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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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Namaste by Jim Klobuchar

Last week we announced that legendary journalist Jim Klobuchar would be joining Ecumen’s Changing Aging blog and posting monthly. Jim is an incredible story teller with incisive insights and vast life experiences. He’s epitomizes successful aging and living to the fullest. Welcome to Jim’s first post.

A Boy in the Mountains

He was a boy on a mountain trail, a poor kid with large brown eyes and floppy hair, staring at me where I sat on a great flat-topped boulder high in the Himalayas. He seemed bewildered. But now I remember him as a child who altered a part of my life.I may have been the first westerner he’d seen--an alien creature on a rock, clad in the trekker’s garments of wool cap, expensive down jacket and multipocketed Patagonia pants. In three days my friends and I had hiked down from the base camp of Mt. Everest. We’d camped beside the roiling Dudh Khosi River and, with supper still a half hour away. So I walked up the trail and scrambled to the boulder top to admire the vast Himalayan panorama. and dozed beneath the streamers of sun radiating off the glaciers. I woke to sounds on the trail. A young Sherpa couple was returning from the potato patch they farmed. Neither noticed me. The boy fell behind and for a few moments stood motionless, regarding me. Then slowly he raised his arm and waved.I waved in appreciation. He smiled. I smiled. He scrambled to catch up with his parents, turned at the head of the bridge, and waved. I waved. By now we were friends. His parents, oblivious, crossed the bridge. The boy followed and waved. Because the trail through the rhododendron forest was steep and rose 500 feet to their village home, it switched back five or six times. At each switchback the boy stopped and waved. Some times he had to duck beneath branches. Our mutual arm thrashings became very aggressive and more or less fun. At the top of the slope the mother saw me, noticed her son’s excitement and then said something to him. The boy turned, slowly put his hands and fingerips together beneath his lips and said something. I couldn’t hear, of course. But I knew what he was saying:'Namaste.' In the Himalayas Namaste (Nah-mah-Stay') means in its most lyric sense, 'I praise the God who lives within you.' It’s the most beautiful word I know. It’s the greeting you exchange there. Consider. The God within you. Within me. Something divine dwells there. And if we allow it, if we release our resentments and fears, it can bring us closer together; to better understand each other, to forgive when we are wronged, to cleanse us when we need.I put my fingertips to my lips, turned to the boy a half mile away and said 'Namaste.' And at that moment, the poor boy and I were together, perhaps for the rest of our lives.Jim

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The Future of Senior Living: The Eskaton Home

At the end of the day, caring will re-center in the home, where compassion and personalization reside.- Mike Magee, M.D.

90% of Minnesota baby boomers want to live at home, even if they or their spouse of a debilitating illness or disease.- Ecumen Age Wave Study, 2007

This is cool. And it’s the senior housing and services profession that is leading the way.

It’s a national demonstration home for advances in housing for seniors or multiple generations. The single-story model house is a creation of our colleagues at Eskaton, a senior housing and services non-profit company in California. The home opened last month.
'Three hundred-some people have toured this house,' said Sheri Peifer, vice president with Carmichael-based Eskaton Senior Residences and Services. It’s a daily pilgrimage of architects, home builders, technology insiders and elder-care professionals. Visitors came this week from Florida, Georgia and Oregon. The 1,850-square-foot house is a joint venture with Roseville builder Lakemont Homes.Most people associate 40-year-old Eskaton with assisted living. But its demonstration house is a pitch to the design and building industry for what’s possible now in standard senior housing. The new in-home technology on display helps seniors with what they want most: to stay in their own house as long as possible.So think fitness centers for the brain instead of biceps. (A special computer designed with help from the UCLA Center on Aging offers memory exercises to ward off dementia). Or picture in-home blood pressure checks on a wireless device that sends results to nurses. Webcams offer personal medical consultations without an office visit. (Intel’s new touchscreen Health Guide device asks: 'How are you feeling today?' If not so good, it suggests what to do before it turns into trouble).The remote monitoring, however, is most interesting to children of aging parents. A 'Grand Care' digital system 'allows seniors to live at home and offers family members peace of mind they’re doing fine,' said Kathy Hatten, an Eskaton guide who takes people on tours through the house.Sensors that look like computer mice and detect motion can be placed throughout the home. If motion falls to an unusually low level €“ suggesting a fall or medical problem €“ alerts are sent to children or others who may be down the street or across the country.This two-bedroom, two-bath house, however, is not just about technology. It also contains small touches you never think about when you’re younger. The air filter is near the floor instead of in the ceiling. Doors are 36 inches wide to accommodate wheelchairs. There are no steps to trip on. Shelves are low and electrical sockets are high.Welcome to the future of senior living.

Want to Learn About Other Senior Living Technologies?: Visit Our Technology Page

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Successful Aging Profile: Ecumen customer Art Tysk, Selling With Purpose

Last weekend was the Prep Bowl in Minnesota - our state high school football tournament. Amid the youthful achievements on the Metrodome field, 93-year-old Art Tysk was giving lessons on growing old well by doing what he loves to do.Tysk, 93, is a familiar face at Minnesota state tournaments and the Minnesota State Fair where he’s sold popcorn and candy since 1956. He’s been selling game programs since the 1920s. He started in sales as a kid, hawking the Pioneer Press and Dispatch newspapers. It’s the Pioneer Press' Brian Murphy, who featured Art on the front page of the sports page during Saturday’s Prep Bowl festivities. When he started selling, thepapers cost a half-cent wholesale, and he sold them for 2 cents a piece.Art is an Ecumen customer in the Twin Cities. All four of his kids have worked in the family vending business that Art started. His company became the 'official' game program supplier of the Minnesota State High School League in the early 1970s.His daughter Frid recalled attending an Alice Cooper concert at the Saint Paul Civic Center in the early 1970s and waiting impatiently to greet the origional Goth rocker as he talked shop with her father.'My girlfriends and I were teenagers, and we’re hoping to get a picture with Alice Cooper. He’s in full makeup, sitting there talking business with dad, about how to put on a show.'Frid used the word purpose in describing her dad’s love for sales, crowds and persuading others to buy his products. She says 'it is part of him …' Valuable insight as we all grow older … love what you do … do the things that give you purpose and joy … and even if you can’t do them as fast as you once did, or you have to sit down instead of standing … you can still tap that purpose and joy.

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