elderly
Aging, is and always has been, a team sport!
I am a big fan of some of some of the leaders who I consider the pioneers in reshaping how we think of aging in this country. One was Dr. Robert Neil Butler, MD who first coined the word “ageism”, started the first geriatric medicine program in the country (at Mt Sinai Medical Center), was the first Director of the National Institute on Aging and won the Pulitzer Prize for his groundbreaking book on aging called “Why Survive? Being Old in America”. Sadly Dr Butler passed away in 2010. But he left us a legacy of his work.
Another leader who is still very active is Dr Bill Thomas, MD, geriatrician and a professor at the Erickson School at the University of Maryland, Baltimore County. He has founded two movements that aim to reshape nursing-home care: The Eden Alternative and the Green House Project. Dr. Thomas his wife developed the Eden Alternative in the early 1990’s as a bodybuilding-seriously.net philosophy to deinstitutionalize long term care facilities by alleviating the “three plagues” of boredom, helplessness and loneliness. In 2008, The Wall Street Journal named Dr. Thomas one of the 12 most influential Americans shaping aging in the 21st Century. US News and World Report described Dr. Thomas as a revolutionary, “With his startling common-sense ideas and his ability to persuade others to take a risk, this creative and wildly exuberant 46-year-old country doctor has become something of a culture changer–reimagining how Americans will approach aging in the 21st century.”
Here is a sample of some of Dr Thomas’s (for America) revolutionary statements on the plethora of dismal nursing homes in this country:
“One important way we can reduce the fear associated with communal living arrangements, and improve the lives of frail elders and their families, is to abolish nursing homes in America. Currently we have more nursing homes than Starbucks outlets. Our archipelago of institutional long-term care facilities houses 1.6 million elders and adults living with disabilities. Most of them are serving life sentences, stripped of privacy, independence and choice. Ironically, the buildings are aging even faster than the people in them. They won’t survive to house the coming boom of elders. Should we rebuild them, as thousands of developers are already doing, and subject another generation to the cruel embrace of the institution?
The fact that so many people, whose only crime is frailty, are confined in this way is powerful evidence that we live in a deeply ageist society. We dread aging because we associate growing older exclusively with disability, depression, dementia and death. In fact, old age is a complicated life stage with abundant opportunities for growth, joy, meaning and worth. Around the world and through the ages, elders have proven their value as peacemakers, storytellers and sages. They are the glue that holds families and communities together, and we need them now more than ever. “
He writes this in response to the fear that so many old people have about living in groups, and rightly so given the vast majority of the existing models. But, he says, as in the title of this blog post, AGING IS A TEAM SPORT! How I have described it, along these same lines, is that “It takes a village!”, stealing from Hilary Clinton’s old book title. I have seen this over and over, that the highest quality of life belongs to those older people who have a loving and competent circle of family, friends, caregivers, church members, health professionals, etc around them when they need them.
Older people nowadays want to stay home and “age in place”. This is understandable given the alternatives! It’s time for us to create warm, welcoming, vibrant group settings where individuals can have privacy and alone time for contemplation, and friendship and support and connection when they want that to. I’m sure we can figure this out. And we should because the boomers are fast coming down the aging track.
Dr Thomas has started the Green House Project, a new model aimed at creating a real home that provides care but also supports those seeking to redefine the worth and meaning of late life. With support from the Robert Wood Johnson Foundation, more than 100 Green House Project homes have opened in 32 states since 2003, and more than 100 others are in development.
Hogewey “Dementia Village” in Holland
With more and more individuals (and their loved ones) suffering from dementia in our rapidly aging population, it behooves us to come up with some creative and compassionate living alternatives that embrace them with respect, value, safety and opportunities to have fun.
The Dutch have created one such alternative pharmacom. What will we come up with here in the United States? And what will be affordable for the hordes of aging baby boomers who not only are getting old but also developing dementia? Time will tell! Meanwhile we can learn from other countries and cultures.
Medical Foster Homes – An Emerging Supportive Housing Choice for Older Veterans
Medical Foster Homes – An Emerging Supportive Housing Choice for Older Veterans
Housing Choices in Later Life
As our population ages, more and more living scenarios are surfacing for how to live out our lives safely with dignity, comfort and with as much control as we can maintain. Increasing numbers of older people remain in their own homes as long as they can in order to preserve their independence. The number of people living out their whole lifespans in the comfort of their homes has increased by 50% over the last two decades.
When living alone is no longer an option, elders often opt to move closer to adult children who can provide assistance and advocacy. Often, additional hourly home caregivers are brought in; at times, live-in roommates exchange services for rent. Full-time, live-in caregivers are another, albeit expensive, option.
“Aging in place” member-driven, non-profit, community-based organizations such as Marin Villages strive to provide the kinds of support that older people are looking for in order to continue to live in their own homes, apartments or condo’s.
Independent living retirement communities serve as well-known housing alternatives for older adults. Assisted living and skilled nursing facilities come into the picture as health declines and care needs increase.
Smaller “board and care” homes are another alternative – with usually 2-6 residents. Board and care homes can be comfortable and safe environments, particularly for those older adults who do not need the full medical services available in assisted and skilled nursing facilities.
A Special Alternative for Veterans
Recently I found out about an interesting project that the Veteran’s Administration has been spearheading for several years called “Medical Foster Homes”. These homes provide an alternative to nursing homes for veterans who are unable to live safely and independently at home or lack a strong family caregiver. The homes are open to vets of all ages but the average age is 70.
Initiated by VA social workers in Little Rock, Arkansas, the program currently serves about 600 veterans and has cared for 1,500 since it began. The program has grown to operation in 36 states and is scheduled to expand to 10 more states soon. Program administrators have reported that 30 percent of veterans who would qualify for VA-paid nursing homes choose instead to live in – and to pay out of pocket for – medical foster homes. This is evidence, they state, that the vets prefer a home setting.
Living in a medical foster home is paid for by veterans from their VA and social security benefits – the monthly costs range from about $1400 to $2500 depending on the applicant’s income and the level of care he/she needs. It should be noted that the VA rigorously screens and monitors the Medical Foster Care homes – only about 1 in 10-15 applicants is accepted.
For more information, read the full New York Times article For Veterans, an Alternative to the Nursing Home or go to the Department of Veterans Affairs Medical Foster Home website. You can also call the Marin County Veterans Service Office at (415)473-6193 and speak with Marin County Veterans Service Officer Sean Stephens. Sean’s email address is veterans@marincounty.org.
Won’t it be interesting if the VA’s valuable knowledge obtained as they continue to grow this popular housing solution can be translated for the general, non-veteran population of older adults? Stay tuned!
The Trouble With Hearing Aids
The Trouble With Hearing Aids
Many older people I know would say they have had a problematic relationship with hearing aids.
First of all, they cost a fortune – typically about $3000 each – and Medicare doesn’t cover them.
Secondly, they get lost so easily! They’re tiny and one lady I know lost hers in her sheets and it all got put in the retirement home laundry, never to be found again.
And lastly, they are tricky to get fitted, to get used to, and oftentimes they don’t work that well, especially at first. It’s important to find a top-notch provider and to have patience through trial experiments and fittings.
Here’s the toughest problem, though, and it’s not about the hearing aids – it’s about hearing loss.
Without good hearing, older people start to feel more and more isolated. As their hearing deteriorates, it’s challenging for them to hear much at all in public spaces where ambient noise is present – places such as church, restaurants, auditoriums. So, they tend not to go out anymore which leads to isolation and loneliness.
So older people experiencing hearing loss are in a bit of a Catch-22. They need to be able to hear in order to participate fully in relationships and their social lives. And they need to be able to find one that works that they can afford.
Here’s a good article published by Consumer Reports called “How to Select a Hearing Aid Provider“. Its full of good tips and can help an older person and/or their family take some first steps towards getting help.
Are We Giving Up on our Oldest Adults Benefiting from the Internet?
The Digital Have-Not’s – Our Oldest Adults – Closing the Gap
(Click on the link above to read a good summary of this issue written by blogger Laurie Orlov.)
Are we as a society just giving up on the 75+ age group as far as encouraging and teaching them about the valuable information, tools, and community they can find online?
People point out there is scarce funding to reach these people – they are the digital have-not’s. I think they are the digital “would be’s” if there were helpers to teach them about the benefits (connection with friends and family, health information, interesting stories, etc.) of online and to teach them how.
Locally-focused online communities focused on aging, grassroots reviews leading to accountability of service and product providers, social connection, information-sharing… this has to be one answer. Again, with some help to teach how.
What Do We Call Ourselves as a Group as We Get Older?
What do we call ourselves as a group as we get older? Seniors? Elders? Crones? Older adults? Geezers? Will baby boomers always just be called baby boomers? What else can we call ourselves when referring to our demographic cohort? Here’s a good article on this called Elderly No More from the New Old Age Blog which is such a wonderful blog on aging.