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February 15, 2009

ChangingAging.org Redesign -- Please Bookmark!

Attention Readers! We are launching a new design for the blog that will be hosted directly at the URL www.changingaging.org. Please navigate to www.changingaging.org and reset your bookmarks and sign up for our new RSS Feed. In the coming days we will set up an automatic redirect to the new hosting site. See you there!

Web Master

Posted by Kavan Peterson on February 15, 2009 8:00 PM |Permalink |Comments (0)

December 12, 2008

The Ripening

Elders Bring More to the Table than they take away..aging in
society as a net positive

Given the baby boomers tsunami like numbers and supposed burden
to
society, their aging process is occurring in an environment
built by their
efforts and achievements. Its important to remember that they
were babies
once, and they were taken care of in a world without all of the
technology, efficiencies, and advancements that are a part of
their
legacy. To consider the aging population to be a burden on our
society is ridiculous.

Elders very well may save the world through what they offer to
younger
generations, in wisdom, in practical solutions, in sharing their
stories
and world view.

Recognizing that we will all be in their shoes, if we make it,
will help
contribute to our analysis of "their" net value.

Seeking wisdom from our elders will help us then guide the next
generation. And someday we just might be our own
grandpa/grandma.

Monica, Betty, Aileen

Posted by Dr. Bill Thomas on December 12, 2008 12:55 PM |Permalink |Comments (2)

King Lear's Family Values

Remember when you were a teenager and you thought that there was absolutely NO WAY your parents could understand how life really is? For those of us who grew up in the 80s, the angst is best represented by this Will Smith video.

It was much the same for the Lear family, only this time the daughters weren't teenagers... they were fully grown (and ostensibly) mature. The oldest two were dead set in their belief that Dad just couldn't understand how the contemporary world works.

To them, dad just didn’t understand that the young, the “savvy” and the powerful should be left to make the decisions. The young should inherit the earth. These two daughters valued short-term gain and did not respect the experience and wisdom of their elder.

But then there was the black sheep of the family, Cordelia, who valued honesty and self-determination for herself and her father. In the immortal words of Cookie Monster, “one of these things is not like the other.”

Posted by Dr. Bill Thomas on December 12, 2008 12:18 PM |Permalink |Comments (2)

Against Declinism

Declinism vs. Developmentalism

“Are the old really human beings?”
 Simone De Beauvoir

Back in the 60s when De Beauvoir asked this question, she answered it by examining how the old were viewed in many cultures. In the US she found that they were invisible and treated as less than human, making her an early articulator of the declinist view of aging.

Here is a poem in which one woman cries out to be seen, affirming De Beauvoir’s observations.

See Me

What do you see, nurses, what do you see?
Are you thinking, when you look at me --
A crabby old woman, not very wise,
Uncertain of habit, with far-away eyes,
Who dribbles her food and makes no reply,
When you say in a loud voice -- "I do wish you'd try."

Who seems not to notice the things that you do,
And forever is losing a stocking or shoe,
Who unresisting or not, lets you do as you will,
With bathing and feeding, the long day to fill.

Is that what you're thinking, is that what you see?
Then open your eyes, nurse, you're looking at ME...
I'll tell you who I am, as I sit here so still;
As I rise at your bidding, as I eat at your will.

I'm a small child of ten with a father and mother,
Brothers and sisters, who love one another,
A young girl of sixteen with wings on her feet.
Dreaming that soon now a lover she'll meet;
A bride soon at twenty -- my heart gives a leap,
Remembering the vows that I promised to keep;
At twenty-five now I have young of my own,
Who need me to build a secure, happy home;
A woman of thirty, my young now grow fast,
Bound to each other with ties that should last;
At forty, my young sons have grown and are gone,
But my man's beside me to see I don't mourn;
At fifty once more babies play 'round my knee,
Again we know children, my loved one and me.

Dark days are upon me, my husband is dead,
I look at the future, I shudder with dread,
For my young are all rearing young of their own,
And I think of the years and the love that I've known;
I'm an old woman now and nature is cruel --
'Tis her jest to make old age look like a fool.

The body is crumbled, grace and vigor depart,
There is now a stone where once I had a heart,
But inside this old carcass a young girl still dwells,
And now and again my battered heart swells.

I remember the joys, I remember the pain,
And I'm loving and living life over again,
I think of the years, all too few -- gone too fast,
And accept the stark fact that nothing can last --
So I open your eyes, nurses, open and see,
Not a crabby old woman, look closer, nurses -- see ME!

This poem was found among the possessions of an elderly lady who died in the geriatric ward of a hospital. No information is available concerning her -- who she was or when she died. Reprinted from the "Assessment and Alternatives Help Guide" prepared by the Colorado Foundation for Medical Care.

The protagonist is asking to be seen as a human being, which is a developmental point of view. She is treated as one of many like her, who need to be fed and clothed but are not recognized as still living. We advocate for a new cultural view of aging which recognizes that human beings don’t stop growing and learning until they die. This view is called developmentalism. The following poem appeared in a book by Leon Zuckrow, a 91-year-old in a senior community who exemplifies the developmental view.

Expected—the despair,
the sigh and tears and moans
because she has gone where
body is stripped to bones.
Yet?—silliness? laughter?
frivolity? and mirth?—
so scandalous after
that consignment to earth!
But she decrees it! Then,
when I come from above
we are masters again
of joy as well as love.
In revelry, not grief,
she and I will resume,
robbing time, that old thief,
as a new bride and groom.

Nancy, Mary, Carolyn and Boo Group 1

Posted by Dr. Bill Thomas on December 12, 2008 12:02 PM |Permalink |Comments (0)

My Live Blog of the Snow Storm Special

12:01 Working on the technical details for the class. The big goal is to help people to connect the range of ideas that we talked about during the semester. Hope it works!

12:27 Getting prepped for the technical rehearsal that starts at 12:45. Fingers crossed.

1:45 Technical issues solved! Great job by the E-School Team.

1:53 Seven minutes to Show Time

2:23 The students are hard at work

2:29 David Sachs is hanging out in the back of the classroom

3:03 Students hard at work. Great buzz in the room.

3:33 First blog posts on line soon

Posted by Dr. Bill Thomas on December 12, 2008 12:00 PM |Permalink |Comments (0)

April 7, 2008

Change We Can Live In

If you take a look at the left-hand column on my blog you'll notice a list of books that are Changing Aging. The Erickson School this Friday is providing a rare opportunity to hear from the author of the newest and one of the most influential additions to this list -- "Old Age in a new Age: The Promise of Transformative Nursing Homes," by prominent free-lance journalist Beth Baker.

I've had the privilege of talking to Beth numerous times in the course of her compassionate and insightful reporting on the transformation of long term care in America. Do you think nursing homes have to be a place of last resort? I highly encourage you to come and meet Beth Baker and learn how nursing homes are turning into transformative homes, and how this change will benefit us all.

WHEN: 1:30 p.m., Friday, April 11, 2008
WHERE: UMBC, ITE Building, Room 102

To RSVP, or for more information, contact Kathryn Gallagher at 443-543-5645 or kathryng@umbc.edu

Posted by Dr. Bill Thomas on April 7, 2008 9:28 AM |Permalink |Comments (0)

February 12, 2008

Masters Students Conquer Mountain of Knowledge

I have often noted that the Masters students at Erickson are exceptional people. I am honored to be called their teacher.

Here a are a couple of photos from last weekend's class meeting. The entire group worked together to synthesize the content from the Aging 600 course that I co-taught with Judah Ronch.

Good times!

And here is the product of that combined brain-power.

Posted by Dr. Bill Thomas on February 12, 2008 3:33 PM |Permalink |Comments (2)

January 28, 2008

Role of the Next Generation of Culture Change Advocates

[Note from Dr. Bill] Best part of my new job as a university professor is, hands down, the students. Below is a guest post from one of UMBC's best and brightest grad students. I'd like to extend an open invitation to all UMBC students, faculty and staff interested in Changing Aging to join our conversation. Enjoy --

Hello All!!!

First and foremost, I would like to thank Dr. Thomas for letting me guest post today. I am honored to have the opportunity to make my first post on such an active and important blog.

While my blogging name is JazzRespect&Heart my real name is Patrick Doyle. I am a first year doctoral gerontology student at the University of Maryland, Baltimore County (UMBC). My interests are in researching quality of care in long-term care and through this, furthering the progress we have already made in the culture change movement.

The goal of this post is to start an active dialogue on the future directions of the culture change movement and the role of beginning and aspiring gerontologists in this vision. So please don’t just read this post, take a second to comment with ideas and suggestions.

While the concept of culture change is relatively new, the history is rich. In the initial meetings discussing culture change, scholars in the field of gerontology gathered and shared revolutionary ideas about elder care. These ideas laid the foundation for a new and dignified elderhood. These scholars came away from the meetings determined to move from institutional care to a home-like care setting focused on the needs of the elder NOT the institution.

The pioneers of this movement were active advocates for change, which, I would argue has triggered a paradigm shift. This change in zeitgeist was difficult for many people used to the old system as it required a complete alteration in their weltanschauung (I figured I would add to the intrigue of the post by incorporating a few German philosophical terms). What sets new gerontologists apart is that for the most part, we were not taught that old method of care. Due to the efforts of innovators of culture change, the ideals now being taught closely align with the once revolutionary principles they advocated. From these teachings, students are molding their “world views” which leads to a greater adoption of the culture change philosophies.

I am not saying that all new gerontologists accept or are even aware of these concepts but that now more than ever there is a growing following in this movement. The bottom line is that in order to further culture change these students must become entrenched in the movement.

Here is the X factor:

As I see it, we have two generations in this movement – the innovators and the student supporters. For the culture change movement to maintain momentum in the upcoming years these students need to be dedicated, well-trained and knowledgeable in gerontology/culture change. They need to know what has been done, what has not; what works, what does not; what we have tried and where we are going….

Who can teach this better than the innovators themselves? I say no one. That is why I feel the most important thing for this movement is to form a close collaboration between the innovators and the students. Here is the million dollar question for everyone:

How do we accomplish this?

I have some thoughts but I want to hear yours!

(Commentary on specific roles of new gerontologists and the future of culture change would also be greatly appreciated!)

[Patrick can be reached at pdoyle1ATumbcDOTedu]

Posted by Dr. Bill Thomas on January 28, 2008 8:00 AM |Permalink |Comments (3)

January 3, 2008

Feel The Excitement

Later this month, Judah Ronch and I are co-teaching (along with a stellar guest faculty) a terrific course on collaborative approaches to long-term care...

CREATING COLLABORATIVE CULTURES IN SENIORS HOUSING & CARE: A PRACTICAL APPROACH
JANUARY 15-18, 2008
Judah Ronch, Ph.D., Professor, The Erickson School and
William H. Thomas, M.D., Professor, The Erickson School and Founder of The Eden Alternative and the Green House

Consumers drive change in our society, and the senior housing and care sector is becoming increasingly responsive to consumer demands. In the past, organizations could concentrate on the fundamentals of finance and operations and expect to flourish. Now, consumers (along with regulators, advocates and family members) want more. A person-centered organizational culture increasingly defines the core of success in this emerging market. Formerly "soft" goals like "dignity," "respect," "autonomy" and "meaning" are moving to center stage. How can leaders balance the new emphasis on "person-directed" cultures with the equally pressing need for effective management of capital and human resources?

Leading approaches to developing person-centered organizational cultures will be examined, including the strengths and weaknesses of each. Companies representing different person-centered approaches will share their real-world experiences. In addition to industry representatives, guests will include government officials from the Centers for Medicaid and Medicare Services, who will address regulatory issues, and author Beth Baker.

For more information, call Melissa Roane at 443-543-5646, email melissa4r@umbc.edu, or visit http://erickson.umbc.edu/.

Posted by Dr. Bill Thomas on January 3, 2008 3:46 PM |Permalink |Comments (0)

November 26, 2007

Wealth, Age and Society: Part One

First, I am going to ask for a little patience. This is a long-ish post and another of its kind might soon follow. The reason is that I am sorting through some new ideas and I think that the blog might be a good place to take them for a spin.

Here is the challenge: Is it possible to create an easy-to-understand, flexible, useful framework that can truly integrate aging, public policy and management?

Let’s start with the conventional wisdom...

Aging-- The aging of America (and the rest of the industrialized world) is a demographic “plague of locusts” which threatens the financial underpinnings of the status quo. (namely the greedy geezers are going to bankrupt us all)

Public Policy-- Policy-makers often present choices in terms of a zero-sum game. For example, if we expand eligibility for this program, we will have to cut the resources available for that program. Policy is seen, almost exclusively, in terms of the transfer of resources from one group or program to another.

Management-- Conventional business doctrine draws a bright line between the common good and the measurable performance of a particular organization. Whether the organization is for-profit or not-for-profit hardly matters, the most important thing is success in meeting particular quantified goals.

I can find exceptions to each of these statements but, for the most part, the exceptions will help to prove the rule.

Now the challenge is to find a way to unify these seemingly isolated domains. This will require us to gain access a deeper, much more fundamental level of meaning. My candidate for the role of unifier is...

Wealth

Before proceeding, I need to unpack the conventional wisdom of “wealth.” People, countries, communities and families who are said to be wealthy earn this distinction, almost exclusively, as a result of their ability to attract and retain financial capital and its equivalents. Wealth is equated with access to and control over financial capital. Money is what makes “rich” rich.

True Wealth

The definition offered above holds true as long as access to financial capital can be seen as an end in itself. The Forbes list of the richest Americans operates on that basis and its list is ranked according to a strictly numerical accounting. When we venture beyond the world of the marketplace, however, we can see other kinds of wealth on display. We can honestly speak of a “wealth of knowledge” or comment that a person is “rich in friendship.” It seems that there are other forms of wealth and that our society does a poor job of accounting for them. This is, I think, understandable in that financial capital is a strictly quantitative affair and so-called “social capital” is almost exclusively qualitative in nature. Just to be clear, I am going to define social capital this way...

“The net value of all of the voluntary, reciprocal, social relationships in which a person, or community, participates in over time

.”

I believe that I have the majority of philosophers and theologians on my side when I argue that real wealth is a hybrid that blends the virtues of access to social and financial capital.

Both are necessary...
Neither, alone, is sufficient.

Wealth Creation and Wealth Destruction

One more base to touch before we can begin using this “theory of wealth.”

When it comes to financial capital, we are immersed in powerful, highly accurate measuring, forecasting and tracking tools and methods. Just imagine walking into your local bank, asking for your account balance and hearing the teller respond, “Well I can’t say for sure, you see it sort of depends, on a lot of things, hard to tell, really. Now, is there anything else I can do for you?” Who would accept such an answer?

On the other hand, we find that considerations of social capital to be are bound to be inexact. “Hmmm. The value of the friendships that are part of my life? What my freely chosen, mutually beneficial relationships have contributed to my sense of well-being? That would be hard to say wouldn’t it?” Yes, that would be very hard to say.

As a result, the idea of wealth is gradually taken over (conquered really) by the equation of wealth and money. The “softer” side of wealth, in contrast, is exiled to the drugstore greeting card rack. Warmth. Sentiment. Love. Enduring commitment. Honor. Patience. Tolerance. Forgiveness. All of these thing, are at once vital to the “wealth” of every living soul and dismissed as strictly private, emotional matters.

A moments reflection show us that both financial and social capital can be created and destroyed over time. The accumulation of financial capital can be carried out skillfully and purposefully (recall the great “captains of industry”) or it can be a matter of plain dumb luck, such as a lottery ticket or an inheritance. Similarly, we understand that some people are able to build and maintain vast social networks which contribute to the quality of their lives in ways both tangible and emotional.

The same holds true for the destruction of wealth. Everyday, financial fortunes are lost as a result of poor management and the thoughtless assumption of risk. Everyday, the money that makes some people “wealthy” is lost because of chance events, runs of bad luck that disperse all that was gathered together.

We don’t often think of it in these terms (mostly because we are reluctant to see social capital as a legitimate form of wealth), but social networks, long a rich source of a person’s well-being can also be destroyed. Anger, jealousy, a grudge nurtured beyond reason, or the uncomplicated workings of misfortune, all are capable of damaging relationships and networks of relationships.

Wealth and poverty are complex phenomena which change with circumstances (that is they can be influenced but not controlled) and they involve matters that include but are not limited to access to financial capital.

Coming Soon...

The First Connection: Wealth and Age

Posted by Dr. Bill Thomas on November 26, 2007 1:28 PM |Permalink |Comments (2)

November 1, 2007

Age With Rage

Kavan Peterson, a crack writer and one of the driving forces behind this blog turned the spotlight in this provocative piece on the emerging power of the Aging Services sector of the American economy.

Aging Industries Ranked Among Most Lucrative Markets For Making Millions

Kavan works with us at the Erickson School and we are poised, IMHO, to make history. From its home-base on the University of Maryland, Baltimore County (UMBC) campus, the school will, in short order, have influence in every corner of the nation. Our school offers opportunities for incoming freshmen, transfer students, graduate students and people working in the field who seek premier Executive Education coursework. And yes we also have plans for world domination.

Great faculty, great staff, great campus, we are all about Changing Aging.

Posted by Dr. Bill Thomas on November 1, 2007 6:12 AM |Permalink |Comments (2)

September 30, 2007

The Masters

We just finished up the first week of intensive instruction for the students enrolled in the first of its kind Erickson School Masters of Aging Services Program. We have 27 students enrolled and they are an exceptionally strong group. The class discussions were lively and offered an excellent look into the successes and failures of the aging services field as it stands today. Judah Ronch and I rolled out our Aging 600 course (with a power assist from Chip Warner). Some might recall that the course revolves around Shakespeare's King Lear. Chip did a great job introducing the play to the students. Much more blogging to come on this as I think it represents the beginning of the beginning of a new generation of leaders.

Posted by Dr. Bill Thomas on September 30, 2007 3:31 PM |Permalink |Comments (1)

September 18, 2007

King Lear

The first ever Erickson School Masters of Aging Services class kicks into gear next week and I am team teaching the Aging 600 class with Judah Ronch. Our course looks at issues and controversies in aging and uses Shakespeare's tragedy "King Lear" as an central element of the course. I am going to be blogging on my experience with the class all semester and wanted to kick off the topic with a nice online illustrated story version of the play. You can also listen to me discuss Lear on NPR by clicking here.