By Emily P. Walker, Washington Correspondent, MedPage Today
Published: August 16, 2011

The researchers expected that seniors, when faced with mounting out-of-pocket costs, would switch to cheaper generics. In fact, that was one of the main arguments behind the coverage back when Medicare’s drug benefit was created in 2006. If seniors saw how much drugs cost, they’d be more thrifty consumers and seek out cheaper drugs, some reasoned.

But the current study shows that hasn’t been the case.

Rather than seeking cheaper alternatives to prolong entry into the doughnut hole, some seniors just stop taking their prescriptions once they reach the coverage gap or alter their dosing regimen to make their medication last longer.

The Affordable Care Act (ACA) will eliminate the doughnut hole by 2020 and until then, the law takes measures to help seniors defray the costs of the coverage gap.

For example, in 2010, many seniors received $250 checks in the mail, and this year 900,000 Medicare beneficiaries have already received a 50% discount on prescription drugs while in the doughnut hole.

But until the doughnut hole is truly closed in 2020 “beneficiaries may still be at risk of decreased drug utilization and adverse clinical consequences,” the authors wrote.

“In contrast to blunt cost-sharing approaches such as the coverage gap feature, more nuanced, clinically informed insurance strategies that specifically promote the use of drugs with high benefit and low cost may hold the most promise for governments and insurers seeking to improve the health of their citizens while reining in drug costs,” they concluded.

One alternative strategy, the authors wrote, would be to encourage the use of generic drugs from the outset in order to forestall entry into the coverage gap.

The study was funded through grants from the National Institute on Aging, the National Institute of Mental Health, the National Heart, Lung, and Blood Institute, Robert Wood Johnson Foundation, and CVS Caremark.

The study authors reported a number of conflicts of interest, including that lead study author is a consultant for a company that contracts with the Centers for Medicare and Medicaid Services; another author is a consultant to United Healthcare, which sells Part D plans, and receives research funding from CVS Caremark, Aetna, and Express Scripts, which all have Part D business. Another author worked at CVS Caremark during the study, and CVS Caremark provided funding and data for the study.

 Primary source: PLoS Medicine
Source reference:
Polinski JM, et al “Changes in drug utilization during a gap in insurance coverage: An examination of the Medicare Part D coverage gap” PLoS Med2011; 8(8): e1001075

Help family caregivers through holidays

Give family caregivers a gift this holiday season by inviting them to participate in one of the upcoming “Home for the Holidays” webinars. This hour-long informational session provides family caregivers with information on how to help their senior loved ones manage holiday travel, family gatherings, seasonal depression and other issues that can occur during this busy time of year. The webinar will be offered on:

Tuesday, November 15 at noon Central Time

Click the following link to register for this date and time: https://www3.gotomeeting.com/register/316436230

• Monday, December 5 at 7 p.m. Central Time

Click the following link to register for this date and time:

https://www3.gotomeeting.com/register/321591990

The “Home for the Holidays” webinar is the next installment in the Caring for Your Parents: Education for the Family Caregiver^SM support series and is moderated by the Home Instead Senior Care^® network, hosted by the American Society on Aging (ASA) and co-sponsored by the National Family Caregivers Association (NFCA) and the National Alliance for Caregiving (NAC).

The Caring for Your Parents: Education for the Family Caregiver support series is another way Home Instead Senior Care^® businesses across the country are building trust in communities and supporting clients and their families.  

Why Seniors are Moving from Institution Back Home

After living for three years in a nursing home following a stroke, Gail, 78, went through his life savings paying for the nursing home and eventually qualified for Medicaid. He had always wanted to and intended to move back home, but his condition required that he stay in the nursing home. His ex-wife, Sue, and a social worker at the nursing home informed him about a program called “Money Follows the Person” (MFP), which supports efforts to move institutionalized individuals back home.

In 2009, MFP enabled Gail to move into Sue’s house because she is his main care provider. The program allotted $1,500 for home services, modifications to the home in the form of ramps and a handicap accessible bathroom, 16 hours of personal care services each month, and attendance at adult day care each day. Gail’s health has remained steady, he is able to enjoy more of a routine life, and he is able to get the care he needs at home while surrounded by friends and family.

The U.S. Congress authorized the MFP as part of the Deficit Reduction Act of 2005. MFP was designed to assist states in rebalancing their long-term care systems and help Medicaid enrollees transition out of institutions and back to their communities.

Since 2008 when the first senior moved back home through the MFP program, an increasing number of states have been making stories like Gail’s a reality for seniors and others with disabilities. As of February 2011, 43 states and the District of Columbia participate in the “Money Follows the Person Rebalancing Demonstration Program.”  The significance of this program for seniors is found in its intention for establishing a strong foundation of person-centered, consumer-directed, and community-based services. Seniors are receiving the services they need in an environment that is more comfortable for their recovery and/or daily living. Ultimately, the service model is no longer provider-driven and institution-based, but rather it is more conducive to successful living because of the personalized approach. (Centers for Medicare and Medicaid Services).

More recently, with the passing of the Affordable Care Act in March of 2010, the MFP received a boost in funding and a time extension through September 30, 2016. Additionally, the MFP program expanded the eligibility requirements to include anyone who is in an institution for more than 90 consecutive days. The old restriction was anyone who had been institutionalized for six months to two years. The longer an individual has been institutionalized the more likely they are to have relinquished a community residence and it is often more challenging for them to again establish a community residence. Individuals who have been institutionalized for a shorter period of time may still have a home to which they still have access. 

States have their own methods for identifying appropriate candidates for the MFP program. Once identified, the individual has access to the designated funds for their case for a period of twelve months and receives assistance in achieving the needed transition services.

After the program is complete, the continuity of care in each state will vary. Generally, MFP participants may be able to access existing waivers. Participants will continue to be served through these waivers as long as they continue to meet the eligibility criteria.  Therefore, there will not be a lapse in services for MFP demonstration participants. Check with your state on the plans the Medicaid office has in place for the post-demonstration period.
 
Challenges that Affect the Program
While each state handles their grant money from the MFP program differently, each is working to gain foothold in providing opportunities for their institutionalized citizens to regain status as community members. Implementing a MFP program involves comprehensive and extensive planning at the state level as well as collaboration with Centers for Medicare and Medicaid Services. The two main challenges to the success of the program continue to be available housing and accessibility of community service providers.

Housing – The number of residential units available for Medicaid dependents is limited in any case, and states recognize the squeeze that the MFP program places on this issue. More and more states have launched a concerted effort in conjunction with other government agencies such as the U.S. Department of Housing and Urban Development (HUD) to increase their chances of creating and locating safe and affordable housing arrangements.

Examples of what states are doing specifically to address this problem include: Ohio has a housing specialist under the MFP umbrella whose job it is to build partnerships with housing officials. Michigan has 26 housing coordinators throughout the state who identify housing opportunities for MFP recipients (www.kff.org).

Community services – Already stretched thin, service providers who can provide Medicaid supported home- and community-based services (HCBS) are difficult to find. MFP aligns more individuals with service providers, but without enough service providers, the MFP program recipients may not have access to these services. States are working hard to develop HCBS services using MFP dollars because community services are typically more cost-effective compared to institutional care when measured on a per-person basis.

Examples of the most commonly expanded services that states are employing are: case management to coordinate transition; help with home modifications; and one-time housing expenses such as security deposits, use of assistive technology, and transportation (Kaiser Family Foundation). North Dakota has developed a 24-hour back-up nursing service.

All of these efforts are to create more opportunity for community-based service providers that will support the long-term care of seniors and people with disabilities in their homes by providing the care they need.

Successes for Seniors Now and Long-Term
Each year, the numbers of participants transitioning increases as solutions to barriers are identified and significant technical assistance helps states meet transition goals. As of December 2010, almost 12,000 individuals returned to the community as a result of these demonstration programs, with a reinstitutionalization rate of only about 3–4 percent.

The infrastructure that is creating avenues to affordable housing and HCBS continues to be strengthened through plans customized at the state level to provide support for seniors even after MFP is slated to end. This infrastructure is required if states plan to successfully extend the opportunity of transitioning institutionalized individuals for the long-term.

According to the Kaiser Family Foundation, “MFP is likely to continue to help states reorient their long-term services and support systems toward more community-based care. This program in conjunction with other ACA Medicaid policy options has the potential to expand Medicaid home and community-based services for many more seniors and persons with disabilities who desire to live in the community.” Kaiser Family Foundation expects this trend to extend beyond the life of the MFP program demonstration and have a positive long-term impact for seniors.

Resources:
To find out if you are eligible and to apply for MFP, contact the Department of Social Services or related Medicaid office in your state. To get to your state’s official website, most states follow the website address pattern of www.insertnameofyourstate.gov, i.e. www.colorado.gov.

Centers for Medicare and Medicaid Services:
www.cms.gov 

October is National Breast Cancer Awareness Month

Breast cancer is the second most common cancer in American women behind skin cancer.  Seniors are at an increased risk to develop breast cancer, so take time during National Breast Cancer Awareness Month this October to learn more about this deadly disease.  Here are a few facts regarding seniors and breast cancer, provided by the National Breast Cancer Awareness Month website (www.nbcam.org).

• The risk of developing breast cancer increases as a woman grows older, but the risk increases significantly for women age 60 and older.
• Breast cancer is not common in women younger than age 35, but it can occur.
• There is some evidence to suggest young African-American women are at greater risk for breast cancer than young Caucasian women.
• Medicare covers mammography screening every year for female Medicare .  Eligible women and their doctors may not know about this important benefit, so be sure to share this information with your female clients and their families. A series of publications regarding this benefit are available in English and Spanish.
• For more information about Medicare coverage, contact the Medicare toll-free hotline at (800) MEDICARE or the Medicare Web site, www.medicare.gov.

Join the effort to detect Alzheimer’s early

The Home Instead Senior Care^® network has joined the Alzheimer’s Early Detection Alliance (AEDA) in a nationwide effort to educate people about the warning signs of Alzheimer’s disease and the importance of early detection.  The AEDA is a group of corporations, nonprofits and government entities under the leadership of the Alzheimer’s Association dedicated to making a difference in the fight against Alzheimer’s disease.

There is no cure for Alzheimer’s disease and no way to prevent it. Early detection allows those living with the disease – and their families – time to plan for the future. The Alzheimer’s Association created the following list of warning signs for Alzheimer’s disease and related dementias. Every individual may experience one or more of these symptoms in varying degrees:

1. Memory changes that disrupt daily life
2. Challenges in planning or solving problems
3. Difficulty completing familiar tasks
4. Confusion with time or place
5. Trouble understanding visual images and spatial relationships
6. New problems with words in speaking or writing
7. Misplacing things and losing the ability to retrace steps
8. Decreased or poor judgment
9. Withdrawal from work or social activities
10. Changes in mood and personality

If you notice any of these signs in your senior clients, contact the client’s family members immediately.

To learn more about the 10 signs of Alzheimer’s disease, contact the Alzheimer’s Association at www.alz.org/10signs or 877-IS IT ALZ (877.474.8259).

I don’t have to tell you that Alzheimer’s is a worldwide epidemic.  Currently, five million people in the U.S. have this disease, and there are more than 35 million globally.  By 2030, those numbers will double, and by 2050, they’ll more than triple.  Last year the worldwide cost of Alzheimer’s was more than $600 billion – if it were a country; it would be the 18th largest economy in the world.  That’s because it costs about four times as much to care for a senior with Alzheimer’s.   And there is no cure in sight, sadly.   

But what occurs to me is that until that cure is found, Home Instead CAREGivers ARE the treatment for Alzheimer’s.  Quality home care is the future.  Home Instead trains our CAREGivers to deliver on that care for your family! Our training program is paramount to your parent’s best quality of life & quality of care.  There is no greater differentiators for hiring a Home Instead CAREGiver we could offer today than our specialized Alzheimer’s program. 

  We have partnered with David Troxel, Dr. Amy D’Aprix and the University of North Carolina at Chapel Hill – to take gathered information and add their expertise to create a training that directly responds to family needs and is custom tailored to our Home Instead CAREGivers.  

If you have a family member suffering from Alzheimer’s and you are looking for some help at home, please visit our web site to learn more about Home Instead CAREGivers or call our office and ask us about our training programs. We’d be more than happy to share our expertize with you. You are not alone, We are your home care & Alzheimer’s Solution!

www.homeinstead.com/sonoma

Exercise your Brain-Regularly- encourage your brain cells to form new connections or relationships between cells.

• Complete crossword puzzles, jumblers,or word searches, play complex cards or board games, take classes to learn something unfamiliar, play a musical instrument, learn new Skills or movements, dance with a partner, switch hands…

Exercise your Body-Regularly-approximately 100 minutes per week of aerobic activity are recommended to keep blood vessels in better health.

• Additional activities that enhance flexibility, coordination,and endurance are helpful to promote a sense of well-being and enhance movement skills.

Eat a heart smart diet-increase fresh fruits & vegetables (8-10/day), limit cholesterol & saturated or trans-fattyacids & sugars to foster heart and system health.

• Substitute omega-3 fatty acids, fish oil,and pure vegetable oils- those without partially hydrogenated oils
• Foods that are high in anti-oxidents and are low  in cholesterol and sugar help to control other health conditions that may increase the risk of dementia.

Get enough vitamins-Especially Vit. C, B complex and E. These Vit. have been implicated in a reduced risk of Alzheimer’s development in select populations.

• conducted and have shown that 1000-2000 IU of Vitamin E are protective (2004)
• A new Annuals of Internal Medicine  meta-analysis indicated not to take large doses of Vitamin E, as it might slightly increase the risk of heart disease deaths.400IU- (1/05)
• Best Way to get these- in foods- greens & green leafy vegetables, vegetable oils, wheat germ, nuts, fruits, mango’s,& kiwi, cereal, berries.



Keep your weight down…or get it down to a normal range- Obesity and being over- weight has been the linked Alzheimer’s in women.

Avid head injuries-wear seat belts, wear protective headgear during risky activities.

• Risk of Alzheimer’s disease increases if there have been significant head injuries in the past.

Get enough sleep on a regular basis-adults need 7-8 hours.

• Lack of sleep can lead to problems with thinking, decision making & mood

Maintain an active social support network-spend time with people you enjoy on a regular basis.

• People with multiple, sustained social contacts have been  shown to be somewhat less likely to develop dementia later in life.

Control your blood pressure & diabetes-damage to tiny blood vessels when these conditions are not controlled can set you up for mini-strokes in your brain.

Get clinical depression treated in a timing manner- seek help and take recommended medications as soon as possible when depression occurs.

• Evidence suggests people with episodes of untreated ddepression earlier in life are at a higher of developing Alzheimer’s disease later in life.

Control iron intake- some people ma y need o limit iron intake or may need to reduce iron stores- too much iron can be related to Alzheimer’s disease.

Control lipid levels- use statins if recommended

• Elevated lipids can cause inflammation of blood vessels in teh brain- increasing risk.

Monitor homocysteine levels-higher homocysteine levels increase your risk- ask your MD to monitor and correct

Take one baby asprin a day- this may protect your heart and blood vessels- ( not recommended if on blood thinner already)

Stop smoking- Cigarette smoke starves some cells in your brain.

• Smoking contributes to problems with your heart and blood vessels and can limit your activity level.

Gingko Biloba, curcumin, & soy may be helpful- studies are in progress…

***** Always work with your health care professional to make sure these ideas will work for you*****

Take a look at these two Brains….

These two people were-

• the same age
• the same gender
• the same physical size

 The only difference- the person on the left  had ALZHEIMER”S Disease  and the person on theRIGHT did NOT!

SO….WHICH BRAIN DO YOU WANT O HAVE?

What changes will you now make?

How will you shedule it into your life?

Who will you get to help you change your life?

How will you keep track of the changes?

How will you Celebrate?

MAintain Your BRAIN!!!!!

it’s the only one you’ve got!

Larry king will be hosting on May 1^st 2011 the CNN special “Unthinkable: the Alzheimer’s Epidemic”

How many of you know that Alzheimer’s is the 6^th leading cause of death in the US?

Many of us still don’t know or understand the facts about Alzheimer’s’ disease. On May 1st 2011 Larry King will do a one hour special deciphering the facts from fiction on Alzheimer’s.  Who will get it and why? And are we yet on the horizon of finding a cure or effective treatment?

An estimated 5.4 million people are living with Alzheimer’s. That number could grow to as many as 16 million Americans living with Alzheimer’s disease by 2050

King ‘s guests will be familiar faces who have been touched by Alzheimer’s disease and will include interviews with former First Lady Laura Bush and California’s former First Lady and Alzheimer’s activist Maria Shriver; actors Seth Rogen, and  Angie Dickinson; TV host Leeza Gibbons; football star Terrell Owens and  son of President Ronald Reagan, Ron Reagan. Neurosurgeon and CNN chief medical correspondent, Dr. Sanjay Gupta will explain what Alzheimer’s is and how this disease affects the human brain.

On the Alzheimer’s Association website, there’s a chart that lists the 10 signs of Alzheimer’s and the first two are memory loss that disrupts daily life and challenges in planning and solving problems.  For those of us of a certain age, and at 41 years old I count myself amongst this population, it seems possible to look at the list and think: well, some of those things are happening to me. How do you know at what point you should see a doctor?

10 warning signs of Alzheimer’s:

	Memory loss that disrupts daily life
	One of the most common signs of Alzheimer’s is memory loss, especially forgetting recently learned information. Others include forgetting important dates or events; asking for the same information over and over; relying on memory aides (e.g., reminder notes or electronic devices) or family members for things they used to handle on their own.What’s a typical age-related change? Sometimes forgetting names or appointments, but remembering them later.

	Challenges in planning or solving problems
	Some people may experience changes in their ability to develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things than they did before.What’s a typical age-related change? Making occasional errors when balancing a checkbook.

	Difficulty completing familiar tasks at home, at work or at leisure
	People with Alzheimer’s often find it hard to complete daily tasks. Sometimes, people may have trouble driving to a familiar location, managing a budget at work or remembering the rules of a favorite game.What’s a typical age-related change? Occasionally needing help to use the settings on a microwave or to record a television show.

	Confusion with time or place
	People with Alzheimer’s can lose track of dates, seasons and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there.What’s a typical age-related change? Getting confused about the day of the week but figuring it out later.

 

	Trouble understanding visual images and spatial relationships
	For some people, having vision problems is a sign of Alzheimer’s. They may have difficulty reading, judging distance and determining color or contrast. In terms of perception, they may pass a mirror and think someone else is in the room. They may not realize they are the person in the mirror.What’s a typical age-related change? Vision changes related to cataracts.

	New problems with words in speaking or writing
	People with Alzheimer’s may have trouble following or joining a conversation. They may stop in the middle of a conversation and have no idea how to continue or they may repeat themselves. They may struggle with vocabulary, have problems finding the right word or call things by the wrong name (e.g., calling a “watch” a “hand-clock”).What’s a typical age-related change? Sometimes having trouble finding the right word.

 

	Misplacing things and losing the ability to retrace steps
	A person with Alzheimer’s disease may put things in unusual places. They may lose things and be unable to go back over their steps to find them again. Sometimes, they may accuse others of stealing. This may occur more frequently over time.What’s a typical age-related change? Misplacing things from time to time, such as a pair of glasses or the remote control.

 

	Decreased or poor judgment
	People with Alzheimer’s may experience changes in judgment or decision-making. For example, they may use poor judgment when dealing with money, giving large amounts to telemarketers. They may pay less attention to grooming or keeping themselves clean.What’s a typical age-related change? Making a bad decision once in a while.

 

	Withdrawal from work or social activities
	A person with Alzheimer’s may start to remove themselves from hobbies, social activities, work projects or sports. They may have trouble keeping up with a favorite sports team or remembering how to complete a favorite hobby. They may also avoid being social because of the changes they have experienced.What’s a typical age-related change? Sometimes feeling weary of work, family and social obligations.

	Changes in mood and personality
	The mood and personalities of people with Alzheimer’s can change. They can become confused, suspicious, depressed, fearful or anxious. They may be easily upset at home, at work, with friends or in places where they are out of their comfort zone.What’s a typical age-related change? Developing very specific ways of doing things and becoming irritable when a routine is disrupted.

Copyright © 2009 Alzheimer’s Association^®. All rights reserved.

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For the entire story go to:

http://inthearena.blogs.cnn.com/2011/04/26/larry-king-to-host-cnn-special-program-unthinkable-the-alzheimers-epidemic/

 

Please stop & think for one second…..

and I am certain EVERYONE of us DOES know someone effected directly,  if not indirectly by Alzheimer’s. Educate yourself and watch this education 1 hour program. You will be glad you did!

 

Wheather you live in historic Petaluma,  Santa Rosa, charming Rohnert Park, Windsor, the Sebastopol countryside or on a vineyard in sunny Healdsburg, you can listen to KSRO radio and Kira Reginato on Fridays from 12:30pm to 1 in the afternoon! Kira hosts gifted, talented & educated experts in Elder Care every week. You can now also hear her Sun. on KFRC too!

 There are archived shows on Podcasts so you dont ever have to miss a beat from Kira. You can even listen to shows I have been on with Kira talking about Home Instead’s ” Be a Santa to a Senior” program, or on how to hire home care, or our LIFECATCHING program and how we care for Alzheimer’s clients in Sonoma County. Below is the list of experts coming on Aprils shows with Kira. Give her a listen!

The Elder Care Radio Show  April 2011 Dear Listeners,    Baby Boomers are becoming senior citizens at the rate of almost 8000 each day!  They are grappling with the prospect of Social Security and when to apply for it, Medicare, and what the future holds for their financial security and social well-being.  April’s guests will discuss options available, steps to take and when, and mending broken family relatioinships to create support system insurance.  I hope you will give yourself a 30-minute break each week to tune in to the live show or to a podcast.  Take good care, Kira Reginato
	Lowell Kepke Deputy Communications Director Social Security Administration    Find out when you’re eligible and how to apply for Social Security.  Social Security is the largest source of income for most elderly Americans today, but it was never intended to be the only source of income after retirment.  Some project that Social Security funds will be drained by 2037.    KSRO 1350 AM:  Friday, April 1, 12:30 – 1:00 p.m. KFRC 1550 AM:  Saturday, April 2, 8:30 – 9:00 a.m.   Julie BennettHICAP Community Outreach Specialist We’ll talk about Medicare, Medicare D,  supplemental insurance plans, and why you might need one.  HICAP (Health Insurance Counseling and Advocacy Program) provides free and objective information and counseling about Medicare.  Volunteer counselors can help you understand your specific rights and health care options.KSRO AM 1350:  Friday, April 8, 12:30 – 1:00 p.m.KFRC AM 1550:  Saturday, April 9, 8:30 – 9:00 a.m.  Yvonne BaginskiOwner/PublisherBorn to Age Directories   April 16 is National Healthcare Decisions Day.  Yvonne is a senior advocate who publishes widely on caregiving, aging, chronic illness and community resources.  We will discuss the importance of Advance Healthcare Directives, the POLST form, and ways to ensure that your health care wishes are carried out.    KSRO 1350 AM:  Friday, April 15, 12:30 – 1:00 p.m. KFRC 1550 AM:  Saturday, April 16, 8:30 – 9:00 a.m.  Carol NelsonRetired R.N.Charles NelsonRetired Profesional Handyman  Listeners have heard me refer to my parents on past shows.  Now is their chance to be heard!  I will ask them how they set about their plans for retirement and find out how they now spend their time.  Their open discussion and disparate examples will provide food for thought about “real retirement.”   KSRO 1350 AM:  Friday, April 22, 12:30 – 1:00 p.m. KFRC 1550 AM:  Saturday, April 23, 8:30 – 9:00 a.m.  Jane IddingsAttorney and Elder Mediator   Cate Griffiths Executive Director RECOURSE Mediation Services What happens when you are in the hospital and the staff asks who they can call to get help returning you home?  Has it been years since you’ve spoken to your son or your sister?  If you are estranged from family, we will be getting advice on how to restore relationships so you have a support system in place. KSRO 1350 AM:  Friday, April 29, 12:30 – 1:00 p.m. KFRC 1550 AM:  Saturday, April 30, 8:30 – 9:00 a.m.
	About Kira ReginatoKira Reginato, host of The Elder Care Show, is a San Francisco native who has worked with older adults and their families to navigate the challenges of aging for more than 20 years.  She and her guests offer pragmatic advice and create an on-air community where listeners realize they’re not alone in facing the often difficult decisions of aging.  Kira brings insight, a compassionate personality, and humor to subjects that can be difficult to address.As President of Living Ideas For Elders, a consulting and case management firm she founded in 2007, Kira has been active in geriatric care professional associations, serving three years as chair of the Sonoma County Section on Aging, chair of the Petaluma Senior Care Connection, and co-chair of the Bay Area Chapter of the Western Regional National Association of Professional Geriatric Care Managers.  In 2010, the Petaluma Chamber of Commerce presented her with the Award for Excellence in Service to Seniors.
Weekly Downloads and Podcast Archives  Archives of The Elder Care Show are available on podcast at www.lifegcm.com/podcast.  To subscribe for weekly downloads, go to http://itunes.apple.com/us/podcast/the-elder-care-show-kira-reginato/id344595102.