New Year's resolutions: lessons from anti-aging marketing research

What do you see when you look at this image? The young beauty--or the "feared self" of the future?

Afraid of aging? Most of us are, if we judge by the number of products and ads aimed at helping us avoid the “feared older self” the marketers keep holding before us. (Last week’s blog Princesses and hags addressed attitudes toward aging and how we train ourselves to fear and dislike it.)

Researchers Brett Martin from the University of Bath and Rana Sobh from Qatar University found that when beauty products, diets, Botox, and plastic surgery didn’t seem to be working, women were more likely to keep using them.

That’s right: failure to look younger kept aging anxiety high, and women continued doing more of the same to try to keep the wrinkled old woman at bay.

On the other hand, when the products and interventions seemed to work, women stopped using them. Their anxiety eased, they no longer worried so much about the face of the future.

This research finding in 297 women delivers an odd message to anti-aging manufacturers and providers: if you want people to continue using your product, market with fear (the wrinkled hag of Christmas Future)—and make sure your product doesn’t do the job it promises to do. Because if it works, they’ll stop being so afraid. And they’ll stop coming back to you.

In another study, Martin found a different result with men and women working out in gyms. As they became happier with their bodies, their frame of mind improved. Success—and a positive image of what they might become—were the motivators to keep on going.

When you’re making your New Year’s resolutions, keep these studies in mind. You’re much more likely to succeed—and stick with--changes that improve health, like working out. Even if the goal is cosmetic, the healthy body has a sneaky way of creating a healthy, positive mind.

Have a wonderful New Year! May you walk (run, skip, dance) toward the future in happiness and health.

Please share your New Year's resolutions about aging well in the comments section!

When the reality of aging loved ones hits home

Labyrinth of Hope from Johns Hopkins University Interfaith Council

Almost daily for the past month or so, I’ve gotten an “aging alert” article about using the holidays to check on one’s aging parents. It’s the perfect time, the authors say, to evaluate how well older adults are doing in their current living situations.

This year, the message became more than academic for me. My sister called the day before Christmas Eve to say that Mom, who lives in independent senior apartments, wasn’t doing well. Pain from arthritis in her spine was making it hard for her to walk, and her anxiety was soaring. With those triggers, she was becoming confused.

I drove up a day earlier than planned and stayed a day longer, feeling grateful that my kids were old enough to have their Christmas usurped without feeling resentment.

Trying to get information and make arrangements over the holidays is a nightmare. But because Mom lives in a retirement community with multiple levels of care, we were able to get an assessment for assisted living today. If all goes well, she will move to a place that’s familiar to her and where she’ll feel safer and get the help she needs on Monday.

We are all feeling a little stunned, apprehensive, and relieved right now. The pieces seem to be sliding into place as well as possible.

Some random thoughts:

• We who live in Milwaukee are so fortunate to have sources of information and assistance that aren’t available in smaller communities.
• I’m so grateful to the social workers and home care managers who return calls even on Christmas day. Your service in allaying anxiety and helping people think through next steps is incredibly valuable.
• While many of us hope to see more “catered” home care delivered in people’s homes and independent apartments, the model of senior apartments-assisted living-skilled nursing on one campus still has a tremendous amount to offer.

To all of you who take care of our older adults, creating safe home for them wherever they are, deepest thanks. It truly takes a community to support us throughout our lives.

Princesses and hags: How we train ourselves to look at aging

Images from Rich Gentleman Hide PhotoShop tutorial.Isn't the older woman beautiful before being transformed into America's Next Top Model?

Yesterday, Rush Limbaugh asked, “Does our looks-obsessed culture want to stare at an aging woman?” The woman in question was Hillary Clinton, of course.

“It's like almost an addiction that some people have to what I call the perfection that Hollywood presents of successful, beautiful, fun-loving people. So the question is this: Will this country want to actually watch a woman get older before their eyes on a daily basis?”

He illustrated his point with an exceptionally unflattering photo of the Democratic party presidential candidate next to an exceptionally presidential photo of Mitt Romney, courtesy the Drudge Report. The conclusion? The Republican is much prettier and therefore more electable. In other words, a better presidential candidate.

The same day, 24-year-old Amanda Hinsperger asked: “What is it about anti-aging?. . .Women in particular carry the anti-aging burden, since most anti-aging ads are marketed to women. Are we afraid of aging? Does the natural course of life disturb us? Nobody likes to admit their body is failing. With all the stress this worrying brings on, and with the aging impacts of stress, maybe we'd be doing ourselves a favour by embracing age.”

Offensive as Limbaugh’s screed is, his observations about our culture’s fear, even hatred, of aging, are sound.

I don’t know how to change that, but Gene D. Cohen, MD, PhD, Director of the Center on Aging, Health & Humanities at The George Washington University, believes the negative attitudes about aging get their start in childhood. Think of the fairy tales we read to our impressionable toddlers: they’re full of wicked witches, stepmothers who are ugly inside and out, old women who live in shoes and abuse their too-large broods.

The Center has compiled a list of stories for children of all ages that show older adults as kind, active, humorous, wise, creative, brave—all the rest of the admirable qualities we aspire to at any age.

That is, if we aren't aspiring only to looking good.

Seems we need to start at the beginning. Give a child you know a good book—and some real-life experiences with women--and men--who are older, but not worse for it.

Citizen philanthropy in the Internet age

Image from the Plymouth Intergenerational Center

Milwaukee Aging Consortium member Marsha Vollbrecht, Director, Senior Services, Aurora Senior Health Services, is part of a brave new experiment in charitable giving.

Before I explain, a little background. Getting the margin to support even the most worthy mission is a challenge for nonprofits. Large and well-known organizations vie for big support dollars from big foundations. Meanwhile, small or newer organizations compete to gain enough support to build momentum through charitable donations.

But some believe the Internet might “democratize” charitable giving. Case Foundation co-founder Jean Case thinks that “philanthropy shouldn’t be defined as a bunch of rich people writing big checks. Small amounts of money given by large numbers of individuals can be combined to do great things.”

The more citizens are involved, the idea goes, the more the nonprofit activities can reflect the real needs and desires of the people.

So Case started the "Make It Your Own" grants program, inviting community-based organizations to submit their "citizen-centered civic engagement" programs. From a pool of more than 4,000 programs, a board selected the Top 100 Ideas. The programs are displayed at the website, along with space for comments by the "citizen philanthropists:" you and me.

You can even make a direct contribution to one of the programs from the site.

Vollbrecht’s " Top 100" project with the Plymouth Intergenerational Coalition involves Linking the Generations. It brings together volunteers from the school district, senior center, government, childcare center, finance, healthcare, and more.

Starting today, you and the rest of the world can read about and comment on the grants. A panel of judges will score the proposals, narrowing the field to 20. Each of those will receive a $10,000 grant toward “making their idea a reality.” And in February, we’ll be able vote to select the most worthy project. The top four vote-getters will receive additional $25,000 grants.

If you think Linking the Generations is a worthy idea, why not help make it happen?

And if you think the Milwaukee Aging Consortium is a worthy idea, we'd love to have your support, too, of course.

The Case Foundation site is full of interesting ideas about taking fund raising electronic. Take a little time to browse the ideas at the site. They are new, complex, and layered (and not always clearly described). But it's worth the effort to look around.

What might this brave new world of fund raising mean for your organization? Share your ideas with us here!

“A system begging for transformation” and other important reports

Image from Tokyo Contemporary Art Gallery

From Isolation to Integration: Recommendations to Improve Quality in Long-term Care was released this month by the National Commission for Quality Long-term Care. The report says that “like the health care system, the long-term care system begs for transformation” and recommends bipartisan approaches for national reform.

New population health statistics and trends for older adults are now available through the Centers for Disease Control and Prevention website. The full report, "Health, United States, 2007, With Chart book on Trends in the Health of Americans, " was published by the National Center for Health Statistics Press (December 2007).

Finally, the Center for Retirement Research at Boston College has released a number of fascinating working papers on economic conditions and circumstances relevant to older people:

1. Capital income flows and the relative well-being of America’s aged population
2. Why are companies freezing their pensions?
3. The impact of late-career health and employment shocks on Social Security and other wealth
4. Health insurance and the labor supply decisions of older workers
   
5. The effect of economic conditions on the employment of workers nearing retirement age

Thanks to James Schmidlkoffer, Bureau of Aging and Disability Resources, Office on Aging, Wisconsin DHFS, for this information.

“Outliving their profit potential”: hospice patients

Image by Ryan Stone, Flickr

“Hundreds of hospice providers across the country are facing the catastrophic financial consequence of what would otherwise seem a positive development: their patients are living longer than expected,” according to Kevin Sack in the New York Times.

The problem is the Medicare Hospice Cap, a law passed in 1982 to limit aggregate Medicare reimbursement to each hospice and assure that the average cost of caring for hospice patients was less than the cost of caring for them in acute care settings. The cap is determined by multiplying the number of patients by a per-patient allowance--$21,410 in 2007. When a hospice exceeds its cap, it must repay Medicare for services.

In the 25 years since the Hospice Cap was established, things have changed. Limitations on an individual’s length of stay have been removed, as long as a physician continues to recertify the patient as terminally ill. And those with non-cancer diagnoses became eligible. The two factors mean that the average hospice stay is considerably longer than in 1982: 86 days for people with Alzheimer’s disease versus 44 for those with lung cancer.

However, except for the yearly multiplier, no other changes have been made to the Hospice Cap.

In 1999, few hospices hit their cap. But estimates from the Medicare Payment Advisory Commission for 2005 project that 220 hospices in 25 states will be billed for repayment of $166 million. Most of these are independent hospices, and in some southern states, half of hospices will hit their cap.

In Wisconsin, 10-15 hospices hit their caps last year, according to notes from the May 2007 National Hospice-POE Advisory Meeting, Chicago CMS Regional Office.

Even with the increases in lengths of stay, hospice care saves Medicare money, according to Duke University professor Donald Taylor. And so the National Alliance for Hospice Access is calling for an immediate 3-year moratorium on calculating overpayments for 2005-2007, during which time Congress must develop a “fiscally sound, responsible, long-term solution.”

And if they don’t? To remain in business, some hospices have already begun to admit only cancer patients. Others, hoping to buy time, are “aggressively recruiting new patients in order to pay off last year’s cap charges.”

The next step may be to discharge patients who are medically eligible but just “live too long.” The Center for Medicare and Medicaid Services points out management issues behind that dramatic statement, especially doctors certifying patients too early.

Of course, you can’t tell the hospice story by numbers. Joan Rademacher’s end-of-life journey in the Wisconsin State Journal (May 2007) shows what hospice is all about.

Have you had an experience with the Medicare Hospice Cap? Care to comment on patients as “profit potential”—or anything else? Use the comment area or e-mail me at cmclaughlin(symbol for “at” here)milwagingconsortium.org.

Giving thanks: a work in progress

Today's blog is from Tom Thoreson, program coordinator.

I’m thankful that I have a family and community(ies) that support me for who I am and graciously receive the gifts we all share.

I’m thankful for the good health I have and the gift I am developing to provide guidance, direction and health to others.

I am thankful for the times in which we live. In many ways these are challenging times and the future can look quite bleak. Nonetheless, I feel much hope for our children and their determination for growth and development of ecological systems that sustain our planet. These are the best of times for many peoples that would not have had a voice in the past.

I’m thankful that I have chosen a path (sometimes it feels as if the path has chosen me) that guides me towards heights and depths and with a breadth I could only dream of. I’m thankful for those dreams.

I’m thankful for all of the teachers and clients and elders and youth and colleagues that people my days and nights.

I’m thankful for the mindfulness to be still and silent and patient.

I’m thankful for my thirst and hunger and curiosity and playfulness.

I’m thankful for this opportunity.

First Lesson in Magic

Everything you need comes to you.
The gift you didn't expect
is the other half of memory.
Use it whenever you need it.
Don't worry about why
you're different. The truth is
expect it. You're alive!

-Ann Filemyr

Are you ready for the aging workforce?

Looking around the room during meetings of professionals in aging, you’ll see many people, mainly women, of “a certain age.” People in their 20s, even 30s, are rare.

So when I read about the aging workforce, I think of us.

What, I wonder, are our own organizations doing to prepare for the future? For shortages and loss of skills and knowledge caused by our own retirements? What are we doing to attract and develop younger people?

Right now, I can't imagine not working--or not seeing the committed, still-passionate professionals I've come to admire in this field. But they tell me it can happen--will happen, one way or another.

The AARP’s Workforce Assessment Tool is a great way to take stock of the situation. It’s designed to help businesses “assess any potential impact the aging workforce will have on your organization.” It takes about half an hour to complete, and it generates a report of strengths and "opportunities." (That's "room for improvement" to those of us who predate the "no problem" era.)

It’s also a great way to look at the functions your organization performs, who performs them, what knowledge retention strategies you have, and more.

Some of the sections may lead to some corporate soul-searching. “Positive Work Environment” and “Workplace Accommodations” are two that might. So may “Training and Development Opportunities,” which inventories the types of training available to workers and whether the training is targeted to those over age 50.

Sometimes, we forget the need for lifelong learning in people who already have a lot of knowledge--or the desire for advancement even in people who may already seem advanced.

In looking at the “Flexible Work Arrangements” section, I was struck by how congruent the flexibility that appeals to older workers is to the flexibility younger workers—especially parents of young children—need.

Making a better workplace for older workers is making a better workplace for everyone.

Manpower, one of the Aging Consortium's member organiztions and sponsors, has some in-depth research on the aging workforce. You might want to look at New Agenda for the Older Workforce and Old Age Thinking, New Age Thinking.

Meanwhile, how’s your organization doing? Let us know your thoughts.

Time goes by

It's been difficult writing lately. This has been one of those times when so many friends and coworkers are dealing with illness and death that I can't help but see mortality everywhere.

About half of the daily alerts on aging that come over my desk have to do with looking good. Creams and surgeries, excercises to make people look and, I suppose, feel younger.

Not so much about growing character and spirit or finding ways to deal with loss. The misproportion of information frustrates me.

Then I came across a blog, The Elder Storytelling Place. It's part of the Time Goes By: What It's Really Like to Grow Older weblog. I'm going to bookmark Time Goes By; it's wonderful.

Today's entry, A second chance at life, is by Georgie Bright Kunkel, who at 87 is still a freelance writer and stand-up comic.

Her story isn't a laughing matter, though she reminds us that at $10,000 or more a month for life in a skilled nursing center, we could all retire to the Ritz Hotel.

It's about considering that her life will soon likely be the life of a single woman. But now, though she and her husband spent their 59th anniversary in the emergency room and he is now being cared for at $10,000 a month, for the moment, they have some precious time together. And the grace to know how precious it is.

And so I cherish the time spent with my partner, as un-private as it may be in our present circumstance. Even if complete recovery may not be possible, we have been given a second chance at living and loving and we must make the most of it.

And so I bring the crossword puzzle to share with my husband every day. I play on the keyboard that our granddaughter loaned us so that my husband can enjoy all the songs we sang in the nineteen forties. I throw the beach ball to my husband so he can catch and throw in order to restore his waning coordination. We kiss each other and whisper sweet nothings into each other’s ears, even knowing the room is bugged for health monitoring purposes.

No way will I lose this opportunity to partner with my husband. . .We still have each other. I don’t want to consider the alternative just yet.

There is so much pain and loss. But there is so much more. Maybe age lets us see the two together, teaching us to love more what we have to love right now.

“To be a person is to have a story to tell.”

Isak Dinesen said that.

And William Carlos Williams said, “Their story, yours and mine -- it’s what we all carry with us on this trip we take, and we owe it to each other to respect our stories and learn from them.”

Precious commodities, these stories.

You don’t have to be old to have a story. But being older means you’ve had a chance to accumulate a lot of chapters. You may have developed some insight into what the story means. And using experience or imagination or both, most people continue to work on that story until "the end."

If you know someone whose story you’d like to hear and preserve, there’s still a chance to become part of the StoryCorps project in Milwaukee.

Last January, the UWM Center on Age and Community partnered with the Milwaukee Public Library to make Milwaukee the first local “outpost” for this National Public Radio project in recording real people’s stories.

• StoryCorps will be recording in the Milwaukee Central Library Oriental Room until January 24, 2008. Log onto the site to register or call toll free 800-850-4406. You’ll get help—and a CD of the interview. With permission, a copy will also be sent to the American Folklore Center at the Library of Congress as well as the Milwaukee Public Library.

• On Tuesday, November 20, 7 pm, at the library’s Centennial Hall, you’ll be able to hear David Isay, founder of StoryCorps and author of a book about the project: Listening Is an Act of Love: A Celebration of American Life from the StoryCorps Project. The book contains some of the most compelling stories the project has collected. Call 414-286-3572 for reservations.

(Studs Terkel, who’s devoted a lifetime to telling the stories of real people, says the book "is history in the richest sense of the word, the kind that makes people feel like they count. . . This is what our country is all about." )

Spend $1 million, get $15 million back: Restoring the Milwaukee Housing Trust Fund

This entry is from Tracy Straub, new Housing and Services Project Leader for the Milwaukee Aging Consortium. The Housing and Service Project is a multi-faceted effort to promote housing and service options that result in livable communities for older adults.

Today, Tracy shares information about the Milwaukee Housing Trust Fund, which was created but then only partially funded.

In November 2006, the Milwaukee Common Council created and Mayor Barrett signed legislation creating the Milwaukee Housing Trust Fund (HTF). Under the trust fund guidelines, 25% of the trust fund's dollars will be used to develop housing and provide services for people who are homeless, 35% will be used to develop or rehabilitate rental housing, 25% will be used to create and maintain home ownership, and the remaining 15% of the fund will be "flexible" and used for other housing needs.

For 2007, the city committed $2.5 million to the HTF to be raised by issuance of a general obligation bond. The response by housing developers has surpassed all expectations. The HTF has received 21 funding requests totaling more than $5.6 million. More importantly, the applicants would bring to the table $85 million dollars in matching funds.

In other words, for every $1 the city funds an additional $15 is invested from other sources.

As proposed in the original legislation, it was anticipated that the city would contribute an additional $1 million to the HTF in 2008. Unfortunately, the Mayor’s 2008 budget reduces funding for the HTF to $400,000. After making the bond payment, this will leave $160,000 available to fund projects in 2008. Clearly, the proposed funding is not anywhere near the originally anticipated amount and woefully inadequate to support affordable housing development in the city.

If you would like to weigh in on this issue, you can contact your alderman at 414-286-2221 or write to him/her at 200 E. Wells, Milwaukee WI 53202. If you are not sure who your alderman is, you can find out here.

Clarifying Quinn: women and Social Security benefits

An article by Jane Bryant Quinn in the current AARP Bulletin is causing a bit of a buzz. Quinn wrote:

There's an exception for married people in good health when one of them has a small Social Security benefit. Typically, that's the wife. If she retires first, she should start her individual benefit at 62. When her husband retires, she'll switch to the spousal benefit. By using her own account first, she taps a benefit that otherwise would have gone to waste.

But Mary Jane Yarrington, senior policy analyst for the National Committee to Protect Social Security and Medicare, says that Quinn’s information is misleading.

. . .a wife cannot "switch." When a wage earner applies first for his or her own benefit, it stays in effect. A wife who takes her own benefit early does never receives the full 50 percent spouse benefit when the husband begins his benefit. The difference between her full-retirement-age benefit and 50 percent of his gets added on to her monthly benefit amount. This factors in the fact that she has been receiving months of early benefit. JBQ does not make that clear.

By taking the benefit early, does the wife "tap into a benefit that otherwise might go to waste?" Probably. Depends on how long the husband lives. When he dies, if she is full retirement age or more when widow benefits begin, she receives 100 percent of the benefit he would receive if still alive. Her own early retirement is ignored in determining her widow entitlement.

If you have questions about Social Security, you can “Ask Mary Jane.”

Thanks to Glenna Schumann, Coalition of Wisconsin Aging Groups, for passing this along.

Collaborative care for people with dementia

According to blogger Jeff Muise (Caregiver Notes), it’s about time that the medical community is discovering what most people in the caregiving and service sectors have understood for a long time. An article in the November issue of the Journal of General Internal Medicine posits the need, Muise said, for “a system that fosters collaboaration among healthcare providers, community service organizations, and caregivers.”

To which Muise, a caregiver for his 90-year-old father, says, “well, duh.”

Again relying on Muise (I don’t have the journal), researchers at the Indiana University Center for Aging found that “most people with dementia only get care from their primary care doctor, and in the words of study co-author Malaz Boustani, MD, MPH, neither the primary care system nor primary physicians have the time or resources to meet the biopsychosocial needs of individuals with dementia.

In other words, it takes a village to support the whole lives of vulnerable people and those who care for them. But right now, that village doesn’t have enough money to sustain it.

Muise says the article’s vague endorsement of the right combination of critical components of dementia care to the right patient and the right caregiver at the right time really boils down to this: “each primary care practice should have a dedicated professional caseworker to follow up patient needs that extend beyond the practice walls.”

Muise lives in Woodstock, New York. I think things are a little better here in the Milwaukee area, in part because we have an amazing collaborative community, as we just witnessed at our Annual Networking Conference for Professionals in Aging last Friday. There, people not only collected business cards, pens, candy, and information; they discussed solutions to problems and shared dreams.

As Stephanie Sue Stein (director of the Milwaukee County Department on Aging) has said, what we have in Milwaukee is unique and advanced beyond the professional collaborations in aging services anywhere else.

But there’s still so very far to go. Please share your experiences in collaborative care. We’d be especially interested in hearing about successful collaborations with physicians.

Depression and stress: how can we help caregivers?

The National Survey on Drug Use and Health includes some concerning evidence about depression among caregivers--and people in social services. One way to help caregivers: a local event for the mind, body, and spirit.


The Problem

People employed in personal care and service have the highest rate of major depression, with nearly 11% reporting episodes in the last year, according to a report released last week by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA). (Depression among adults employed full-time, by occupational category)

A “major depressive episode” lasts two weeks or longer. The overall rate of worker depression is about 7%, and it leads to $30-40 billion in lost revenue. It’s a huge cause of absenteeism and low morale.

Other occupations that seem to put people at greater risk for depression are food preparation/serving, community and social services, and healthcare practitioners and technicians (all around 10%).

Women are at higher risk than men. The one good piece of news for people in the job market: those who work full time are significantly less likely to have had depressive episodes than people who are unemployed.

Caring for the Caregiver:
Not just a concept but an event

If you know caregivers, chances are you know people under stress. The Milwaukee Aging Consortium’s Caregiver Retention Project is one local effort to reduce caregiver stress by improving training, networking, and stress management among direct care providers.

An important free, day-long event for all types of caregivers is being offered by a number of concerned organizations including the Consortium. Please tell the caregivers you know about Caring for the Caregiver: an Event for the Mind, Body, and Spirit,Saturday, November 3, 2007, from 11 am to 5 pm, at Mount Mary College, 2900 N. Menomonee Parkway in Milwaukee.

Highlights include resources, networking, and a keynote address by Mary Marcdante (Author of My Mother, My Friend).

Perhaps most intriguing are breakout sessions include financial and legal issues, caring for difficult people, stress management, grief, faith and inspiration, laughter therapy, dementia, and activities.

At the end, caregivers will receive a certificate of attendance. Call 414-220-8600 to register.

And please let us know about your ideas, events, and experiences with caregivers and caregiving!

Older workers and the law

Is age discrimination a serious problem, and should protections be included in the Civil Rights Act?

According to the American Society on Aging July-August 2007 Aging Today (just received today), the answer to both questions is a strong yes. Stereotypes of older workers are used to discriminate in hiring. And even when people are happy with their older employees, it may not occur to them to offer them promotions or training.

The topic of age discrimination is much in the news.

Last week, an appeals court ruled that Brian Reid could proceed with his age discrimination suit against Google. Google fired the 54-year-old Stanford University professor after two years of coworkers' calling him “an 'old man,' an 'old guy,' an 'old fuddy-duddy.' They told him his knowledge was ancient, and joked that the CD jewel case office placard should be an 'LP' instead of a 'CD.'"

The same week, the Supreme Court agreed to revisit Gomez-Perez v. Potter to decide whether age discrimination provisions for federal employees include anti-retaliation protections for reporting such conduct.

Myrna Gomez filed an age discrimination suit against her employer, the US Postal Service, when she was 45. After that, she said, her employer and co-workers “retaliated” against her and cut her hours.

What’s the story in Wisconsin? I can’t say. But here’s some information about the state’s Fair Employment Law. And here’s where you go to start filing a federal complaint in Milwaukee.

It seems odd to be hearing about age discrimination while we’re also hearing about labor shortages. According to that other law, supply and demand, businesses would do well to cultivate their older workers.

Last spring, the Small Business Journal ran The Graying of Milwaukee, which reported that Wisconsin’s labor shortage will be particularly acute. It will accelerate after 2010, and “by 2015 all of the growth in the working age population will be generated by people age 55 and older.” (emphasis added)

That means finding new ways to do business and new ways to train and keep older workers.

What experiences and insights do you have about older workers -- and attitudes toward them? Should there “be a law”?

The Art of Aging (Gracefully)

One of the Google Alerts I get daily on the subject “aging” offered this tasty tidbit: “The Art of Aging.”

Who could resist?

Click the link: the article was about cheese.

But might there be some lessons in aging cheese for aging people? After looking at The Nibble and Whey to Go! On The Art of Aging (Gracefully), I’m ready to say yes.

“When I mentioned to a friend that I was writing an article on aged cheeses, she shuddered, adding that she couldn’t stand 'strong, stinky, old cheeses.' Hold on, there! There are some very strong, sharp, er, particularly aromatic aged cheeses, but they’re not all like that, not by any means. . .”

“Cheeses are either fresh or aged. Fresh cheeses are generally mild and soft in texture. . . creamy and somewhat bland. . .Aged cheeses are. . . multi-textured. One of the great things about (them) is their range in flavors. . . some are sweeter. . . though beautifully complex.”

“The aging process is also known as ripening, maturing, or affinage.” (That’s French for “refining.”)

Here’s a point I can identify with:

“Without a good rind, a cheese will lose too much moisture during refining.” I don’t know about you, but my own refinement has involved a distinct loss of moisture.

The cheesemaker’s solution? Wash the exterior periodically with brine, oil, brand, whey, beer, cider, or wine. While the article didn't mention it, I've had some good cheeses that applied the wine internally as well.

The paths of people and cheese diverge when it comes to ripening, though. Cheeses do best in dark caves: people don’t.

One last lesson: You just can't judge a cheese by its appearance. Its beauty lies in its deeper essence.

Changing the ways we do business

Nonprofits are businesses, and we have the responsibility to be financially successful so we can deliver on our missions. I believe strongly that too few nonprofits are thinking about services they need to change in response to the age wave. For me, my board members, and the people who work at Ecumen, the issue of providing services to the aging is very personal. At some point, we all will need these services — and there better be good choices.

So said Kathryn Roberts, president and CEO of Minnesota-based Ecumen, one of the country’s largest nonprofit senior housing and services companies.

In case you have any questions about why the Milwaukee Aging Consortium is growing to include housing and services, you’ll find some clues in a recent interview with Roberts in Boardmember. The article addressed how and why Roberts led her company’s way into the private sector market to create new ways to approach the organization’s mission, “to provide the poorest and the neediest with housing and nursing care.”

It’s all about imagination, partnerships, crossing boundaries, and creating new ideas in the spaces in between them.

An excerpt from the interview:

. . .In 2004, after I had been at Ecumen for about a year and was starting to put some strategies in place to ride the (aging) wave, the board went on a retreat. The members used that time to identify a vision for our future and a five-year plan. Since then, it’s been “Go, Kathryn, go. Go as fast as you can.”

I may be overstating this, but if this organization hadn’t changed, it would not be looking at its 200th anniversary. And the board knew it too. Five years ago, more than 80 percent of our revenue came from government reimbursement, primarily through our nursing home line. With set rates and declining Medicaid support, we were only going to lose money. Because the nursing home industry is so regulated, our expenses were completely out of our control as well. So our choice was to either change our product line or run through our cash and close up shop.

Facing this dilemma, we strategized with the board and came to the consensus that we would need to add services that are less regulated and generate private revenue to offset the inherent losses in the nursing home line. My leadership team and I recommended that these new services include independent housing, assisted living, and care for those with Alzheimer’s and other memory impairments. One of the goals we set in that first strategic plan was to reduce the percentage of our income that comes from our nursing home line from 82 percent to 52 percent — there is no question in my mind that we will achieve that goal and maybe exceed it.

You can read the rest of the article at Changing Aging.

Are you doing business in new ways to fulfill your mission? Share your stories and ideas with us!

Wisconsin: leader in long-term care, aging in community

Wisconsin in the mid 1990s was the first to set up what it called Aging and Disability Resource Centers (ADRCs), well-advertised storefronts that provide information and advice on home care services, such as bathing and dressing, meal preparation, nursing, housekeeping and specialized transportation.

Now, 42 other states, with the help of federal grants, are following Wisconsin’s lead.

This from an article published earlier this month in Stateline.org.

Stateline.org has been a daily online public information service of The Pew Charitable Trusts since 1999. Professional journalists provide news to “help nourish public debate of important state-level issues such as healthcare, tax and budget policy, the environment, welfare reform and other issues that in recent years have not gotten the media attention they deserve.”

In-home services are important not only because they're what most people want, but because they save a lot of money. Home care costs about half of what nursing home care costs.

The article devotes much space to Wisconsin’s success and quotes Donna McDowell, director of the state Bureau of Aging and Disability Resources.

Wisconsin is now in the second tier of percentage of Medicare dollars spent on homecare services, devoting 42% to those services. Fourteen states now do better. The top five: Oregon, 70%; New Mexico, 67%; Alaska, 63%; Vermont, 60%, and Minnesota, 59%. So we have a way to go to get back to the front of the parade.

More from the article:

Since 2004, the U.S. Department of Health and Human Services (HHS) has given states more than $42 million in grants to create Wisconsin-style centers, which now serve about 22 percent of the population. Last month, 11 states – Alaska, Arkansas, California, Florida, Georgia, Illinois, Indiana, Iowa, New Mexico, North Carolina and Wisconsin – received additional money to make centers available statewide.

You thoughts? Comments? Stories? Please share them with us.

Communications robots gather dust in Japanese nursing homes

When it comes to technology, genius inventors probably need to talk to seniors before trotting out high-concept, high-tech products for them. Or so the Japanese are finding out, according to a Reuters news release.

A pale green robot that talks, sings, and plays trivia to help seniors stay mentally agile is less popular than stuffed animals that do none of the above but offer some creature comfort.

It shouldn’t be a surprise. Harry Harlow, famed Wisconsin researcher, found out years ago that like people, Rhesus monkeys preferred to be “nurtured” by padded surrogates than wire ones.

What most seniors predictably want technology for is making their lives easier. That means big buttons, better audio, and physical adaptability: simpler phones and tools, adjustable countertops.

Two high-tech innovations that show promise are an electric tea kettle with a radio transmitter and a spoon with a built in stabilizer. The tea kettle sends e-mail to the family, letting them know whether Mom has made tea that day. The spoon compensates for shaking hands.

High tech is great, but it won’t ever replace the need for high touch--the voice and hands of real-life caregivers.

What technology do you know that improves the lives of seniors? What would you like to see?

A shortened life for caregivers?

According to the September 20 ScienceDaily, there’s new “concrete evidence that the effects of chronic stress can be seen both at the genetic and molecular level in chronic caregivers' bodies.” (Accelerated Telomere Erosion Is Associated with a Declining Immune Function of Caregivers of Alzheimer’s Disease Patients. J Immunol 2007 179: 4249-4254.)

What that means for caregivers--spouses and children who care for loved ones with Alzheimer’s disease in this case—may be a shorter life expectancy by four to eight years.

The study, published in the Journal of Immunology, was done by a group from Ohio State University's Institute for Behavioral Medicine Research including director Ronald Glaser, professor of molecular virology, immunology and medical genetics; Jan Kiecolt-Glaser, professor of psychology and psychiatry; and Nan-ping Weng and other researchers from the National Institute of Aging.

The group has been looking at the effects of psychological stress on immune status in many different groups. In an earlier study, they showed chromosomal damage and premature aging in mothers of chronically ill children.

Interestingly, the Institute is also investigating whether yoga can reduce levels of stress hormones. While many people believe that to be true, there’s no scientific evidence—yet.

So there’s another good reason to help caregivers. This fall, watch for all the opportunities around Milwaukee. A few follow:

• On October 4, we’re sponsoring a caregiver training event in Milwaukee that talks about one source of stress--lack of health insurance--and one intervention that might help caregivers and the people they care for stay healthier—better nutrition.

• October 29-31 in Port Washington, the Wisconsin Alliance for Family Caregiving is offering a train-the-trainer session for people interested in using the curriculum Taking Care of You: Powerful Tools for Caregiving.

• And Saturday, November 3, there’s a free all day event for caregivers at Mount Mary College, Caring for the Caregiver: an Event for the Mind, Body, and Spirit. This event is sponsored by the Milwaukee Aging Consortium, Interfaith-Family Caregiver Support Network, Milwaukee Center for Independence, IndependenceFirst, Golden Living, New Health Service, Stowell Associates SelectStaff, and Interfaith Older Adult Programs, Inc. To register or for more information, call 414-220-8600.

Uninsured caregivers would benefit from Badgercare Plus

One of the points that has the Wisconsin State Legislature stuck in budget morass is the governor’s plan for universal health insurance, Healthy Wisconsin.(Note: link changed 9-17-7.) The Republicans won’t budge on this radical innovation that would change the entire climate of health care reimbursement in the state.

But there’s one thing many of us, including the Wisconsin Long Term Care Workforce Alliance and the Wisconsin Direct Caregiver Alliance, can get behind, and that’s BadgerCare Plus. Healthy Wisconsin or no Healthy Wisconsin, this program is a must for many caregivers, whose average monthly income in Wisconsin is $1,700.

Many caregivers tell us that they must choose between having a car, increasingly a requirement for employment, and health insurance. It’s hard to imagine affording either on that income.

BadgerCare Plus is an expansion of the state’s existing healthcare program for families with children who are unable to afford health insurance. The expansion would include individuals and families with no children in the home who meet income requirements.

To help support direct care workers by seeing that they can have health insurance, contact your legislators. If you’re personally affected, tell you story.

There's a link on our website to a factsheet that should help you make your case about BadgerCare Plus and direct your message to the right person.

And please share your stories with us as well!

A tale of two agings. . .and another warning about the budget

Two aging-related articles telling very different stories of the lives of aging people appeared in the Milwaukee Journal Sentinel September 12.

Front page (though below the fold) was Retiring an old notion. It’s about people staying employed into their 60s and 70s. And it confesses to an “idealized glimpse of the American way of working into the golden years. . .” The article featured Pat Benway, who works for Consortium member Stowell Associates SelectStaff, and who is at the top of her game at an age when many are retired.

It’s a story we all love to hear. People who are vital doing vital work as long as they feel like it, and shaping the job to suit their own changing desires.

Then there’s the other article, buried a little on page 3 of the Metro section: Study finds disparities in area nursing homes. Milwaukee holds the dubious claim to the largest gap in quality care between blacks and whites in nursing homes, according to a study in the journal Health Affairs.

According to the study, which was based on data from the year 2000, race, poverty, and segregation are intermingled in this sorry state of affairs. It's not that individuals of different races receive different care in the same nursing home.

Nursing homes in Milwaukee are largely segregated--by race and income. Mainly white nursing homes—not in the central city; mainly black nursing homes with high percentages of residents receiving Medicaid—in the central city.

The disparities include more significant inspection difficulties, staffing shortages, and financial problems in the inner city nursing homes.

In fact, the environment has changed greatly since 2000, if only because many nursing homes in the central city that served predominantly African-American clients have been closed down.

As Stephanie Sue Stein, director of the Milwaukee County Department on Aging, pointed out, in the few that still exist, “It is very difficult for a nursing home with 100% Medicaid recipients to provide a quality of care that we would expect to provide to older people.”

* * *

Another article appearing a day earlier suggested that the state may have to cut Medicaid payments to hospitals and doctors by 35% starting in January—if the legislators haven’t passed a budget.

Cuts for nursing homes and other home and community based waiver services would be at the rate of 15%, according to Secretary Kevin Hayden of the Wisconsin Department of Health and Family Services. That's because these long-term care providers "provide vital supports to highly vulnerable frail elders and individuals with disabilities.

Of course, if the legislature adopts a state budget, the whole thing becomes moot.

Maybe some of those Elder Boomers we talked about the other day and other vital working adults—including our elected officials--can put their heads together to improve an unacceptable situation.

Thoughts? Ideas? Stories?

Baby Boomers, grow up!

And when you do, says Elders Guild founder Barry Barakan, you get to stop being babies and start being elders. And that’s a very good thing. But it’s full of responsibility, too.

Elders are the people with the experience, knowledge, and wisdom to rebalance a world gone far out of kilter.

Each of us needs to decide when to engage our aging with the intention to consciously prepare for the marathon of productive longevity. For each of us that moment is different, but as soon as we know that the second half of life is upon us, it is time to begin the process of reconceptualizing our reality. The process requires no less a level of dedication, effort, preparation, and continued learning than the work of establishing and growing a career and family.

Barkan has been a leader in elder-centered community action for thirty years. You can read more about his ideas at Tikkun. He was one of the founders of the Pioneer Network, in which the Milwaukee-based ActionPact change consulting group plays a large part.

The idea of the Elder Guild:

. . . to launch a new initiative that creates the organizational structure for a health-creating society for all. It will provide the antidote to the disconnection, impotence, and lack of meaning that contribute to our social malaise.

We need to learn to be effective, as we stand not just for ourselves, but also for the future generations to whom we have an ever-increasing debt. We call this initiative the Elders Guild.

The Elders Guild is truly radical, innovative, and based on proven experience. It is a new paradigm for regenerating community. And that is not just the community of the elders, but the whole multi-generational continuum.

It’s a tall order. But someone’s got to do it. What are your thoughts? Can elders, and especially Elder Boomers, lead the way? Does Elder Guild activity interest you? Share your ideas with us!

Who can’t afford what here?

Here’s a personal story we just received from someone responding to Congress and caregivers: no overtime pay that appeared here June 15. The blog reported the Supreme Court decision that caregivers were not entitled to overtime pay under federal law.

The comment is edited a bit for typos and such. Other than that, I’ll let it stand on its own.

I personally work for one of these senior care companies. Unfortunately it is true, they do not pay overtime. I currently work on average 44 to 52 hours a week. I have four children to support. The excuse of the company was the elderly just cannot afford the care. Well, I believe not.

I work for not one person that is not living in a mansion compared to my shack. These people pay for home care because they want to stay in there home. A residential facility costs about $3000.00 a month. That is a fraction of what I pay to live. I make $1500.00 a month on average working over 40 hours a week. I have to support 4 children on this pitiful wage.

Who can’t afford what here?

Anyone have any answers or fixes for this very real–and very uncomfortable—problem?

“Expand this program.” Family Care expansion not in the budget yet

Last year, the Legislature overwhelmingly voted to support Gov. Jim Doyle's proposal to expand the program statewide. On the heels of that strong bipartisan support, Doyle put $20 million in his budget in February to expand the program over the next two years. The Senate kept the money in its budget, and the bipartisan Joint Finance Committee voted to include the money in a 15-1 vote. Journal Sentinel, September 2, 2007.

Unfortunately, the Wisconsin Legislature hasn’t allocated funds for the program, and the Conference Committee hasn’t put funding into the budget as they continue to dither about it.

The editorial writers concluded:

Time's running out. If the legislators don't act soon, they're going to be bumping up against federal deadlines and state and local timelines that could delay or even jeopardize the expansion, Doyle spokesman Matt Canter says.

Kudos to Aging Consortium and Make It Work Milwaukee Coalition members Tom Hlavacek, Altzheimer’s Association, and Barbara Beckert, Milwaukee Jewish Council for Community Relations, for persisting in getting the story in front of the public.

And kudos to Consortium member Gwen Jackson, who wrote that it’s time to set politics aside. Scroll down in the article a bit to read her letter to the editor:

Nearly 2,500 people with disabilities in Milwaukee County are waiting; many are adult children whose aging parents are desperate to have community supports in place for their children. Many have no choice but to leave their own homes and enter nursing homes, which are far more costly than community services.

There are all sorts of good reasons to favor expanding Family Care, one of Wisconsin’s successful pilot programs for keeping low-income seniors out of nursing homes, to people with disabilities. Chief among them are the 11,000 people waiting for help the program can provide. Nearly as important is the $60 million in federal funds Wisconsin’s $20 million investment will draw.

Please write your legislators now!

Talks with communities: senior housing

We just held two neighborhood meetings to discuss innovative ideas in senior housing that came out of the UWM School of Architecture and Urban Planning’s Senior Housing Ideas Competition earlier this year. You can see the competition designs and download the report here.

6th and Walnut

The first meeting on August 30 looked at ideas for the site of the former Plymouth Manor nursing home in Bronzeville. While most of the sites selected for the competition were “wouldn’t it be nice if” sites, this one is well along the way to actual development. Prince Hall Masonic Foundation, along with ELL Development, LLC, is building the Prince Hall Campus there. Plans aren’t set, but the entire continuum from independent living to skilled nursing is in the works.

Competition architectural firm Plunkett Raysich is developing the plans, which probably won’t look much like the ones you see at the UWM website.

Lots of movers and shakers attended the meeting at the United Way. The development group is working on funding, including the possibility of bonds; completing studies; issuing an RFP for service and management; and developing an advisory board to help in the process. If you’d like to be involved, contact Georgia Cameron, gcameron@pobox.com.

At the end of the presentation, Stephanie Stein, director of the Milwaukee County Department on Aging, challenged everyone to find ways around barriers to create a better model, one that doesn’t have separate areas and ideas for different levels of care.

People don’t want to move from place to place to place, and they shouldn’t have to. Seniors in independent living will hide problems because they want to stay where they are, not be moved, she pointed out.

Bringing services to the people and community whenever possible rather than sending people to the services is the bottom line for all the sites, not just this one.

Sherman Park

The evening meeting for the Sherman Park neighborhood was a different ballgame. That site, the location of the no-longer-used Jackie Robinson Middle School, is for sale. But nobody’s been talking about new ways to develop it, and no buyers seem to be looking at the site.

A smaller group, mainly neighborhood residents, attended. They looked and listened with open minds, and maybe the “hmmmm” of new possibilities opening. The idea of a large scale senior living center hadn’t been raised before.

However, the attending neighbors said that as they thought about it, there was indeed a need for congregate senior living places in their neighborhood of single-family homes. They also wanted to pay attention to this site as a focus for strengthening the neighborhood. And the plans, they said, showed places they might like to live themselves.

Another bottom line: build the place you'd want to grow old in yourself!

Stay tuned to hear about future meetings. And please share your thoughts with us.

The great diaspora: moving seniors

How—and where—seniors will live is a lively discussion topic for communities with aging populations. And that would be almost all of them.

“Housing for elderly sparks protest” was a front page headline in the August 27 Milwaukee Journal Sentinel, as one Mequon neighborhood digs in to oppose an 8-person assisted living group home among their half-million dollar homes.

Just a day earlier, however, the same paper proclaimed: “Condos find niche in Grafton: new projects helping attract seniors to walkable downtown.” The article profiles a Mequon couple who wanted to avoid the traffic congestion in their neighborhood, so they moved into Grafton’s “rural-urban downtown, where you can walk to get some coffee or walk to the river or walk to a restaurant. You don’t always need your car anymore.”

What’s going on here?

On one hand, we see smart developers going after the affluent “young” senior population. On the other hand, we see communities objecting to assisted living "homes" in suburban neighborhoods.

It looks like the idea of moving seniors “out” of where they now live is strong, whether it’s to chic and pricey housing in revitalized downtown areas or to larger community-based residential facilities in more commercial parts of town.

Move them, but don’t put ‘em in my back yard is the message in Mequon. “I think it’s a great thing. I just don’t think they should be in the middle of a neighborhood with 30 kids around,” a woman said.

You’d think we were talking about sex offenders.

Of course the story’s more complicated than that. It seems that the Mequon CBRF owner neglected to talk to the neighbors about her plans, and that’s always a huge mistake. The first principle of creating a great community place is “the community is the expert,” the place where you start the planning.

Still, it seems there's a huge disconnect between what people in the aging field and those in the rest of the community are thinking. Staying in your home or at least your community and non-institutional group living is the direction we're headed. But the trends don't seem to have filtered into the way the community at large sees aging.

For many seniors, the best place to live is home, or a place like home. And some of those places should be in the neighborhoods in which people raised their families.

No better place to explore the “do unto others as you would have them do unto you” rule.

Employers rediscovering the value of experience

Is age 74 the new 47 for job hunters? According to an article in the August 23 Milwaukee Journal Sentinel, it may well be.

According to manager Greg Gardetto, 43, who hired 74-year-old Ron Mulvaney to sell mattresses for Verlo Mattress Factory, “I hardly look at this as charity work to bring someone in who’s older. . .He already knows how to interact with people.”

To those of us who are over 40—the age at which some begin to tag us as “older workers”—that seems to state the obvious.

But obvious or not, scarcity of good employees and increased need or desire of “mature” people to contribute their gifts in the workplace seem bound for what could be a happy collision.

Interfaith Older Adult Programs is an important player in helping older workers find jobs. Writer Joel Dresang says that employment services director Pat Delmenhorst is noticing that employers seem more willing to consider mature workers.

After all, who would prefer immature workers?

The secret to a long life. . .

. . . is not just how you live but where you live. Walk fast and live in a big city. Or so says Clive Thompson in New York Magazine.

Oh, Wisconsinites still live longer than New York city residents by about six-tenths of a year (79.2 vs 78.6). But they’re moving up faster: we only gained about 2 months from 2002-4 to 2003-5 to their 5 months.

Read the article: it’s fascinating. But here’s a brief synopsis of why New Yorkers (and Chicagoans and Bostonians) are living longer.

• They walk a lot, and they walk fast. Research says the fast walking is key. (They also do a lot of climbing: the city is “built like one big jungle gym for pedestrians,” someone said.) The built environment makes it hard to drive and forces people to be active.

• They weigh less—10 pounds less. That’s partly because they walk a lot. “The more you drive, the more you weigh,” said professor Lawrence Frank.

• Because it’s crowded and people are out walking a lot, they bump into each other and have extensive social networks. Which means, I guess, they walk a lot with each other.

• The city is aesthetically pleasing and charming. Which makes people want to get out and. . . walk a lot.

• New York cleaned up its environmental and criminal acts, making it possible to . . . walk a lot.

• Proximity matters. People visit parks more because they are closer, and they. . . walk around them a lot.

• The city is rich and prospering. Gentrification leads to better housing, better food, better hospitals, better health care. The rich always live longer. And ambitious, driven cities attract ambitious, driven people, who. . .


walk a lot.

Steal this idea!

According to Changing Aging, the Ecumen blog, “Parmly LifePointes, an Ecumen community in Chisago City, Minnesota, is embarking on a very cool new journey built upon successful aging.” Ecumen, affiliated with the Evangelical Lutheran Church in America, is one of the nation's largest nonprofit providers of housing-and-services to seniors.

Once you get past that pesky extra “e” in LifePointes, you’ll probably agree that the Vitalize! Wellness Centre (don’t get me going about the ! or the other oddly placed “e”) is indeed a very cool venture.

It’s an up-to-the-minute gym with “TechnoGym weights and TechnoGym aerobic fitness equipment that digitally measure one’s personal progress, a warm-water lap pool, a warm water pool with a treadmill, herbal teas and great food, exercise rooms, massage, plus classrooms for lifelong learning that helps people explore, personalize and enhance dimensions of successful aging."

There’s also a feng shui garden.

One of the coolest things about it is that it’s multigenerational and open to community members. According to the blog, “Vitalize! will be the place where a 25-year-old certified nursing assistant (what a great asset this will be for Parmly employees) and an 85-year-old who might have a chronic condition and lives in assisted living or the nursing home, go to take greater control of their life and how they travel through it.”

Cool indeed!

Keeping good things going

The Milwaukee Aging Consortium is no longer a direct advocacy organization, but some things have clear benefits for seniors, and it’s worth getting behind them. Make it Work Milwaukee! (MIWM) Coalition offers some alerts for immediate action. On the state level, Family Care expansion funding is threatened. On the Milwaukee County level, transit costs threaten to soar as access is reduced.

Family Care
One hundred and thirty people showed up for our meeting on Family Care Thursday, August 16. Also present were representatives from iCare and Community Care Inc., two other care management organizations serving both older adults and people with disabilities. We hope this was only the first meeting of senior and disability service providers we'll host.

Family Care is an innovative Wisconsin program that helps low income seniors and people with disabilities continue living in the community. It has a track record in nine counties, and expanding the program has bipartisan approval and was supported by the Governor, the Joint Finance Committee, and the state senate in the current budget cycle. Yet the Assembly eliminated Family Care expansion from the budget.

Family care is cost effective, keeps people out of nursing homes, and gives consumers choices about services, among other qualities.

Negotiations are going on right now, so it’s important for Family Care supporters to let elected officials and the media know why this is important.

More information in this Action Alert.

Transportation

Transit is a persistent problem for seniors. And it doesn’t look like it’s going to get better with the current county budget. Rising fares, fewer routes, and reductions in Transit Plus services hurt seniors and others who must rely on public transportation the most.

Like the state budget, the county budget is currently being hashed out. If transit is important to you and your clients, see MIWM budget highlights , including phone numbers of key people to call.

If you’d like more information on either issue or to become involved with the MIWM! Coalition, contact Barbara Beckert, Milwaukee Jewish Council, 414-390-5718, or Tom Hlavacek, Alzheimer’s Association, 414-479-8800.

Milwaukee, best city for boomers—because of you!

Atlanta; Portland (Oregon); Chandler, AZ; Boston; Milwaukee. . .to people who don’t live here, there’s one surprise in AARP’s list of best cities for Boomers to live—and retire-- published this week.


Milwaukee’s “vibe” is listed as “urban renewal at its best.” Director of the Department of City Development Rocky Marcoux said the city is making sure it stays appealing. “We think sustainability has a lot to do with accessibility. It’s what will make it possible for future generations to age in place. People shouldn’t have to leave their home because it’s badly designed.”

If that all sounds like a page from the Expanding Housing Options Summit we held in January, there’s a reason.

Members of the Milwaukee Aging Consortium have a lot to do with the quality of life for seniors cited in the article. The five free “fitness centers” mentioned are really Milwaukee’s acclaimed Senior Centers,managed by Interfaith Older Adult Programs and funded by the Milwaukee County Department on Aging (Clinton Rose; Kelly; and in the parks, McGovern, Washington, and Wilson).

And as an example of what can be done for lower income seniors, the article cites Lapham Park—a partnership venture that includes Community Care, Inc. and SET Ministry, along with the Department and our friends at the Housing Authority City of Milwaukee and others.

But there’s much work left to be done in neighborhoods that aren’t part of the waterfront boom. There’s much work to be done for housing-and-services for those who are frail or the “older old,” people in their 80s and beyond. And we’re going to be an important part of that.

On Thursday, August 30, the Consortium and the UWM School of Architecture and Urban Planning, along with Connecting Caring Communities, will host two neighborhood meetings presenting exciting ideas from the school’s senior housing ideas competition last winter. The plans we’ll showcase focus on creating senior housing and communities that keep older adults vital in those neighborhoods. While the ideas developed for the sites in the competition may not be the plans that will eventually be developed there, they present a great starting point for thinking and future planning.

The Walnut Street neighborhood meeting will be held 11:30-2:00, United Way, 225 W. Vine Street. The Sherman Park meeting will be held 6:30 – 8 pm, Wheaton Franciscan Healthcare-St. Joseph’s Hospital, Klieger Auditorium (M1010 in the Marquette Building) 5000 W. Chambers Street. While meetings are geared to neighborhood members, if you serve people in the area or have a special interest, call 414-289-0890 to register.

Stay tuned for more about the Consortium’s housing interest groups and carrying on the work of designing Milwaukee for aging in community.

"Don't call me 'elder'!"

Baby boomers are “the pig in the python” that moves through time in America, changing the shape of everything they pass through. And many are trying to predict how they—we—will change the end of life.

Ecumen, Minnesota’s largest non-profit senior housing company and affiliated with the Evengelical Lutheran Church in America, studied a cohort of Minnesota boomers to find out what they thought. Age Wave findings make interesting reading. Among other things, I now know that “80 is the new 60.” Which must mean that 60 is the new 40: what a relief!

What’s in a name?
“Senior” and “older adult” are okay; “elder” and “third-ager” aren’t.

Call them “people,” not “residents.”

They want to live in “homes,” not “units.”

“Community” is the term of choice for where they live: forget “facility” and “campus.”

“Community with services” is good, but not “assisted living.”

“Life care community” is the term of choice, not “nursing home.”

And they don’t like the term “long-term care;” it had negative connotations for nearly half of those studied.


Care options—and how to pay for them
They may not like the term “long-term care” but they know they are going to need it.

89% support using Medicaid dollars to pay family members to provide care for a senior in the home, a model being tried in Vermont (and Wisconsin's Family Care).

86% would pay a payroll tax of up to $12/month to provide funding for a year of guaranteed long-term care.

80% support a lifecare annuity: a single payment that would yield an ongoing income stream to pay for long-term care costs.

Most important characteristics
Between 90-100% of boomers say these will matter as they age:

1. Independence
2. Nearby friends and family
3. Privacy
4. Easy access to health care
5. Safety
6. Easy access to shopping
7. Spiritual opportunities
8. Easy access to transportation

The next most frequently named list (64-81%)

9. Meaningful volunteer opportunites
10. Welcomed community involvement
11. Easy access to fitness opportunities
12. Multi-generational community

Is this our future?

Welcome to Elliot Lake, Canada's most elderly community. Upsides: Bungalows under $100K, wheelchair accessibility, carpet bowling. Downsides: Doctor shortage, dwindling tax base, con artists. This is our future.

- Patrick White, July 30, Globe and Mail, Ontario, Canada

Elliot Lake is the oldest town in Canada. By that, I mean the town with the highest average age: 55. One in three people is over age 65. And it got that way on purpose.

After the mines that employed most of the citizens closed in 1990, the city council decided to pursue a new industry: senior citizens. They invested millions in making the town physically accessible—and senior friendly. Golf courses and condos proliferated. And mobility vehicles whir down the streets, defying laws that no one has the heart to enforce.

If this is the future, we might take heed of some lessons to see what it really means to age in community.

For one thing, we need to look beyond real estate. Planners failed to take services into consideration, and services cost money. The town is running out of doctors. At the same time, the hospital is now the biggest employer in town.

“There will come a point when the tax base on a municipal basis can’t take it any more,” said the town’s mayor, Rick Hamilton.

Elliot Lake is also overrun with scam artists selling unneeded or non-existent products and services to people.

Might be a good idea to make the elderly everybody’s concern, not just their “business.” At the same time, this in vivo "laboratory" suggests that a community needs balance in everything, including age.

On their shoulders

This Thursday, July 26, is the Milwaukee Aging Consortium’s annual Excellence Awards and recognition event at the Italian Community Center. It’s also our fifth anniversary. The governor will be there, along with the mayor. We hope to see you, too!

This year, so we can reflect on all the people and organizations that went before us—and in so many cases, are still part of our Consortium—we have fewer award categories than usual.

We’ll be giving Starr Krause the Distinguished Caregiver award. She’s been employed as a caregiver for about 30 years and is about to retire from her formal caregiving job at Aurora Day Care Center.

We’ll also be giving Daniel Bader and the Helen Bader Foundation the Leadership award for their role in helping start and sustaining the Milwaukee Aging Consortium. We are privileged to be one among many of the programs for aging and Alzheimer’s disease benefiting from that organization’s stewardship.

But first, we’ll recognize the members of the Older Adult Service Providers Consortium that went before us, our first board members, and the original founding members of the Milwaukee Aging Consortium. What an impressive group they are!

In getting ready for this event, I got to learn more about the history of not only the Consortium but aging professionals in this area. Not only are they a wonderful bunch, but they are still out there, in the work world or in private life, making life better for older people.

Thanks seems like such a small word to express our gratitude.

1. Sites for affordable housing; 2. The Wisconsin Quality Home Care Commission

Today's Milwaukee County issues day!

Affordable Housing

On Wednesday, July 18, the Committee on Health and Human Needs of the Milwaukee County Board of Supervisors passed a resolution to “create a work group of County officials. . . to survey all county-owned land that potentially could be utilized for affordable, accessible, and supportive housing benefits for seniors and disabled citizens” and to prepare a list of appropriate sites.

The list will be sent to appropriate County Board committees and the Committee on Economic and Community Development. Authors of the resolution were Supervisors Holloway and DeBruin.

This may be an important step in locating affordable service-and-housing for those who need it most where they need it most—throughout the county.

* * *
Wisconsin Quality Home Care Commission

The second agenda item, a discussion of a report about the benefits and potential problems that might result from instituting the Wisconsin Quality Home Care Commission resolution (QHCC), was more controversial.

And trying to figure out what it all means has been an education! This is really long, but I wanted to share the fruits of my sometimes frustrating search for information. I'm counting on you to help me out if I'm off-base!

The Wisconsin Quality Home Care Commission is an intergovernmental entity, separate from the state or county, established in 2006 to provide services to consumers and providers of home care and personal care services. It promises to develop a provider registry, offer assistance for consumers in selecting providers from the registry, and serve in some capacities as the employer of record for private providers (those who aren’t affiliated with an agency) who want to be in the registry. Dane was the first county to sign the agreement, and the Commission is looking to Milwaukee County to sign on.

The Milwaukee County committee voted 5-1 endorsing the principle of the Commission. That’s different from actually signing an intergovernmental cooperation agreement, as Dane County and the Wisconsin Department of Health and Family Services (DHFS) have.

Presently, the Commission is only in the developmental stage. It has no continuing funding source, and it’s intended to “improve the quality and accessibility of supportive home care and personal care services” for clients with disabilities who receive medical assistance waiver services, not elderly people.

So why write about it here?
One of the reasons for looking at this proposal, according to Paper #436 (May 2, 2007), Health and Family Service—Disability and Elder Services, is the need to grow the pool of personal care workers in light of the expansion of Family Care, the nursing home diversion initiative, and other long-term care community program options. So it seems reasonable to follow carefully what unfolds here. It may be something in the future for home care providers for the elderly, too.

Who’s your boss?
If you are an independent personal care worker in a participating county, the Wisconsin QHCC could be a sort of Professional Employer Organization (PEO) for you.

With a PEO, you really have two employers--the person or organization that hires you and supervises you, and another entity that “assumes much of the responsibility and liability for the business of employment, such as risk management, human resource management, payroll, and employee tax compliance.” Training and orientation can also be PEO roles.

Because of the role of the Service Employees International Union (SEIU) in establishing the Commission, it would be a very new thing indeed—a union PEO. Traditionally, PEOs are “white collar” entities.

About the registry
A prototype registry already exists, and it’s expected that the provider registry of the Wisconsin Regional Training Partnership and the Service Employees International Union (SEIU) will be folded or developed into the QHCC registry.

Here’s what the provider registry form for Dane County looks like. Presently, it seems to be a list of skills and preferences, without a way to evaluate quality.

Back to the meeting
Corey Hoze, director of the Milwaukee County Department of Administrative Services, expressed reservations related to potential costs and limitations on consumer choice. Apparently, he’d expressed support for the objectives of the Commission but the same reservations at the previous meeting.

But the room was packed to overflowing with supporters, mainly from the Wisconsin Home Caregivers United for Quality Care, who spoke eloquently to the pressing need for quality home care--and support for the people who provide it.

I spoke to an organizer for Local 150 of the SEIU, who confirmed that the Wisconsin United people were from his organization.

Wherever you sit on the question of unions, there’s no question about the value of some of the points made by the supporters, especially about the need for better training and quality of care.

Ann Kruschke spoke to the lack of any but basic training for home care workers, compared with hospital employees who can upgrade their skills. “People are coming home in much more serious condition, with tracheostomies for example, and there’s no training for the people who take care of them. There should be at least one place they can go to learn more.”

Another woman, new to home care, talked about a gap she found in caring for older people. Formerly a childcare worker, she pointed out that part of the caring job with children was to provide cognitive, emotional, physical, and social stimulation. But there is nothing like that in the task list she receives from the agencies for which she works. “I’m afraid if I start a puzzle, sit down for coffee with my client, or take them for a walk, I’m stealing from the agency’s time. But I know how important those things are.”

A place for training for some
Important points, and we’d love to hear your comments on them. But there’s one place direct care workers who work with the elderly can go for free education and professional development.

The Milwaukee Aging Consortium's Caregiver Retention Project has been providing ongoing caregiver enrichment education since 2004. The next resource event, Thursday August 9, 5-7 pm at the Milwaukee Center for Independence, is providing skills and knowledge in dealing with people with disabilities and seated exercises home care workers can use with their clients.

Just what the Wisconsin United folks are looking for. Is this another place to develop partnerships?