Are You One of the Village People?

by Janet Simpson Benvenuti

Next Thursday, June 30th, I’m heading to Cape Cod to join the Village People. I won’t be donning my cowboy boots or singing “Y-M-C-A” but I will be leading a fun, community-wide conversation about aging and aging in place with Neighborhood Falmouth, one of the first virtual retirement villages in the United States. Joining our conversation will be experts in law, financial planning, home care and senior housing along with working daughters juggling aging parents and teenage children, Baby Boomers planning for their own longevity, and a random cowboy or two. If you’re heading to Cape Cod for the fourth of July, especially if you’ll be spending time with your older relatives, stop by and join the conversation. Learn why fewer Baby Boomers will be using senior housing. No singing skills required.

Here’s where we’ll be on Thursday, June 30, 2016, 7pm-8:30pm: Unitarian Universalist Fellowship of Falmouth, Sandwich Road, Falmouth.

c2016 Circle of Life Partners, LLC. All rights reserved.

BOOK REVIEW: Being Mortal by Atul Gawande

by Janet Simpson Benvenuti

Let’s talk about death, or better yet, dying. Our guide is Dr. Atul Gawande, brilliant surgeon and best-selling author, who weaves a compelling narrative that informs, enlightens and challenges clinicians and senior housing leaders to improve the way our institutions of care impact lives. Unlike his previous books The Checklist Manifesto: How to Get Things Right, Complications: A Surgeon’s Notes on an Imperfect Science, and Better: A Surgeon’s Notes on Performance, Gawande gets personal in Being Mortal: Medicine and What Matters in the End, with a perspective enriched by his father’s end-of-life journey. “We are not ageless,” Gawande writes, pushing readers past the denial that afflicts both the physician and the patient. Our goal, he continues, is “not a good death, but a good life to the end.”

The challenge, of course, is how to achieve that goal when only three percent of medical students receive training in geriatrics. While Gawande and his colleagues at Ariadne Labs focus on physician education, Being Mortal provides insights that readers can use with their own families.

My favorite tip was his description of ODTAA Syndrome, the signature way to tell when a patient or loved one is nearing the end of their lives. ODTAA Syndrome is when one experiences “One Damn Thing After Another,” a sure sign that the body is weakening and starting to fail. While the medical community uses clinical markers and checklists for stages of dying, this intentionally amusing name most clearly describes what families experience.

Long before ODTAA syndrome begins, older people with medical concerns face three housing choices: aging in a home setting with assistance, moving to an assisted living community, or moving into a skilled nursing home. While each option has benefits and challenges, Gawande describes resources worthy of consideration.

1. The Eden Alternative – As a new medical director of Chase Memorial Nursing Home, Dr. Bill Thomas found that residents were suffering from boredom, loneliness and helplessness. His solution? Admitting 100 winged and six four-legged residents. Gawande shares this hilarious story about the founding of the Eden Alternative; you may find nursing home communities that subscribe to their philosophy here.

2. Assisted Living Communities – As a caution to families, Gawande reminds us that today only 11 percent of assisted living communities “offer both privacy and sufficient services to allow frail people to remain in residence,” the original intent of Dr. Keren Brown Wilson, the founder of the first community for assistance in Portland, Oregon. One of the model organizations recorded by Gawande is Sanborn Place, led by friend Jacquie Carson who provides the kind of passionate advocacy and skilled care all elders deserve.

3. Palliative and Hospice Care – Perhaps the most useful guidance in Being Mortal were the examples of how patients, including his father, weighed treatment options during the last few years of their lives. Highlighting the importance of palliative consultations and hospice care, Gawande used his father’s fear of becoming a quadriplegic to demonstrate those often difficult conversations about care options, conversations that are the focus of the 5 Wishes, The Conversation Project, and the popular card game My Gift of Grace.

Here is an excerpt of the questions a physician trained in palliative care might ask.

1. What do you understand your prognosis to be?
2. What are your concerns about what lies ahead?
3. I need to understand how much you are willing to go through to stay alive.
4. What are your goals if your condition worsens?
5. If time becomes short, what is most important to you?

Unfortunately, until more physicians and health care providers are trained in palliative care, it remains for family members, especially those who are designated as health care agents, to clarify their loved one’s wishes. Being Mortal gives families insight into how to have those conversations. Buy a copy and use it to start the conversation with those you love.

HIGHLY RECOMMENDED. You may purchase a copy here.Being Mortal: Medicine and What Matters in the End

c 2014 Circle of Life Partners, LLC. All rights reserved.

What Immigrants Teach us about Aging

Bowne Park 2014 by Janet Simpson Benvenuti

Last Sunday, my early morning walk took me to Bowne Park in North Flushing, NY an oasis of trees, grass and walking paths surrounding a pond in the borough of Queens. I wandered past the neatly manicured lawns of single family homes first built by the successful physician and attorney sons of Irish and Italian immigrants, now inhabited by their Korean and Chinese counterparts. I joined the dog walkers doing laps around the park, past the basketball court where my son once played, perfecting his three point shot through a chain-link hoop. On one end of the court, a future Jeremy Lin practiced his layup while on the other, four grandparents stretched in synchronous motion, practicing their tai chi.

Ahead, an elderly woman stepped up and down the on the lower rung of the climber where my daughter once scampered gleefully showcasing her skills on the slide and jungle gym. On my left, another did gentle pushups on the back of a park bench near which two men and a woman chatted, speaking in tongues and sharing a laugh.

I live in two worlds. In one, I engage with global leaders worried about an aging America. State governments shudder at the cost of long-term care. Health care providers predict rising demand while business leaders offer employees flexible benefits and housing leaders construct more assisted living complexes, anticipating future demand from aging boomers. In this world, I speak nationally about strategies for supporting an older America, coach families who need guidance through the perplexing maze of available options while encouraging entrepreneurs bursting with ideas that can make a difference.

In the second world of my personal life, I see easy solutions that are blind spots to those whose vision of the future includes separating seniors from their families. I returned home from my walk, climbed the front stairs, and unlocked the door of my mother-in-law’s home that I have shared for the past twenty years. Despite the street appearance of a single family home, the interior opens to three separate apartments each inhabited by family members. As children and teenagers, a visit to grandparents by my children meant running upstairs while a trip to their great-aunt and uncle required a loop outside to the backyard and three steps back inside to knock on their kitchen door. My husband, his brother and cousins were raised in this home along with their grandmother after whom our daughter and niece are named.

This week, we put the family home up for sale. At 89, it’s time for my mother-in-law to transition to a new home closer to her physician son. With only two days notice, 19 realtors attended the open house, and we received 15 offers within five days, all but one from Asian families planning to use the home as it was intended, a place of inter-generational love and support, with walking access to stores, the post office, buses and the railroad, a 20 minute commute to downtown Manhattan.

In few decades, my husband and I will need to downsize. Will we move into a retirement community in a sunny locale, find an assisted living community to live with strangers, or will we build a new three family home and invite our children and theirs to grow old with us? Only time will tell.

c 2014 Circle of Life Partners, LLC. All rights reserved.

Fit or Flabby? Your Insurer Wants to Know

imagesCAHGPGB7by Janet Simpson Benvenuti

In Florence, Italy, my 22-year old son joked about the abs on Michaelangelo’s David, his own physiology sculpted by the intense training regimen of a college athlete. While our physiques pale when compared to the ideal or even our twenty-something bodies, swimming or golf, tennis or yoga, cycling or walking will help keep us and our parents fit. Some of you may already be wearing a bracelet from Fitbit or Up by Jawbone to monitor your daily routine or using apps such as MyFitnessPal. With the roll-out of the Accountable Care Act, expect your health insurer to request four health statistics – height, weight, blood pressure and waist size – and future insurance premiums through your employer will be adjusted based on your overall fitness and health.

If you’re looking for a new way to stay fit with friends, check out Vizifit, a wellness venture being launched in Silicon Valley. Vizifit offers friends the opportunity to take exercise classes together on-line, regardless of where each friend is located. Yoga, Zumba, cardio and other classes are offered and during your workout, you see only the instructor and your friends. Best yet, you can interact with your friends and talk among yourselves without disrupting the class. The site is in beta-testing right now, but it sounds like a great way to exercise with long-distance friends or when you are traveling.

Have you considered getting your parents or older loved ones Fitbit or Up by Jawbone to self-monitor their sleep, eating and exercise habits? At present, these bracelets are being marketed only to young and middle-aged consumers, but the real health benefit may be for able-bodied seniors. Today, most products for our parents focus on managing illness, not wellness – alarmed electronic pill box, anyone? – it’s up to us to change that paradigm.

© Circle of Life Partners

 

 

 

 

 

 

 

 

Sleepless in Boston: From Stress or Reading in Bed?

by Jan Simpson Benvenuti

Recently, several Circle of Life supporters joined me at a luncheon sponsored by the Women’s Health initiative at Brigham and Women’s Hospital where we learned about the gender differences in our natural sleep cycles.  At my table were women juggling careers and children, aging parents and teenagers, each challenged to maintain their own health and the health of their loved ones. We listened as Diane Patrick, the First Lady of Massachusetts, spoke eloquently about her own struggles with insomnia years ago, a symptom of depression that was successfully treated.

Women are two to three times more likely than men to suffer from insomnia and simple changes in bedtime routines can lead to a more restful night. Here are 12 simple steps to improve sleep (12 steps). I was aware of some of the recommendations, like establishing good bedtime routines and sleeping in a cool room. Yet having switched to reading from a tablet at bedtime instead of a hardcover or paperback book, I have unwittingly increased the likelihood of disrupted sleep.

Do you read from a tablet before bed?

© Circle of Life Partners

More Boston Seminars on Aging Parents: Navigating the Journey

by Jan Simpson Benvenuti

The fall has been busy as our Aging Parents seminars that bring the experts and families together continue to grow in popularity. My last two public programs offered in Boston for 2012 are noted below. I hope that you or your colleagues can join me.

Two weeks ago, I spoke to an overflow crowd of Harvard-educated executives as they shared their stories about navigating the aging journey with their parents and reflected on how to improve programs for employees within the organizations they lead. Last week, I moderated a panel in Wellesley, MA to help families better understand how to care for their older loved ones and themselves as they juggle work, family, and other responsibilities. This week, I’ll be moderating a program hosted by the Women’s Bar Association in downtown Boston on Thursday evening that is open to the public. And, on Saturday November 3rd, I’ll be speaking in another public event in Boston at the National Association of Healthcare Advocates’ Conference. If you have a personal interest in attending one of these programs on Aging Parents or if you know others who would benefit from expert advice for the price of a latte and a snack, please plan to attend if your schedule permits. Both events require registration, but last-minute registrants are welcome.

  • Thursday, October 25th at Baystate Financial, 200 Clarendon Street, Boston @ 5:30 p.m. Click here to register.

The Women’s Bar Association of Massachusetts is hosting this informative evening on Aging Parents: Navigating the Journey ™. As moderator, I will be joined by Martha Payne, Financial Advisor, Baystate Financial Services; Dianne Savastano, Principal, Healthassist; and Kristin Shirahama, Esq., Partner, Rosenberg, Freedman & Goldstein LLP. Proceeds from the sale of my book Don’t Give Up on Me! will be donated to the WBA’s Elder Law Project.

  • Saturday, November 3rd at the Hyatt Regency in Boston @ 11:30 a.m.  Click here to register.

The National Association of Healthcare Advocacy Consultants will hold its fourth annual conference in Boston. This three-day conference includes medical professionals and experts convening to discuss The Leading Edge of Reform: Roles and Goals for Healthcare Advocates. The Saturday program is open to the public for $25. My session will include a mix of families and the healthcare professionals who advise them. All workshop participants will receive a free copy of Don’t Give Up on Me!

I’m grateful that so many professionals donate their time and expertise to our educational programs. We are planning the 2013 calendar now, so stay tuned as we host programs in cities across the country.

 

© Circle of Life Partners LLC