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August 2008 Archives

August 1, 2008

My Dad Will Like This Post*


A Polish ambient artist named "Emphasis" created the song. it is called, "vayur anilam."

* The cars much more than the music...

Posted by Dr. Bill Thomas on August 1, 2008 1:43 PM |Permalink |Comments (2)

Low Road Campaigning

This made me laugh.

The joke will make sense only if you have seen both Obama's speech on American race relations and the movie "The Matrix."

obamamatrixkh0.jpg


Posted by Dr. Bill Thomas on August 1, 2008 7:02 PM |Permalink |Comments (0)

August 2, 2008

Green House in Alaska

There is a nice article about the new Green Houses in Seward, Alaska

Here

In a plot behind the Seward High School, bulldozers and other machines busily cleared land for the new long-term care center slated to open in the fall of 2009.

The facility is part of the Green House Project, an innovative concept that replaces institutionalized elder care with a home-like atmosphere.

It’s the first such project in Alaska and one of only approximately 15 around the country, with another 40 or so in the developmental stages.

“These will be actual homes,” said Valerie Gunchuck, director of nursing at Wesley Rehabilitation and Care Nursing Home in Seward. “There is nothing institutional about them. We don’t even like to use that word.”

The Seward center, modeled after existing Green Houses, will be made up of four homes with a separate administrative building. Each house will contain 10 bedrooms with private baths directly off a centralized area termed the “hearth,” a large communal living room and kitchen which, according to Gunchuck, will look like “any other kitchen and living room in any of a thousand of houses you might enter.”

Houses will have enclosed patio areas and yards, with possible gardens. Pets are optional, depending upon the rules of that particular house.

All 31 Wesley residents will be tra­­nsitioned to the center. Once situated, they’ll prepare meals together in one large kitchen and eat in a family-styled dining room. They’ll also be encouraged to decorate their bedrooms with furniture from their own home.

“They can do that here of course, but it still looks like a hospital room,” Gunchuck said. “You can only make a hospital room look like a bedroom so much.”


(H/T Alex M)

Posted by Dr. Bill Thomas on August 2, 2008 1:33 PM |Permalink |Comments (0)

August 3, 2008

Caring.com: The Interview


I did an interview with Caring.com and now it is up...

Wide ranging and the Camille did a great job of capturing the essence of our conversation.

A sample...


Can you describe Eden at Home?

Yeah! The whole idea is to take all that stuff we've learned in long-term care and make it available to family caregivers at home because, as I was saying before, even if you've got an M.D. from Harvard, you're not prepared. So it takes Eden philosophy and Eden messages and puts them into the hands of people who are caring for somebody they love at home.

What's an example of something from the Eden philosophy that caregivers can integrate into their lives?

We teach people how to go beyond care giving. There's this idea, which is very common in our culture, that care giving is a "pair" relationship: a caregiver and the person getting cared for. It's a one-on-one relationship and other people help, if they can. And that's actually not the way care has been given in most of human history, when care needs were distributed across a clan or tribe or family network.

So we try to help people build "care partner networks," so that the elder is a part of that care partner network, along with maybe a daughter, and maybe a friend from church. We help teach people that one of the most important things you can do as a care partner is to help grow the network, so that you have more people lending a hand, and that is healthier for the elder and the care partner.

Where can people read about the Eden at Home concepts?

At the Eden Alternative website, and there are also trainings people can go to. We're working on making them available in more parts of the country.

Posted by Dr. Bill Thomas on August 3, 2008 1:36 PM |Permalink |Comments (0)

August 4, 2008

Best New Blog

Emi Kiyota has just returned from Sri Lanka. She is working to develop culturally appropriate designs and systems for aging there. This is the best new blog I have seen in a long time.

A sample from Sri Lanka...

Chairs.JPG


I discovered the magical power of "cheap plastic chairs" in long term care facilities in Sri Lanka. Most of the elder care homes had a front porch with several light weight plastic chairs. It seemed to be the most frequently utilized space by elders, staff members, and visitors.

Normally, chairs were neatly placed along the wall. When people came out to the front porch, they slightly adjust the location of the chairs and sat. I have observed that people were constantly adjusting their chairs to maintain their comfortable distance among others. The distance and configuration were also adjusted in different social functions. Because these chairs were light enough for elders with limited strength to move easily, everybody was able to find their most comfortable location in the area.

William Whyte found that providing movable chairs increases the peoples' usage of public open space in NYC. This time, I have witnessed that simple movable chairs gave a magical power to draw people into gathering space in rural Sri Lanka. It was quite amazing to learn that simple and inexpensive furniture like plastic chairs could help elders to make their own place.

"Place making..." can be a meaningful concept only when users are fully involved, which has been over-done by designers so far.

We have a lot more to learn...

Posted by Dr. Bill Thomas on August 4, 2008 9:05 AM |Permalink |Comments (0)

Power-Up Monday: More Dementia News

[Editor's Note: Al Power is filling-in for Christa "Monkhouse Mondays" while she's on vacation.]

I'll follow up Wednesday's "Pre-Dementia" post with three more items that have popped up in the past two days:

(1) On July 28th, our local newspaper described a new study from the University of Kansas, to be published this fall in the American Journal of Alzheimer's Diesase and Other Dementias. In this study, it was found that people with dementia take great offense to being talked down to with demeaning names or infantile language. Many people reacted with increased agitation and physical aggression. Even people with fairly advanced dementia can tell when they are being demeaned or patronized.

This lends support to those of us who feel that interpersonal interactions are an important factor in the genesis of behavioral symptomatology. I only have one complaint: The article states that this method of address is so common that "researchers have coined a word to describe it - 'elderspeak'".

Now wait just a minute here! That isn't elder-talk - it's baby-talk! Let's not besmirch a title of honor and respect by associating it with infantilizing language.

(2) The UK has a new drug that claims to "halt the decline of dementia", something no other drug has succeeded in doing. The media has descended like vultures on the report of this trial drug named Rember (get it?). The study claims that there was no significant decline in cognitive function after 19 months on the drug, compared with an 81% relative decrease in those not taking it.

The drug appears to work by attacking the "tau protein" that forms the damaged nerve tangles of Alzheimer's. This is an industry-sponsored study, and hasn't been put to intense scrutiny or replication yet. However, it was enough to impress Clive Ballard, a prominent researcher in the UK. Others cite the evidence that the drug decreases blood supply to some brain areas as an indication to proceed with caution into further trials.

So we'll keep our fingers crossed and see what happens here...

(3) Finally, back on the topic of social capital, the BBC also reports that single people have three times the risk of dementia that married people have. This was reported by the Karolinska institute, after a study of 1449 Finns. It is theorized that the "intense social and intellectual stimulation" of marriage has a protective effect. Those who were widowed at a young age and never remarried had six times the risk.

This certainly adds to recent evidence about the beneficial effects of social interaction on cognition and other health indicators, (though a few of my formerly married friends might take issue with the hypothesis!).

I would comment that the article does not tell if cognitive testing was done on these people, or just an interview and health history. The latter would not rule out the effects of an ongoing relationship in helping to "cover" for mild deficits. There is also evidence that untreated depression can be neurotoxic - this might also be an issue in cases of divorce and bereavement. Finally, there may be lifestyle differences associated with stable marriages (diet, exercise, etc) which contribute.


Keep an eye on this blog for the latest developments!

-- Al Power

Posted by Kavan Peterson on August 4, 2008 11:20 AM |Permalink |Comments (2)

Word Clouds

This is an interesting method for comparing the web sites of the two major party candidates for president. See if you can guess whose is whose before you read the short article that accompanies the images. Word Clouds Here

Posted by Dr. Bill Thomas on August 4, 2008 11:47 AM |Permalink |Comments (0)

August 5, 2008

Harvest Moon

I love this song. What can I say?

Posted by Dr. Bill Thomas on August 5, 2008 11:37 AM |Permalink |Comments (0)

August 7, 2008

The Art of Aging


Great post on aging over at "The Art of Aging."

Being old is only numbers. Being alive to new challenges, new pleasures and new friends is who you can become right now. Make something wonderful happen for you today … for your sake and for all of those who need your help, your experience, your creativity, the valuable, unique person you were yesterday and still are today.


The whole thing is worth reading...

Find it Here

Posted by Dr. Bill Thomas on August 7, 2008 1:05 PM |Permalink |Comments (0)

August 8, 2008

Power Rant


This just in from Al Power...


First, a rant. I was giving a Keynote at a conference a few weeks back, and got to ranting about the common concern that the aging of our population is going to bankrupt our country.
It went something like this: "We have 50 million people without health insurance and an equal number are underinsured, gas is $4 a gallon and we have no coherent energy policy, we're slipping into recession, the housing and banking industries are crumbling under the subprime mortgage fiasco, Iowa is underwater and we're fighting two wars overseas -- do you really think old people are going to be main cause of our economic collapse??"

Now, two raves: First, from our local daily, kudos to Nicholas Gatto!
Gatto is a partner of Legacies of Life, a Rochester company that writes elder histories. He wrote an op-ed expressing the need for a community "Board of Elders", who could bring their wisdom and experience as a valued resource for the community. In addition, it "would enable our children to see that engaging Grandma and Grandpa's wisdom is essential to securing a bright future for all". Yes!
Second, my daughter Caitlin passed me a copy of the remarkable novel "Where River Turns to Sky", by Gregg Kleiner (Harper Perennials, 1999). This story is told, in alternating chapters, through the eyes of two elders - George Castor, a prickly gentleman with unresolved guilt over the death of his best friend Ralph; and Clara Paulson, victim of a stroke which has left her virtually speechless.
George has issues with the nursing home where Ralph died, and where Clara lives. So he devises a unique "aging in community" solution for Clara and a few of her neighbors. That's all I'll say about the plot.
Kleiner has a unique style and an original approach to words and images that kept me riveted. Even more, this apparently young first-time novelist has told the stories of elders with a remarkable authenticity of spirit and perspective. (This isn't just my opinion - my 81 year-old mother felt the same way.)
Kleiner has been an exchange student in Thailand, on retreat in a Buddhist monastery, a goat herder, a wildlife biologist and a journalist. I can't wait to see what he comes out with next!

Posted by Dr. Bill Thomas on August 8, 2008 12:22 PM |Permalink |Comments (1)

August 10, 2008

Tell Me Why...

This just in.



Drug companies are quietly pushing through price hikes of 100% or even more than 1,000% for a very small but growing number of prescription drugs, helping to drive up costs for insurers, patients and government programs.

The number of brand-name drugs with increases of 100% or more could double this year from four years ago, researchers from the University of Minnesota say. Many of the drugs are older products that treat fairly rare, but often serious or even life-threatening, conditions.

Among the examples: Questcor Pharmaceuticals last August raised the wholesale price on Acthar, which treats spasms in babies, from about $1,650 a vial to more than $23,000. Ovation raised the cost of Cosmegen, which treats a type of tumor, from $16.79 to $593.75 in January 2006.

The average wholesale price of 26 brand-name drugs jumped 100% or more in a single cost adjustment last year, up from 15 in 2004, the university study found. In the first half of this year, 17 drugs made the list.

It is not a "free market" when producers can arbitrarily push through price increases for products people need to survive at will and nothing can be done to stop them. Where is the pressure to lower prices? By some bizarre logic, we are expected to accept the "workings of capitalism" when companies raise prices by 100 percent and we are supposed to object to our government acting to bring prices down by increasing competition.

Nice work. If you can get it.

More here.

Posted by Dr. Bill Thomas on August 10, 2008 12:11 PM |Permalink |Comments (1)

August 11, 2008

This Also Applies to Smoking

There is a something called a "contagion" effect that results in ideas and and habits being spread through close social contact. The things that are transmitted through contagion can be good or they can be bad.

In this case, not so good.

NEW YORK (Reuters Health) - Obesity may be contagious because most people feel good about themselves if they are about as heavy as the people around them, according to new research from an international team of economists.

This could explain the rapid rise in the prevalence of overweight around the world, the researchers say. That is, the norm that most people compare themselves to has become fatter and fatter, feeding a cycle of "imitative obesity."

"What we're finding is that human beings are probably driven tremendously by comparison. Unless you understand those comparisons, you're not going to understand the rate of obesity," Dr. Andrew J. Oswald of the University of Warwick in the UK told Reuters Health. "Understanding the sociology of obesity is much more important than understanding the biology."

Last year, Oswald and his team note, Drs. Nicholas Christakis of Harvard and James Fowler of the University of California, San Diego published a study showing that people were more likely to become obese if their friends and family members were heavy.

In the current analysis, which they presented at the National Bureau of Economic Research conference July 25 in Cambridge, Massachusetts, Oswald and his colleagues attempt to use an economic model to show why this happens. They analyzed data from several sources on body mass index (BMI) and people's perception of their weight for 29 European countries.

More than one-third of Europeans think they are too fat, the researchers found, and people who are more educated were more likely to think they are overweight.

The researchers also found that for women, satisfaction with their weight depended on their own BMI in relation to the average BMI for a woman of their own age living in the same country. For their part, men who were overweight tended to be happier if the people around them were overweight too.

The link between people's relative BMI and their general life satisfaction is likely unconscious, according to Oswald. "They may not be aware of it. Our computers can trace out these patterns without the individual necessarily knowing them."

So the average person doesn't mind being overweight if people around him are too; hence he is "keeping up with the fat Joneses," Oswald explained.

However, for "high-status" individuals, being thin is becoming more and more important, he added; this may explain the rise of super-skinny models and actresses, as well as the prevalence of anorexia among upper-middle class girls and boys.

It might be possible to change people's weight-related norms by having them look at images and movies from decades ago -- when people were, on average, 20 pounds lighter, Oswald suggested.

"They don't have to be 220 pounds," he said. "Their parents got on fine in their life at similar ages weighing many pounds less."

Posted by Dr. Bill Thomas on August 11, 2008 1:57 PM |Permalink |Comments (0)

August 12, 2008

C Wright Mills


c-wright-mills-1-sized.jpg

C Wright Mills...

One of my favorite thinkers.

One my favorite quotes...

Do not allow public issues as they are officially formulated, or troubles as they are privately felt, to determine the problems that you take up for study.


Above all, do not give up your moral and political autonomy by accepting in somebody else's terms the illiberal practicality of the bureaucratic ethos or the liberal practicality of the moral scatter.

Know that many personal troubles cannot be solved merely as troubles, but must be understood in terms of public issues - and in terms of the problems of history making.

Know that the human meaning of public issues must be revealed by relating them to personal troubles - and to the problems of the individual life.

Know that the problems of social science, when adequately formulated, must include both troubles and issues, both biography and history, and the range of their intricate relations.

Within that range the life of the individual and the making of societies occur; and within that range the sociological imagination has its chance to make a difference in the quality of human life in our time.

(Mills 1959: 226)

Posted by Dr. Bill Thomas on August 12, 2008 2:19 PM |Permalink |Comments (0)

August 13, 2008

Deep Thought

Deep thoughts are crunchy, very chewy and nutritious. They also demand effort from us.

Here is a good one.

Older people are caught between a social ethic which
values independence on the one hand, and, on the other, a service ethic which
constructs them as dependent. This paper argues that this dichotomy between
dependence and independence results from a depoliticisation of need, in part
the legacy of a radical individualism combined with a postmodern therapeutic
ethic.


First sentence...

"Older people are caught between a social ethic which values independence on the one hand, and, on the other, a service ethic which constructs them as dependent."

Translation.

"It's a hell of a thing. When you get old everybody judges you by how 'independent' you are. Independent= good. Dependent= bad. The trouble is that all the things you need to stay 'independent' are in the hands of people who insist on defining the people they help as 'dependent.' Ouch!"

Second Sentence

"This paper argues that this dichotomy between dependence and independence results from a depoliticisation of need, in part the legacy of a radical individualism combined with a postmodern therapeutic ethic."

Translation

"Life is difficult. It always has been but part of being human is being able to rely on others even as we are relied upon. This is the world's oldest two way street. It is fundamentally inhumane to close this "two way street" (and thus destroy 'interdependence') and replace it with a pair of one way streets. On one of these streets we find INDIVIDUALS who are struggling to be INDEPENDENT. On the other street, we find INDIVIDUALS who are receiving services designed to manage the burden of their DEPENDENCE.

This system destroys connectedness and too often drains the joy out of life in Elderhood."


Here is where you can find the whole enchilada...

Ageing and Society, Cambridge University Press 1997 (Vol. 17, 1997, 425-446) "Beyond Apocalyptic Demography : Towards a Moral Economy of Interdependence" by ANN ROBERTSON*


*Very smart person " />


Posted by Dr. Bill Thomas on August 13, 2008 5:28 AM |Permalink |Comments (0)

August 15, 2008

This Blows Me Away

From an Op Ed in the NYT...

WHAT is the secretary of Veterans Affairs thinking? On May 5, the department led by James B. Peake issued a directive that bans nonpartisan voter registration drives at federally financed nursing homes, rehabilitation centers and shelters for homeless veterans. As a result, too many of our most patriotic American citizens — our injured and ill military veterans — may not be able to vote this November.

I have witnessed the enforcement of this policy. On June 30, I visited the Veterans Affairs Hospital in West Haven, Conn., to distribute information on the state’s new voting machines and to register veterans to vote. I was not allowed inside the hospital.

Outside on the sidewalk, I met Martin O’Nieal, a 92-year-old man who lost a leg while fighting the Nazis in the mountains of Northern Italy during the harsh winter of 1944. Mr. O’Nieal has been a resident of the hospital since 2007. He wanted to vote last year, but he told me that there was no information about how to register to vote at the hospital and the nurses could not answer his questions about how or where to cast a ballot.

I carry around hundreds of blank voter registration cards in the trunk of my car for just such occasions, so I was able to register Mr. O’Nieal in November. I also registered a few more veterans — whoever I could find outside on the hospital’s sidewalk.

There are thousands of veterans of wars in Korea, Vietnam, the Persian Gulf and the current campaigns in Iraq and Afghanistan who are isolated behind the walls of V.A. hospitals and nursing homes across the country. We have an obligation to make sure that every veteran has the opportunity to make his or her voice heard at the ballot box.

Connecticut’s attorney general, Richard Blumenthal, and I wrote to Secretary Peake in July to request that elections officials be let inside the department’s facilities to conduct voter education and registration. Our request was denied.

The department offers two reasons to justify its decision. First, it claims that voter registration drives are disruptive to the care of its patients. This is nonsense. Veterans can fill out a voter registration card in about 90 seconds.

Second, the department claims that its employees cannot help patients register to vote because the Hatch Act forbids federal workers from engaging in partisan political activities. But this interpretation of the Hatch Act is erroneous. Registering people to vote is not partisan activity.

If the department does not want to burden its staff, there are several national organizations with a long history of nonpartisan advocacy for veterans and their right to vote that are eager to help, as are elected officials like me.

Wow, that's cold.

Posted by Dr. Bill Thomas on August 15, 2008 5:36 AM |Permalink |Comments (0)

Power-Up Friday: Reader Challenge

In an effort to solicit more comments from readers, I'd like to offer a little challenge: What are some of the unexpected ways that the aging of our population might change societal conventions and standards over time? Positive and negative ideas both count.

For example: Will we have different views about the economic value of sports stars and entertainers? Will charitable donations and volunteerism increase or decrease? Will roadways or traffic patterns be constructed differently? What will TV look like? In what ways will the frontiers of technology change?

I have no idea. I'm just asking. Send us your thoughts - let's have a conversation.

I will close with the Quote of the Week, courtesy of Mimi Bommelje: "The reasonable man adapts himself to the world; the unreasonable one persists in trying to adapt the world to himself. Therefore, all progress depends on the unreasonable man." -- George Bernard Shaw (1856-1950)

-- Al Power

Posted by Kavan Peterson on August 15, 2008 8:08 AM |Permalink |Comments (2)

Obama Worldwide


Emi Kiyota, recently returned from Sri Lanka, sends this picture...


Obama%20sticker%20in%20Sri%20Lanka.JPG

Posted by Dr. Bill Thomas on August 15, 2008 9:55 AM |Permalink |Comments (0)

Excellent Post

This post from Timegoesby really grabbed me.


“She had learned, in her life, that time lives inside you. You are time, you breathe time. When she’d been young, she’d had an insatiable hunger for more of it, though she hadn’t understood why. Now she held inside her a cacophony of times and lately it drowned out the world. The apple tree was still nice to lie near. The peony, for its scent, also fine. When she walked through the woods (infrequently now) she picked her way along the path, making way for the boy inside to run along before her. It could be hard to choose the time outside over the time within.”

- David Wroblewski, The Story of Edgar Sawtelle

Posted by Dr. Bill Thomas on August 15, 2008 11:03 PM |Permalink |Comments (0)

August 18, 2008

Monkhouse Mondays: Every wrinkle counts

[Editor's Note: While Dr. Thomas is out of country for the rest of the month, Changing Aging bloggers Christa Monkhouse and Al Power will be filling in.]

"They are not perfect, not young and not frightfully thin. The models involved are over 80 and residents of the Senior-Foundaton Eilenriedestift in Hannover, Germany, so the headlines.

"The models“ consented to being portrayed by three young art-students. This project, "Young looks at Old“ was initiated by Dorothee Wiederhold, a friend, visionary and accomplished leader in ageing-services and director of care. The artists stay in the residence and have so far painted over 70 portraits. The residents stood in line, they loved the idea.

Watch the short TV-clip (2:11) in German, it is mainly self explanatory, but there are some translated quotes from the students below:








"An old face has much more to tell than a young face“
"Every wrinkle tells a story, shows lived life“
"Every wrinkle counts, this is the message, we take away from here“

And finally, an answer to Al Power to his very good Friday-post question: "What are some of the unexpected ways that the aging of our population might change societal conventions and standards over time?“

I think that older faces will be perceived within a new aesthetic, not one of decline, but as one of it’s own beauty, a new artistic iconography of lifespan development, such as Ronni Bennett’s portraits on the Time Goes By website.

-- Christa Monkhouse

Posted by Kavan Peterson on August 18, 2008 1:31 AM |Permalink |Comments (0)

Chillaxin

I will be Chillaxin with the family for the next two weeks.


Chill.

Very Chill.

See you in September.

I suspect that the ChangingAging.org bloggermeisters will be around while I am out.

I look forward to reading their posts when I return.

Later...

Posted by Dr. Bill Thomas on August 18, 2008 5:56 AM |Permalink |Comments (0)

August 19, 2008

Buon viaggio, Bill!

Bill is spending the rest of August near Siena in Tuscany. I had a nice visit there with my family in 2005. There is a wonderful traffic-free piazza, Il Campo:
Piazza.jpg

Every July and August, they run the Palio, a horse race around Il Campo, in which the 17 neighborhoods of Siena compete for top honors. In fact, it was supposed to be today! I wonder if Bill caught it...

We had a great stay at Albergo Bernini and a particularly memorable meal at Ristorante Guidoriccio. The owner tried to tell us they were booked, but my wife said he had been recommended by Rick Steves, and he melted and told us to return in a half hour. Then he served us a five-course meal which he personally selected and a bottle of the wonderful Brunello di Montalcino, which was only about $15 there, but costs 3 - 5 times as much here.

My other recommendation to Bill was to take the train a few hours north to my favorite spot from our Italian travels, Vernazza on the Ligurian coast. Here's my favorite photo of the town from our trip:
Vernazza_2.jpg

It may be a bit overrun by tourists in August, but it quiets down at night, when most of them leave, or along the trails which lead to the other seaside towns of the Cinque Terre.

Buon viaggio, Bill!

-- Al Power

Posted by Kavan Peterson on August 19, 2008 11:38 AM |Permalink |Comments (1)

August 20, 2008

On a lighter (summer) note, ageing images

Upload any picture to this ingenious and truly fun Japanese website http://labs.wanokoto.jp/olds. Choose English in the top right hand corner. Push "convert“ and after a few seconds you get the feel of a newspaper clipping, cut out some generations ago. Push "save“ -- fun guaranteed.

--Christa Monkhouse

Dr.%20BillThomas%20in%201948.jpg
[Bill Thomas in 1948]

Posted by Kavan Peterson on August 20, 2008 9:39 AM |Permalink |Comments (0)

August 21, 2008

Summer Fun -- On the Move

Here's a great example of changing aging, from right here at St. John's Home in Rochester. This was "On the Move" week, supported by a generous gift from Bob and Mary Hastings. Our Generations Child Care has several special events with the elders at St. John's all week long. Here are some highlights:

Monday: NASCAR Day

The kids put on "pit crew" shirts and decorated the wheelchairs, followed by a series of races. It also made the local news broadcastNascar%20Day%208.08%20018.jpg


Tuesday: Up Up and Away Day

A hot air balloon demonstration, first in the adjacent park:
Up%20Up%20and%20Away%2008%20093.jpg
Then inflated on its side in the Auditorium so kids and elders could go inside the seven story envelope:
Up%20Up%20and%20Away%2008%20296.jpg

Thursday: Water War. This was a hoot and everyone got soaked:

100_1786.jpg

For those who think that life ends when you go through the doors of a nursing home, think again. Many of us are challenging that idea!

Posted by Kavan Peterson on August 21, 2008 10:00 AM |Permalink |Comments (1)

August 23, 2008

Advance Directives

Check out this recent post by Jane Gross, who blogs on aging issues for the New York Times:

The article includes a letter written to a nursing home by restraint reduction pioneer Neville Strumpf, regarding her mother's care. The letter is put forth as an excellent example of how family members can provide constructive feedback regarding their loved one's care. But there are more lessons to be learned here.

Unfortunately, all did not go well for Ms. Strumpf's mother. The letter highlights a few areas that seem to be all too common. In large part, it boils down to poor communication.

A precipitous move to a different room was very disruptive to Ms. Strumpf's mother and her family. Subsequently, she was hospitalized for a low sodium level, a condition which was deemed readily correctable, but ultimately was not. (What often looks like a simple chemical imbalance can actually be a sign of impending organ shutdown.)

Most important was the fact that Ms. Strumpf's mother was apparently hospitalized in violation of a prior expressed directive, and she ultimately died in hospital, when a comfort-oriented approach at the nursing home would have been better for all.

This reveals a two important flaws in our system of care. One is the idea that it is okay to ignore a directive if a problem looks like it can be easily treated. A person who requests "no hospitalization" is aware that this could lead to death and has accepted this eventuality. We must respect this choice, and not reverse it without the consent of the person or her proxy.

Another flaw is the refusal of our insurers to pay for more intensive levels of acute or palliative care within the nursing home. Such care is usually more cost-effective than that given in the hospital. But there is no reimbursement for "subacute care" in the nursing home, so the home is faced with the choice of either giving the extra treatment at cost with no reimbursement, or shifting the cost to the hospital, where such treatment may be less desirable but is always paid for. It is a system that encourages expensive treatment by strangers and discourages a more sensible approach within familiar surroundings.

I share Professor Strumpf's frustration. We see this all too often.

Posted by Kavan Peterson on August 23, 2008 9:10 AM |Permalink |Comments (0)

August 25, 2008

Monkhouse Mondays: Older employees

The Berlin Institute state in their latest study on European regional development about Switzerland*: "Six of Switzerland’s seven regions are ranked among Europe’s ten best. All these regions are typified by relatively stable demographic structures as well as by high aggregate value added, good education levels, and impressive employment levels — also for older persons."

Older people are an asset for economic development as much as for social capital. I am sure that many more studies in the future will mention the older population and its value, not only in economic terms. This will be the beginning of a systematic reappraisal of older age.

*Download an English summary from the web here.

-- Christa Monkhouse

Posted by Kavan Peterson on August 25, 2008 9:17 AM |Permalink |Comments (0)

August 29, 2008

Power-Up Friday: End of Summer Reading

I'm reading the new travel narrative, "Ghost Train to the Eastern Star", by Paul
Theroux. Here's a provocative quote from the book, which I will submit for this
week's post:

"As a young man I regarded the earth as a fixed and trustworthy thing that would
see me into my old age; but older, I began to understand transformation as a
natural law, something emotional in an undependable world that was visibly
spoiled. It is only with age that you acquire the gift to evaluate decay, the
epiphany of Wordsworth, the wisdom of 'wabi-sabi': nothing is perfect, nothing is
complete, nothing lasts."

-- Al Power

Posted by Kavan Peterson on August 29, 2008 4:44 AM |Permalink |Comments (0)

Yes We Will

I think Bill would want to share this historic moment.

Posted by Kavan Peterson on August 29, 2008 6:40 AM |Permalink |Comments (0)

August 31, 2008

Changing Aging Updates

[Editor's Note]

Hi Folks -- Another summer is winding down and although peaches will be in season well into September, today feels like a fall day. It was cool and drizzly this morning and campus is once again full of student life.

I want to say welcome to UMBC students from Dr. Thomas' exciting new undergraduate course "You Say You Want a Revolution: How Boomers are Revolutionizing Aging." Bill and his colleague Judah Ronch will be revolutionizing undergraduate education with this groundbreaking course. They're throwing the pointy-headed lecturer model out the window and experimenting with a live video-mashup TV-style interactive classroom. More on that below.

But first, Bill gets back from Italy tomorrow and hopefully will have some great picts and stories to share from his travels. I also want to briefly share a couple new features ChangingAging.org readers can look forward to this fall.

You may have noticed the new box on top of the right hand column that reads "What Am I Doing?" That's called a Twitter feed. What, you may ask, the heck is a Twitter? Simply put, it's a way for friends to share "what they're doing" online anywhere, anytime, through a quick cell phone text message. Here's a quick explainer:

Bill spends a lot of time on the road meeting cool people and visiting cool places and with Twitter we'll be able to hear more about it.

Back to the video mashup course. Starting next week, Bill's students will be visiting the blog as part of their classwork. We'll be launching a new section of ChangingAging.org to feature their course and I invite all readers to follow along. We may even webcast some of the courses live to give everyone a sneak peak.

Until then have a great Labor Day and if you're in Maryland find some peaches, they're amazing this year!

-- Kavan Peterson

Posted by Kavan Peterson on August 31, 2008 9:49 AM |Permalink |Comments (0)

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