Kathryn Roberts on Aging Services: Deliver The Right Care in the Right Place at the Right Time
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 TimeMinnesota 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.
Martha Stewart Talks Caregiving on Capitol Hill
The aging services drumbeat is getting louder … Yesterday was a big day on Capitol Hill as Martha Stewart testified before the U.S. Senate Special Committee on Aging about caregiving. She, Robyn Stone from the American Association of Homes and Services for the Aging, John Rowe, MD of Columbia University and others had some very insightful testimony at the hearing entitled: Caring for our Seniors: How Can We Support Those on the Frontlines? You can read the testimony here.
Grumpy Seniors? Think Again Says University of Chicago Study
You have to have a certain degree of confidence to wear a Speedo (this blogger doesn’t have it). But we have customers, such as the one above, who do.We are fortunate to serve a lot of people who have found a great deal of contentment in their life, people who are comfortable 'in their skin.' In talking with them you’ll find authenticity, straightforwardness and happiness. A new study by the University of Chicago confirms what many in our profession know already . . . many Americans grow happier as they grow older. Interestingly, the next generation of seniors - the baby boomers - don’t score so high in the happiness study. Any thoughts as to why that’s the case?
Long-Term Care, What’s Age Got to Do With It?
That’s the question that our friends at Future of Aging are asking. They have a few others they’d like younger readers to think about on long-term care and how the heck they’ll pay for it, too. Go here to check the questions out . . . .They get you thinking.
Ecumen Community Honored for Senior Housing Design
The Villages of North Branch, an Ecumen community pictured above just north of Minneapolis has been named as one of the country’s top designed senior housing communities by a panel of judges convened by Design Magazine.
The 14-member panel of judges, which included a number of leading national architects, selected The Villages of North Branch as one of four winners for top design in the March issue of Design. Thirty-seven senior housing designs from across the nation qualified for the judging process.
The Ecumen community was honored for its focus on empowering residentsm its use of technology, household-based care philosophy and interior design. The Villages of North Branch provides assisted living, memory care, rehabilitation and nursing services.
To see what senior housing and care services looked like in North Branch before The Villages, go here. Talk about a new day.
A Different Kind of Play: All the Leading Men and Women are 70 or Older
Have you seen any plays where the leading actor or actress is over 70? I can’t think of any.The Mixed Blood Theater in Minneapolis is changing that.Minneapolis Star Tribune entertainment writer Graydon Royce calls Mixed Blood’s 'Exit Strategy' a theatrical Ocean’s 11 … a classic risk/reward scheme as a means out of a dump (In this case, the dump is the type of senior housing that makes us cringe.)The mean age of the three actors is just shy of 76. Exit Strategy producer and writer Bill Semans, 71, wrote and directed 'Herman USA,' a film from a few years ago about a small Minnesota town full of bachelors who advertised their availability and drew women from 37 states and four nations. I love his quote in Graydon’s story:
'I hope this is the best thing I’ve ever done. And if it’s not, I’ll keep trying.'
Christian Scientists and Nursing Homes: The Not So Big House Movement
Christian Scientists might soon bring one of the country’s smallest nursing homes to Minnesota and continue the 'Not So Big House' Movement in long-term care and aging services.
The city of New Brighton, Minn., has approved the nonprofit’s preliminary plan to build a small, six-bed care center next to the First Church of Christ, Scientist. It would be 10,000 square feet. The faith’s form of nursing care doesn’t include medications but covers personal and bedside care, cleaning and dressing wounds, and spiritual support. Approval of the final plan is expected within the next couple of months.
Raise Taxes to Pay for Senior Services? Ohio Does It … A Lot
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 LoisIn 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.
We Want Your Thoughts - The Aging Services Customer Experience
Can you spare a minute, and respond to this post (just click on comments below to respond)? We want your thoughts.You might have seen this in the news.
Angie’s List -- which has 600,000 members nationwide -- built its business by providing a forum for its customers to rate painters, roofers and other service providers. Now, the company allows members to log on to www.angieslist.com to share their real-life experiences with local doctors, from the cleanliness of waiting rooms to the physician’s bedside manner. It’s the latest sign that 'consumerism' is becoming a driving force in health care.
Aging services is all about people. It seems that creating an online forum for customers to share good reviews and bad reviews about assisted living, home care, etc., is an idea whose time has come - probably yesterday. Yes, you’d likely get some mean people who abuse it, but it seems that a moderator could screen those types of situations. You’d also likely get insights that need correction and attention. Also, when someone has something good to say, others would see it in that person’s very real words. That’s better than any type of advertising could be. It also could be a very helpful tool for people navigating the mouse-in-the-maze health care and aging services systems.
What do you think? What am I missing? Other ideas?
10 Questions with Dr. Brent Ridge of Martha Stewart Living Omnimedia
Changing Aging recently had the opportunity to sit down with Dr. Brent Ridge, who is Vice President for Health Living at Martha Stewart. Prior to joining Martha Stewart he was on the faculty at Mount Sinai Hospital and was a driving force in the development of the Martha Stewart Center for Living at Mount Sanai, which is a new center for the management of chronic health conditions and for the promotion of healthy aging.Dr. Ridge is available to answer your questions every week on 'Ask Dr. Brent' on Martha Stewart Living Radio. Dr. Ridge is a graduate of the University of North Carolina School of Medicine. He completed his post-graduate training at Columbia University in internal medicine and a fellowship in Geriatrics at Mount Sinai. He also holds an MBA from New York University.1. Geriatrics isn’t a specialty that most physicians choose, so what drew you to this field?There were several reasons that I chose this field. First, I spent a lot time with my grandparents as a child, and I always had a wonderful rapport with older patients. Second, I love the natural narratives of medicine, and I’m always enthralled by the personal histories of my older patients. Lastly, it was a strategic decision on my part. Although I enjoyed the practice of medicine, my real passion was in business, and I knew that for the entirety of my career the aging of the baby boomers was going to drive virtually any business.2. You’ve said aging is 'living.' We believe that here at Ecumen, too. What does 'aging is living' mean to you?There are tremendous stereotypes surrounding aging that we really need to dispel. Aging should not be synonymous with loss of productivity or vitality. There are challenges that come along with getting older just as there are social and physical challenges at nearly every stage of life. I think that one of the reasons we have such negative images of aging in our society is that there has never been a critical mass of positive role models. Obviously, this is about to change in BIG way.3. Do we need a new name for geriatrics, or do we need geriatrics to be looking at life and aging differently?I think as an academic discipline, 'geriatrics' is an appropriate name. However, to the healthcare consumer, it is very distasteful. If we want more people to approach aging in a proactive way, we’ve got to be able to reach them and compel them. It’s just good marketing. This is one of the reasons that the new facility at Mount Sinai does not have the word 'aging' or 'geriatrics' in its name.4. I’ve read that you want to live to 100, how much of getting there is up to a person’s approach to lifestyle, rather than genetics?Genetics are somehow involved in virtually every aspect of health, whether we’ve identified the specific loci or not; however, my philosophy has always been that EVERY decision that you’ve made throughout your life (or that was made for you) contributes in some way to how well you age. It’s foolish to overlook the impact that diet, exercise, and not smoking has on longevity.5. Fast forward to 100; how do you want to be living?I hope that whatever I’m doing is exactly what I WANT to be doing. Can anyone ask for more than that?6. In the U.S. and globally, we’re facing an unprecedented age wave. But aging has often been shoved aside rather than embraced in public policy, media and business. How do you see that changing? Are we on to a new movement, rising around aging?I think there will be much more attention focused on the issues of older America, simply because there are going to be more older Americans€”more vocal ones at that€”demanding that their needs be met.7. We have a whole industry built on anti-aging, why should people look forward to growing old?Philosophically speaking, I look at every new day as a way to learn something new about myself. As a physician, I’m fascinated with the way the body works and what’s happening to it as it continues to change and 'evolve'. Even for the average person, having an understanding of the basics of anatomy and physiology can be very powerful in terms of forging an understanding of what types of lifestyle modifications can pay off in a big way.8. What does your role entail at Martha Stewart?I’m leading the development of a new core area of the company focused specifically on health and wellness. The focus is not as narrow as aging but on healthy living in general. Martha and I both realize that a lot of people read the magazines, watch the TV shows, listen to Sirius radio, and visit the website, and if we somehow influence just a small number of those millions of people who enjoy our product to learn something new about their health or to make healthier life choices, then we’ve done something good.9. What top tips do you have for enhancing longevity and living well?This is actually much simpler than people expect:
