Medical care for the elderly a challenge in NNY



Despite the north country’s significant aging population, there are few medical professionals in the region specializing in geriatric care. According to Dr. Gary R. Berk, however, that’s not necessarily a problem.

“There is no such thing as a “geriatrician” in St. Lawrence County. There are primary care providers ... many of whom are very knowledgeable about issues of the elderly and manage medical problems in this population as a part of their everyday practice,” Dr. Berk, chairman of family practice at Canton-Potsdam Hospital, said in an email. “One problem I see in the elderly population is the tendency to see many specialists and consider that to be ideal medical care.”

Dr. Berk said good preventive and primary care is the best course for most patients.

“(Specialization) is an expensive way to get care and many extra tests seem to get done, some are even duplications ... Not many people have lots of extra money to pay medical expenses when they already have insurance and might get a giant balance bill,” he said.

According to the Centers for Disease Control and Prevention, fewer than half of Americans over the age of 65 are up-to-date with their core preventive health care, even while receiving regular checkups.

Despite being some the biggest health risks for older adults, nearly 17 percent of women ages 65 to 74 reported not receiving a mammogram within the past two years, more than 36 percent reported not receiving any colorectal cancer screenings, and 31 percent reported not getting tested for high blood sugar or diabetes within the past three years (if not already diagnosed).

Sixty-two percent of black women and 54 percent of Native American women reported never receiving osteoporosis screening, compared with 33 percent of older white women, and 5 percent of adults 65 or older had not had their blood cholesterol screened within the past five years.

The CDC cites a lack of awareness of recommended services, not knowing most services are covered by Medicare, and a lack of communication with doctors as possible reasons older adults may fail to receive such health services.

Not having an established primary care provider may also be a deterrent, along with other physical or social barriers like transportation or language challenges.


Dr. Berk also called dementia a “huge issue” for the elderly.

“Dementia is when forgetfulness gets bad enough that the person is unable to adequately care for themselves. ... The worst part is making good decisions when the person’s judgement and understanding may be impaired,” he said. “Often, the patient is defensive about their deficits and works hard to cover up their problems until late in the disease. It is never easy when the child is forced to become the parent.”

He recommends designating someone to have the legal right to make decisions on the aging person’s behalf.

In 2016, the U.S. Department of Health and Human Services reported 46 million people over the age of 65 nationally, a population projected to reach 74 million by 2030. On average, Americans reaching 65 today can expect to live 19.3 more years.

“We have several residents over 100 years old. People may not plan for that,” said Barbara Morrow, vice president of long-term care at Samaritan’s Summit Village nursing home and Keep Home.

According to Health and Human Services, 80 percent of older adults have at least one chronic condition and 37 percent have not visited a dentist in the last year.

Doug and Nancy Carlson credit their good health as one of the reasons they’ve remained both active and financially stable well into retirement.

They retired nine years ago, and since have been involved in the nonprofit Chapin Living Waters, which provides bucket irrigation systems to underdeveloped countries.

During their four years in the Dominican Republic, the Carlsons said health insurance was much cheaper, which helped bridge the gap into their Medicare years. Mrs. Carlson even went back for her most recent dental work. Still, no one is spared the ravages of time .

“I love the snow but as I get older I like it less and less,” Mr. Carlson said.

“Winters are something I absolutely talk to a lot of families about,” Ms. Morrow said. “Home care may be able to help ... but even travelling in the snow to check on a loved one can be problematic.”

“Our society has to decide what value we put on comfort and happiness in the elderly ... My opinion is that medical care will never get cheaper as time goes on,” Dr. Berk said. “People are living longer and are treating and preventing serious health issues. Drugs and medical procedures are dramatically increasing in cost, as health care providers are being burdened with computers, paperwork and endless rules...”

“Everybody dies. Americans expect the best care and want the right to access expensive treatments that might help them, but aren’t sure about making sure everyone has the same access,” he said. “Expenses at the end of life are very high and don’t have to be. Our society has to go back to valuing home care at the end of life, rather than hospitalization, and having the courage to make wise decisions about the best interests of the person involved.”

Getting around can be a battle for the aging population



Many seniors still drive their cars and feel comfortable behind the wheel. Others, however, have challenges driving, and their difficulties may push them to give it up.

For senior citizens who still drive but may want to either refresh their knowledge of traffic laws and hazards or learn the latest rules, AARP offers driver safety courses.

According to the AARP website, the driver safety course also teaches senior citizens methods for adjusting to new rules and conditions and how they can manage the changes in their own vision, hearing and reaction time.

Wayne A. Harris, president of AARP Chapter 346, which covers Jefferson County and parts of Lewis County, said taking the course can provide a discount on car insurance.

The regression in their driving ability can also occasionally place senior citizens in jeopardy.

Instances of incidents caused by senior citizens behind the wheel happen occasionally in Jefferson County, Sheriff Colleen M. O’Neill said, and when it happens, the next step can be difficult.

Deputies have found senior citizens involved in accidents and have pulled senior drivers over for driving erratically and below the speed limit, Sheriff O’Neill said. While responses can vary on a case-by-case basis, Sheriff O’Neill said an incident could lead to serious conversations about whether a senior citizen should continue driving.

Sometimes the conversation takes place between deputies and the state Department of Motor Vehicles. Other times, it takes place between deputies and family members, sometimes in a hospital after an accident, Sheriff O’Neill said.

“It’s a freedom being taken away from somebody … who had it for a long time,” she said, “but you have to keep their safety and the safety of other motorists in mind when you deal with those situations.”

In Lewis County, however, accidents, traffic violations, reckless driving and other incidents caused by senior citizens behind the wheel has been, and remains, virtually unheard of, County Sheriff Michael P. Carpinelli said.

“We’re pretty lucky so far in this county,” he said.

Sheriff Carpinelli said many seniors are comfortable driving throughout the county because they have years of experience. Having nearby family members and access to transportation services helps reduce potential incidents and supports senior citizens who can’t drive, Sheriff Carpinelli said.

Less traffic in Lewis County also helps prevent accidents and violations caused by senior drivers, he said.

“It’s definitely a lot slower here in this county,” he said, “most of the time.”


Having access to transportation services can be crucial for senior citizens who no longer drive and a lack of options can create barriers between them and their day-to-day needs.

The Volunteer Transportation Center is a service seniors can contact that operates in Jefferson, Lewis and St. Lawrence counties.

The center, which has offices in Watertown and Potsdam, provides transportation for people who don’t have it to attend medical appointments and grocery shop once a month for free, said Sam M. Purington, executive director of the center.

“There’s just a huge need for transportation,” he said.

The number of rides provided by volunteers at the center has increased consecutively in the past three years from 110,318 trips in 2014, to 120,648 trips in 2015 and then 134,441 trips in 2016. Mr. Purington attributed the continuous increase to a rising aged population and fewer families staying together as children leave the area in search of employment.

“I think it gives them the ability to stay in their homes longer,” he said. “It has provided (drivers) a chance to be a part of the community; to interact with the community and to provide a service to the community.”


Getting from point A to B can be challenging in a county as large and rural as St. Lawrence.

However, transportation services for seniors and the rest of the public, have greatly improved and expanded over past several years, according to Andrea M. Montgomery, St. Lawrence County’s Office for the Aging director.

Two years ago, her agency signed a contract with Volunteer Transportation Center, a not-for-profit organization that operates in Jefferson, Lewis and St. Lawrence counties. The volunteer center has on office on Route 11, Canton, and earlier this year hired a mobility manager who is tasked with identifying ways to improve services.

He has been tasked with looking for gaps in service in the county making the public aware of the existing public transit opportunities.

“They do our medical transportation for seniors,” Ms. Montgomery said. “They’re a great program. They will do up to five (medical) trips a month for seniors who can’t drive or don’t have a car. The trips can be in county or out of county. For example, they can take a senior to Burlington (Vt.) five times a month.”

Those receiving cancer treatment or dialysis can receive an unlimited number of trips.

They also provide one grocery shopping trip and five nursing home visits a month.

“If your spouse is in a nursing home and you have no way to go see them they will bring you to the nursing home,” she said.

Through an annual contract, St. Lawrence County pays the transportation center $35,000 a year. The Office for the Aging is billed by Volunteer Transportation Center for clients who receive Medicaid. Seniors who don’t receive Medicaid can make a donation for the ride service, but they’re not required to.

Using volunteer drivers, the transportation center transports Medicaid clients in the county to appointments, regardless of their age.

“The volunteers drive their own cars and are reimbursed mileage,” she said. “There are quite a few drivers, but they are always looking for new drivers. The demand is increasing. The more senior citizens who find out about it, the more want to use the service.”

Criminal background checks are conducted on volunteer drivers. They are also tested for illegal drugs.

Prior to signing on with Volunteer Transportation, the county’s Office for the Aging coordinated volunteer drivers.

“We were limited to three trips a month for each senior,” Mrs. Montgomery said.

St. Lawrence County also offers a public transit bus system through a contract with NYSARC, but getting to pick up and drop off points can be challenging for seniors.

“With public transit, they still need to get to a transit stop, which can be tricky,” Mrs. Montgomery said.


In addition to the Volunteer Transportation Center, Sheila M. Kehoe, the New York Connects coordinator for the Jefferson County Office for the Aging, said seniors who live in the city of Watertown have access to the paratransit system provided by Citibus and local cab services. Companies including Lundy Services Medical Transportation, Cleveland Services Medical Transport and Guilfoyle Ambulance also provide transportation to medical appointments, she said.

The Paynter Senior Center in Clayton and Wilna-Champion Transportation Association Inc. also provide transportation, Mr. Ruetten said.

“Those really are the only options we have going,” he said.

In Lewis County, Casandra M. Buell, a planner with the county planning office, said seniors can take advantage of Lewis County Public Transportation’s eight fixed routes, one in the village of Lowville and seven that extend out to other municipalities, which it provides through a contract with Birnie Bus Service Inc. The bus can transport seniors to places such as Walmart, Lewis County General Hospital, apartment complexes and medical appointments.

“There are a lot of options,” she said.

Mrs. Buell also said senior citizens can use services such as Dial-A-Ride and non-emergency medical transport through Medical Answering Services LLC to request transportation for appointments.


While many senior citizens have access to a variety of transportation services throughout Northern New York, some seniors and care providers argue that there are not enough, and not everyone has easy access to the existing services.

Mr. Ruetten said seniors in rural areas like Adams, Antwerp, Rodman and Philadelphia don’t have as many transportation options as those in Watertown, making it more challenging for senior citizens to leave their homes.

“The ability to travel within the county is important to a person’s well-being,” he said.

Mrs. Kehoe said the existing transportation services can help senior citizens with activities that may be a part of their daily routine, but the county lacks transportation that allows senior citizens to participate in community activities and events, including nighttime festivities in Watertown.

“It might make them feel more isolated,” she said.

Not driving a car can limit a senior’s social opportunities, which can lead to feelings of isolation, Ms. Montgomery said.

“We did a needs assessment survey in 2014 and a large number of respondents reported feeling isolated and lonely.

In a region as vast as the north country, transportation is a challenge for many seniors who have stopped driving for financial reasons or because their driving skills are not what they once were.

Vicki Clark, first vice president of the St. Lawrence County chapter of the American Association of Retired Persons, said giving up driving is a difficult step for many who may feel isolated and upset about losing this piece of independence.

“At some point, many seniors must give up owning a vehicle due to costs, including maintenance, insurance, etc. or they recognize that they’re not as sharp as they once were and take themselves off the road, Ms. Clark said.

She said it would be beneficial to teach younger drivers about the challenges faced by older drivers so that the two generations can more safely share the road.

“For the aging, reaction times are slower, range of motion is more limited, traffic signs and roadway markings may be unfamiliar,” she said.

For elderly, social contacts can be vital


Stanley J. Holland is the president of the Lorraine senior citizens group, and his wife, Ida, is the program chair.

“We usually get between 15 and 35 people at our meetings,” Mr. Holland said. “It depends on the type of meeting or program we are hosting.”

The senior citizens group meets at the Lorraine Methodist Church at 6 p.m. the first Friday of each month, but the group is non-denominational.

“It’s about fellowship. … Fellowship is very important,” Mrs. Holland said. “People enjoy getting together.”

Each month’s program hosts either a guest speaker or musical performance, and most people bring a dish to pass.

“The seniors don’t have to be from Lorraine or Worth. Anybody is welcome to come,” Mr. Holland said.

The Hollands and the Lorraine seniors group have been active for many years and they plan to continue their efforts as they feel the meetings are important.

“Socialization, especially for seniors, is extremely important,” Mr. Holland said.

The Lorraine seniors group is reportedly one of the few ongoing senior citizens groups nearby.

“We have been doing this for 17 years,” Mrs. Holland said. “People must enjoy it, because they keep coming.”

Taking time to step out of the house and away from reality is something the Hollands say is key when it comes to being a senior citizen.

Several officials from the offices for the aging in the north country not only recognize the importance of senior citizens to be able to live and thrive in their own homes, but think about their desire when facilitating existing programs and creating new ones.

“Our main programming speaks to that (desire),” said Timothy J. Ruetten, director of the Jefferson County Office for the Aging.

A few services that both the Jefferson and Lewis offices provide that help seniors live in their homes longer include hot, home-delivered meals through the offices’ nutrition programs, homecare and light housekeeping.

Mr. Ruetten said senior citizens who can complete most of their daily tasks by themselves but lack the ability to execute one or two such as dressing or cleaning should not have to relocate to a long-term care facility. The programs provided by the office, he said, help fulfill those one or two tasks seniors cannot perform and allow them to continue living independently.

“The north country has a tough and resilient population – especially in our senior population,” Mr. Ruetten said.

Brenda J. Bourgeois, director of the Lewis County Office for the Aging, said aging is an inevitability for everyone, and she considers the resources she and anyone else would want to have access to in 10 or 20 years to project what the new demands of the county’s senior population could be. The challenges senior citizens face are experienced by everyone, she said, but those challenges are amplified.

“They want to be healthy and independent in their own homes as long as possible,” she said.


Many seniors have children or other family members who have relocated, and now those who remain rely on each other and members of the community to keep them motivated.

Spouses are usually the first.

“We have always relied on each other,” Mrs. Holland said. “You can’t make your children an emotional crutch; it’s not fair to them and it’s not fair to you, either. You’ve got to have a life and they’ve got to have a life.”

The Lorraine senior citizens group also hosts special events around the holidays, and this summer, they hosted their inaugural Lorraine/Worth community picnic.

“We were really happy with the turnout and the weather was just beautiful,” Mrs. Holland said.

Several seniors were at the site, along with a few of the younger families in the area.

Senior Chalkley DeForest said, “I think it’s important to get us elderly folk together and give us something to do.”

Other members of the senior group in attendance were Anita DeForest of Lorraine, Virginia Nohle of Adams and Laura Macklen of Worth.

“We get to go on trips once in a while,” Ms. Macklen said. “But this is nice to be here, getting together, right in the community.”

Ms. Macklen added, “you have to get out and do things ... If you don’t use it, you lose it.”

According to Ms. Nohle, “events like this are important to us, and we also rely a lot on our church community.”


Officials from the offices for the aging also recognize the importance of community involvement for senior citizens and host events and educational programs to bring them together.

Mrs. Bourgeois said the Lewis County office hosts educational programs like tai chi for arthritis and events such as senior prom and Oktoberfest.

Mr. Ruetten said the Jefferson County office also hosts educational programs such as the Chronic Disease Self-Management Program, which the Lewis County office also offers, and events including the annual senior picnic, which brings hundreds of seniors each year to Wescott Beach State Park.

“People get to know each other and feel like they’re a part of the community,” Mr. Ruetten said.

The two directors also said the congregate meal sites in each county allow seniors to communicate and connect with one another in addition to enjoying a hot meal.

Progress evident in senior housing availability



Anna M. Patterson, executive director for Ives Hill Retirement Community and the Lodge at Ives Hill, said the number of senior housing facilities in Jefferson County is “adequate” because several facilities still have available units. According to the Office for the Aging’s Guide to Services pamphlet, the county offers 47 housing projects that seniors can access, although some projects weren’t developed solely for senior citizens.

Many of these housing facilities also help senior citizens by providing services such as housekeeping, lawn care, transportation and meal preparation, she said. Ms. Patterson also said senior housing in Jefferson County is affordable because the cost is equal to, “or is even better than,” the cost of owning a home when considering the assistance programs provided.

“I think we have made much progress in the last few years,” she said about senior housing in Northern New York.

However, L. Sam DeLong, a Cape Vincent resident, said the county lacks non-subsidized housing for seniors who earn too much money to live in subsidized housing. She said she hopes elected officials will contract a developer to build town houses with recreational opportunities and assistance programs for seniors.

Senior citizens in Northern New York searching for housing that can better accommodate them aren’t limited to nursing homes or assisted living facilities.

Jefferson, Lewis, St. Lawrence and Oswego counties offer several housing projects for seniors, including subsidized apartments for seniors with less income. Sheila M. Kehoe, coordinator of NY Connects Program for the Jefferson County Office for the Aging, said many of the projects offered in Jefferson County are suited for low-income seniors.

“Obviously, there are a lot of seniors out there who still need help with rent in order to live in adequate housing,” said Michael C. Robare, executive director of the Watertown Housing Authority. “There are a lot of great landlords out there providing a great service to the elderly.”

A typical apartment for seniors offered at complexes includes one or two bedrooms, a bathroom, and either a separate kitchen and living area or one room for both.

Most facilities also offer a community room, Mrs. Kehoe said, where senior residents can enjoy different activities and events. Some facilities also house congregate meals sites including Hilltop Towers at 113 W. Main St. in Watertown, Countryview Apartments, 87 East St. in Adams and Aubrey Courts, 455-499 Bay St. in Cape Vincent.

Mr. Robare said the properties managed by the Watertown Housing Authority offer common areas with kitchens where the authority’s senior residents typically host bingo nights and holiday dinners. The Watertown Housing Authority manages seven properties in Watertown including four high-rise apartments that cater to seniors such as LeRay Street Apartments, 847 LeRay St., Midtown Towers, 142 Mechanic St. and Skyline Apartments, 454 Mill St.

“It just gives them a chance to socialize with their peers, family and friends,” he said.

The housing projects managed by Snow Belt Housing Co. Inc. in Lowville provide property maintenance services for its elderly and handicapped tenants, including lawn care and snow and garbage removal said Executive Director Cheryl L. Shenkle-O’Neill.

The Lowville-based company manages four properties that are accessible to low-income seniors including High Falls Apartments, 4061 Cherry St., Lyons Falls; Whitton Place Apartments, 7320 E Main St., Port Leyden, Steeple View Court, 6926 George St., Croghan and Valley View Court, 5590 River St., Lowville. Ms. Shenkle-O’Neill said Snow Belt’s housing projects also feature common rooms and laundry rooms for tenants.

“For seniors, I think these projects are critical for their quality of life,” she said, adding that the company’s housing facilities provide seniors with options they may not have otherwise.

Some complexes in Northern New York, however, are nearing or have already reached maximum capacity, and seniors looking to move in have been placed on waiting lists.

Mrs. Kehoe said some complexes in Jefferson County have waiting lists, particularly complexes with smaller apartments, meaning seniors will have to sign up in advance. Mr. Robare said the Watertown Housing Authority’s seven facilities, including the four high-rises, also have waiting lists, adding that the authority has a 3 percent vacancy rate across all housing projects. Ms. Shenkle-O’Neill said she has a waiting list for each of Snow Belt’s housing projects, but “It’s not huge.”

Seniors who visit the Jefferson County Office for the Aging with concerns about available housing typically express concerns about moving into a specific housing project, said office director Timothy J. Ruetten. While office staff may not be able to help them move into their first choice for housing, Mr. Ruetten said they will “help them locate the next best option.”

“If a person is willing to work with us, we can find them a place to live,” he said.

Seniors visit the Jefferson County Office for the Aging more often with concerns about paying for their current housing or for heat, Mr. Ruetten said. Financial issues are typically resolved by locating the necessary paperwork, Mr. Ruetten said, and seniors who struggle to pay for heat can request help from the office to fill out the necessary paperwork for the Home Energy Assistance Program.

While seniors throughout Northern New York have access to a variety of subsidized apartments, officials argue that the north country lacks other types of housing for its aging population.

Mr. Ruetten said Jefferson County could use more small homes and cottages dedicated to senior living, similar to the senior cottages available on Strawberry Lane in Clayton. Ms. Shenkle-O’Neill said Lewis County lacks housing for middle-income seniors who earn too much for subsidized housing and can’t afford to live in other senior developments.

“It’s a challenge not just for seniors,” she said. “There just aren’t any programs out there at all that work for rural areas” for middle-income housing projects.

Some elderly struggle with limited retirement income



Senior citizens across Northern New York live different lifestyles on varying incomes. Some struggle to meet their basic needs using the limited funds at their disposal, while others have found ways to live comfortably.

Linda A. Holder said many seniors can’t secure transportation or afford medicine or housing. Ms. Holder, 77, of Watertown, said city officials should have vacant properties transformed into affordable senior housing to help homeless seniors.

“We should have a place for them,” she said.

L. Sam DeLong, however, has been able to afford living by herself at her home on Dablon Point in Cape Vincent.

Ms. DeLong, 73, said she and her husband Bill’s retirement funds and investments have allowed her to continue living in her two-story home on Lisa Drive. Mr. DeLong, who died in February 1999, served in the Army for more than 20 years and had several other careers, including serving an Arizona state senator.

Ms. DeLong said she also sold real estate after her husband died.

In order to build her house in Cape Vincent, Ms. DeLong said she used “all of the cash I had,” which included the money from selling their home in Tucson, Ariz., and insurance, to build her house and move to the north country. Ms. DeLong said she didn’t qualify for a mortgage at the time.

“I’m very comfortable,” she said “Am I wealthy? Absolutely not. Am I on a limited income? Absolutely. Am I able to live within my limited income? Absolutely.”

Cheryl A. Torrey relies on multiple prescription plans to help her afford her medication, which includes 17 pills and two different types of insulin.

The insurance plans cover Ms. Torrey’s several medications once she meets her deductible, which she said can be challenging to meet at times, but don’t provide enough coverage for her to obtain all of the insulin she needs. Ms. Torrey, 68, of Philadelphia, said the lack of coverage forces her to rely on free insulin samples.

Ms. Torrey also said she hasn’t been able to afford groceries in about four years, and relies on the Watertown Salvation Army and other food banks for her food.

“And it’s enough to kind of get through the month,” she said.


Seniors who struggle obtaining food or a nice meal have access to the Watertown Salvation Army’s food pantry and daily in-house meal program.

“It is, as far as I know, the only program like it in town,” said Maj. Dennis J. Smullen.

Mr. Smullen, who serves as co-commanding officer of the Watertown Salvation Army with his wife, Maj. Karen D., said the Food Bank of Central New York connects the Watertown Salvation Army, 723 State St., with vendors who provide them food for both meals and the food pantry.

The organization’s food programs not only help people, including seniors, who struggle purchasing their own food, but also people who cannot prepare their meals themselves, Mr. Smullen said. The nonprofit has offered both programs since the early 1990s.

The Watertown Salvation Army typically serves 80 to as many as 200 people, including senior citizens, daily, Mr. Smullen said, although the dining room can only accommodate 25 people. Mr. Smullen said senior citizens typically wait outside until the clock strikes 11:30 and they can receive their meal.

“It is a blessing for the people involved,” he said. “Everything goes to use.”

Ms. Holder has volunteered with the Salvation Army for more than 40 years. She recently was signing people in to receive meals.

“I look forward every day to coming here,” she said. “I was taught to share everything. I love the lord and I share all I can do to do.”

Chris, who declined to give his last name, said he likes receiving a hot meal from the Salvation Army because purchasing food can be difficult. Chris only receives about $20,000 annually through retirement funds and Social Security disability payments.

The Salvation Army also provides a safe haven for people, including seniors, Chris said. He uses the nonprofit’s program to set a behavioral example by saying please and thank you to Salvation Army employees.

“It’s a nice asset for people,” he said.


While many senior citizens in Northern New York have access to Medicare, Medicaid and other programs that provide insurance and other financial benefits, some experience confusion and need help finding the best services for their needs.

Brenda J. Bourgeois, director of the Lewis County Office for the Aging, said seniors come to her office often expressing concerns about their finances and navigating the different assistance programs out there, particularly health insurance plans.

The Lewis County Office for the Aging provides information and counseling in an effort to help seniors select the best health insurance packages for them through the office’s Health Insurance Information, Counseling and Assistance Program, or HICCAP.

“Health insurance is complicated, anyway,” Mrs. Bourgeois said.

The Jefferson County Office of the Aging also fields finance-related questions from senior citizens, including questions about health insurance, food stamps and financial assistance to help pay for heating.

Sheila M. Kehoe, the New York Connects coordinator for the Jefferson County Office of the Aging, said HICCAP is one of the most requested services at the office. Timothy J. Ruetten, director of the Jefferson County Office for the Aging, said office staff members are particularly busy helping seniors with insurance counseling during open enrollment for Medicaid.

“All the letters and numbers — it’s confusing,” Mrs. Kehoe said. “(HICCAP) is probably one of the biggest programs, (along with) our home-delivered meals.”

Navigating health insurance can also challenge many senior citizens because it changes constantly, Mr. Ruetten said. During open enrollment, he said the office hires three part-time counselors in an effort to “help seniors make sound and informed decisions.”

“The wrong plan can be unnecessarily expensive and might not provide the best level of coverage for a person,” he said.

Both Jefferson and Lewis County offices also provide counseling and information about the Home Energy Assistance Program which, according to the state Office of Temporary and Disability Assistance, helps people with lower income pay their heating costs.

Working past retirement age enjoyable for many, needed for some



Phyllis M. Sauer has been working for the South Jefferson Central School District since 1973, and although she is in her 80s, she has no plans to retire any time soon.

“Oh, I love it ... I love to come to school,” said Ms. Sauer.

Prior to working for the school district, she held positions as an EMT with the South Jefferson Rescue Squad, and as a sole appointed assessor for the town of Lorraine.

Her role for the school district?

“I am the study hall monitor, after-school detention monitor and after-school sports monitor at the Clarke Building,” she said. “There’s no reason not to continue working here. My co-workers are fabulous and the kids are great.”

Ms. Sauer also assists with sewing and other special projects for the school musicals and graduation.

She said the money is not why she continues to work, although it does help pay for extras, like bingo and travel.

“When your spouse is gone, it gets really lonely,” Ms. Sauer said. “This job is just the highlight of my day.”

She plans to continue working until she has at least one paycheck past the age of 100.

To help make ends meet, a 61-year-old Massena man said he took a minimum-wage job cleaning the food court at the St. Lawrence Centre Mall.

The employee, who asked that his name not be used, works about 22 hours a week.

Most of the money he receives from his Social Security disability payments goes to paying his mortgage, so the income from his part-time job helps pay for other expenses, he said.

He resides with his 71-year-old brother, who is retired.

“This income helps us a lot and I like to stay busy,” he said.

The job involves clearing trays and wiping down tables in the food court, sweeping, mopping and cleaning the bathrooms.


When it comes to working past retirement age, many people are on board with this way of life for a number of reasons, including a way to pass time, socialization and a boost to finances.

Many people who pass retirement age may need assistance getting back into the swing of the workforce. This is where organizations such as the Associates for Training and Development come in handy.

The Senior Community Service Employment Program (a branch of the training program) which has several offices in New York State, including St. Lawrence, Jefferson and Oswego Counties, offers qualified older workers the opportunity to work part time, in a paid internship, while learning skills toward employment and financial independence.

The program was funded by a grant awarded by the U.S. Department of Labor’s Employment and Training Administration.

Mary Branagan, a public relations specialist for the training program, said, “Seniors tend to have a lot of social vulnerability compared to other demographics and tend to be isolated because of it. There’s no cost to participate and it’s a safe place to come.”

Mature workers, 55 and older, who apply for the program and are accepted, will work 20 hours per week for a nonprofit, and be paid for their work.

“This allows them to go somewhere and be part of a team again,” Ms. Branagan said. “This is a transformative experience, that they are no longer depressed or lonely and therefore they get their self-confidence back and are ready to work again.”

According to their website, the program’s host training sites are expected to provide the participant with meaningful job skills training. They are also expected to encourage and help participants in their job search efforts.

“The program serves as a “stepping stone” back into the workforce, Ms. Branagan said. “It is a transitional program where people get support in the job search process.”

The “interns” modernize their skills, improve self-confidence, work on computer skills and develop updated job search tools including resumes and references. Assignments are temporary, because the program isn’t designed to be permanent.

Program officials say 61 percent of the people who complete the program move-on to unsubsidized employment; 71 percent of the participants have retained their new jobs for at least three quarters and 73 percent reported having a more positive outlook on life after training.

Nursing homes a key element of NNY elderly living



WATERTOWN - When the elderly reach a point at which they are no longer able to care for themselves, their options dwindle significantly.

Most medical experts say the first option in many cases should be using home health care to keep the elderly in their homes. However, there are a number of reasons this arrangement doesn’t work, including handicapped accessibility, the severity of the medical condition and a lack of a nearby support network of family or friends.

When that happens, institutional care is probably necessary.

“I am a believer in helping the elderly to stay in their own homes, even as they need help in the activities of daily living,” said Dr. Gary R. Berk, chair of family practice at Canton-Potsdam Hospital. “The biggest issue may be access to services. There is a scarcity of assisted living and nursing home openings in St. Lawrence County, especially in the Gouverneur, Canton, Potsdam corridor.”


According to Barbara Morrow, vice president of long-term care at Samaritan’s Summit Village nursing home and Keep Home, the recent closures of nursing and assisted living homes in Watertown, Carthage and even Oswego County have created added pressure for Summit Village and the Keep Home.

“It’s a hard business to be in from a financial standpoint, even with the hospital to back us up,” she said. “We recently got into home care ... only mostly in Jefferson county, but it’s hard, we’re a big county.”

With a total of 439 beds, both facilities are running at approximately 98 percent occupancy with waiting lists between four and nine months.

“Just because we have a bed open, it doesn’t necessarily mean it fits an applicant’s health needs or financial concerns,” Ms. Morrow said.

Ms. Morrow stressed the critical need for long-term and end-of-life care, as the needs of each person and family are different.

“The dynamics of families have changed, most households are two-income, which means no one is at home and able to take care of their parents full-time. Many grown children move away from their parents, and (the parents) need a place to go.”

When looking into a nursing home, Ms. Morrow said the first concern for most families is the price. While the homes will help applicants enroll in Medicare and Medicaid, cost can be a real barrier, which is why she recommends planning well in advance.

“The biggest thing is to talk about it. It’s not always a comfortable conversation, which is why it’s important to talk about it before something happens,” Ms. Morrow said. “Get a financial plan when you’re not under stress, not after.”

She also believes in designated health care proxies, in filling out Medical Orders for Life Sustaining Treatments, and getting one’s wishes down on paper, even if it doesn’t feel pressing.

Tragedy can hit at any moment, and having the decision making out of the way helps reduce stress.

“No one wants their loved one to have to go into a nursing home. People feel guilty ... it’s a very emotional thing.” Ms. Morrow said. “I tell my staff no one says “I can’t wait to go into nursing care,” so we have to work to make it the best home we can.”


Several recent closures of nursing and assisted living homes underscore the stress felt by many families looking for quality long-term care for their loved ones, and ups the pressure for other facilities and services scattered across the north country.

Angel’s Inn Adult Home closed at the end of July, after nearly 70 years of fighting to stay open.

Mary Ryan-Allen started the home, originally Ryan’s Nursing Home, in 1946. Now 93 years old, the owner and operator was faced with a choice — pay hefty fines from the state Department of Health or shutter the supervised care facility.

Established as a 40-bed nursing home and reduced over the years to a 24-bed supervised care facility, Angel’s Inn was down to its last five residents and 14 employees.

“After 70 years it’s pretty heartbreaking,” Mrs. Ryan-Allen said. “It’s been a wonderful place that has made a lot of people happy.” A July statement from the Department of Health said, “The Department identified serious deficiencies at Angel’s Inn which included systemic breakdown in the operations of this facility. The department is working with the operator of the facility to resolve these issues. The Department will continue to hold Angel’s Inn and other providers who violate regulations accountable for their actions.” According to Mrs. Ryan-Allen, to stay in operation, the home was told to pay a $50,000 lump sum penalty and $1,000 a day in fines. She has faced similar fines and battles with the state in the past, but said this time she chose not to fight it.

In 70 years, the home faced its fair share of hurdles. Mrs. Ryan-Allen fought for ownership and operation of home for decades, since divorcing her first husband and co-owner Robert D. Ryan in the 1970s.

The 7,500-square-foot Pine Street adult home, which has the capacity to house up to 24 people in its 17 rooms, is now in disuse after years of Department of Health violations and subsequent fines for many years.

Angel’s Inn faced $21,975 in fines in 2014 for structural and maintenance violations, and in that same year went through three home administrators. At the time, the home noted to a Times reporter that none of the violations was in regard to patient care.

Carthage Area Hospital’s skilled nursing unit succumbed to the harsh long-term-care environment earlier this summer as well, announcing in June its plan to close as soon as its remaining 23 residents found new homes.

“Despite our unwavering commitment to quality resident care, it has grown evident in recent years that we are unable to continue to operate the unit,” said Rich Duvall, Carthage Area Hospital chief executive officer, in a written news release.

“This, combined with declining cost-based reimbursement for services provided to nursing home residents, has made the hospital’s decision essential.”

In a previous interview, Mr. Duvall told the Times that hospital officials could see no path that would provide even a break-even income flow. Since that time, proposed changes in federal health-care policies have made the picture even more bleak.

In its petition to close the unit, the hospital cited “long-term financial challenges brought by changing state and federal mandates.” Also cited were escalating costs facing smaller skilled nursing facilities that are saddled with a scale of operations that is too small to be competitive.

All residents were transferred to local facilities assisting in relocation, including the 90-bed Country Manor Nursing and Rehabilitation Center near the hospital, Lewis County General Hospital’s 160-bed Residential Health Care Facility, and Samaritan Medical Center’s Keep Home.

Michaud Residential Health Service, a nursing home in Fulton, Oswego County, also officially shuttered Aug. 28, after finishing the relocation of its patients.

Plans to close the 89-bed facility were announced in July amid financial difficulties.

Jen JacksonComment