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Posts Tagged ‘Family-Elders’

Generations: Crooks lurking to nab stimulus money

Friday, May 15th, 2009

Older adults waiting for $250 stimulus checks from Uncle Sam this month are warned about scammers lurking on the Internet and on the other end of telephone line.

Perpetrators of fraud and theft of the stimulus checks have been reported by federal agencies, and all eligible older consumers should be vigilant.

Unlike last year, when all consumers had to file a federal income tax return to receive stimulus checks, recipients this year get their money automatically.

About $13 billion in payments to nearly 55 million eligible people on Social Security, Supplemental Security Income, railroad retirement or veterans disability began going out May 7 and should continue through the end of the month.

The money will be delivered the same way as current benefits, such as through direct deposit to a checking account or via debit card or paper check.

Crooks have been sending official-looking e-mails asking for bank account numbers, trying to persuade people the information is needed so that stimulus checks can be directly deposited into bank accounts.

Instead, the scammers drain the accounts and disappear, according to the Federal Trade Commission.

Other bogus e-mails purporting to be from government agencies ask for personal information to “verify” that the recipient qualifies for a payment.

In another variation, e-mails provide links to Web sites on the premise that people can find out if they qualify for the money.

But by clicking on the links, consumers download malicious software or spyware that steals personal information used for identity theft, the FTC said.

Scammers also have been working the phones, trying to snag bank account numbers or personal information by claiming it is needed for direct deposit of stimulus checks or to verify future entitlement to Social Security benefits, according to the Social Security Administration.

Callers sometimes get hostile or call repeatedly if individuals refuse to divulge the information, the agency said.

In another ploy, Web sites also have been claiming that for a small fee they can help consumers apply for money from the stimulus fund.

Be suspicious of anyone who tries to collect a fee for filing a claim for stimulus money, the FTC said.

Remember, eligible recipients do not need to sign up anywhere or do anything to get the money.

And the Social Security Administration does not have to contact anyone for information.

Working seniors aren’t eligible for the $250 because they are getting stimulus money through reduced paycheck withholding throughout the year.

People who have not received their $250 by June 4 should contact the Social Security Administration at 800-772-1213.

The payments are not taxable as income and will be sent separately from current Social Security benefits.

To report suspected fraud, contact the FTC at 877-382-4357 or use the online complaint assistant at ftc.gov.

For the Social Security Administration’s fraud hot line, call 800-269-0271 or visit socialsecurity.gov/oig/hotline.

Today’s information is provided by Adina Wingate, PCOA’s public relations director, using approved information from the Federal Trade Commission and Social Security Administration information about fraud. Visit online at www.pcoa.org

Miss California keeping title . . . for now

Monday, May 11th, 2009

BEVERLY HILLS, Calif. – Officials of the Miss California USA pageant have strongly criticized titleholder Carrie Prejean (pray-ZHAN’) but say it’s not their decision whether she should be stripped of her crown.

Co-executive directors Keith Lewis and Shanna Moakler told a Beverly Hills press conference Monday that only Miss USA pageant owner Donald Trump can make that decision.

The 21-year-old San Diego native created controversy during the Miss USA pageant when she said she believes marriage should only be between a man and a woman.

The state pageant has been investigating whether she violated her contract by making public appearances with groups opposed to same-sex marriage. Prejean also failed to reveal that she once posed in her underwear.

Proposed state budget cuts threaten lifelines for seniors

Friday, May 8th, 2009

Lost services matter of life, death for some

Billy Brown, 71, has received assistance from Community Home Repair Projects of Arizona through the Pima Council on Aging.

Billy Brown, 71, has received assistance from Community Home Repair Projects of Arizona through the Pima Council on Aging.

Related: Depression survivor fears losing independence

Just as more older Tucsonans need help with basic necessities – food and a safe place to live – the agency that cares for the aging in Pima County is facing crippling budget cuts.

Expected cuts of about $3.8 million statewide, if approved by the Arizona Legislature, could gut programs that allow seniors to live safely in their own homes, said Jim Murphy, president and CEO of the Pima Council on Aging.

The proposal under consideration in the House could mean about $760,000 in cuts to PCOA, on top of another $413,000 in cuts earlier this year, requiring a reduction in services and staff, Murphy said.

“The services were never sufficient to support people before, and now we are facing massive budget cuts,” said Diana Edwards, a program director at PCOA.

“We’ve been successful in keeping people on the brink. But now as our funding is jeopardized, they’re going to fall over, and what are we going to do?”

State Sen. Jonathan Paton knows budget cuts will hurt vulnerable seniors, but he said lawmakers are hamstrung by the economy.

“It’s absolutely difficult to make these decisions, affecting people in a vulnerable situation,” the Tucson Republican said. “You’re choosing between seniors and kids and neither choice is easy.”

The Legislature is forced to fund a $10 billion budget with $6.5 billion, he said, and cuts are unavoidable.

For PCOA, cuts may mean a reduction in services that include emergency home repair, transportation, personal hygiene services, mortgage counseling, job training and other help. The agency serves thousands of Pima County seniors and their family caregivers.

“What is that train wreck that is coming just around the corner?” Edwards asked. “What’s that going to look like? We know it’s going to be messy and ugly and there’s nothing we can do to prevent it.”

She worries that with some clients, cuts in services are a matter of life and death.

“It’s who lives and who dies, literally, because we’re talking about food and shelter,” she said.

Many seeking help since the economic downturn have been self-sufficient all their lives, she said. Some live in high-end retirement neighborhoods and have lost investments and retirement income.

“We’re seeing people who have never needed help before,” Edwards said. “They’re desperate.”

PCOA official: Cuts more costly in long run

For 42 years, Pima Council on Aging has helped older Tucsonans with services they need to survive.

Last year, the agency provided nearly 375,000 meals, 22,000 rides, hundreds of emergency home repairs and countless baths, housekeeping services and other help.

The agency operates on a budget of about $8.3 million, with 85 percent provided by federal, state, county and city funding, said Jim Murphy, president and CEO of PCOA.

Based on a bill passed by the Appropriations Committee in the Arizona House of Representatives Tuesday, the agency expects to lose about $760,000 in funding from the state this coming fiscal year, Murphy said. It lost another $413,000 from the state in March.

Under the current budget, PCOA received about $3.2 million in state funds. For the fiscal year that starts July 1, that amount could be $2.5 million.

“We know we’re going to have to reduce services and staff,” Murphy said.

PCOA is the designated Area Agency on Aging, coordinating services for older adults and their families through local agencies. The services allow older Tucsonans to stay in their homes longer.

Murphy said program cuts will be more costly in the long run. “By providing these services, we are able to delay on an average of three years folks going into care,” he said.

While a nursing home for an indigent senior can cost the state $3,500 per month, PCOA services cost about $250 to $300 per month, Murphy said.

With the spiraling economy and increases in foreclosures and unemployment, PCOA is getting more requests for help.

“People are calling in and saying they have never had to seek services, but they now need help to buy food or even to pay for their homeowners association fee,” said Debra Adams, chief operating officer at PCOA.

Many are distraught when they find there are not enough services.

“People assume there has been a social safety net,” said Diana Edwards, a program director at PCOA. “There never was much of a net. It had great big giant holes. And now it’s a thread and people are shocked.”

In the past couple of years, growing numbers of seniors have taken in adult children who have lost jobs, or they are raising grandchildren.

“That Social Security check has covered the older person, but it’s not going to stretch for the added mouths to feed,” Edwards said.

While state dollars are dwindling, it appears federal dollars are stable. But often state dollars are used as a required match for federal funding, which could jeopardize some grants, Adams said.

The good news, according to the agency, is that nutrition programs, including delivered meals, appear to be safe for now. Stimulus dollars have been earmarked for senior nutrition.

But Adams said cuts will force agencies to make difficult choices.

“Is it more important to bathe people? Is it more important to repair their homes? Is it more important to make sure they can stay on Medicare? Is it more important to help caregivers? How do we decide who gets the service and who doesn’t?”

She said families are not looking for handouts.

“Take the person who’s providing everything for his father except for the twice weekly bath,” Adams said. “That’s all they’re asking. They are not looking for freebies.”

Not enough money for homes needing repairs

The roof on the old trailer leaks, and the swamp cooler hasn’t worked in years.

A shattered window is boarded up, and bare wires on the roof pose a fire hazard.

The toilet in the tiny bathroom wobbles precariously.

The home of Billy and Loma Brown is in desperate need of repair.

“Things are really falling apart, and I can’t fix this on my own,” says homeowner Billy Brown, 71, who is ill and disabled. For 35 years, he has lived in the South Side trailer with his wife, Loma, 70.

Thanks to Pima Council on Aging, the Browns got help this week fixing up some of the more urgent problems, allowing them to live safely in their own home.

But expected cuts in state funding to PCOA could leave older Tucsonans like the Browns with nowhere to turn for help.

“It’s so hard to find people who will help you out, and it sort of leaves you stranded,” said Loma Brown, who survives with her husband on about $1,100 in Social Security each month.

Last year, PCOA provided emergency home repair grants of up to $750 per household to 683 Pima County residents. It also provided grants of up to $4,000 to 65 residents for more major repairs.

Most of the people receiving the home repairs – 77 percent – were older women.

But budget cuts threaten to gut the program.

Volunteers Kristi Bowman and Dan Portice with the nonprofit organization Community Home Repair Projects of Arizona spent a couple of days at the Browns’ trailer. PCOA contracts with the agency to do repairs.

They replaced the motor and pump on the swamp cooler and rewired it. They patched the leaky roof.

They fixed the window and installed grab bars in the bathroom to prevent Billy Brown from falling as he gets in and out of the tub. Twice the fire department has been called to help him up.

“This helps out a whole lot,” said Brown, who became medically disabled in 1980 after several on-the-job injuries at a transportation company.

Bowman said there are more people who need help than there are grants.

“It gives me a whole different perspective on what it means to have a roof over your head,” she said of her volunteer work.

Agency seeing more suicides as elderly lose homes, hope

They come to Pima Council on Aging hoping mortgage counseling will save their homes from foreclosure.

But it soon becomes obvious that some seniors are nearing the end of their rope.

Mortgage counselors at PCOA “will see four or five people a day who say if something can’t be done, I’m going to kill myself,” said Donna Carender, who heads training through the Older Adults Suicide Prevention program at PCOA.

She worries that recent economic troubles combined with health problems and isolation many seniors experience are resulting in more suicides.

Tucson has the third highest suicide rate in U.S., out of 54 large metro areas, and the older you are, the more at risk you are, Carender said.

“It’s going to get worse,” she said. “We’re hearing more and more people that are losing everything. Older adults had enough stressors on them in the first place. To take more stressors and not have an idea of where to go to get help, we’re going to see (suicide rates) jump really high.”

Carender trains social workers, meal delivery volunteers, home health care workers, family members and others on what to look for in a suicidal senior.

She also trains people to do interventions. Some take place at the PCOA office.

She said if a senior can be connected with solutions to problems, often the desperation can be alleviated.

Carender advises people about how to talk to seniors about suicide, using the word, so seniors can identify who they would tell if they were considering it.

“Most people don’t want to be dead. They just don’t want to be alive right now,” she said. “We don’t want them to take that step to get rid of that problem that’s going to be permanent.”

Program helps older people looking for work

Dan Toth is certain of one thing: He has no desire to be a Wal-Mart greeter.

But armed with a master’s degree and a lifetime of work experience, Toth, 59, is finding it difficult to get a job in this economy.

So he’s turned to Pima Council on Aging’s Mature Worker Connection for help.

“It’s kind of painful to think of yourself as a mature worker, but I considered it an opportunity to build a network,” said Toth, who has worked as a remodeling project manager, a business developer and a youth corrections worker. He also owned his own business.

“Part of my dream job would be working at management level at a nonprofit or a private company,” Toth said.

Since January, Toth, the married father of four grown children, has been optimistic about three jobs. He’s had one interview, and no job. He spends his free time volunteering.

Roger Forrester, program administrator for the free Mature Worker Connection, said calls from older residents like Toth who are looking for work have quadrupled in the past 18 months.

“People are worried about outliving their retirement income,” he said. “These are people who thought they had it made. They are desperate for work, at a time when employers are laying off.”

The program, among the first of its kind in the country, has an annual budget of $143,000 and relies on volunteers. It is unknown how cuts in the state budget will impact the program, but Jim Murphy, president and CEO of PCOA, said it is likely that it could lose some funding.

About 750 older workers have been placed in jobs since the program began in 2006.

“They come from every walk of life and profession,” said Forrester, who started the program after he retired. “We’ve had doctors, a judge – you name it.”

Half are seeking jobs in their former professions. The others are looking for new careers.

About 54 percent of people in the program are women, some who have never been employed.

The program is open to workers ages 50 and older. Some applicants are in their 80s.

Forrester said many older job hunters feel “invisible.”

The program connects potential workers with free job training and helps employers understand the value of mature workers, Forrester said.

Currently, 507 employers are registered, including Raytheon and the University of Arizona.

Toth, meanwhile, hopes the right company will appreciate his years of experience.

“You have to be optimistic just to get through it,” he said. “It’s really a tough time out there.”

Kristi Bowman of Community Home Repair Projects of Arizona explains some of the repairs she did on the swamp cooler at the home of Billy and Loma Brown.

Kristi Bowman of Community Home Repair Projects of Arizona explains some of the repairs she did on the swamp cooler at the home of Billy and Loma Brown.

Kristi Bowman, a volunteer with Community Home Repair Projects of Arizona, installs safety bars in the shower at the Browns' home.

Kristi Bowman, a volunteer with Community Home Repair Projects of Arizona, installs safety bars in the shower at the Browns' home.

Billy Brown talks about the couple's finances. The Browns survive on about $1,100 a month in Social Security payments.

Billy Brown talks about the couple's finances. The Browns survive on about $1,100 a month in Social Security payments.

Generations: Helping aging parents with finances

Friday, May 8th, 2009

For most of us, it’s hard to face the fact that our parents, the people who took care of us, are getting older and may need assistance in decision making and caring for themselves.

It’s also difficult to ask questions about finances. Many of our parents are of a generation that considers financial matters private. Here are some tips for talking to your parents to provide you and your siblings with some communication strategies and consideration for these important conversations. One size will not fit all families, but these suggestions can help in opening this dialogue with parents.

• Start discussions early

Don’t wait until there is a medical or behavioral crisis. While your parents are still in good health, use the opportunities to start the conversation.

• Include family members

You are not in this alone. Bring other family members into the discussions with your parents, but first determine whether they have different opinions that would possibly undermine what you are trying to accomplish. Get all the issues on the table and gather support from siblings and other relatives.

• Explain the purpose of your conversation

Let your parents know you are concerned about them, and you want to do the right things for them as they age. Explaining the purpose of the conversations will help everyone better understand why you are bringing up sensitive issues.

• Understand your parents’ need to control their own lives

At some point, you may need to balance your parents’ independence with their safety, but try to discuss and resolve the issues to not take away their sense of control over their own lives.

• Agree to disagree

Their wishes should prevail unless their health or safety is in question. Constructive communication strategies center on listening and conversing but not bullying or controlling the conversations.

• Use good communication skills

Offer options, not advice. Remember to ask for your parents’ ideas. Express your concerns rather than telling them what they should do. Listen and don’t be anxious about silence. Use open-ended questions that foster discussion rather than closed questions that are answered with a “yes” or “no.”

• Ask about records and documentation

You can start by asking your parents where they keep their papers, and whom you should contact in case they are in an accident or are incapacitated. Know where your parents’ insurance policies, wills, health care proxies, living wills, trust documents, tax returns and investment and banking records are located.

• Provide accurate information

Parents may not have enough information about the legal and financial options available to them and you can greatly assist the parent by serving as an informed resource to them, by providing material for them to read. Contact Pima Council on Aging Central Intake by calling 790-7262 during weekdays from 8:30 a.m.-5 p.m. with questions or to request a meeting with a social worker or ombudsman and also check out online resources at pcoa.org.

For example, your parents may be eligible for government programs. Check benefitscheckup.org for assistance for people older than 55.

Understand that Medicare generally does not cover long-term care, and Arizona’s Medicaid – Arizona Health Care Cost Containment System (AHCCCS) – pays long-term care expenses only for low-income individuals. PCOA’s Medicare and Health Insurance Assistance and Elder Rights and Benefits Assistance experts will help clarify plans and options.

Suggest that your parents learn about long-term care insurance options by understanding the Arizona Long Term Care System explained in PCOA’s monthly workshop about the Long Term Care System.

Identify the home- and community-based network of services available through PCOA and listed online at pcoa.org that may be available if your parents were to remain in their home as long as possible. Some home modifications and medical safety alert systems may make sense.

Re-evaluate and consider conversation with a PCOA specialist, geriatric case manager, financial planner or attorney.

If the conversations over time are going well, assess what may be any hurdles and consider that your parents talk with a third party – a geriatric care manager, the family financial planner or a lawyer (consult the local chapter of the National Academy of Elder Law Attorneys in Tucson) for contact information through the PCOA Central Intake at 790-7262.

• Treat your parents with respect

Treat your parents with love and respect and reassure them that you will be there for them as they age.

Today’s information is provided by Adina Wingate, PCOA’s public relations director. Visit online at www.pcoa.org

Baby Boomers turn to blogs to find jobs

Thursday, May 7th, 2009

Bette Publicker, 58, entered the blogosphere last week.

The event planner, who was laid off last year, created her blog at a workshop hosted by the Scottsdale Job Network. The Valley-wide group hosts meetings that focus on job-transition training and connects job seekers with employers and business leaders.

“I’m being dragged kicking and screaming into the technological world,” read her very first post at bettepublicker.wordpress.com. “It is like running with a broken leg after a fast-moving train.”

Publicker was joking, but it’s an apt comparison for how many laid-off Baby Boomers feel.

The recession is dropping a growing number into a job market that requires everyone to market themselves through newer and newer Web technology in order to get hired.

Résumés are posted on blogs. Contacts are made on LinkedIn and Facebook. Reputations are built and broken instantly on Twitter.

It can be particularly daunting for those who’ve held the same job for years and are used to searching classifieds and handing out a paper résumé.

“It is a whole new world with regard to looking for a job,” said Brad Taft, Arizona workforce-policy adviser for AARP and a career consultant.

“In the old days it was, ‘Hurry up, send me your paper résumé and wait.’ Then in the 1980s it was, ‘Hurry up, fax me your résumé and wait.’ And now it’s either, ‘E-mail or attach résumé online . . . and wait.’ ”

Changes in job-search technology, combined with the severe recession, have prompted Valley groups like Scottsdale Job Network and Boomerz to help job seekers gain an online edge.

Boomerz plans to start holding workshops across the Valley on social networking and the Web.

“Many, many employers will Google you,” said Cindy Cooke, executive director of Boomerz, a non-profit group that specializes in career and entrepreneur development. “And if you don’t exist on Google, you don’t exist as far as they’re concerned.”

Angelo Fernando, communications and outreach manager for ASU’s Decision Theater, told last week’s audience that blogs allow them to quickly showcase a résumé, network and publish ideas.

That strategy gives hiring managers a much better picture of skills, interests and opinions before the interview.

The sooner that people become familiar with blogging and other social-networking applications, the better, Fernando added. Technologies are only going to get more sophisticated. Candidates who can stand out on the Web have a much better chance of getting noticed and hired.

Phoenix resident Martin Piraino, 43, is younger than members of the Baby Boom generation – those who are between the ages of 45 and 63 in 2009 – and started his blog in January (martinpiraino.com).

The IT professional was laid off last year and has made connections through his blog and has gone on a few interviews.

He continues to chronicle his job search, offer tips and showcase his experience.

“It has offered a way for employers to find me online,” he said. “It has afforded me some opportunities that may not have come along otherwise.”

Publicker, who is also on LinkedIn, plans to post her résumé on her blog and chronicle her experience learning new technology.

“Now that I am looking for new job and business opportunities, ‘social-networking skills’ seem to be as necessary as a résumé, business cards and gumption,” she wrote on her second post. “In every networking event I am asked about Web sites, LinkedIn and my Facebook. Now perhaps my eyes won’t glaze over and I won’t have to fake cough an answer.”

———

From zero to blog in 15 minutes

1. Decide how you’ll use your blog to brand yourself. Will you write daily musings? How will it help you connect?

2. Click on WordPress at www.wordpress.com to create a free blog.

3. Click on the “sign up now” button. Register yourself. You must already have a personal e-mail address through a provider such as AOL or Hotmail. Create a username and password.

4. Create a blog name, such as wordpress.com/yournamehere. This is the URL address you’ll give to people who might be interested in your blog.

5. Design your blog. Choose from one of the premade templates.

6. Give your blog a title. It doesn’t have to be your name. But if you’re using it for professional reasons, don’t be too cute.

7. Set up the basic categories, called content buckets.

8. Learn the meaning of and how to use the following: tags, blog roll, trackbacks, RSS and widgets.

9. Start posting your messages. Keep your posts simple and short. Write catchy headlines. Be topical and creative. Reward your visitors by giving them new information or your expert analysis.

10. More help: Check other Web sites, including David Meerman Scott’s blog (www.davidmeermanscott.com), John Cass (pr.typepad.com) and Daily Blog Tips (www.dailyblogtips.com).

Source: Angelo Fernando, communications and outreach manager for ASU’s Decision Theater

CareGiver institute gets help from eegee’s fundraiser

Wednesday, May 6th, 2009

The CareGiver Training Institute will be this year’s recipient of the eegee’s 17th Annual Coupon Card.

During June, eegee’s customers can donate $5 to CareGiver and receive a coupon card good for 50 percent off purchases for the next 12 months, a potential savings of $72 over the course of the year. The promotion, started by eegee’s in 1992, has raised more than $1 million for local charities.

The not-for-profit institute educates compassionate, quality, certified caregivers and certified nursing assistants to work in nursing homes, assisted-living facilities, hospice centers and private homes.

All expenses for the promotion are underwritten by eegee’s so that all funds raised this year, including change collected in coin canisters at eegee’s 21 locations, will go to the institute’s programs and services.

States consider ‘Silver Alerts’ for missing adults

Monday, May 4th, 2009
Herbert Hicks points out the combination locks and latches he had to install on the doors  of his home in Montville, Conn., to prevent his wife, Betty, from  wandering away after she was stricken with dementia. Hicks has been a  moving force in getting the Connecticut General Assembly to consider a Silver Alert system.

Herbert Hicks points out the combination locks and latches he had to install on the doors of his home in Montville, Conn., to prevent his wife, Betty, from wandering away after she was stricken with dementia. Hicks has been a moving force in getting the Connecticut General Assembly to consider a Silver Alert system.

MONTVILLE, Conn. – Thomas Drew was 91, frail and suffering from dementia when, clad in a maroon sweat shirt and jeans, he disappeared from his home in rural northwest Connecticut.

Drew hasn’t been seen since that warm Saturday afternoon in July 2007, an example of the perils facing millions of Americans living with dementia, Alzheimer’s disease and other mental impairments.

Now, several states and Congress are considering alert systems to notify the public when a cognitively impaired adult like Drew goes missing or wanders away. Called “Silver Alerts,” they are modeled on the Amber Alerts issued to prompt widespread publicity about missing children.

As baby boomers age and dementia diagnoses are skyrocketing, 15 states have adopted Silver Alert systems. Lawmakers in several others — including New Hampshire, Tennessee and Wisconsin — are considering them.

Connecticut’s state Senate approved a bill Thursday to set up such a system, sending it to the state House for a vote. On the same day, Indiana Gov. Mitch Daniels signed his state’s Silver Alert program into law.

A measure to set up a national Silver Alert system also has passed the U.S. House of Representatives and awaits Senate action.

Supporters say the goal is simple: spreading the word as quickly and widely as possible when an impaired adult wanders away so they can be returned to safety.

In many states, it involves flashing the person’s face on electronic billboards; working with broadcasters to spread the person’s description; and posting messages on highway traffic-incident signs and state lottery ticket terminals.

The Chicago-based Alzheimer’s Association says 5.3 million people in the U.S. have Alzheimer’s disease, including 5.1 million of them ages 65 and older. And with baby boomers aging, they say, there’s a new case about every 70 seconds.

About six of every 10 Alzheimer’s and dementia patients will wander away from their caregivers at least once, with only limited mental ability to explain their predicament to strangers or find their way home.

“The biggest thing is that to find somebody, it takes bodies, people — and there’s not always enough law enforcement to do that. This recruits so many extra sets of eyes,” said Herbert Hicks, of Montville, Conn., who testified before state lawmakers this year for the proposal.

For Hicks and millions of other caretakers nationwide, the issue goes beyond statistics.

Frontal lobe dementia transformed his wife, Betty, in less than three years from a savvy bank executive to a restless woman who talked plaintively of wanting to “go home,” though she was sitting at her own kitchen table.

Her attempts to wander away prompted Hicks to retire early from his firefighting career, hire caretakers and install special locks on doors to keep her inside. She died in April at age 68.

Though they had what Hicks calls “a few interesting experiences in the yard” as she was caught and diverted inside, others haven’t been so lucky.

Drew, missing since 2007, was popular in his small town of Salisbury, where “missing/endangered person” signs featuring his face and description still hang in some stores and the library.

Searchers returned to the region as recently as April 25, finding no sign of the retired fashion designer.

Police and his family often wonder whether Drew, who was so frail he could barely walk in church without gripping each pew, may have been picked up by a stranger in a vehicle — a stranger who, if a Silver Alert had been in effect, might have known that his passenger was the subject of a frantic search.

A short distance away, Litchfield still mourns the 1999 disappearance of James Garris, an 80-year-old Alzheimer’s patient who wandered away from a convalescent home on one of the year’s hottest days. Like Drew, his body has never been found.

Allison Drew, one of Thomas Drew’s two daughters, said the family is unsure whether they will ever have answers, but that her experience leads her to fully support Silver Alerts.

“I don’t know what happened to my father or how he came to be missing, but basically all we know for sure is that he’s not there,” said Drew, a professor who lives in the United Kingdom community of York and frequently returns to Connecticut.

“Any system that would provide information would be a great idea to help if someone who’s a vulnerable person is missing,” she said. “Who’s to know if it would have helped in my father’s case, but I think it definitely would be helpful in general.”

Centenarians to party like it’s 1909

Friday, May 1st, 2009
Dorothy Kruppenbacher at age 5 (above) and at age 100

Dorothy Kruppenbacher at age 5 (above) and at age 100

What do you get when you mix 50 folks ages 99 through 106 for 90 minutes to reminisce and schmooze?

One heck of a party.

Pima Council on Aging’s 22nd annual Salute to Centenarians was planned for Friday morning at Tucson Medical Center, just in time to kick off May as Older Americans Month. We chose three of the honorees to profile.

Dorothy Kruppenbacher

Born Feb. 25, 1909

Anyone wishing to catch a word with Dorothy Kruppenbacher has to first catch Kruppenbacher.

That is not an easy task. If the 100-year-old Brooklyn-born beauty is not in the middle of a trip back to New York City, she may be heading to California for the weekend.

She’s been to Italy, England, Australia, France and all the Scandinavian countries, and just returned from Florida last week.

“I like to travel,” she said, “and I’ll do it as long as I can.”

Her favorite stop was probably Germany because her parents were born there, but she falls in love with most every place she meets.

“I loved living in Cape Cod,” she recalled.

Constantly being on the go may have helped Kruppenbacher stay so young at heart, but she quickly revealed another secret of her longevity.

“Having six children,” she said with a laugh. “I’m glad I made it.”

Her oldest child is a 77-year-old daughter. Her youngest is a 60-year-old daughter with whom she lives. Four sons came in between.

“My children have been very good to me,” said Kruppenbacher, who is also grandmother to 14 and great-grandmother to 18.

“I love to take care of little children. I love just watching them now, as old as I am,” she said. “When they come to visit, the children always talk to me. They’re so cute, honestly.”

Kruppenbacher treats her family as well as she treats herself.

In fact, she was on her way out the door Wednesday afternoon with her daughter Diane Jackson to her nail appointment.

“She’s an amazing woman,” Jackson said. “For a lot of people she’s a role model.”

Walter Michael Sr.

Born June 25, 1907

Walter Michael has had many notable moments in his 101 years, including hanging out with a murderer.

The killer was Winnie Ruth Judd, who shot her two roommates. She disposed of the bodies by shoving them into steamer trunks, dismembering one of the bodies in the process.

Michael first ran into Judd when he was chairman of the Arizona Board of Pardons and Paroles and denied her parole in 1969.

She was released from prison two years later yet kept in touch with Michael.

“She was the sweetest, kindest old lady you ever saw,” he said. “I sent her back to prison and she loved me ever since.”

Judd even called him the day before she died in 1998, asking him to pay her a visit in Phoenix.

“I think she wanted to tell me secrets she had,” he said, perhaps who helped her chop up the body. “I’m always sorry I didn’t go.”

Other notable moments during his 75 years as member of the Tennessee Bar Association include sitting in on the Scopes Monkey Trial and watching a 1919 Tennessee vote act as a tie breaker for a deadlocked national vote regarding women’s suffrage.

Michael met Annie Pope at a bridge game and married her in 1941. They moved to Arizona for their son’s health after their first child died of cystic fibrosis at 18 months.

Michael said there is no secret to longevity – “I was not a virtuous person” – but does say that not smoking or drinking has surely helped. “With a good heart and liver, you can get around pretty well physically.”

The biggest change he’s noted in the last century is not necessarily a change for the better.

“We’re becoming more savage,” he said of the human race. “We’re not big enough to police and tame the world.”

Carmen Amado Acevedo

Born Jan. 2, 1909

Carmen Amado Acevedo’s biggest life-changing moment happened 89 years ago, but she remembers it as if it were yesterday.

When Acevedo was 11, her mom was the victim in the first recorded motor vehicle fatality in Arizona.

“No one ever told us she was dead,” Acevedo recalled. “We went to town thinking we were going to take care of her.”

She and her six siblings found out otherwise when their aunt told them the real story.

Her mother’s death prompted the family’s move from their ranch in Amado, which bears their name, to Tucson.

Acevedo and her cousin were fixtures on the social scene, often cruising Congress Street looking for friends.

“We had a lot of fun,” she said. “We all got together and had ice cream.”

They also frequented the Blue Moon Ballroom, a popular dance hall from its opening in 1920 until it burnt down in 1947.

She even met her husband, Cornelia Acevedo, there. Actually, she first met him when she and her cousin were strolling along Congress and he drove by in a Packard.

“Driving a Packard was really something at the time,” she said. He asked her cousin to come dance and added, “Bring her, too.”

Cornelia ended up dancing with the cousin once and Carmen the rest of the night. They married four years later and stayed together until his death in 1973. They had one daughter.

A matter-of-fact attitude and a few basic necessities help keep Acevedo going.

“I live my life the best I can and that’s it,” said Acevedo, who still does her own gardening, takes frequent outings and can’t stand sitting around. “You need a smile, a hug and a laugh every day,” she advised. “Life is too short, but mine is long.”

Walter Michael in earlier days (left) and recently

Walter Michael in earlier days (left) and recently

Carmen Amado Acevedo in high school (left) and in 2003

Carmen Amado Acevedo in high school (left) and in 2003

Generations: Follow tips to improve quality of life

Friday, May 1st, 2009

May is Older Americans Month, a great time to bring attention to the issues that affect older adults and create communitywide opportunities to help elder Arizonans improve their quality of life.

This year’s theme is “Living Today for a Better Tomorrow,” and we, as a community, must work together to give older adults the tools they need to make healthy decisions.

By 2030, 1 in every 5 Americans will be 65 or older. Although the risk of disease increases with advancing age, poor health is not an inevitable consequence of aging. Many illnesses, disabilities and even death associated with chronic disease are preventable.

Nearly 40 percent of deaths in America can be attributed to poor health habits such as smoking, and lack of physical exercise and proper nutrition. Older Americans can prevent or control chronic disease by adopting healthy habits such as exercising regularly, maintaining a healthy diet and ceasing tobacco use.

The benefits of regular physical activity include weight control; healthy bones, muscles and joints; arthritis relief; reduced symptoms of anxiety and depression; and more.

Exercise does not have to be strenuous and is safe for people of all age groups. In fact, it’s healthier to exercise than eliminate it altogether. Older Americans can greatly benefit from a regular routine that includes strength, balance, stretching and endurance exercises.

In addition to a regular exercise routine, good nutrition is vital in maintaining good health. Improving older Americans’ diets can reduce the occurrence of chronic diseases, but most adults over age 65 do not maintain a healthy diet. Reducing saturated fats and eating a balanced diet of fruits, vegetables and grains can help older Americans get on the right track to staying healthy.

Tobacco use increases the risk of heart disease and cancer and is the single most preventable cause of death in the United States. Older adults who stop smoking will gain immediate and long-term health benefits.

While it’s important for older Americans to have good physical health, it’s equally important that they maintain good mental health. Nearly 20 percent of Americans 55 and older experience depression and anxiety disorders.

Studies have shown that engaging in social activities within the community can greatly improve mental health. Research has demonstrated a strong relationship between volunteering and mental health, and that volunteering provides older adults greater benefits than younger volunteers. Benefits include better mental and physical health; greater life satisfaction; less depression; and lower mortality rates.

The U.S. Administration on Aging and its National Aging Services Network support a number of successful programs throughout the country that are helping older adults live better today and in the future. These programs help keep people independent and out of nursing homes through streamlined access to health and long-term care information and options. And they provide home and community-based systems of services that include support for family caregivers.

These home and community-based programs also encourage older people to remain active and make behavioral changes through the increased use of evidence-based disease prevention programs under the Older Americans Act as well as the use of preventive benefits available under Medicare.

Arizonans of all ages and backgrounds can celebrate Older Americans Month. Contact Pima Council on Aging, your local Agency on Aging, and volunteer for activities in your area; promote community, state, and national efforts to serve older adults; and find ways to enrich the lives of older adults who touch your life.

Additionally, actively search out ways you can involve your community’s older adults in volunteer efforts, allowing them to share their wisdom and energy. By working together, we can improve the health and well-being of our community’s older adults and pave the way for better health as we age.

For more information about PCOA’s programs and services, call its Help Line at 790-7262 or visit pcoa.org online.

Information for Friday’s column is provided by Jim Murphy, PCOA’S president and chief executive officer.

Generations: Get help for talk with parents on end-of-life wishes

Friday, April 24th, 2009

Q My mother doesn’t like to discuss anything about end-of-life issues; she and I have started to talk about what her services should be like, and she periodically drops some ideas, but how can I more fully engage her in this important conversation?

A: You are addressing one of the complex subjects for discussion between you and your parent. Trained caregivers and elder law specialists say there is no one way to approach the conversation but a frank willingness to start is a very good sign for what may become a series of conversations that unfold in discussing end-of-life preparations.

At some point for everyone, it will be time to discuss the end of life. The reluctance of many to engage in this conversation is understandable because most do not like to think of their own mortality. But as the population ages and technologies appear that provide the opportunity for continued life, however one defines it, these discussions become more and more important.

There are many good local resources available in Tucson and also a lot of reputable materials online that you can consider to prepare yourself and learn about the basic tenets of advance directives.

You may choose to contact Pima Council on Aging by calling our Central Intake at 790-7262 to speak with a specialist or to schedule a phone or face-to-face confidential meeting. You can also read up about advance directives online to learn more about PCOA and allied community resources available to you and your parent.

Physicians have a prominent role to play in discussing end-of-life issues with patients. Because they are so intimately involved in the decisions that patients must make, physicians must be knowledgeable about such patient options as surrogate decision makers – also known as a durable power of attorney for health care – and advance directives.

According to the American Medical Association, physicians should encourage patients to document their treatment preferences or appoint a health care proxy in the event that a health decision must be made when the patient is unable to make it.

In the United States, death is increasingly the province of old age, and 73 percent of deaths occur among people age 65 or older. Although most would prefer to die at home after a short illness, most actually die in institutions after prolonged declines. Despite this discrepancy, elders and their adult children often do not discuss end-of-life preferences. Use of advance directives has not been widespread, and people often avoid the subject until a crisis. National and local experts say end-of-life care in the U.S. is mediocre at best and therefore is an emerging health concern.

That is one perspective on why Pima Council on Aging caregiver specialists, a team of compassionate, highly trained and experienced social workers, specializes in aging issues affecting families and individuals, including how to improve communications about end-of-life issues.

The experts who work at PCOA in the office of Elder Rights and Benefits Assistance can also help you and your parent navigate how to improve the conversations and understand the use of advance directives and the preparation of documents.

Knowing the obstacles to and aids for discussion between adult children and their parents can help everyone and also assist public health professionals to develop more personalized approaches for encouraging elders and their families to discuss preparation and preferences before a crisis.

People can increase the likelihood that end-of-life care will meet their wishes by communicating those wishes to others. Advance directives (i.e. a living will and a health care power of attorney) have been advocated since at least 1990 when Congress passed the Patient Self-Determination Act, but they still are not widely used because little is known about the process.

Experts agree that there are many important benefits of advance planning. They encourage you and your parents to take the opportunity to talk about health care planning, and how, why and when to make end-of-life decisions.

Today’s information is provided by Adina Wingate,PCOA’s public relations director. Visit online at www.pcoa.org

Boomers learn to work, and play, around arthritis

Friday, April 17th, 2009

Azam Anwar played competitive tennis in his youth, and trophies aren’t the only thing he has to show for it. An arthritic right knee reminds him of the years spent on the singles court.

“Your body starts talking to you, and you have to start backing off, trying other alternatives,” says Anwar, a cardiologist in Dallas. He has had two surgeries on his knee.

Experts say there’s no need for Anwar, 49, and other Baby Boomers with arthritis to trade their Nikes for a rocking chair.

“People with arthritis might be living under the myth that they can’t be physically active, but now we know there is no doubt that, if you exercise, it keeps you more mobile as you age and builds muscle needed to support your joints,” says rheumatologist Patience White, chief public health officer of the Arthritis Foundation.

White says there are numerous ways to reduce achy joints and stay in the game, including:

• Incorporating stretching and strength training into workouts.

• Playing sports that don’t place a heavy burden on joints.

• Injections for temporary relief.

• Alternative therapies.

“Your most powerful asset may even be your state of mind,” White says.

Ditch the high-risk activities

Anwar knew the solution wasn’t to stop exercising, which could lead to weight gain. So he has modified his fitness routine.

“You can’t be a hermit, but there are certain activities that are very high-risk. Now I stretch a lot more, weight-lift, golf, walk a lot,” he says.

Hard-on-the-joints sports include football, skiing, basketball and soccer, says Nicholas DiNubile, an orthopedic surgeon in Havertown, Penn. Walking, swimming, biking and strength-training are healthier for the joints.

Stretching and core-strengthening activities such as yoga and Pilates help stabilize weakened joints, says Nisha Manek, a rheumatologist at the Mayo Clinic.

Keep the weight off

Eating healthy shouldn’t be overlooked as an arthritis management strategy, says David Karp, chief of the rheumatic diseases at the University of Texas Southwestern Medical Center.

“In this country, obesity is one of the biggest risk factors for arthritis,” Karp says. “Overweight people can obtain joint relief even if they lose 10 pounds.”

Medicate with caution

Over-the-counter and prescription drugs can help calm arthritis enough to make exercise comfortable, says Frederick Azar, orthopaedic surgeon at the Campbell Clinic in Memphis. But they carry risks.

Avid basketball player Mark Liszt, 61, of Los Angeles landed in the hospital with an ulcer from prescription anti-inflammatory drugs he took for arthritic knees. “Now, I don’t take anything,” Liszt says.

Cortisone shots can reduce inflammation but also have side effects, Azar says.

“Hyaluronic acid is another weapon in our arsenal,” Azar says, which consists of injections of a fluid already present in joints. But Azar says not all patients benefit.

Mayo Clinic rheumatologists April Chang-Miller says Botox injected into specific muscles may ease pain. “Early studies are promising,” she says.

Beyond conventional care

Alternative therapies may help, but not all are clinically proven, Zashin says.

Researchers at the Baylor Research Institute say more than half of patients in a 2007 study reported better movement and less pain after taking tart-cherry supplements.

Vitamin D is touted for bone health but also is believed to play a role in inflammation. A study published this month in the Archives of Internal Medicine associated D-deficiency with inflammation in healthy women.

Preliminary data from a Tufts study suggests tai chi and chi gong exercises help knee osteoarthritis. But mostly, keep a positive attitude, says Theresa Nustvold, 44, of Amery, Wis., who has lupus-related arthritis.

Generations: Always handle medicines with care

Friday, April 10th, 2009

Today’s medicines cure infectious diseases, prevent problems from chronic diseases, and alleviate pain for millions of adults. But medicines can also cause harm.

Patients and their families or caregivers can do a number of things to help reduce the risk of harm from medicines.

According to experts at the Centers for Disease Control and Prevention in Atlanta, one of the most important things patients can do to keep themselves and their families safe is to learn how to properly take, monitor and store their medications.

• What is medication safety and what are adverse drug events?

Medication safety includes a number of things that patients can do to make sure that they get the most benefit from medications with the least risk of harm. When someone has been harmed by a medication, they have had an adverse drug event.

• Are adverse drug events a big problem?

There are many ways to measure the size of the problem of medication safety. Recent work at the CDC has focused on the short-term, severe problems of medicines taken by people outside of hospital settings. It is estimated that there are more than 700,000 visits to emergency departments for adverse drug events each year in the United States. Nearly 120,000 of these patients need to be hospitalized for further treatment. This is an important patient safety problem, but many of these adverse drug events are preventable.

• Who is at risk for adverse drug events?

Anyone who takes medicines has some risk of a harmful effect. How high that risk is depends on the individual patient’s health, the particular medicines a patient is using, and how patients use their medicines. Nevertheless, national data suggests there are some key risks and risk groups:

• Older adults: Older adults (65 years or older) are also twice as likely as others to come to emergency departments for adverse drug events (more than 177,000 emergency visits each year). Older adults are nearly seven times more likely to be hospitalized after an emergency visit, but most of these hospitalizations are due to just a few drugs known to require careful monitoring to prevent problems.

Common drugs that can require monitoring are blood thinners (e.g. warfarin), diabetes medications (e.g. insulin), seizure medications (e.g. phenytoin) and digoxin (a heart medicine).

• All adults: The death rate for unintentional prescription drug overdoses is highest among middle-aged adults (40-49 years old). In 2004, more than 7,500 Americans died of unintentional overdoses of opioid (or narcotic) analgesics (pain medications such as oxycodone, hydrocodone or methadone), more people than from cocaine or heroin.

• What can patients do?

• Know your medicines. Keep a list of the names of your medicines, how much you take (daily dosage), and when you take them (time of day). Include all over-the-counter medicines, vitamins, and supplements and herbs. Take this updated list to all your doctor visits.

• Follow the directions. Take your medicines exactly as prescribed. Don’t take medications prescribed for someone else.

• Ask questions. If you don’t know the answers to these questions, ask your doctor or pharmacist: Why am I taking this medicine? What are the common problems (side effects) to watch out for? What should I do if they occur? When should I stop this medicine? Can I take this medicine with the other medicines on my list?

• Take pain relievers only as directed. If you are taking opioid pain relievers, be sure to tell your doctor about all other medicines you are taking because some medicines, when taken with pain relievers, can cause an adverse drug event, such as an overdose.

• Ask if you need blood testing. If you take any medicines that require special testing, pay particular attention to taking these properly and get regular blood testing. Common medicines than can require monitoring are blood thinners, diabetes, seizure and some heart medications.

Today’s information is provided by Adina Wingate, PCOA’s public relations director, using materials provided by the Centers for Disease Control. Visit online at pcoa.org

Generations: ‘File of life’ packets helpful for EMTs

Friday, April 3rd, 2009

Emergency medical situations are fraught with many time-critical decisions, so having a mini-medical history about the patient available in a handy packet for emergency medical technicians to review is a timely and often lifesaving resource.

Local emergency medical staff and Pima Council on Aging experts got together to discuss how to develop and make available a single emergency medical information form, in a special red packet, that would help at-risk people, including frail elderly and disabled adults.

PCOA, in cooperation with the Southeast Arizona Emergency Medical Services Council and BlueCross BlueShield of Arizona, have produced a pocket-sized packet with a new emergency medical information form to be filled out by the person or his/her caregiver to document accurate health information to be used by emergency medical personnel in a health emergency.

The File of Life packet is a community service initiative organized by PCOA in cooperation with SAEMS and produced with a grant from Blue Cross Blue Shield of Arizona. There is no cost, but it is limited to one packet per person.

The emergency medical information packet includes the approved form and a red plastic holder labeled File of Life, with a magnetic backing so the packet may be attached to the refrigerator door.

Pick up a packet at the office of Pima Council on Aging, 8467 E. Broadway, during weekday business hours from 8:30 a.m. to 5 p.m. Local senior centers and case management agencies also will distribute the packets.

Today’s information is provided by Adina Wingate, PCOA’s public relations director. Visit online at pcoa.org

Seniors say budget cuts hurting the state’s elderly

Friday, April 3rd, 2009

PHOENIX — One hundred years old and legally blind, Lucille Myers couldn’t travel to the State Capitol from her Phoenix home Wednesday, so her caretaker, Cyndy Scheidle, made the trek to Senior Action Day for her.

State funds allow Myers to remain in her home while Scheidle checks in to help with groceries, laundry and prescription pickups. So when Scheidle heard the program was in danger due to state budget cuts, the Surprise resident wielded a picket sign bearing Myers’ face to lobby her legislators.

“It’d sure make her living situation difficult,” Scheidle said. “We keep seniors independent in their own living environment so they don’t have to go into nursing homes or assisted living.”

Cuts of $153 million from the Department of Economic Security’s fiscal 2009 budget have left many seniors lacking essential services, said Lupe Solis, associate director for advocacy for AARP Arizona, which organized the event. More cuts in fiscal 2010 would be devastating, she added.

“What we’re trying to do is raise awareness and consciousness,” Solis said. “The aging community cannot afford any more cuts.”

Several dozen sign- and banner-bearing seniors from around the state marched around the Capitol esplanade, chanting slogans and chatting up their legislators.

AARP estimates that the home-care system that serves nearly 8,000 people statewide costs Arizona $2,200 annually per person compared to upwards of $24,000 annually per person to house a senior in public long-term care facilities.

Dick Morse of Peoria, the 82-year-old federal liaison for AARP Arizona, said caring for seniors in their own homes is a win-win.

“We’ve got a general legislative goal of protecting the most vulnerable of our citizens,” he said while manning an information booth in front of the State Senate building.

Many attendees came north via bus from District 23, which covers most of Pinal County and parts of Gila and Maricopa counties between Tucson and Phoenix.

The district’s representative, Barbara McGuire, D-Kearny, came down from her office to join her constituents. She said cuts to Meals on Wheels, state facilities and senior transportation programs are on the table this year too.

“Do they expect these people to become homeless transients living on the streets?” she said. “We need to make their today the tomorrow that they worked so hard to achieve.”

McGuire added that the cuts affect rural Arizona the most.

“Rural areas suffer, I think, more hardship than the urban areas,” she said. “Urban areas have more resources.”

Winkelman resident and World War II veteran Gordon Tebben, 88, said he and his 92-year-old wife, Belan Cluff, are lucky enough to enjoy a pleasant retirement. Unfortunately, he said, some seniors in his area aren’t so lucky.

“It’ll hurt them most,” he said. “The politicians always talk about how they’re going to hit the rich. Well, it’s a reverse in this situation.”

Dale Vaughan, a 77-year-old Mammoth resident, said he hopes Gov. Jan Brewer accepts the maximum federal stimulus dollars possible and allocates some for seniors. He said he doesn’t understand concerns that some GOP leaders nationally have raised about strings attached to stimulus money.

“I think that’s a bunch of malarkey,” he said. “They should match any fund that the federal government is offering.”

———

Arizona’s senior citizens

— By 2020, 26 percent of Arizonans are expected to be over the age of 60. That figure stood at 17 percent in 2000.

— By 2030, the number of Arizonans over age 65 is expected to equal that of children 17 and younger.

— In the decade leading up to 2005, the number of Arizonans over age 85 increased 82 percent, more than any other age group.

Source: Aging 2020, Arizona’s Plan for an Aging Population, Governor’s Office.

New curbs placed on private Medicare plans

Monday, March 30th, 2009

WASHINGTON – The Obama administration Monday placed new curbs on private insurance plans that are popular with seniors in Medicare, but have been criticized for marketing abuses and high costs to the government.

Medicare officials said the changes include winnowing the number of versions of a plan that insurers can offer, protecting patients with chronic diseases from excessive copayments and banning a practice by some plans of charging patients more for brand name drugs.

“The overall theme here is to make sure there is less confusion and more transparency, so consumers can make well-informed choices,” said Jonathan Blum, who runs the Medicare division that oversees private plans.

The new policies reflect an administration effort to put its stamp on private plans in Medicare, which flourished under Republicans but are seen by some Democrats as undermining the traditional program. The plans are offered by major insurers such as United Healthcare and Humana.

“I think it’ll move toward cleaning up the marketplace so it’s easier for folks to compare plans,” said Paul Precht, policy director of the Medicare Rights Center, an advocacy group. Stronger minimum standards for the plans mean “when you get sick, it’s harder to stick you with higher costs,” he added.

About 10 million seniors get comprehensive medical coverage through such plans, and another 17 million are signed up in private drug plans. Every year, they get the opportunity to sign up or change plans during an open enrollment period.

In a separate move, the administration has proposed payment cuts of 3.75 percent overall to private medical plans that serve seniors. Insurers claim the cut could be as high as 5 percent for some plans, and they’ll have to pass on the cost through higher premiums or fewer benefits.

The changes announced Monday were in an annual “call letter,” a contracting document that sets the rules for insurers wanting to offer coverage in 2010. Insurers must submit their bids by June 1.

Officials said the reduction in the number of Medicare plans is meant to cut down confusion, not reduce choice. Most insurers offer several variations on a basic plan. Nearly 1,400 plans out of some 7,000 have fewer than 10 members, officials said. Medicare will closely scrutinize the private plans’ bids for 2010 to eliminate offerings that only tweak a basic plan.

“These low-volume plans crowd the field and make selecting a plan much more difficult,” said a Medicare statement.

Medicare will also take a close look at pricing policies that try to shift costs to beneficiaries with chronic illnesses.

Insurers are allowed considerable leeway to design their Medicare coverages. Some, for example, offer plans that charge much higher copayments for a nursing home stay, cancer drugs or kidney dialysis than does the traditional Medicare program. That sends a signal to patients that people with those conditions are not welcome. The administration said it will limit copayments to the amounts charged under traditional Medicare.

Finally, Medicare will ban a practice that some prescription drug plans use to charge seniors more for brand name drugs. In addition to a higher copayment for the brand medication, these plans also tack on the difference between the cost of the brand drug and a generic version.