“Solving the Aging in Place Puzzle: Innovative Ideas for Independent Living” was the focus of a major program sponsored by B’nai B’rith St. Louis, which featured a panel of experts on the topic and extensive questions from the audience of nearly 200 people who attended the event last week in the Pasternak Auditorium of the Jewish Community Center.

Morgan Gable, MSW, assistant director of Grassroots Advocacy for B’nai B’rith Interational (BBI), who herself has an extensive educational and professional background in geriatrics and gerontology, served as moderator of the panel.

In her introductory remarks, Gable urged those in attendance to send letters to both of Missosuri’s United States senators, Claire McCaskill-D and Christopher (Kit) Bond-R, urging them to support the Community Choice Act of 2007, Senate Bill 799.

“The bill, introduced by Senators Arlen Specter, R-Pa. and Tom Harkin, D-Iowa, gives individuals who are eligible for nursing home services, or other institutional care, equal access to community-based services and supports,” Gable said. “This bill directly relates to B’nai B’rith International’s desire to promote Aging in Place policies for older adults and for those living with a disability in the United States.”

John Gamache, director of planning for the Mid-East Area Agency on Aging, said that his agency is one of 10 in the United States, which serves people 60 years and older. “The only criterion is being 60 or older; health and income do not matter,” he said. “We serve older adults in St. Louis County and Franklin and Jefferson counties; the City of St. Louis has its own MEAAA program.”

Among the many services provided by the MEAAA, Gamache listed senior centers, including Covenant Chai Apartments; dance and other classes; chess clubs, computer classes, swimming pools and libraries.

“We also provide home-delivered meals under our Monday through Friday Meals on Wheels program. There is no charge for the meals, but we do offer people the opportunity to make voluntary contributions,” he added. “In addition, we provide information and assistance, transportation help and caregiver support, including longterm care and ombudsman service for nursing home residents.”

He encouraged those interested in the services or information to call 800-392-0210.

Dr. Monique Williams of the Washington University School of Medicine, offered a description of the physical, psychological and emotional issues in the aging process, “a physician’s overview of the physical changes with age.” She offered the example of an 89-year-old woman who has arthritis and osteoporosis and macular degeneration.

“As we grow older, we experience a decrease in our ability to naturally compensate for our physiological challenges,” she added.

Among several physical conditions discussed by Williams among elderly are return of earlier illnesses, such as shingles or tuberculosis, decreased maximum heart rate, decreased aerobic capacity and decreased lung elasticity. She also discussed Alzheimer’s disease and other memory loss issues.

Lori Goldberg of the staff of the Jewish Family and Children’s Service, warned against promising elderly parents and other close relatives that “you never would place them in a nursing home. Do not make promises that you may not be able to keep.” She gave as an example an elderly mother who “is becoming forgetful and confused, but who has been promised that her daughter would not place her in a nursing home.” She added that 41 percent of Baby Boomers are primary caregivers to aged family members.

“The average caregiver is a 46-year-old Baby Boomer, who can spend more than 18 hours a week in providing such care, and who has an average income of $35,000 per year.”

Goldberg said that it is important to make an evaluation in the home of an elderly relative to determine if the aged person is receiving the services needed to live independently.

“Evaluate how the older person manages day-to-day activities. Obtain medical and other important information from collateral sources,” she added. Goldberg encouraged development of both short- and long-term plans for “living well,” and said such plans need to be “customized” to meet each individual’s specific needs. Among other concerns are “non-medical health care, such as bathing and grooming, along with medical care, occupational, physical and speech therapy.”

Dr. Susan Stark, of the Washington University Medical School faculty, the final panelist, stressed the importance of modifying existing homes to meet the changing need of elderly residents to assure that they can remain in those homes for the longest possible period. “Each year AARP, the American Association of Retired Persons makes a study and always reaches the same conclusion that most homes are not designed to meet the needs of people over the age of 65. Yet some 83 percent of older persons want to remain in their own homes for as long as possible.”

Stark said that the needs of older persons can be taken into account in building new homes, but most elderly live in homes built 35 or more years ago, and which lack safety and other features that are essential for the aging population.

Stark indicated that there are several principles which should be kept in mind in modifiying homes for the elderly.

“Equitable use, which means that all people can use them with ease, like the automatic doors at supermarkets; flexibility, such as two-way scissors and faucets and telephone pads that are simple and intuitive. It is also important to have a high tolerance for error, and safety features, such as a new bathtub which is made out of rubber to help prevent slipping and falling..”

Stark said that most homes can be successfully modified to meet the needs of the elderly for about $600 per home. She added that she has evaluated the effectiveness of the home modifications she has suggested and which were implemented in the NORC neighborhood, about three square miles in Creve Coeur. The event was sponsored by B’nai B’rith International, B’nai B’rith St. Louis, Missouri Lodge #22, B’nai B’rith St. Louis, Jewish Community Center with help from the Jewish Federation of St. Louis, Jewish Family & Children’s Service and MERS/Goodwill.