in India back in 1990. At that time, India began to default on its World Bank loans. Finance Minister Monmohan Singh -- who is now India's Head of State -- saw that the system was not working and started the country on a different path.

"He got rid of the government, encouraged entrepreneurship and lowered taxes."

Above all, the patient must take responsibility and be in control of his/her own health care. It can't fall to the federal government to make important decisions regarding people's health care, no matter how well-intentioned they might be.

Déjá vu

In addition to drawing from the experience of his native country, DeSa also discussed two other examples of what he sees as a health care system set up for failure.

The U.S. government's new health care model is based on the Massachusetts health care model, which DeSa called "an abject failure." He cited problems related to his comments about young, healthy citizens abusing health insurance.

"Just Google 'Massachusetts Health Law -- success or failure?'"

Socialized health care has proven disastrously ineffective in Britain as well.

"Just this month, Britain recognized that its system is a failure and said they are going to change the whole thing."

Part of that change will be a shift in power from bureaucrats -- of which there are 1.5 million overseeing the United Kingdom's National Health System -- to the doctors. As good as this sounds, DeSa fears it may be too late for it to work.

"The doctors (in the UK) have no business experience. Up to this point, the government has been taking care of everything."

His concern is that U.S. doctors will share a similar fate. As his presentation drew to a close, he told everyone that under the government's new plan, there will be over 120 new bureaucracies controlling health care.

DeSa admitted right at the start of his presentation that he had a bias as a health professional. He encouraged everyone to do their own research and decide for themselves whether or not the new health care reforms are to be welcomed or feared.

Dr. Victor DeSa talked with seniors Friday about the federal government's new health care legislation. This followed his hour-long presentation, sponsored by the "Older Adult Ministries" program of Batavia's First United Methodist Church.

DeSa is a retired surgeon who had a private practice in Batavia for many years and currently serves on the United Memorial Medical Center Board of Directors. He is well renowned and respected in the community and very knowledgeable about how the health care field works -- including the role of legislation and the relationship between health care and the government.

There is a lot of misinformation about the new health care law and how it could affect  people -- especially Medicare and Medicaid recipients.

The doctor expressed disappointment in the mainstream media's handling of the topic.

"The people in the media are not doing their job," DeSa said. "The media used to look out for the common man, but now they have a bias and a preference. (Consequently), the news we get is filtered and we don't have all the information we need in order to make informed decisions."

For those who could not be there, here's the gist of DeSa's presentation (it will be divided into two parts for the reader's convenience) -- it reflects the arguments he made based on careful and meticulous research, and does not necessarily reflect the opinion of The Batavian.

Health care: rights and responsibilities

The question of whether health care is a right or a privilege came up early in the presentation. This language, said DeSa, is problematic. The real question is this:

"Is health care a right, or is it a personal responsibility?"

He pointed out that health care is considered a right in socialist countries, where people "have abrogated their rights to the government" so that the government "will take care of (them) from the cradle to the grave -- and that includes health care."

"The United States is not yet a socialist country," he said (and yes, he did emphasize yet), "so here, health care is a personal responsibility."

What he meant by this, is that each person has a certain amount of control over his/her own health (diet, exercise, etc). For instance, if someone chooses to live on bacon, cheeseburgers and cigarettes all the time, then he/she is indirectly "choosing" to have weight problems, heart problems, high blood pressure, etc.

"If I'm responsible for my own health, should everybody pay for it or should I?"

Misconceptions about U.S. health care

DeSa assured his listeners that we here in the U.S. do, in fact, have the best health care in the world. To prove it, he spent some time debunking two popular myths that lead people to believe the contrary: that our infant mortality rate is higher than in countries with socialized health care, and that lifespan is shorter in the United States than in said countries.

On infant mortality, he said: "We (in the U.S.) over-report infant deaths, while other countries under-report them. Here, we're so meticulous about reporting, that if a baby takes a couple breaths and has a couple heartbeats after birth, it's reported as infant mortality. But in developing countries, a baby dies an hour or two after being born and it's reported as a stillbirth."

He also pointed out that a large percentage of infant deaths take place in the inner-cities, where there are a lot of crack cocaine and AIDS babies.

"These babies die in spite of very good health care. Their deaths are due to social problems, not medical problems."

As far as lifespan goes, he said that longevity is about the same in this country as in those that have socialized health care; what doesn't get factored in with lifespan studies is the fact that the U.S. is the "murder and accident capital of the world."

"If you took the murders and deaths from accidents in Chicago, Detroit or New Orleans in one month, they are more than the deaths of our soldiers in Iraq or Afghanistan in one month."

In short, the evaluation of U.S. life and health often ignores social problems and unfairly puts all the blame on health care.

Universal care vs. universal insurance

...Wait a minute, aren't they the same thing? Not according to DeSa.

"We do have universal care in the U.S. The EMTALA Law ensures that no one who comes into the emergency room will be refused care -- even illegal immigrants. That's the right thing to do, the humane thing to do and the moral thing to do, and I support it."

He says there is a "subtle but important difference" between this and universal insurance, which we don't have. There are currently 47 million Americans uninsured.

The Congressional Budget Office predicts that as a result of the new health care legislation, 32 million people who were previously uninsured will be insured at the end of 10 years. However, there will still be 21 million people uninsured -- and this is in spite of the fact that the new law will require people to buy insurance!

Who are these 21 million uninsured, you ask? Young, healthy people making between $35,000 to $82,000 a year.

"When you're young, and you're starting a family, and you have mortgage payments, you have a whole host of other host of things you have to worry about. You're going to say, 'Well, I'm young, and I'm invincible...maybe I won't fall ill. I'll take the chance and hold off on buying health insurance.'"

This is going to have a couple of important consequences. First of all, DeSa said, "the IRS is going to need about 16,000 new agents to track them down."

Even if they do track them down, not much is likely to change.

"If I'm a young person," DeSa said, "and a federal agent tells me I have a choice between a fine -- which starts at $95 and over the course of seven years will go up to about $700 -- and purchasing health insurance for $12,000-$13,000, it's a no-brainer."

Secondly, these people will cycle in and out of insurance programs. Faced with a serious condition like cancer, a young person will go to an insurance company for coverage -- and they cannot be refused under the new law. But when they get better, they will forego the insurance.

"People will abuse the system. That's just human nature."

While uninsured, these individuals will be able to make partial payments for hospital visits about 27 percent of the time; the rest will be covered by the state's "uncompensated care pool," into which each hospital in the state pays.

But even this won't cover the whole cost. To whom does the remainder of the cost shift? The taxpayers.

"This varies from state to state depending on the percentage of uninsured they have, but the average each person pays is $300."

The second and final part of the article will be up soon.

Watch out for the little old man hobbling along with his walker the next time you're at the store -- he could be dangerous.

Dangerous on the road, that is.

Batavia resident Catherine Roth said she has seen a number of people out in public -- most of them senior citizens -- who drive even though they shouldn't.

"I once saw this man who could barely walk, and he's got an SUV!" Roth said.

Roth is well-known in Batavia for voicing her concerns about elderly drivers. This started with the death of her 30-year-old son almost 20 years ago.

Jim Roth was killed in October 1991 by an 81-year-old man driving the wrong way on Route 481 in Syracuse.

Catherine and her husband, who died two years ago, both worked hard to toughen the rules regarding elderly citizens on the road. Roth defends her position by citing laws in other states -- including "Katie's Law" in Texas, and a New Hampshire law requiring drivers over 65 to be tested every five years -- that regulate and limit senior drivers.

She has caught wind of some resistance to her efforts among Batavia's older population, but she sticks to her guns nonetheless.

"We have all these laws for young drivers," Roth said, "but when we talk about laws for elderly drivers, forget it!"

The trouble is, Roth has come to the point where she herself might have to surrender her place behind the wheel. She will be 90 years old soon, and has concerns about whether or not she should still be driving.

"I've been thinking about giving up driving for the past several years," she said. "When I realized I would be turning 90 and that my license was going to expire (this month), I realized I had to decide whether to renew the license or quit driving."

Roth said she doesn't have any specific problems that compromise her ability to drive safely, but she worries that "reaction time" might slow with age.

"Right now I drive as little as possible," she said. "I drive to Stafford three or four times a week to work at the museum. Everone who's rode with me has said I'm a good driver. But I've already begun to explore different ways of getting around (like taking a taxi)."

Roth actually asked to be re-tested to see if her driving skills were up to par -- her request was denied.

At this point in time, New York State has no system set up for that sort of thing. Re-taking the driver's test is only possible for those who have been reported.

This is an important issue for Roth, because better testing for senior drivers is one of the reforms she and her husband pushed for over the years.

"A lot of times, all it seems to depend on is eyesight," she said. "If someone's eyesight is good, he can mail in his license and get it renewed. That's just wrong!"

She then pointed out that the person in question could have very good eyesight, but at the same time barely have the ability to walk.

Sometimes, according to Roth, even a doctor's caution is unhelpful.

"If their doctor tells them they shouldn't drive, they'll go to a different doctor."

Roth understands seniors' reluctance to give up their licenses and, by extension, their independence.

"I've been without a car for the past week, and it's been driving me nuts!" she said.

Most of Roth's friends are in their 80s and in the same boat. She is far from unsympathetic to the tough decision facing older drivers.

"I know you want your independence -- but darn it, don't kill my son or anyone else."

She shared some recommendations for seniors who would like to continue driving, but not be a danger to other drivers: don't drive at night; avoid streets near schools around the end of the school day; and avoid big cities.

In addition, she listed some decent alternatives to driving for seniors who still need to get around.

"The Office for the Aging has some good programs," she said. "And you can take a taxi in Batavia for about $5. And then there's always the option of turning to friends, but you try not to bother people for little things.

"It's best to do all of your errands in one trip (so you don't have to call your friends whenever, for instance, you need some milk). You try to keep your independence, even if you have to be dependent in some ways."

 ADDITIONAL FACTS ABOUT ROTH:

Roth is on the Board of Trustees for the Stafford Historical Society, and just finished -- after nine years -- serving on the Board of Trustees for Batavia's First Presbyterian Church. She is also a volunteer at the Batavia Cemetery.

A most interesting fact about her is that she is a triplet. She and her two sisters will be celebrating their 90th birthday very shortly.

"As far as we know, we're the oldest living triplets in the United States," Roth said.