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Jim Klobuchar: Suddenly, A World With a Pulse

Happy New Year from Changing Aging!!!Would like to start off this year with a post about rejuvenation from our guest blogger Jim Klobuchar, adventure traveler and legendary newspaper columnist.

Suddenly, A World with a Pulse

My friend emerged from the self-inflicted doldrums of retirement a few days ago to announce that he had been rescued, and he is now aflame with the gifts of a restored passion.He identified his rescuer as the late Ludwig von Beethoven. After I read the account of my friend’s deliverance, I added an asterisk to include a departed little lady as one of his anonymous angels.My friend taught economics for years at a prominent eastern university. Since his retirement he and his wife have traveled often and experienced scenes and sensations that were rewarding. By his own confession, though, he has lived a life-both on campus and in later-- with head 'buried in texts, ordered by logic and hard evidence, with few opportunities to develop an openness to the higher ranges of emotions...'This is a serious admission, friends. But the condition didn’t vanish when he retired, and it didn’t seem particularly reversible.Yet how much do we really know about the odd linkages in our lives that can suddenly unleash a core identity in us, a thrill we never expected no matter our age or our resistance to something suspiciously new.I have to introduce my mother here. Convinced that I was going to be the next Rachmaninoff of the keyboard, she insisted that I should take piano lessons despite the evidence coming out of our old upright when I played Mozart. After four years she ended the unequal battle and I went back to football. But the seed she planted was stubborn and in later years I came to love serious music and to play it. A few months ago my friend and his wife visited and I invited them into my music room to hear and see a DVD of Beethoven’s Third Symphony, conducted by Claudio Abbado. With today’s technology one can create a whole library of the masters, and now on a spread screen you can immerse yourself, almost physically, in glorious music here and now, at hand.My friend wrote a few days ago. They have retooled their TV and expanded the sound. They have fled their formal dining room and become unapologetic snackers, taking their meals surrounded by Beethoven, Schubert, Shostakovich and Puccini. I’d told them that the adagio movement of Brahms 2nd Piano Concerto was so serene and wistful and so touched with longing it would bring them to tears.'It’s an absolute joy,' he wrote. 'experiencing pure beauty so close, with such intimacy.'I thought, 'This one is for you, mom. But don’t remind me of Beethoven’s 'Fuer Elise. Too many notes!' I still can’t play in right.

You can read last month’s post from Jim here.

by origineight

Senior man and woman having coffee at table seen through window

Cookbook Medicine Doesn’t Work for the Elderly

If you’ve ever had the opportunity to bring a 80+ year-old person with chronic illness into a primary care physician, you may have had an experience where you wonder if the doctor sees a a living, breathing human being there. What we’ve seen happen a number of times in our family with my wife’s 87-year-old mom, who has several chronic illnesses, is a very narrow questioning by the physician that doesn’t really take quality of life into concern at all. This is by no means an isolated incident. But after one of these incidents, you can see how physicians and senior services professionals could work so much closer together in managing chronic care and improving quality of life to the end of life. For a look at this emerging future, check out Jane Brody’s articles today in the N.Y. Times on the new Martha Stewart Center for Living (we need this in Minnesota).

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Happy Holidays From Ecumen

Holiday wishes to you from Ecumen.There are a number of holiday traditions at Ecumen communities. Today, we’d like to share with you one of them. Glen Glancy is the leader of dining services at Lakeview Commons, an Ecumen community in Maplewood, Minn. Each year Glen creates a beautiful Gingerbread house for the Christmas season. It’s a big hit for all who live and visit Lakeview Commons, especially area school children. Below are some of the key stats on Glen’s Gingerbread creation this year:- It took 120 hours to build.- The icing is comprised of 30 lbs.- 20 lbs. of Gingerbread were used.- Features 30 different kinds of candy.- All the building are lighted and it features a working fire engine.-

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Twin Cities Aging Policy Summit: Vision for the Future

For our Twin Cities-area readers, you’re invited to register for the Aging Policy Summit: Vision for the Future:When: Tuesday, January 13, 2009 from 8 a.m. to noon.Where: Wilder Center Auditorium, 451 Lexington Parkway, Saint Paul, MN 55104What: A look beyond the financial challenges of the 2009 legislative session. Exploring how Minnesota can affirmatively respond to the coming demographic age wave of seniors as the Baby Boomers retire. Audience participation sought to help shape legislative proposals for the 2009 session. Speakers will include national AARP board member Skip Humphrey; Jean Wood, exec. dir., Minnesota Board on Aging and Paul Anton, chief economist at Wilder Research, as well as a legislative panel.Fee: General Audience: $20; Age 60+: no fee, donation requested to Vital Aging Network.To Register: Go to www.mnlcoa.org or www.vital-aging-network.orgThe program is also co-sponsored by the Minnesota Board on Aging.

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Nuns Turn to Cookies to Finance Long-Term Care

A salute to these nuns in Cleveland for their entrepreneurial spirit, but it’s a shame that in this country, we have nuns having to turn to cookie baking to pay for long-term care. The Sisters of the Holy Spirit have started a cookie baking business to pay for long-term care because Medicaid doesn’t cover the cost of delivering that care at the Jennings Center for Older Adults in Garfield Heights, OH. Time for our country to get entrepreneurial and transform how we pay for long-term care in the United States … . cookies aren’t going to do it for everyone.If you’d like to order NunBetter cookies, go here.

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A Telemedicine Disconnect


Here’s another example of how traditionally segmented areas of care are merging and technology is the connector. And another reason why we have to change an antiquated way of paying for care.Dan Gunderson of Minnesota Public Radio had an interesting story the other day on telemedicine being used in Wadena, Minn., at Tri-County Hospital. Tri-County Hospital uses telemedicine to provide consultations for residents of the nursing home. It’s a win-win. It allows nursing home staff to talk directly to hospital staff, saves people from having to travel (especially nice on a below-zero day such as today). A study in Maine found an average savings of $580 for each nursing home patient seen with a telemedicine appointment… .… Seems like an obvious way to save costs and improve services to patients, right?There’s a catch … Most nursing homes don’t have the technology and can’t afford it under today’s government reimbursement system. Telemedicine equipment that cost $55,000 a decade ago can now be purchased for $5,000. Too bad we haven’t made the same jump forward in changing how we finance care and integrate services to better serve the patient.

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How is State Budget Money Being Spent? Look at Long-Term Care Says Pioneer Press

The editorial folks over at the St. Paul Pioneer Press wanted to see where the rising dollars of government health care are being spent in Minnesota, so they went and talked with folks at the Departments of Human Services and Management & Budget. (Governor Tim Pawlenty cited a 21 percent increase in state spending on health care as a major driver in Minnesota’s $5.28 billion budget deficit.)Among many things they learned, here are two interesting points:- It’s not the cost of insuring state workers that is spiking. It’s the cost of providing health care and related services to poor, seniors and disabled people. These include direct health care services, such as hospital and physician visits, nursing home services, home care and other medical and long-term care services.'- The bulk of the growth is in the state’s version of the federal Medicaid program, known in Minnesota as Medical Assistance or MA, which pays for most nursing home costs in the state.Think it’s time for long-term care financing reform. Read the full Pioneer Press article here.

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Minneapolis Star Tribune: A Growing Price Tag for Long-Term Care

Following is an excerpt from a Minneapolis Star Tribune editorial yesterday on long-term care financing …

While poor children, their parents or pregnant women make up the majority of Medicaid enrollees, two-thirds of the Medicaid budget is spent on the elderly and disabled. One-third of the program’s total spending goes toward long-term care, which is why reform here could yield dramatic savings and benefits. Unfortunately, while there is traction in Washington and at the state level for medical health care reform -- especially in Medicare -- long-term care finance has not been enough of a priority. It’s been completely absent from the health care reform debate at the state level so far,'' said John Tschida, Courage Center’s vice president of public affairs and research.That has to change. Overhauling long-term care doesn’t mean starting from scratch. Proposals to revamp Medicare -- rewarding high-quality providers and finding ways to deliver services efficiently-- also make sense for Medicaid. In addition, there are a number of thoughtful proposals to increase the number of people who buy long-term care coverage -- from tax incentives to public-private insurance programs. One idea worthy of more discussion -- a public-private savings plan modeled on an initiative from the American Association of Homes and Services for the Aging -- was advocated on the opinion pages this week by Kathryn Roberts, CEO and president of Ecumen, and Jan Malcolm, CEO of Courage Center.Read the full article here.

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Ecumen’s Kathy Bakkenist Discusses Technology on The Daily Cafe

[youtube]http://www.youtube.com/watch?v=WCggLxEbJ8s[/youtube]Technology is an essential part of changing aging.' Yesterday, Kathy Bakkenist, Ecumen’s chief operating officer and senior vice president of strategy, appeared on the show 'Daily Cafe' in New York City discussing the use of QuietCare technology at Ecumen. Daily Cafe is a co-production of NBC and Retirement Living TV. We’ve provided the clip above for you to view.(Yes, the co-host is Fred Grandy, the former Iowa congressman, most recognized as 'Gopher' from The Love Boat show.)

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Minnesota Can Be a Leader on Long-Term Care Financing

Ecumen’s CEO Kathryn Roberts and Jan Malcolm, CEO of Courage Center and former Minnesota Health Commissioner, had a joint op-ed in today’s Minneapolis Star Tribune on developing a new way to finance long-term care. Below is the text of the article.StarTribune.com

Minnesota Can Be A Leader on Long-Term Care

By KATHRYN ROBERTS and JAN MALCOLM

December 8, 2008

Designer Michael Graves gazed upon the crowd from his wheelchair at a Courage Center fundraiser and exclaimed, 'Welcome to the new normal.' He was referring to the unprecedented number of people living longer with physical challenges -- a reality that means we have to approach how we pay for tomorrow differently.Nearly a quarter-million Minnesotans -- young and old -- use an assistive service or need long-term care. They’re friends, family members and likely someday us. To be a healthy state -- physically and fiscally -- we must mix personal responsibility and the common good to transform how we pay for long-term care, those diverse services that help people maintain well-being amid physical challenges.Medicaid expenditures for long-term care in Minnesota are among the country’s highest -- nearly $2 billion -- and steadily growing. Our government care system is frustrating to navigate and are biased toward institutional living. Per capita, more people here live in nursing homes than do in most states. And while some nursing homes have rebuilt and diversified services to serve people better, others can’t afford to.Medicaid doesn’t cover what it actually costs to provide this care; hence, a continuous cycle occurs of scraping together financial Band-Aids at the State Capitol for a systemically underfunded care system. Cutting services is a short cut to a dead end, even in bad budgetary times. There’s no meat on this bone.
To go beyond this ineffective cycle, we must change how we fund long-term care and connect people to services that work best for them. Long-term care often isn’t care for the long term but rather a mix of services -- from technology to assisted living -- that support self-determination and independence. Needing such services is a risk, not a certainty. But many people -- even diligent savers -- find themselves bankrupted by today’s system. Private insurance policies are a solution for some. But relatively few people purchase long-term care policies, and many with preexisting health conditions can’t get them.To be an innovation state, we must create a comprehensive solution that lets people self-direct services that best fit their needs, increases personal savings and ensures a strong safety net. A Minnesota Empowerment Initiative could do that. It would be a public-private savings plan patterned after a framework in place by the American Association of Homes and Services for the Aging. A national solution would be wonderful, but we can’t afford to wait for Washington. Minnesota must lead.Affordable premiums -- not state general revenues -- would fund the savings plan with low overhead and an all-inclusive risk pool. Benefit levels would provide for a foundational level of services consistent with ensuring the plan’s actuarial strength. After vesting, a person of any age could access funds as demonstrated by physical need. Beneficiaries would self-direct cash benefits. Not all will use the benefit; others will use it longer. An independent state-chartered organization could manage the Minnesota Empowerment Initiative, which we’d see as funded largely by opt-out personal savings. People of very low income could receive a state match to participate. Not all expenses would be covered, opening a door for insurers' supplemental plans adorned with a State Good Housekeeping seal to increase product appeal.The Minnesota Empowerment Initiative would promote consumer choice, ease and equitable benefits; would ensure a safety net for those in poverty; would reward innovation, efficiency and competition; would integrate medical care and community-based services; would bolster family and informal caregivers, and would promote personal and state financial responsibility. Most importantly, however, it would allow people to access services and care in a place that they most want to call home. And that’s a new normal Minnesota can and must achieve.

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