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History of Brevard Alzheimer’s Foundation

History of Foundation Services: The Foundation initiated its adult daycare program in 1992 as the former East Coast chapter of the National Alzheimer’s Organization, serving 15 persons one day a week.  In the next eight years, the Foundation opened two 20-person daycares in Titusville and a 50-person daycare in Melbourne.  In June 2002, the Foundation dedicated the Harry and Jeanette Weinberg Care Center in Micco, one of Florida's first rural dementia-specific daycares.  In 2006, we opened a new state of the art facility in Titusville, which can serve 60 clients per day in the adult day care program. We started our in-home respite program in 1995, when the Space Coast Interfaith Coalition was developed to provide free, regularly scheduled respite care for functionally impaired homebound adults.  Respite is provided without discrimination as to age, race, gender, income, or religious affiliation, and without subjecting people served to proselytizing efforts. (Interfaith means that people of all faiths work together to help others in need.)  The success of the program motivated the Florida Secretary of Elder Affairs to choose the Brevard Alzheimer’s Foundation to test their pilot respite program, Project R.E.L.I.E.F., which we are currently under contract with the state to provide.  Support services include counseling, caregiver training classes, support groups, community education, Helpline, Wanderer's Identification Program, newsletter, weekly radio show, television shows and a weekly newspaper column in Florida Today that focuses on elder needs and service programs.  

 

Adult Day Heath Program (Adult Day Care): Our Adult Day Health Program provides relief from the constant supervision, companionship, therapeutic and personal care of the dementia patient.  A protective environment in a home-like atmosphere, staffed with caring health professionals and volunteers serves the needs of frail elders and their families with dignity, empathy and respect.  Friends and family who are coping with round-the-clock care giving can enjoy peace of mind when they enroll loved ones in the program, which is specifically designed to encompass the capabilities of each client.  Caregivers who place Alzheimer patients in daycare programs have lower levels of care giving-related stress, better attendance at work and better psychological well-being than persons who do not use this service.  Three important needs are addressed through the program: socialization, safety and respite.  Activities modified for the cognitively impaired and a full day of socialization with peers are offered.  Adult daycare can also reduce behavioral problems and prevent excess disability and functional decline. Program objectives include assisting clients in maximizing their existing health and abilities, allowing clients to remain in their homes longer, maintaining health and mental stability and enabling caregivers to function longer in a care giving role.

 

The Foundation’s Adult Day Health Program comprises three facilities in Titusville (North Brevard), Melbourne (Central Brevard) and Micco (South Brevard). All centers operate Monday through Friday from 7:00 am to 5:30 pm.

 

The Melbourne & Micco facilities are licensed to serve up to 50 clients daily.  The Titusville facility is licensed to serve 60 clients daily. Other programs within the Foundation provide education and assistance to caregivers and family members.   Working caregivers can drop off enrollees, go to work and then pick them up after work.  We also provide daily transportation for those enrollees needing this service.  

 

Morning activities offered in the Adult Day Health Programs may include crafts, seniorcises, or singing, followed by a break for lunch.  Since there is an increase in fatigue and restlessness after lunch, afternoon sessions often include large group activities, such as bingo. Areas are provided for those needing a nap or rest during the day.  Entertainment is arranged, including therapy pets, youth performing groups, musicians and storytellers.  Staff includes LPNs/RNs, social workers/case managers and program aides in a 6:1 client to staff ratio.  Staff is trained to work with frail elders, especially those suffering from memory disorders. Bilingual Hispanic staff is available to serve the growing Hispanic community.  Trained volunteers assist staff members.

 

In-Home Respite - The Burden of Care: Family caregivers are the “invisible health care workers” who provide care at enormous personal cost.  The caregivers’ physical and mental health decline, family and job responsibilities are neglected and their own financial security becomes non-existent.  Caregivers of Alzheimer’s patients often provide more than 40 hours of care each week.  They can be highly reluctant to seek outside assistance because of the embarrassment to have others see the behavior of their loved one. 

 

Strained caregivers have higher levels of depression and are prone to illness.   Timely caregiver support can extend the ability of families to provide care and delay nursing home admissions. By reducing stress and frustration, respite results in stronger and healthier caregivers that make better decisions for care receivers.  

 

The Brevard Alzheimer’s Foundation believes long-term care is not just nursing home care; rather, it is a continuum of services beginning with respite care for the caregiver—without intervention an elder’s condition can escalate to more expensive service needs.

 

The Foundation has been under contract with the State of Florida to administer and provide services under the Project R.E.L.I.E.F. in home respite program since 1997. On average we are currently serving 95 caregivers/families per month in Brevard County under the program. 

 

Case Management: Case management is provided to every client enrolled in our services. Each client is assigned a case manager to assist in planning and coordinating for various services to enhance their quality of life and have their needs met. The case management department consists of trained professionals who take an initial assessment to develop an individualized plan of care. Both the family members and their loved one are assessed.

 

Some of the areas assessed are ensuring a proper medical assessment, in-home needs, assistance with activities of daily living, financial concerns, legal questions, social and emotional needs for both the caregiver and their loved one. Once the plan of care is developed, referrals are made to various agencies to help the family with their concerns.

 

Additionally, case managers are experienced in conducting financial screenings. The Brevard Alzheimer’s Foundation case managers currently help families make the necessary steps to get enrolled through the Medicaid Waiver (Med Waiver) program, the Alzheimer’s Disease Initiative (ADI), Community Care for the Elderly (CCE) and Older Americans Act (OAA) programs and each client is referred to either the local CARES office or the Senior Helpline’s Aging and Disability Resource Center (ADRC) for additional financial and in-home support to families.

 

Support Services: Every client is informed of and offered the Foundation’s  support services. Currently, there are over ten different support groups throughout the county that meet on a weekly and monthly basis to provide emotional and social support in an effort to reduce the risk of isolation and also receive a break from caregiving responsibilities. The Brevard Alzheimer’s Foundation provides respite care to the caregiver’s loved one during the groups offered on-site and during hours of operation.

 

Another support service offered is one-on-one or family counseling in the office. This gives the caregivers an opportunity to discuss any issues or concerns and the counselor is able to listen, support, and educate. Opportunities for education are also referred out to community partners such as the East Central Florida Memory Clinic when a class is being offered.

 

State of Florida Nursing Home Diversion Program

 

The Nursing Home Diversion Program is a Medicaid Program designed to "keep elders out of nursing homes" and safely in their home for as long a possible. The program is for elders who are age 65 or older, have Medicare A and B or a Medicare HMO and meet physical and financial requirements.  The program coordinates the senior’s regular medical care and long-term care. It is a care management program that provides the services. The program is directed to senior citizens who would otherwise be served only in a nursing home.

 

Initial management of the programs in 13 Florida Counties have been predominately under the control of HMO's. The Brevard Alzheimer’s Foundation has shown the Department of Elder Affairs instances where client management has not been in the best interests of the intent of the program, therefore the state invited the Brevard Alzheimer’s Foundation to become a manager/provider, serving Brevard County.

 

Our application has been submitted and approved by the State of Florida, Department of Elder Affairs. We are working towards signing a contract and beginning to provide services by the end of the year.

 

This program is a huge opportunity for the Brevard Alzheimer’s Foundation  and the elders in Brevard County. As a managed care organization in Brevard County, we will be better positioned to provide more services to our elderly population as well have better control of our own revenue production under the program.

 

The Brevard Alzheimer’s Foundation Corporate Philosophy Administering the Diversion Program: The Foundation will use our extensive experience and knowledge in administering and providing community based services to elders such as adult daycare and in home respite under the Diversion program. The Brevard Alzheimer’s Foundation believes these services provide a preferable and less expensive alternative to institutional care. Institutionalization, especially nursing home care, which on average costs $120 per day, is primarily funded through Medicaid. With the growing number of people with Alzheimer’s/dementia and other health related concerns in the state of Florida, Medicaid costs for institutionalization is placing a financial strain on the state’s revenue.

Furthermore, the Brevard Alzheimer’s Foundation believes the Florida Legislature was on target by creating the Diversion program in 1997 to provide community based services to elders that delay the immediate placement and potentially prevent the inevitable placement in long term institutionalization such as nursing homes.

 

The Brevard Alzheimer’s Foundation supports this approach of providing community based services as it is a better service for our elders and allows them to live independently at home and preserve their quality of life. The program also benefits the state of Florida as it saves the state precious general revenue dollars to re-allocate to other areas of critical need throughout the state.

 

As a care management program under the Diversion program, Brevard Alzheimer’s Foundation (dbs YourCare Brevard) will provide many community based services to enrollees and their caregivers/families necessary to delay and potentially avoid placement in institutionalized care.