Honors and awards

Blog entry by Amy Ambrose, executive director, Milwaukee Aging Consortium.

I love a story about gut-intuition that turns out to be right. And I love a story about people investing in services for older people where they are needed most. Last week I had the pleasure of participating in the Milwaukee Awards for Neighborhood Development Innovation (MANDI Awards) celebration, hosted by Local Initiatives Support Corporation (LISC-Milwaukee).

The Milwaukee Aging Consortium sponsored a nomination for Community Care under the category of Building Blocks Award: Large Project. Last year's winner was the Dr. Wesley L. Scott Senior Living Community, developed by our friends (and a sponsor of our April 4 housing conference ) the Gorman and Company and the Milwaukee Urban League.

Community Care, a Milwaukee Aging Consortium member, is a private non-profit organization that provides health, home and community services to low-income frail elderly and adults with disabilities. The organization's mission is to provide the support people need to stay in their homes and communities, where they can continue to enjoy the fellowship of friends and family and play a vital role in their community.

Here's where the intuition gone right part comes in. In order to better meet the needs in Milwaukee, Community Care recently invested $5 million dollars in a property on Vliet Street in the Walnut Hill neighborhood. They turned an old factory building into a state-of-the-art adult day health center that includes examination rooms, a dental clinic, rehabilitation facilities, day center space for social activities and hot meals, and a full-sized commercial kitchen.

The Vliet Street Adult Day Health Center and clinics now serves about 200 participants. Physicians and nurses; physical, occupational and recreational therapists; dietitians, dentists and other health care providers all are part of the caring team.

According to Kirby Shoaf, Community Care founder and president, this choice of location was not met with great enthusiasm at first. Crime in the area is high, and the economy is poor. Security and staff satisfaction were concerns. But Kirby and others reasoned that the organization needed to be centered where the need was greatest.

They reasoned correctly. Now, they have created a gem in the heart of the city that not only serves the basic needs of elders and their families, but also conveys respect for them and their neighborhood. The Community Care Vliet Street location is now a favored place for staff members to work.

Community Care -- and the community -- "won" in our books, though they did not receive a MANDI award.

But I am proud to say that the winner in the large project category was another Milwaukee Aging Consortium member and sponsor: Manpower. The global headquarters of Manpower, located along the Milwaukee River in the Schlitz Park area, is another example of great investment in our town.

Dozens more innovative companies were honored as a part of the program. If your agency or your company is doing great things for older people, especially by reinvesting in senior services in the city, we’d love to hear about it.

Send your comments to this blog or to cmclaughlin@milwagingconsortium.org.

Did you hear the one about the woman, the black guy, and the Walmart greeter?

Gloria Steinem is 73, Robert Redford and John McCain 71. McCain's mother Roberta, who just renewed her driver's license, is 96. Do they seem "out to pasture," doddering, or foolish to you?

In humor, you have to tread carefully. Unless you are going after "old folks," that is. Much has been said in this year's presidential campaign about sexism and racism. But there's another "ism" that seems to be taken for granted: ageism.

David Letterman calls presidential candidate John McCain a "Walmart greeter" and a "mall walker," according to Julie Bosman in the New York Times. She asks "Has ageism run rampant in mainstream discourse because America exalts youth?. . .is the oldster an archetype so ingrained in the American comic sensibility--a la 'Grumpy Old Men' and 'Golden Girls'--that it trumps identity in politics?"

Great question--although in fairness, ageist humor may be milder now than it used to be. When Bob Dole was running for office, Letterman said “Bob Dole is so old his Social Security number is 2. He’s so old that when he was a teenager, his cologne was New Spice. He’s so old, his Secret Service code name is The Clapper.”

Even McCain gets on board with 'the joke': "Usually, people watch my performance to see if I need a drool cup, or stumble around, or anything like that."

In Politico, Roger Simon points out that John F. Kennedy, for all his appearance of youthful vigor, was frail and ill much of his time in the office he entered at age 43. Youth alone is no guarantee of physical health, mental acuity, or fitness for office.

I'll admit that I'm not ready to give up jokes about old people myself. But I'm making a vow to find jokes where the older person comes out on top of the humor. Because what we say and how we say it makes a difference in how we see--and create--aging.

What do you think about old-age stereotypes? Age-related humor?

A place that makes you wish you were old

"We know what helps people. What helps them age in place is not covered by insurers at this point," said Laura Gitlin, director of the Center for Applied Research on Aging and Health at Thomas Jefferson University in Philadelphia.

She was referring to healthcare and a study showing that periodic visits to independently living seniors by therapists can catch small difficulties before they turn into large ones.

But healthcare isn't all people need to age in place. To have a sense of wellness, we need purpose. Something to look forward to the next day. Ways to actively engage in the world.

Imagine if, instead of watching TV, you were broadcasting it. That was the idea behind the Burbank Senior Artists Colony. It's a 141-unit senior apartment community featuring 24-hour art studios, a film lab, performance space for its theater group, a resident-run internal cable TV station, and much more.

"You walk through this building and you never hear anybody talk about their aches and pains or how many medications they're on. They're just constantly talking about what they're going to do next," said Tim Carpenter of EngAge, a nonprofit organization that brings "whole person" creative programs to affordable senior housing.

The mission: "It's our vision to make aging a beginning. By providing life-enhancing programs to low-and moderate-income seniors living in affordable apartment communities, they will be given the opportunity to continue to grow intellectually, creatively, and emotionally. Programming will focus on the combination of mind, body and spirit to promote active engagement and independent living, and to provide seniors with a purpose."

Resident Suzanne Knode, who wrote her first screenplay after moving in, said "I never thought that I would be able to find something else that's new inside of me. You know that same feeling when you got out of school and the whole world was open for you? Now, all over again, the whole world is open to me and I have no idea what it's going to bring."

Everyone there is an artist, but many never called themselves that before entering a place where creativity is the air they breathe.

Six hundred people were on the waiting list before construction began, and 2,000 artistic souls are on the waiting list for the 43 affordable units that rent for $500 a month (market rate units start at $1400).

Burbank may be the home of Disney and Warner Brothers Studios. But you don't have to be in the entertainment industry to imagine creating senior communities as places anyone would want to live.

The question is, what would it take to do it here in Milwaukee? We'd love to hear your creative ideas.

Slow medicine for the old

Time to "rescue the elderly from standard medical care"? Geriatrician Dennis McCullough says it is in his new book, My Mother, Your Mother. Embracing "Slow Medicine," the Compassionate Approach to Caring for Your Aging Loved Ones. I haven't read the book but the New York Times review makes me want to.

The book is aimed at children and relatives who, McCullough says, are the best medicine--along with a slower, simpler, less expensive, family based approach to medical care. In interacting with the medical system, frail older people need an advocacy team of friends and relatives for protection and moral support.

Among the changes to consider for people at advanced ages: manual breast exams instead of mammography, stool tests for blood instead of colonoscopy, revisiting hypertension medication that works differently in the very old, companionship instead of antidepressants.

Reviewer Abigail Zuger, also a physician, calls the book valuable, "chilling and comforting in equal measure."

The topic is especially timely as we think about our July member meeting. We'll be building on the dialog with discharge planners in January. This time, we'll be considering how family members can talk about "advance directives" that go beyond end of life hospitalization. As McCullough says, hard conversations about topics like when to stop driving and what to do when you can't manage at home anymore need to start early, while the parent is still vital and lively.

It's about anticipatory guidance. The Library Journal's review says that the book will help readers:

—form an early and strong partnership with your parents and siblings;
—strategize on connecting with doctors and other care providers;
—navigate medical crises;
—create a committed Advocacy Team;
—reach out with greater empathy and awareness; and
—face the end-of-life time with confidence and skill

Please let us know your experiences and thoughts about how professionals in aging might help families talk about and plan for all of the transitions from fully independent to needing a wide circle of concern and care!

Ageism and drug safety

The Need for Drug Safety-the Older Person and Ageism grabbed me when it came across my desk through the Badgeraginglist. The listserv is a wonderful source of information for professionals in aging, and the source of many reports the Milwaukee Aging Consortium describes in our newsreel or information links.

Drug safety is not just an abstract good idea to me: it’s personal.

At Christmastime, my 87-year-old mother’s slow deterioration accelerated. It turns out that one of the prime causes was prescription medication toxicity. Another was electrolyte imbalance, a medication side-effect.

I haven’t looked at the bill yet to see what this episode cost in dollars. I won’t try to figure in the days lost from work and from our children for my sister and me. But I have a good sense of what it cost in pain and suffering, not just for my mother but for all of us.

The issue brief from the International Longevity Center-USA points to problems resulting from rapid approval of new medications and the lack of long-term “postmarketing surveillance”—research on what happens to 30,000 users, not just the 3,000 studied before release to the market. In 2007, the report says, the pharmaceutical industry “conducted only 7% of the studies they had promised.”

Drug problems affect older people disproportionately. Only 12% of the population, they use 40% of all prescription medicine. Physiologically, older people process drugs differently. They have the most problems with drug interactions. And yet there is no requirement that older people be included in clinical drug studies.

Report author Robert Butler, MD, uses some strong language: “Because medicines in the United States are disproportionately used by older persons, we must conclude that failures in drug safety are due in part to the belief that older persons, having lived their lives, are expendable. This is a manifestation of ageism.”

The brief calls for significantly increasing FDA funding and power to monitor drugs on the market and in older adults. The up-front cost, Butler says, “will likely save time, energy, and money, not to mention lengthening and improving the quality of lives.”

After a couple months of emergency rooms, hospitalization, skilled nursing facility stays, and rehabilitation, Mom's doing beautifully in an assisted living facility. In fact, she’s doing better than before. I wonder if, had her primary physician been monitoring her better, she could have stayed in independent living. But that’s a moot point now.

We’d love to hear your responses, ideas, experiences. Please comment here or send a message to cmclaughlin@milwagingconsortium.org.

Everybody's doing it: Caregiver help sites

You may have noticed a proliferation of all kinds of websites for caregivers. According to Mass High Tech: The Journal of New England Technology, the surge is partly a response to need--and partly a response to commercial opportunity.

“All of a sudden, it’s like caregivers have money,” said Gail Hunt of the National Alliance for Caregiving. “The baby boomers have to care for their parents, and there’s money to be made.”

Some of the sites, in other words, are all about the advertising.

But folks who run “altruistic” sites with no profit motive can learn some lessons from the often young entrepreneurs who understand social networking. Chief among these: the term “caregiver” doesn’t resonate with Boomers. We don’t see ourselves as caregivers but as family members—or even “baby sitters.” Caregiving is a market with more than one niche.

Realizing that, some sites are including services for the other side of the Boomer sandwich: childcare and tutoring, for example.

One site is called Lotsa Helping Hands. Developed in cooperation with the National Alliance for Caregiving, it has “created 6,000 ‘communities’ for users, mostly networks focused on a specific patient’s circle of caregivers,” according to article author Christopher Calnan.

Sites that list providers often offer a free basic service and charge monthly rates for “premium” services as well as using advertising.

Hunt warns that most of these businesses will disappear like the dot.coms – unless they develop the “Holy Grail:” comprehensive information combined with a database of local resources for users.

In Milwaukee, the Family Caregiver Support Network offers diverse help and information and a social support network for caregivers--for free.

Other excellent noncommercial sites include the Family Caregiver Alliance, and Hunt's organization's website Caregiving.org.

Strength for Caring is a great site owned by a commercial enterprise, Johnson & Johnson.

We’d love to hear about the best websites for caregivers—and what’s needed but not there. Comments and guest blog entries are most welcome!

What's your priority for making communities elder-friendly?

In the newsletter Connections, American Society on Aging (ASA) members identified as their top three policy priorities to make communities more elder friendly:

• 59% Public transportation improvements
• 25% Universal design requirements in building codes
• 10% Walkability mandates in urban planning

Public transportation improvement has been a chronic need for older people in this community since the days of the Older Adult Service Providers Consortium, the Milwaukee Aging Consortium's predecessor organization.

Are those the priorities you'd list, too? What could we do to fix the problems of getting around? We'd love to hear from you.