Reducing Antipsychotic Medications in Nursing Homes - Ecumen Awakenings Initiative
In six months, Ecumen colleagues at Sunrise nursing home, working with physicians, residents, and family members in Two Harbors, Minnesota eliminated the use of psychotropic drugs and decreased use of antidpressants by half. Eva Lanigan (above, left), an Ecumen clinical director who led this work, told the Minneapolis Star Tribune in a article yesterday:
"The chaos level is down, but the noise is up -- the noise of people laughing, talking, much more engaged with life. It's amazing."
Now based on the work of Eva and her team, Ecumen is bringing this drug-reducing strategy to Ecumen's 15 other nursing homes. Helping make the work possible is a multi-million dollar grant from the State of Minnesota. The initiative is called "Awakenings," because people are literally awakening.
This is important work (see stats below) and hard work. But we know it will make lives better and provide insights for our entire profession. It is changing aging.
Did You Know?
- In 2005, Medicaid spent $5.4 billion on atypical antipsychotic medicines, which is more than it spent on any other class of drugs, including antibiotics, AIDS drugs or medicines to treat high blood pressure.
- According to a study published in the Journal of the American Geriatrics Society, more than half are prescribed inappropriately to control dementia-related behaviors even though there is no mental illness diagnosis.
- According to a study published in the Journal of the American Geriatrics Society, more than half are prescribed inappropriately to control dementia-related behaviors even though there is no mental illness diagnosis.
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Visit our YouTube channel to learn more about this initiative and others at Ecumen.
You're Invited as Minnesota Unveils New Ways to Pay for Long-Term Care - December 14
“In only a few generations, ‘old age’ has gone from limited survival after retirement to ‘middle age’ with almost twenty years of life ahead at retirement. But we’ve not prepared as individuals or as a state on how we’ll pay for the huge costs that accompany old age. With the first baby boomers retiring in 2010, the time has come.”
- Stacy Becker, Citizens League Long-Term Care Collaborative
For the last year and half the non-partisan Citizens League's Long-Term Care Collaborative has been working on developing new strategies for Minnesotans to pay for long-term care. The Citizens League Long-Term Care Collaborative is comprised of multiple sectors and diverse ideologies, including senior services, health care, non-profit, business, government, social services and philanthropy.
The group's recommendations will be introduced by the Citizens League's Stacy Becker at a free long-term care financing solutions conference at the University of Minnesota Humphrey Institute on December 14 from 8 a.m. to 12:15 p.m. at the Humphrey Institute's Cowles Auditorium. The discussion will also include insights on the CLASS Act from Washington, D.C. Partners in presenting the conference are: Aging Services of Minnesota, the University of Minnesota's Center for the Study of Politics and Governance, American Association of Homes and Services for the Aging, and AARP.
Registration: Registration is limited due to auditorium size. To register: Contact Kellie Carlson of Aging Services of Minnesota at kcarlson@agingservicesmn.org. See you on the 14th. Here is the event brochure.
How is Senior Living Going to Change?
Technology . . . "Granny Pods" . . . community involvement . . . Home Services . . . all are subject of a front-page article in today's Minneapolis Star Tribune on the future of senior housing.
How do you think senior living is going to change?
A Bumper Sticker Shaped By Experience
A gem from Ecumen colleague Kurt Hansen who knew American hero Don Singlestad well . . . . Don, whose story is profiled here, had an awesome bumper sticker. It read:
"Life is Tough, Wear a Helmet"
Read Don's story and you can see he clearly knew the truth in that quote.
Honor: War Hero and Ecumen Customer Don Singlestad Led a Life of Service in Park Rapids and Far Beyond
Ecumen Changing Aging readers will recall the remarkable story of Don Singlestad, a resident of Ecumen-managed Heritage Community in Park Rapids, who was honored last year for his WW II heroics by the Italian government. Don died just prior to Thanksgiving.
Jeremy Olson of the Minneapolis Star Tribune wrote a beauitful obituary on Thanksgiving Day that highlights several of the key moments from Don's life, a life that had a tremendous impact on many on both sides of the Atlantic Ocean. Following is Jerermy's article. Thank you, Don!
The blessed life of Don Singlestad ended last
week when the decorated World War II
veteran and Minnesota National Guardsman
died at age 93.
A man who rarely discussed the war until he
wrote a 2009 memoir, "The Fighting Fool,"
Singlestad was one of the U.S. military's most
decorated noncommissioned officers and
one of three Americans in the war to earn the
Italian Military Medal of Valor Gold Cross.
Singlestad expected to die on the battlefields
of North Africa or Italy, said his nephew,
Bruce M. Johnson. "There was no fear and
when things got very difficult, he just went
into instinct. And instinct worked. He lived
through it. He didn't think he would."
Singlestad earned the Distinguished Service
Cross for heroism during a 1944 battle in
Italy. The citation said he used grenades and,
when out of ammo, his rifle butt to break
through an enemy blockade and bring
intelligence to his commanders.
A Lutheran, he later was blessed by Pope Pius
XII for working behind enemy lines before
the liberation of Rome to direct air and
artillery bombardments away from the
Vatican and other sites.
Singlestad was part of the National Guard's
Red Bull 34th Infantry Division, which
suffered heavy losses in a pivotal battle to
drive Germans from mountain strongholds in
northern Italy. Last year, at 92, he traveled to
Vernio, Italy, to commemorate a highway in
the division's honor.
"Don beamed with pride as he unveiled a
marker in front of townspeople and Italian
World War II partisans dedicating a mountain
pass as 'Via 34th Divisione di fanteria Red
Bull,' " said Maj. Gen. Rick Nash, adjutant
general of the state National Guard.
After the war, Singlestad was a traveling
salesman for a clothing company and opened
a diner in Litchfield, Minn., with his wife,
Florence. They later owned a girls' clothing
store in Bloomington and sold real estate in
Arizona. The couple retired in Fort Collins, Colo.
Singlestad moved to Park Rapids, Minn.,
to be near his daughter after his wife's death
He struggled with memories of the war and
men he killed. His daughter, Debra Sharkey,
said it showed in his wanderlust.
"That's why he was on the road as a
salesman," she said. "He had to be out, he
had to be about. He had to be active."
Singlestad lived with zeal and a twinkle in his
eye, relatives said. He once rigged a bathtub
on a motorized raft so he could putter
around the lake, singing in the tub. "When he
was around ... people laughed," Johnson said.
Singlestad was active in retirement, planning
a veterans' memorial in Park Rapids, serving
Thanksgiving meals to the needy. Just this
month, he drove elderly voters to the polls.
Thank You from Beyond the Playing Field
Many of us will watch football or some other sport this Thanksgiving weekend. So often, memories and media moments freeze time, making sports stars and in a sense, we who cheer them, seem ageless. But, of course, none of us strike the same pose forever. This year has been a crisp reminder of that:
A few weeks ago Hall of Fame baseball manager Sparky Anderson died of complications from dementia. That followed New York Yankees owner's George Steinbrenner's death after media reported he'd been living with Alzheimer's. Today media are debating the wisdom or lack thereof of Penn State University's football coach Joe Paterno, 84, coming back for his 46th season leading the Nittany Lions. And earlier this year the family of former University of North Carolina basketball coach Dean Smith's family sent a letter to his former players and other friends. This copy comes from a posting on the University of North Carolina student paper website:
Our dad is almost eighty years old, so it’s expected that he might show signs of aging. After spending an entire lifetime without a visit to the hospital except to see players and friends, he had to undergo two procedures in the past three years: a knee replacement surgery and a repair of an abdominal aortic aneurysm. But what other people may have noticed – and what has been speculated about recently in the media – is that our dad may not remember quite like he used to. It’s a stark contrast, because he is widely known for remembering a name, a place, a game, a story – it’s what made other people feel like they were special, because our dad remembered everything.
Coach Smith wanted to keep his professional and personal life separate. But as we all know, the personal and professional life can sometimes overlap, and we understand that many fans, former players, and friends are concerned about his well-being. In trying to balance our dad’s wishes and the genuine concern so many people have for Coach Smith, we want to update you about his health, but ask that you respect his privacy. Our dad has a progressive neurocognitive disorder which affects his memory. So now, he may not immediately recall the name of every former player from his many years in coaching, but that does not diminish what those players meant to him or how much he cares about them. He still remembers the words of a hymn or a jazz standard, but may not feel up to going to a concert. He still plays golf, though usually only for nine holes instead of eighteen. He still attends some sporting events –you might see him in the stands at his grandson’s baseball game. He has difficulty traveling long distances to see the Heels on the road, but he insists on watching all Carolina basketball games on television and cheers as hard as he can for Coach Williams and the team.
Although some of the ways he experiences daily life have changed, he still cherishes his many relationships with Carolina basketball, his family and his friends.
Throughout his career, he has always preferred the spotlight be on the Carolina basketball program and the University, rather than himself. We hope that you will understand and respect his wishes. Thank you for your consideration and well wishes for our dad.
The Smith family letter hits home for many people. This Thanksgiving, thank you to everyone who is caring for and empowering our fellow human beings. Thank you for seeing that one's contributions and value go far, far beyond those "ageless" photos in the scrapbook. Your selfless support defines honor.
Charlie Brown, On-Demand and Senior Housing and Services
The other night I screwed up life for my 4-year old son, Charlie, by forgetting to tune into a Charlie Brown Thanksgiving on TV. And I forgot to DVR it . . .double trouble. But, because it's 2010 and not 1974, I was able to pull it up on online where Comcast's Fancast online on-demand product saved me.
Makes me think about senior housing and services. And how it will continue to evolve in an on-demand world to meet people's wants and needs via technology and other innovation. Five years ago, we didn't have GE QuietCare or HealthSense in any of our housing communities. One year ago we didn't have EcumenConnects, a residential social networking community. The products didn't exist. Charlie Brown's Thanksgiving is every bit as good today as it was in 1974, but the viewing experience is a whole different ballgame. No doubt in today's on-demand world that the channels are going to continue changing rapidly in senior services.
Ways to Honor Our Veterans - Insights from State Chaplain, Minnesota National Guard John Morris
November 11th is Veterans Day. According to the U.S. Census, the United States has 21.9 million veterans. We are home to 9 million veterans who are 65 or older.
It is an honor at Ecumen to provide housing and services for many who have served our country and to be a workplace for many veterans. We thank them for their service and sacrifices in protecting the freedoms we enjoy today.
How can we as Americans honor our veterans on Veterans Day and every day?
We've turned to State Chaplain, Minnesota National Guard John Morris, and father of Ecumen colleague Amy Williams, to provide his insights on that very question. We invite you to add to this list. If you have ideas you'd like to share in honoring America's veterans, please provide them in the comments section.
Honoring America's Veterans
The 11th hour of the 11th day of the 11th month presents us with an opportunity to pause, reflect and give thanks for the men and women who have worn our nation's uniform in the defense of our freedom. The following are several ideas on how you can make this day meaningful:
1. Pause and give thanks to God for the freedom and liberty you enjoy. While doing this, ask a blessing on the men and women who are serving us in Afghanistan, Iraq, Kuwait and many other places around our globe.
2. Fly your flag.
3. Visit your local nursing home and ask to visit with a veteran. Spend 10 minutes listening to their story. Give the veteran a big hug and simply say 'thank you.’
4. Visit your local American Legion or VFW and leave a Hallmark card for a lonely veteran. They'll be sure he/she will get your goodwill card.
5. Attend a local Veterans Day observance. (The newspaper and media websites list services. All the Minnesota Department of Veterans Affair website lists observances as well.)
6. Consider making a donation to the USO on behalf of veterans.
7. Volunteer to help at the Armed Forces Center at the Minneapolis/St. Paul Airport and help welcome military personnel as they pass through the airport.
8. Finally, simply say "Thank you for your service" when you meet a veteran.
A veteran IS a unique individual. At some point in their life, they offered their service to the nation. When they did they literally 'put their life on the line.’ That merits the appreciation of our nation, which is why we have 'Veterans Day.’
Reverse Caregiving?
As the second anniversary of the Great Recession comes & goes, one thing we don’t hear much about is the resultant change of the family structure. Intergenerational households have become an economic reality due to job losses and home foreclosures of recent years. But even more so by demographic changes, as reported by Pew Research Center. Households where two or more adult generations existed declined post-WW II until the late 1970s, but have steadily increased since. In 2008, 1-in-5 adults age 55 to 85+ lived in a multi-generational household. Of the 49 million Americans living in a multi-generational family household, 6% are in a "skipped" generation family unit made up of a grandparent and grandchild, but no parent.
In a separate report, Pew describes a sharp increase of children raised solely by grandparents since the recession began. One of every 10 U.S. kid lives with a grandparent with 41% of those being raised primarily by that grandparent.
Where’s a caregiving grandparent to turn for help? Mari Bell of GrandsPlace.org advocates the need for caregiving grands to make time for themselves. “In each parenting grands’ life there is so much to do that we can often lose sight of our own needs too.” Resources can be found but are few and far between. ROCK (Raising Our Children's Kids), serving 12 northern Minnesota counties, is a program offering crisis assistance, referral, and counseling. New York City's extensive Grandparent Resource Center provides information and referral, recreational activities, educational workshops, and advocacy for people raising their grandchildren. While we can’t wait for, nor expect, more programs to appear, one thing is for sure: a little self-care can go a long way. As Bell states “if we fail to care for ourselves and wind up burning out, then we will be of no good to anyone.” ~Helen Rickman
9,999,999 Kindred Spirits
Richard Taylor, a retired psychologist, was diagnosed with Alzheimer's-type dementia in 2001 at the age of 58. Now 67, he is a champion for individuals with early-stage and early-onset Alzheimer's disease, and author of the book "Alzheimer's from the Inside Out" (Health Professions Press, 2006).
The following plea by Dr. Taylor expresses what we at Ecumen believe in most strongly -- empowering our residents with Alzheimer's and other forms of dementia to live life as fully as possible. That's why we're embarking on a groundbreaking initiative at all of our skilled nursing centers to free these individuals from any and all unnecessary medications that are sadly, typically, prescribed to "calm" the most disturbing symptoms of dementia.
"Awakenings" is supported by a grant from the State of Minnesota, and we'll be asking for support from our friends in the community as well. Expect to hear from us in the coming months as we roll-out our campaign to end the unnecessary "chemical restraints" imposed upon dementia patients through the administration of antipsychotic medications. We can all be part of the next generation of respect for people living with dementia, and in honoring them, restoring their dignity.
Oh woe is me. Oh woe are 9,999,999 kindred spirits. Woe is the life of tens of millions of caregivers and those who know someone living with the symptoms of dementia. Oh woe is our plight, oh woe is our Nation. Like our pioneer ancestors we are all responsible for taking care of ourselves. We are each responsible for living purposeful, productive, loving lives. And for those with disabilities not of their own causing? "light at the end of the tunnel, great progress, breakthroughs?" I sadly think not.
When will we each and all stand up and speak out. Enough of this hoping/exaggerating/wishing/pretending. Let's put most of our research money where the real problems are - living with the symptoms of dementia and caring for folks living with the symptoms of dementia. For every one's sake, stand up and speak out. Vote with your donations, your political support, your discussions around the ipods/watercoolers/skype video calls/under the tables texting at work/in your church and community.
We don't have the luxury of waiting for physicians to be retrained, assisted living communities to grow up, nursing homes to realize more than that their residents are there because it's the only place Medicare pays the bill for room and board for people with dementia. We can no longer hope/pray/expect that the experts and current organizations and leaders will get "it." At least they won't get "it" in yours or my lifetime, and there are no current signs they will get "it" in the lifetimes of your children or grandchildren. Stand Up. Speak Out.