Changing Aging

I encourage you to take a few minutes to read two articles that appeared in the Minneapolis Star Tribune on Sunday (links below).  They provide insightful context to the tremendous opportunities for innovation in our profession, and Ecumen’s role in living our mission, vision and values to help lead and shape that change.

We Want to Be the Choice for Customers’ New Choices

The first story, The New Idea in Elder Care: Membership, outlines the work we and another Twin Cities-based senior services provider, DARTS, are doing to adapt Boston’s Beacon Hill Village “virtual retirement community” model in Minnesota.  The Ecumen project is in Minneapolis, and it’s called Mill City Commons.  It’s being designed to empower people to “age in place,” so they have the choice not to leave the neighborhood they love if they don’t want to.  It also leads with the social dimension of successful aging rather than the medical dimension, while integrating both. Mill City Commons is paradigm-shifting work that’s challenging us to deliver our mission of creating home in a new way, while underscoring our vision for changing aging:  We envision a world in which aging is viewed and understood in radically different ways.

We’re Making Change, Instead of Waiting for it to Happen

Star Tribune political columnist Lori Sturdevant writes in the second column Budget-Hungry Nursing Homes are So Last Century how 70% of the government dollars spent on long-term care in Minnesota goes to nursing homes.  That’s not sustainable public policy, and it doesn’t match up with what consumers want.  That’s why we’ve been diversifying – and will continue to diversify - our services across Ecumen.

The column commends our profession for “looking forward,” and highlights a citizen’s workshop held last week by the Citizens League, a leading non-partisan public policy organization.  The workshop, which involved several Ecumen people focused on shaping ideas for providing and financing aging services.  Ecumen helped convene the workshop as part of our commitment to shaping “what’s next.” 

Two forces are coming full speed at our profession and country: new consumer expectations and needs to finance senior services in new ways.  What an incredible time to be where we are today: making change instead of waiting for it to happen to us.

At least 6 percent of Americans between the ages of 44 and 70, or 5.3 million people, are working in second careers with non-profits, governments, schools, or other organizations that benefit society, according to a new survey.

And half of the people in that age group who aren’t already involved in so-called “encore careers” say they would like to find such employment — a great opportunity for professions in aging.

The survey was commissioned by Civic Ventures, a charity in San Francisco that seeks to engage older Americans in civic activities, and paid for by the MetLife Foundation, in New York. It was based on telephone interviews with more than 1,000 people.

This is a cool mission statement:

To transform a source (the knowledge, talent and skill of the region’s 50+ population) into a force for enriching our community by helping individuals find meaning and the means to contribute to the greater good.

It’s the mission of Coming of Age, a Philadephia collaboration of four partners:  Temple University’s Center for Intergenerational Learning, WHYY Wider Horizons, the United Way of Southeastern Pennsylvania, and  AARP Pennsylvania. 

Coming of Age has three objectives: 

1.  Helping people age 50+ plan for the future;

2.  Promoting 50+ volunteering, learning, and community leadership;

3.  Working with nonprofits to recruit, train, and retain 50+ volunteers.  

Coming of Age is a great model for other communities who want to seize opportunities of an unprecedented age wave.  It’s fresh, invigorating, inspiring, fun . . . It’s also drawing dollars . . . Atlantic Philanthropies recently gave it $1.8 million to expand in other parts of the U.S.. . . . .

Do you know of any other communities that are doing this?

Changing Aging recently sat down with Dr. Andrew E. Scharlach, of the University of California at Berkeley, where he holds the Eugene and Rose Kleiner Chair in Aging. He also serves as Director of the Center for the Advanced Study of Aging Services, which conducts research designed to inform development of innovative and effective services for older adults.  It recently sponsored an international web-based conference on “Creating Aging-Friendly Communities” and  technical support through an ongoing “Community of Practice” is available here.

Dr. Scharlach, who also serves as a gubernatorial appointee on the California Commission on Aging, has published extensively on the needs of older adults and their families, particularly with regard to long-term care services, work and family responsibilities, bereavement, and gerontological social work education.

In addition to more than 40 articles, he is the author of Elder Care and the Work Force: Blueprint for Action (with B. Lowe and E. Schneider; Lexington Books, Controversial Issues in Aging (with L. Kaye; Allyn & Bacon), and Families and Work: New Directions in the Twenty-First Century (with K. Fredriksen-Goldsen; Oxford University Press).

 What are the biggest changes that you think we’ll see in U.S. community planning as it relates to preparing for vital aging communities?

 We’re going to and already are seeing older consumers more involved in the planning process in communities. Aging friendly initiatives and products will become the norm.  You’re going to see much more universal design in housing development.  You’re also going to see products that look good, have good design and that are functional.  Michael Graves, the renowned designer, is creating good and functional design of shower heads, tea pots and other products used in everyday life.  That will become more widespread in architecture and other community infrastructure.

How do you see senior housing changing for the age wave?

I see several different areas for change.  I think you’re going to see more housing that’s built for a lifetime, e.g., universal design.  That’s going to lead to communities that are more intergenerational.  I think senior housing providers also will move more outside of their traditional bricks and mortar, where they help create virtual senior communities by delivering services to people in their home.  Technology is going to play a much greater role.  We’re already starting to see that with sensor monitoring in people’s homes.  That technology is going to have to increase because we’re going have many fewer caregivers. I also think there will be more peer support and less reliance on family care.  Communities that are known as “good places to grow old” are where people will want to live.

What are examples of U.S. communities you’ve seen that “get it” when it comes creating aging-friendly communities?

There are a number of communities that are seeing aging as an asset and working to be livable for a lifetime in different ways. Atlanta has a large initiative called Aging Atlanta, which is part of their regional planning and is focused on making Atlanta a place people want to stay.  The University of Indiana has a Center for Aging and Community under the direction of Dr. Philip Stafford that has been doing a lot of work in this area to help communities become lifespan communities.  Fremont, California, is another one that is doing community-wide work to help people live and stay in Fremont to the end of life.

 

By 2050, the U.S. will have more than a half million centenarians.  Assuming a shortage in professional caregivers, how do you see family care changing for this unprecedented demographic shift?

Technology is going to have to play a critical role.  Robotics are going to take on some roles that were traditionally done by humans.  You’re also going to have nurses checking in with patients by video or by computer via sensors.  We’re going to have to think very locally.  Neighbors are going to have to look out for neighbors.  Community design also is essential for this.  Buildings have to be easy to live in and easy to navigate for people who have disabilities.  You can start to see how the unprecedented age wave in the U.S. will impact just about every area of our society.  Communities can’t plan in silos.  There are a lot of interconnections and intergenerational ties to this.

 What do you want old age to look like for you?

I want to be socially connected.  I’d like minimal physical impediments, and I want to be able to maintain meaningful activities and relationships without undue pressure to maintain the functional levels of earlier years. There’s this image in America that to age well, you have to be jumping out of airplanes or running marathons. Not true. Healthy, successful aging is about enjoying life – not speed or intensity.

 

Policymakers across the country are wondering what to do about rising health care costs and increased needs for aging services coming from the age wave. Ecumen CEO Kathryn Roberts discusses this in the article below, which appeared on the editorial page of yesterday’s Saint Paul Pioneer Press:

Deliver the Right Care in the Right Place at the Right Time

Minnesota spent $553 million on elder care last year. If the age wave and status quo continue on parallel tracks, we’ll soon hit unsustainable budgets and intergenerational conflict.

You get a flavor for that right now as state policy-makers do their biannual budget dance with the elephant in the room — aging services.

Gov. Tim Pawlenty’s budget proposal slices more than $130 million in aging services over the next eight years, most of it from nursing homes. The Senate would delay a 2 percent cost-of-living adjustment to homecare employees, while the House would make no cuts and give nursing home workers a 2 percent pay increase. Even with a budget deficit, cuts to government-funded nursing homes aren’t the right tactic now.

Most people don’t want to live in a government-funded nursing home. But 30,000 Minnesotans rely on their care. Because nursing home care is mostly paid for by government dollars that don’t cover the costs of care, many nursing homes have less than 10 days’ cash on hand. Choosing between payroll and innovation isn’t a choice. The silver tsunami requires transformative thinking, not shortcuts to a dead end.

Most people don’t need “long-term” care and million-dollar nursing home stays. But serious disconnects in our patchwork health system often lead to institutionalizing people, over-doctoring, draining will and devouring public dollars.

In a coordinated, localized short-term care system, people would move much more
easily and with greater confidence from the hospital to coordinated care and services. A nursing home would be a specialized medical respite center for rehabilitation and chronic care management, not an underfunded institution where someone recovering from a hip replacement shares a wing with an Alzheimer’s patient. It also wouldn’t have the overhead of hospitals’ emergency services, surgery suites and birthing centers. And it would pay providers based on the value we bring to the person and to coordinated health care.

This is all about delivering the right care in the right place at the right time. If you’re not at the hospital or respite center, you’re in your own home or an assisted living facility served by professionals. A coordinated short-term care system is also predicated on not turning assisted living into a mega-regulated nursing home that thwarts independence and suffocates people’s willpower.

In a paradigm-shifted approach, the respite center could be the medical home for chronic and elder care — the technologically connected hub that coordinates all therapy and services among settings.

That future is emerging in Duluth, where we’ve replaced an outdated nursing home with a short-term care center and independent, assisted-living and memory-care apartments. The focus is on getting people better so they can go home. If they need more care, it’s coordinated at an Ecumen-managed nursing home. Of 700 people we served last year at the short-term care center, only 30 went to the nursing home.

A short-term, coordinated care system would be efficient and proactive. And it would lead with self-empowerment, which today too often gets compromised.

Other states recognize this. In Oregon, you would spend less time in a government-funded nursing home than would nursing-home residents of any other state. Why? Oregon puts the biggest percentage of government dollars toward self-directed home care rather than institutional care.

Why can’t Minnesota seniors who qualify for government-paid care self-direct that care at home? They can, but few people know about the state’s initiative called Consumer Directed Community Supports. In fact, it has only about 400 enrollees. Many of the thousands eligible will likely have more expensive nursing home stays in today’s mouse-in-the-maze health system.

Minnesota had 69,000 seniors in 1950. We’re now approaching a million, many of whom will need some physical assistance. In the short term, we must forge a long-term strategy for growing old in Minnesota, not keep taking short cuts to a dead end.

Kathryn Roberts is president and CEO of Shoreview-based Ecumen, Minnesota’s largest nonprofit senior housing and aging services company. She was recently appointed to the Minnesota Veterans Health Care Advisory Council.

In many ways aging and aging solutions are local.  Ohio takes that to another level by passing property tax levies to help fund aging services and supplement shrinking state and federal government funds. 

It All Started With Lois

In the late 1970s a retiree named Lois Brown Dale was looking for financial support to build and operate a senior center in a small county in Southwest Ohio. She believed the public would support such an effort through local taxes but was informed that placing such a referendum on the ballot would require special legislation. Undeterred, she successfully lobbied the Ohio legislature to allow counties to earmark local funds for elder services. More than wenty-five years later, 59 of Ohio’s 88 counties have property tax levies raising nearly $95 million for services for older people.

A 90% Passage Rate

- These levies vary greatly from county to county in size and revenue generated, from a .10 mill levy raising $9,000 a year to a .85 mill levy collecting $21 million in the same time period.

- The specific services most often funded by these levies include nutrition, transportation, in-home services (such as home-delivered meals and home health aides) and senior center administration.

- More than 90 percent of Ohio’s senior service levies have been successful at the ballot box, with an average passage rate of 65 percent of the vote.

. . .  Enough with the headlines that depict seniors like neanderthals who live in a cave.

Here’s one today from the Hartford Courant:  Seniors Unexpectedly Receptive to New Technology.

 HELLOOOOOOO  . . . . yes, seniors do use technology, they work out, they work, they breathe, they have sex, they’re human beings.  And pretty soon America’s going to have more people with seniority than we’ve ever had. 

Time for media, policymakers, businesses and every aspect of our society to get real to America’s new reality.

If you want to read how technology is changing aging services, download our technology whitepapers or visit our technology section, where you can find other resources such as the Center for Aging Services Technologies.

 Keep it Real.

“It took me nine-months to plan for a baby; I only had 9 hours to prepare for my father’s care.”

I recently heard that statement, which rings true for thousands of Americans.

Caregiving is becoming a hot topic.  Here are a few pieces of that rising heat from the last 24 hours:

- One of the highest-attended sessions at Mary Furlong’s “What’s Next” Boomer Summit yesterday in Washington, D.C. was on caregiving.

- At the Boomer Summit, best-selling author Gail Sheehy discussed her work on the future best-seller, which will come out next year about the next “green movement” caregiving. 

- Today H.R. representatives from Twin Cities companies and other organizations gathered at Twin Cities Public Television to watch an advance screening of the PBS documentary “Caring for Your Parents,” which will premier next week.  A number of those participants shared how “caring for parents” is becoming a significant issue at their workplaces.

-And AARP just launched a new interactive caregiver resource web site.

The heat is rising . . . because we all feel or will feel it.

The SmartSilvers Alliance is an thought-provoking Silicon Valley group that sees technology as key to active, successful aging.  They’ve compiled a 10 Things to Know About The Silvers Market llist below.   While many Baby Boomers aren’t representative of these stats, these are interesting figures around the large wave of Americans who have seniority next.  To read more about technology in aging services, we invite you to visit our whitepaper library.

1. An American turns 50 every 8 seconds — that’s over 10,000 people every day (AARP).  That makes it the fastest growing population segment.  
2. 78 million Americans who were 50 or older as of 2001 controlled 67% of the country’s wealth, or $28 trillion (U.S. Census and Federal Reserve). Adults 50+ account for an estimated $2 trillion in total expenditures for 2005.
3. The 50+ have $2.4 trillion in annual income, which accounts for 42% of all after-tax income (U.S. Consumer Expenditure Survey)
4. One-third of the 195.3 million Internet users in the U.S., 50+ silvers represent the Web’s largest constituency  (Jupiter Research) — that means  2/3 of Americans age 50-64 use the Internet (SeniorNet).
5. Email is the most popular online activity among 50+ users, followed by web browsing, research, and shopping  (ThirdAge and JWT Boom).
6. 72 percent of baby boomers have broadband Internet in their homes (ThirdAge and JWT Boom); they watch more TV than any other group.
7. Adults 50+ spend an average of $7 billion online annually (SeniorNet). Silvers Account for 40% of total consumer demand
8. The Internet is the most important source of information for baby boomers when they make a major marketing purchase, such as automobiles or appliances (Zoomerang).
9. 82 percent of adults aged 50+ who use the Internet research health and wellness information online (Pew Internet and American Life Project).
10. Contrary to popular belief – Silvers are not fanatically loyal to brands in fact 96 percent of baby boomers participate in word-of-mouth or viral marketing by passing a product or service information on to friends (ThirdAge and JWT Boom).

The Silvers  purchase:  41 percent of all new cars,  buy 25 percent of all toys (spend over $29 Billion annually on gifts for grandchildren),  go on 80 percent of all luxury travel trips , buy 60 percent of all healthcare products,  74 percent of all prescription drugs, and 51 percent of all over-the-counter drugs.  Plus they visit malls more often than any other age group and dine out 4-5 times per week.   (various sources)

People even get old in Aspen, Colorado . . .

Pitkin County, which encompasses Aspen and Snowmass Village, is embarking on a senior housing and services study to determine what kind of senior housing and aging services this ski mecca needs.

This quote in the Aspen Times by Ken Canfield, head of the Aspen Steering Committee, sums it up for a lot of people in a lot of American communities:

“Our goal is to find a way to provide senior living here so that our longtime residents and those who love the Aspen lifestyle don’t have to move away to retire,” Canfield said. “Just because we’re older doesn’t mean we’re willing to sacrifice the lifestyle and friendships we’ve established here in Aspen.”