The Homeplace at Midway opens, with cottages for nursing, assisted living, memory care; first 'Green House' facility in Ky.

By Kacie Kelly and Al Cross
University of Kentucky School of Journalism and Telecommunications

The Homeplace at Midway was formally opened Thursday, June 25, bringing to fruition a 16-year campaign for a nursing home in the Woodford County town of 1,700. For photos from its June 28 open house, click here.

Construction this spring (Christian Care Communities photo)

The Homeplace, which has four residential buildings that look like single-family homes, is more than a nursing home. Two of the buildings are for skilled nursing, but one is for assisted living and the other is for "memory care" or personal care of patients with dementia and other cognitive impairments.

“The Homeplace at Midway represents a new beginning for older adults in Kentucky and for communities across the commonwealth to embrace them as living treasures, not a burden or a challenge,” Dr. Keith Knapp, president and chief executive officer of Christian Care Communities, which built the Homeplace and will operate it, said at the ribbon-cutting ceremony.

Assisted living cottage (Photo by Kacie Kelly)

“We are extremely grateful to the City of Midway, the Midway Nursing Home Task Force, Midway College, state and local government agencies, our capital campaign’s Leadership Council and all our friends and supporters who championed this new direction and envisioned with us a new day when older adults would receive the highest quality care and support, without feeling their lives are being disrupted or overtaken,” Knapp said. “We trust that it will inspire other senior living providers to move in a similar direction.”

The Homeplace is the first facility in Kentucky built with The Green House model, which includes home-like environments and strong relationships with caregivers, with the goal of meaningful lives for residents. Dr. William Thomas, creator of the model, told the crowd at the event, “The Homeplace, with its emphasis on home, shows how care can be made more loving, community centered and effective.”

One of the two skilled-care cottages (Photo by Kacie Kelly)

Patients have been moving in all month. The staff at The Homeplace is trained to use the “best friend approach,” Laurie Dorough, the facility's community-relations manager, said in an interview. Staff and volunteers are to treat residents as they would treat a best friend.

Knapp said at the ribbon-cutting, “Each resident will have a private bedroom and bath and share, just as people do in any home, the kitchen, living room, den and porch areas. It’s all designed to give residents the freedom to set their own daily routines and to live life to its fullest, while receiving the individual care they need – within each cottage.

The assisted-living cottage is larger than the others, to provide room for more activities and “the potential for spouses to live there,” said Laurie Dorough. “It’s kind of the first step out of independent living,” she said. The cottage has an open kitchen where residents can get involved with meal preparation or “come out and see what’s cooking.”

Skilled-care cottage bathroom lift system (Photo by Kacie Kelly)

The skilled-nursing cottages have bedrooms with medicine cupboards rather than medical carts, and a bathroom lift system (photo at right) that takes the resident straight to their own bathroom. The bedrooms are relatively small, an incentive for residents to spend more time in the communal living space.

The Homeplace campus, across Weisenberger Mill Road from Midway College, also includes an administrative cottage and the Lucy Simms Lloyd Gathering House for special gatherings, worship services and activities.

Between the cottages is the courtyard, with lighted walking paths from building to building, a gazebo, and space for outdoor activities. “Our hope is to maybe start a community garden,” said Dorough.

The long campaign for a nursing home, led by the Midway Nursing Home Task Force, began to see success in 2010 when Louisville-based Christian Care agreed to be the developer. Christian Care has facilities in 11 Kentucky cities, and a church-outreach program with more than 230 churches as partners.

The Homeplace will have a partnership with Midway College, which becomes Midway University July 1. “We are excited to work with Midway College to not only provide learning opportunities for students but also for the residents of The Homeplace,” said Tonya Cox, the facility's executive director.

The Homeplace will be offering internships and other learning opportunities for students. This partnership will also benefit residents, Cox said: “Our residents will also have the opportunity to attend events and classes to foster their lifelong learning.”

Cox said The Homeplace aims to provide “unique long-term care in a way that honors their preferences and desires to be home.” More information is on the facility's website. It will host an open house from 1 to 3 p.m. Sunday, June 28.

Newspapers' data analysis finds that Kentucky's seniors on Medicare are among the sickest in U.S.; local data available

Red counties are over 21%. For map with data, click here.

The top 10 Kentucky counties with the highest percentage of seniors on Medicare who have six or more chronic conditions are also in the nation's top 50 for sick seniors, according to government data analyzed by USA Today and The Courier-Journal. Nine of the top 10 counties are in Appalachia.

"That's not surprising," Fran Feltner, director of the University of Kentucky Center of Excellence in Rural Health, told The C-J's Laura Ungar. "And when you're having breathing problems, high blood pressure problems and other problems, to me it seems like you're waging a daily battle against the chronic diseases. It's hard to fight the battle ... and as you get older, it's harder."

The top 10 Kentucky counties ranked by percentage of the 65-and-older Medicare population with six or more chronic conditions are Clay, 27.1 percent; Breathitt, 26.3 percent; Johnson, 26.2 percent; Knott, 25.1 percent; Perry, 24.6 percent; Letcher, 24.2 percent; Bell, 24 percent; Floyd, 23.8 percent; Wolfe, 23.7 percent; and Taylor, 23.6 percent. Taylor County (Campbellsville) is not in Appalachia but borders three non-coal Appalachian counties.

Beve Cotton (C-J photo by Mark Mahan)

Beve Cotton, 81 and with a long list of chronic diseases, is one of those seniors. He lives in Manchester, the seat of Clay County, which ranks 12th among more than 3,100 counties nationally for the percentage of seniors on Medicare with six or more chronic conditions, Ungar reports.

"I'm a mess," said Cotton, who gets around in a power chair and wears a full set of dentures after losing all his teeth. "I'm not able to do things. I'm an accomplished cook, but I can't do that anymore ... I can't drive. My legs don't cooperate. ... It's very hard."

Ungar reports that Clay County, population 21,147, has many of the factors that combine to cause poor health.: "Nearly 38 percent of residents live below the poverty level, compared with a state average of 19 percent, according to the Census Bureau. Median household income is about $22,000 a year, about half the state average.Access to health care, especially specialists, is limited, and there are few well-stocked grocery stores or safe places to exercise. Smoking and obesity rates are sky-high."

Carmen Webb, who directs the senior center in Manchester, told Ungar that many seniors struggle with being able to afford staples, let alone healthy food and also the high cost of transportation, making it difficult to get to doctors appointments to manage their illnesses.

Cotton, who grew up in Manchester, told Ungar that he depends on others for rides, frequently to doctors' appointments, including many at the Veterans Affairs Medical Center in Lexington, about 100 miles away. Webb noted that public transportation in the area costs $1.50 per mile.

Feltner added that many seniors in the area don't know how to prevent chronic disease, some have fatalistic attitudes and because many of them are on multiple medications, they face the dangers of drug interactions and side effects, Ungar reports.

Experts say that such high levels of illness hurts communities, "hastening a downward economic spiral locally and requiring huge portions of Medicare budgets," Ungar writes. It also overtaxes the medical communities in rural counties even thinner.

"These patients need to be seen frequently by doctors, and they need much longer visits. ... These folks need intense care," Dr. Michael Karpf, executive vice president for health affairs at UK, told Ungar. "Given the shortage of primary care in Appalachia, this kind of patient just exacerbates that shortage."

"The real issue is prevention — weight control, exercise, food habits," Karpf said. "But it's hard. Fast food is cheaper than wholesome, healthy food, and (the way people eat) is partly cultural. Those things are hard to change. It's a generational process."

Kentucky's seniors rank 48th in insurance firm's health rankings

Click here to go to interactive map.

Kentucky seniors ranked in the bottom 10 states for 23 of the 35 measures ranked by the 2015 America's Health Ranking Seniors Report, placing Kentucky in 48th place for the second year in a row.

“The report is a call to action. We believe you can’t improve what you don’t measure,” Dr. Julie Daftari, market medical director for United Health Care of Kentucky told Alyssa Harvey of the Bowling Green Daily News. “It may start with seniors taking individual action. If we live long enough, we’ll be part of these statistics in the future."

Kentucky seniors ranked last in two areas, total health outcomes and preventable hospitalizations; next to last in premature deaths and education and in the bottom three states for smoking, seniors who are considered underweight, and poor mental health days.

The report notes that smoking is the leading cause of preventable death in the U.S. and "older smokers are at an increased risk of smoking-related illness as they tend to be heavy smokers with an average smoking duration of 40 years" and "are less likely than younger smokers to believe that smoking harms their health." Kentucky, with 11.8 percent of its seniors regularly smoking, ranked third highest in senior smoking, behind Nevada and Mississippi.

The report is intended to point out the health challenges facing today's seniors and offer a starting point to help states determine what needs to change. That being said, Kentucky ranks very low in an area that could help improve these outcomes: community support, where it ranks 45th.

The report did say that Kentucky seniors do have some strengths. They have a low prevalence of chronic drinking, low percentage of adults needing pain management, high flu vaccination coverage and a low percentage of low-care nursing home residents.

More Kentucky seniors also reported very good or excellent health since last year's report, up to 33.7 percent from 31.2 percent.

The report noted that a decrease in physical inactivity is a nationwide problem for seniors, with 33.1 percent of seniors nationwide reporting they did not get enough physical activity. This percentage was even higher in Kentucky at 40.2 percent, which is higher than the previous two years (34.5 percent in 2014 and 17 percent in 2013).

The report notes that today, one in seven Americans are aged 65 and older, and in the next two decades the rest of the 77 million baby boomers will move into this demographic. The report also projected the increase in Kentucky's senior population between 2015 to 2030 will be 41.8 percent.

“The fact that we were able to identify key strengths and challenges gives Kentucky an opportunity to address those specific issues,” Daftari told Harvey. “If these challenges aren’t addressed, there may be a significant strain on health care in the future.”

The rankings were based on 35 measures of senior health including behavior determinants like smoking and dental visits; micro and macro community and environmental determinants like poverty and social support; policy issues like percentage of seniors on SNAP; and measures of clinical care like the percentage of seniors who receive home health.; and outcomes like the percentage of seniors who have fallen. It also included measures like education and cognition.

Use of walking aids is increasing as population ages; study debunks notion that using them makes falls more likely

In the last 10 years, the use of walking aids—such as canes, wheelchairs and scooters—has increased by half, and is expected to grow as the number of seniors doubles in the next 35 years.

Research has shown a correlation between use of walking aids and falling, which is the leading cause of death resulting from injury for people 65 and older. However, a recent study in National Health and Aging Trends shows that people who employ mobility devices are not more likely to fall than those who do not use such devices.

Previous research that indicated the use of walking aids might increase the likelihood of falling "only looked within groups of people . . . who are already more likely to fall," said researcher Nancy Gell, assistant professor of rehabilitation and movement science at the University of Vermont. "This study is the most in-depth since 2004 and shows no link between mobility devices and falls as previously thought."

Gell reports that 16.4 percent of seniors use a cane, 11.6 percent use walkers, 6.1 percent use wheelchairs and 2.3 use scooters. Those who use canes are more likely to say they refrain from certain activities because of the fear of falling. "For many people, a cane is the appropriate device for their circumstance to stay mobile," Gell writes. "However, if worry about falling continues despite using a cane for support, it is worth considering a different device in order to be as active as possible."

"The question is if it's better to be active or sedentary and not risk falling," Gell writes. "We think it's better to be active."

Logan Co. schools work to keep kids and bus drivers hydrated during hot, humid days; here are tips for dealing with heat

With temperatures soaring into the high 90s and the heat index over 100, the new Logan County school superintendent made sure the students and bus drivers were well hydrated last week, O.J. Stapleton reports for the Russellville News Democrat & Leader.

Dr. Kevin Hub and other members of the central office staff delivered bottled water to all schools for students who would be riding buses in the extreme heat, Stapleton writes.

“I think it’s important to recognize that it’s hot and we do not have air conditioning on our school buses,” Hub told Stapleton. “That makes it hard on our drivers and students. This just falls under the category of ‘a good thing to do’ when it comes to taking care of our students and staff.” He said the gesture was appreciated by both the staff and students.

Signs and symptoms of heat exhaustion, according to the Centers for Disease Control and Prevention, are heavy sweating; weakness; cold pale clammy skin; fast, weak pulse; nausea or vomiting; and fainting. The CDC suggests that if someone has these symptoms they should be moved to a cooler location, lie down and loosen their clothing, apply wet, cool cloths to as much of the body as possible, be offered sips of water and seek medical attention immediately vomiting occurs and continues.

The CDC reports the signs and symptoms of heat stroke, a much more serious condition, as: body temperatures above 103 degree Fahrenheit; hot, red, dry or moist skin; rapid and strong pulse; and possible unconsciousness. These symptoms require immediate medical attention. Call 911 immediately, move the person to a cooler environment, reduce the person's body temperature with cool cloths or even a bath and do NOT give fluids.

Prevention is the best way to avoid these heat-related illnesses, Stapleton reports. He offers some suggestions below on how to protect yourself during these extreme temperatures.

Here are some suggestions to prevent heat stroke:

• Drink more fluids, regardless of your activity level.
• Avoid alcoholic beverages and high-sugar beverages as they can cause you to lose more body fluid.
• Don't wait until you are thirsty to drink.
• Seek the advice of your doctor if you have fluid restrictions or are on water pills.
• Avoid very cold drinks as they can cause stomach cramps.
• Stay indoors in an air-conditioned place if possible.
• Go to the mall or the library for some air-conditioned relief if you do not have home access.
• Seek a heat-relief shelter in your area. Contact your local health department for information.
• Fans do not prevent heat-related illness when the temperatures are in the high 90s.
• Take a cool shower or bath.
• Wear lightweight, light-colored, loose-fitting clothes.
• NEVER leave anyone in a closed, parked vehicle.

Every person is at risk of heat-related illnesses in these extreme temperatures, but some people are at greater risk and need to be checked on regularly, Stapleton writes. High risk adults should be checked on at least twice daily and monitored for signs of heat exhaustion or heat stroke. Infants and children need more frequent watching.

Those at high risk of heat-related illness are:

• Infants and young children
• People aged 65 or older
• People who are ill, especially with heart disease or high blood pressure.

Some advice for being outdoors in the heat:

• Limit your outdoor activities to the morning and evening hours.
• Minimize your outdoor exercise.
• Drink two to four glasses of cool, non-alcoholic fluids each hour if you exercise.
• Drink sports beverages to replace the salt and minerals you lose in sweat. Consult your doctor about the use of sports drinks if you are on a low-salt diet.
• Rest often in shady areas.
• Wear a wide-brimmed hat, sunglasses, and sunscreen.

Study indicates that vitamin D can help prevent early death from cardiovascular disease and cancer

Elderly people with a vitamin D deficiency are more at risk for death from cardiovascular disease and cancer, according to a large-scale study by the Mount Sinai health system of New York and a group of international collaborators, published in the June issue of BMJ, formerly British Medical Journal.

Paolo Boffetta of the Tisch Cancer Institute at Mount Sinai led a collection and analysis of data that showed a significant association between low vitamin D levels and risk of death not only from cardiovascular diseases and cancer in older people with a history of cancer, but death from all causes.

Other studies showed that vitamin D helps prevent issues like hypertension, diabetes and bone loss, but these new findings suggest it might be even more important than previously known. "Going into our study, the effect of vitamin D supplementation on risk of death was not clear," Boffetta said. "Our analysis confirms the protective nature of this substance, especially in elderly patients."

Sunlight, as well as food and supplements, provide vitamin D. Because elderly people generally get less sun, they're more likely to have a vitamin D deficiency. Though researchers don't yet know how much vitamin D is ideal, the study results do argue that people with a vitamin-D deficiency are more likely to die early than those who don't have such a deficiency, Boffetta said.

Researchers use data from eight different studies including 26,018 men and women between ages 70 and 79. During the study, 6,695 participants died—2,624 from cardiovascular diseases and 2,227 from cancer. Participants with the lowest levels of vitamin D had a risk ratio of 1.57, which was double the death risk of the people with high concentrations of the vitamin.

"Vitamin D's protective effect is clear," Boffetta said. "If our results are confirmed in additional studies, it could lead to recommendations for greater vitamin D supplementation in foods and to a better understanding of its role in cancer prognosis." (Read more)