The Changing World

GUEST COLUMNIST OPINION:
Joanne Dodge
The Changing World
of Aging
One size doesn’t fit all. Unfortunately, with all good intentions, we seem to want to look upon our senior population that way. It would make the lives of caregivers and medical practitioners so much easier. Trying to explain to someone the mistake we too often make in talking about seniors, I put my hands together and said, “This represents babies and little children and how they are so much alike. Then I threw my arms wide and said, “This represents all of our adult life, the differences, the talents, the ideas, the interests.” Once again I held my hands together and said, “And this represents how society sees seniors today. But we aren’t all alike. We have different interests, beliefs, and talents.
Once, and sometimes twice a year, there is a performance at a local church starring residents of the County Nursing Home, three assisted living homes and Dearborn Senior Housing in Hampton. Months of preparation with the help of supportive staff make this possible. On the day of the performance, the vans roll into the parking lot and the wheelchairs roll off. Families are there, some with flowers. And the tears roll down!) The world should be there to see what can happen when seniors are given a chance.
In recent years, with seniors living longer and the cost of nursing home rising, “home based care” has been the answer. “Keep seniors in their own homes”, often followed by “where they want to be”. But nobody actually asks the seniors what they want or where they want to be. Is home based care a way to avoid the high cost of nursing home care for the counties? I wonder. Is it the best solution for seniors? I wonder even harder. Having a home health care aid come in and help Mr. Smith bath and dress, then leave him alone until evening when the whole routine is reversed isn’t what all seniors would want. Meals on Wheels stops by to deliver lunch but there’s no time for chatting. For too many who are living that way, extreme loneliness, depression and safety issues can be major problems.
And all around us in every community, senior facilities are being built. Some have assisted living on one side and independent living on the other. There are wonderful meals and bus rides to all sorts of events. The activity room is buzzing with crafts and entertainment. Everything one could possibly want is under one roof. But it is far too expensive for many seniors.
The whole world of aging has changed. Not that long ago, people died in their 70’s. The remaining spouse packed up and moved in with one of the kids--A simple solution that doesn’t work anymore. Wives are working and can no longer stay home and take care of Grandmother. We are living longer and are far more active. Many who are caregivers to their parents are starting to need some care themselves. This is a real dilemma for those in the caregiving field. The growing needs are outpacing the recourses.
“Keep them in their own homes. That’s what they want.” An easy solution, but not always the right one. We aren’t all helpless. We can be stubborn and sometimes frustrating. We still have much
to give. Shutting us out is a major loss to the community. Helping with mailings, making phone calls to other shut-ins, reading to children, and so much more can be very ably handled, even by someone in a wheelchair. Believe it or not, we don’t all like to play bingo!
So, let’s call a summit on aging and invite those seniors who are caught up in this situation. Not the “healthy/wealthy”, not caregivers who want to speak for seniors, just the real people who are at the center of this issue. Others can come and watch and listen but let this be just for the seniors who are at the core of the “problem”. Serve a great meal and I’ll bet you’ll fill the house.
For over 10 years, Joanne Dodge has encouraged seniors, living in nursing and rehab facilities, to write and act and laugh with each other and encouraging the rest of the world to pay attention.



SOCIAL SECURITY TRUST FUND:
Thanks for another great issue (March ’09). I appreciate CWD’s response to my article. However, I must disagree on one point.
Without change, the Trust Fund will eventually run out of money, but Social Security will still take in enough in payroll taxes to meet most of its obligations.
The question is “how to make up this shortfall”, NOT, “how to save the system”. Please note that CWD did not misconstrue this point in her letter.
I agree that we don’t need to reduce benefits or increase the retirement age. I believe that the Ball-Altman plan http://tiny.cc/NSDsz provides a reasonable blueprint for addressing these issues.
Steve Gorin



HOME ENERGY EFFICIENCY
The cost of heating oil this coming 09/10 season is expected to rise, so a pre-buy arrangement continues to be an advisable consideration. But, of greater concern is the heat loss that most of our older homes experience. Research shows that there is greater carbon footprint from our homes than from our cars!
As previously reported, energy audits cost between $250 and $500 on average. However, if you heat with electricity, your utility company may perform the audit for free.
Federal stimulus money is available for weatherization to income qualified households. The Office of Energy and Planning can provide you with the latest information. (www.nh.gov/oep)
Despite the increase in advertising around replacement windows, it isn’t necessarily the top priority in improvements. In many of our older NE homes, insulation may be a bigger concern. While there are differing points of view on the pros and cons of various materials, cellulose appears to be somewhat more efficient. Qualified audit professionals can help you evaluate choices.
BACK YARD FUEL CELLS
Japan, Korea, Germany and Denmark are among the countries experimenting with installing back yard home fuel cells to generate electricity. Japan has installed cells in some 3,000 houses and has seen a drop in both electrical demands and CO2 emissions.
Canada and Japan are working with Ballard Power of Canada to install fuel cells on some 20 buses that will be used in the 2010 Winter Olympics.

Weatherization:
www.nh.gov/oep
Free Cell Phones:
Free cell phones and services provided to qualified individuals, particularly food stamps or Medicaid recipients.
www.safelinkwireless.com
Telephone Shortcuts:
Dial 2-1-1 for telephone assistance to find health and human services help in NH.
For emergencies, Dial 9-1-1.


The forecasts, by the Obama administration and the Congressional Budget Office, indicate that Social Security beneficiaries will not receive any cost-of-living (COLA) increases in 2010 or in 2011.
The COLA is intended to preserve the purchasing power of Social Security, by increasing benefits to keep pace with consumer prices. In the last year, overall inflation has been low, largely because of the economic downturn and a decline in energy prices.
A freeze in Social Security benefits would have major implications for Medicare because the COLA, in effect, puts a cap on premiums for Part B of Medicare, which covers doctors’ services.
If there is no cost-of-living adjustment for Social Security, about three-fourths of beneficiaries will not see any change in their basic Part B premiums, federal officials said.
But some beneficiaries do not have this protection and could face substantial increases in their Part B premiums. In addition, millions of beneficiaries could see higher premiums for drug coverage, provided under Medicare Part D.
Social Security and Medicare trustees will describe the outlook for benefits and premiums in their annual reports this month.
Source NY Times


DEMENTIA AND MUSIC:
Researchers and clinician findings show that when all other means of communication have shut down, people remember and respond to music. Familiar songs can help people with dementia relate to others, move more easily and experience joy. “Tom” had forgotten his name and couldn’t utter one word, but hearing Sinatra prompted him to dance!
Alicia Clair, University of Kansas, noted that Alzheimer’s is retrograde: “Things fall off in the opposite order from the way they were acquired.” So if someone sang to you as a baby, before you even knew words, you’ll respond to music after words are gone.
Music memory is preserved better than verbal memory, according to Ms. Clair, because music, unlike language, is not seated in a specific area of the brain but processed across many parts. “You can’t rub out music unless the brain is completely gone.”
Further, learning to play an instrument, if you are not already a musician, helps to build new neuron pathways, exercises the brain and may delay dementia onset.
PETS:
Research shows that people who have feline pets are 40% less likely to die from heart attacks than non-cat owners. Dogs do not provide quite the same benefit, but owning a pet in general is seen as beneficial. A California study showed that owning a pet reduces the risk of developing non-Hodgkins lymphoma, while fish tanks help focus people with Alzheimer’s.
Source: Boston Globe
We, in NH are rightfully proud of the influence we have in our national primary process. But did you know that a well know elder program has it’s roots in NH?
Marty P. Knowlton, a world traveler fought ageism by cofounding Elderhostel at the University of New Hampshire, a program that pioneered learning vacations for mature adults,
When he was about 50, Marty became annoyed by two things-- the prevailing wisdom that "as you got older your mind automatically began to fail" and the government notifying him that "old age begins at 55".
A self-described hippie--although he was born in 1920 in Texas and fought during World War II in the Philippines--Marty decided to grab his rucksack and challenge such notions of aging.
For the next four years, he traveled through Europe, mainly on foot, and stayed in youth hostels. He recalled being struck in the early 1970s by the number of Europeans well into their 80s who remained active.
After returning, Marty was director of a youth hostel program at the University of New Hampshire, where David Bianco was residential life director. The pair were mulling nontraditional educational approaches in 1974 when they hit upon the idea of serving older students who could fill unused dorms in summer.
The term “elderhostel” came to David when he saw the white-bearded Marty sitting on a porch beneath a “youth hostel” sign.
“It was a very unusual juxtaposition,” David said. “You couldn't look any more like an elderhosteler than Marty.”
The program was started in summer 1975 on five college campuses in New Hampshire. Six people enrolled in the first session on local and oral history and the Old Testament book of Job.
“Marty liked to call them the six apostles," David said, "because those six people spread the word and started us on a spectacular adventure.”
Initially, Elderhostel's minimum age for participants was 60, but it was lowered to 55. “From the very beginning, we've had people lie about their age to get in,” Marty said. “It's always tickled us, but it's also a good measure that the product is good.”
By 1977, Elderhostel had turned into a nonprofit that contracted with academic institutions but was affiliated with none in particular. Marty and his cofounder stepped away from the organization.
“I rode that horse a couple of years, then jumped to save my life,” Marty told the Los Angeles Times in 1995.
Eventually, Elderhostel, which is now based in Boston, grew into an international enterprise. More than 4 million people have experienced its programs.
“Marty Knowlton was an extraordinary, dynamic, unconventional man - truly one-of-a-kind in his vision of the world and of how people could make a difference,” said James Moses, president of Elderhostel.
After Marty moved to Ventura, about 50 miles northwest of Los Angeles, in the early 1990s, he and David launched the Center for Studies of the Future, an Elderhostel affiliate.
Marty died of natural causes on March 12, 2009 at a nursing home in Ventura. He was 88.
Source LA Times
Just what is Long Term Care (LTC)? More often than not people will jump to nursing home care as the response. Given some time, and depending on personal experience, they may add in Assisted Living, Continuing Care Retirement Communities, Home Health Care, Visiting Nurse, and Personal Care Services. And certainly, this is one aspect of Long Term Care, one that is driven by the need for complex or complicated medical care. But let’s take a step back.
What happens before most people get to this level of need? More often than not, problems begin when there is a decline in a person’s ability to handle all the responsibilities of living independently.
It may be hard to find reliable repair people and routine home maintenance slips. Paying bills may become more confusing. Isolation can occur. Nutrition and fitness get less attention until the accumulate affect kicks in. And there can be pressure from children, to “be safe” - move.
Around the country, communities are cropping up called “Villages”. Appealing to individuals with an independent streak, these villages and their services are based on the needs and choices of their members, who pays a fee to join.
“I’ve never had to rely on other people, and I never wanted to,” Ms. Spiro of the Capital Hill Village said. “But I’d rather pay a fee than have to ask favors.”
What can the NH’s LTC Caucus learn from all of this?
• We do have to address a medical model; and
• Seniors can and should be called on to design local solutions.
NH’s medical model approach to LTC is more or less in place. There could be improvements, better public awareness, improved access and workforce recruiting, but the framework is there. But these services and supports have been shaped by public funding, chronic disease/conditions and the political influence of providers.
What we don’t have in NH is a plan that clearly defines the continuum of LTC needs, beginning with prevention at the community level. Such a plan needs to tackles short and long term goals and build on individual and community strengths. EngAGING NH is now working with other elder advocates to help our legislators draft a LTC plan.
But we need your help. Without significant consumer input from rest of us, a medical model could prevail as THE view of LTC.
What do you want to see? Send your suggestions to any of the following:
LTC Caucus Chair: Kate Miller
katemiller@metrocast.net
Contacting your own State house legislators (find my legislator):
http://www.gencourt.state.nh.us/house/members/wml.aspx
EngAGING NH board members who regularly attend:
Carol Currier: lcamst38@peoplepc.com
Barbara Salvatore:
bsalv@hotmail.com
Or consider attending one of the meetings. The next LTC Caucus meeting is scheduled for Monday, May 18 at 3 pm in room 205 of the Legislative Office Building in Concord.
“Almost all profound, pervasive and persistent challenges we face in our lives, our organizations, and our world can be solved. They can be solved because these challenges don’t require solutions that defy the laws of nature; they require people to act differently. “ (The Influencer)

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