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A Newspaper's Lens into the Changing World of Aging and State Budgets

A lot has been made of the demise of newspapers, but they're so essential to a community's growth and evolution by highlighting ideas and trends community-wide, which can become levers for new ideas and, ultimately, action and innovation when people coalesce around them.  Take, for example, the subject of aging and government costs.  In Minnesota's largest newspaper - the Minneapolis Star Tribune - the last three days, you could see this issue twisting and turning toward a new place:

There was an op-ed article by David Olson, head of the Minnesota Chamber of Commerce, a major part of it declared Minnesota isn't prepared for an aging population:

. . . Changing demographics are at the crux of Minnesota's ongoing budget shortfalls. The warnings have sounded since the mid-1990s, but too many policymakers are deaf to the alarms.  An aging population is demanding more public services, especially in health care. That portion of spending alone, if left untouched, is poised to increase 37 percent in the next two years . . .

There was today's Star Tribune article by Warren Wolfe, which outlined the hit long-term care would take in Governor Dayton's budget, with the Republican budget to follow . . .

. . . . When Governor Dayton chose to protect K-12 education and state aid to local governments -- two of the "big three'' slices in Minnesota's budget pie -- it set him up to have to turn to the third slice: health care and human services . . .

 . . . Overall, Dayton's budget would save $775 million in human services programs, though the actual cut in payments is about $383 million because Dayton proposes certain revenue-raising strategies through increased surcharges on nursing homes, hospitals and health plans.

Of the net spending cuts, $87 million would come from Medicaid payments for long-term care -- $50 million, or 6.4 percent, from nursing homes, and $37 million or 11 percent, from the Elderly Waiver program, which aims to keep people out of nursing homes . . .

And then on the Star Tribune editorial page today new Minnesota Health and Human Services Commissioner Lucinda Jesson discussed managed care and getting the best value:

 . .  . to get better value for our state dollars, we must not merely review how we pay for care; we must actively explore new ways to pay for it.

Just as we, as patients, want to hear about cutting-edge best practices to keep our bodies healthy, so our state needs to move to the forefront when it comes to how we pay for care so we can keep our state finances healthy . . .

Demographics is one of our world's biggest drivers of innovation, because you can actually see the demographic change ahead.  And in the articles above, you can see that in the world of changing aging, staying the same isn't an option.  It's why a host of organizations in Minnesota recently came together to develop new ideas for aging and funding at the non-partisan Citizens League.  Read their ideas here.  It's why the report Prepare Minnesota for Alzheimer's 2020 was recently born.  And, on a national level, it was why the CLASS Act is being shaped.  We're all aging.  And we all need to be part of shaping a future that is better.


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What’s possible in the second half of life?

Civic Ventures, a nonprofit think tank on boomers, work and social purpose, has created the Purpose Prize. The focus is on encore careers – jobs that combine personal meaning, continued income and social impact. The prize focuses on investing in people age 60+ who are changing the world. Five people win $100,000 each, and an additional five, called fellows, win $50,000 a piece.

2010 Winner Inez Killingsworth helps homeowners avoid foreclosure by negotiating with banks for more favorable terms on mortgages. Counseling schools on the best ways to engage seriously disabled students, Donald Stedman then helps to assess technological and teacher training needs. Judith Van Ginkel leads a program that provides in-home services for first-time, at-risk mothers – including parenting support – to improve the lives of young families.

Know someone you'd like to nominate? or would like to learn more about purposed-filled careers the second half of life? Check out encore.org.   ~Helen Rickman


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Author of Dementia Beyond Drugs Discusses Ecumen's Awakenings Initiative

G. Allen Power, MD is author of Dementia Beyond Drugs, Eden Mentor at St. John’s Home in Rochester, NY, and Clinical Associate Professor of Medicine at the University of Rochester. He is a board certified internist and geriatrician, and is a Fellow of the American College of Physicians / American Society for Internal Medicine.  He's also a contributor to Bill Thomas' M.D., Changing Aging blog, where today he discusses Ecumen's Awakenings initiative.


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Multigenerational Housing: Would You Live with Seniors and Would Seniors Live With You?

A couple of years ago I was with some Ecumen colleagues on a trip to another part of the country for some market research.  We were visiting a really nice CCRC (continuing care retirement community).  It had really nice townhomes and assisted living and memory care, even a children's day care center. It was a cool neighborhood. I asked one of our hosts if they ever thought about creating housing where anyone could live regardless of age?  She looked at me like I had three heads and said:  "No way.  It would never work."

Maybe that's true for some people.  But it's not true for all people.  And that's going to create new "senior housing opportunities" that are simply "housing opportunities" in communities that are truly for a lifetime. 

More on this topic at our senior housing development blog  . . .


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Ecumen Work to Reduce Antipsychotic Medications in Nursing Homes Covered in New York Times

The New York Times today has a great story on Ecumen's Awakenings initiative to reduce the use of antipsychotic medications among Alzheimer's and dementia patients in nursing homes.

  • According to one report, Medicaid - which pays for most nursing home stays in America and kicks in after a person has spent into poverty - spends more than $5 billion on antipsychotic medicines, which is more than it spends on any other class of drugs, including antibiotics, AIDS drugs, or medicines to treat high blood pressure. 
  • Statistics vary from state to state, but anywhere from 17%-45% of nursing home residents across the U.S. are prescribed antipsychotics.  
  • Moreover, according to a study published in the Journal of American Geriatrics Society, more than half are prescribed inappropriately to control dementia-related behaviors even though there is no mental illness diagnosis.
  • The U.S. Centers for Medicare & Medicaid Services (CMS) reports that about 30% of nursing home residents receive antipsychotic drugs, and approximately 20% do not have a psychosis diagnosis.

There is a better way.  And through Awakenings, which is supported by a $3.8 million grant from the State of Minnesota, we are working to achieve it and empower the people we serve in our nursing homes.  It's not easy work, but it has to happen. For additional information on Awakenings, please go here.


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Love Story in the New Old Age from Ecumen Lakeview Commons

L to R: Jim McShannoch, Irene Filkins, and Ecumen colleague Cathy Collins

Every love story is unique.  Jon Tevlin of the Minneapolis Star Tribune recently sat down with Ecumen customer Jim McShannoch, who shared his journey of love at Ecumen Lakeview Commons and the relationship he shares with his wife, who has Alzheimer's, and his neighbor Irene Filkins, to whom he is engaged.  Here is Jon's column in today's Minneapolis Star Tribune.


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Ecumen Lakeview Commons and VisitingOurs Skype to Bring World Closer Together

Ecumen Lakeview Commons in Maplewood  is partnering with community volunteer Tom Sweeney on a pilot.  Sweeney heads a volunteer organization called VisitingOurs, which is matching volunteers with seniors to use laptop computers to conduct video chats between family members who live far away.  Our customers dig it, and it shows how technology makes the world much smaller, but also how the human touch makes use of the technology possible.  It also gives us insight on how we can integrate the video chat function on the social networking tool Ecumen Connects.  More information is provided here at Ecumen Lakeview Commons site.


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Hip Mill City Commons Hosts Hip Discussion on Changing Aging

Last night a very energizing, provocative discussion on the future of aging was held with about 50 members of Mill City Commons in Minneapolis, a cool neighborhood for a lifetime. 

Moderated by Ecumen CEO Kathryn Roberts, panelists included: Marcia Townley, chair of the Mill City Commons Board of Directors; Peter Hutchinson, president of the Bush Foundation; Rep. Paul Thissen, minority leader in the Minnesota House of Representatives; and Stacy Becker, who oversees aging financing work for the Citizens League.

A few of the many golden nuggets heard last night:

We have to tackle chronic care and stop putting acute care and sub-acute care in separate buckets. . . if we don't, there will be no money for anything.

I know an orthopedic doctor who treats an obese 40-year-old.  But his practice doesn't want him to talk to that patient about "prevention" and weight loss . . . it's only about the joint replacement. . . . the procedure . . . not prevention.

What legacy do boomers want?  How will they become part of the solution in an aging world?
 

Everyone talks about the boomers.  But the generation before the boomers - those who did a lot of major lifting on major issues such as civil rights - are changing aging.  They're the ones who have innovated, creating communities such as Mill City Commons.

A panelist's brother died at a a leading hospital in Minnesota, and it cost $51,000 because they didn't know he had an advanced directive. 

We have to think about dying now.  It should be a patriotic duty to have a living will

Cities need to be part of changing aging with updated zoning laws.  In many cities you can't have 4 people living together under one roof who aren't related.  But that's exactly what four people might want to do to age in place and stay out of a nursing home.

We have to change public policy for long-term care financing. We have to change the incentives.   It would have very positive long-term impacts on the state budget and on people's lives. 

Think about this:  Right now in Minnesota a spouse can be working making $250,000 per year, her spouse can go into a nursing home and qualify for Medicaid.  The nursing home cost is totally covered by the state, with no contribution from the spouse making $250,000 per year.  


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Ecumen Named Best Place to Work By Minnesota Monthly

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Absolutely essential to high-quality senior services is a high-quality, engaged workforce.  We're honored to be named by Minnesota Monthly as one of Minnesota's Best Places to Work.  The issue is on newstands now in Minnesota.  Congratulations to our nearly 4,000 team members who bring our mission "to create home for older adults wherever they choose to live" to life daily.  To learn more about Ecumen jobs and The Ecumen Way, visit our employment area.


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Will America See a New Green Senior Housing Category?

One of the country's fastest changing professions is senior housing and services. As I was reading the news about the new LEED-certified green senior housing that Ecumen recently developed for North Country Health Services in Bemidji, Minn., I'm wondering if we're going to see a new housing category in America - green senior housing?   

Think about land use.  My colleagues who develop senior housing often talk about the need to build not just one-off housing, but to develop "villages" that contain nearby shopping, multi-generational housing and other amenities that provide easy access for people and use land in a more effective way.  Do you think America will see more green senior housing?