by Tyra Phipps, Ed. D. (tyra.phipps@gmail.com)
Dr. William H. Thomas
Dr. William H. Thomas better known as Dr. Bill Thomas is a Harvard Medical School and State University of New York at Cortland graduate who specializes in geriatric medicine and elder care. He is a 57-year-old pioneer of the Eden Alternative, a more humane way to meet the needs of the elderly in long-term care. He recommends a radical reinterpretation of longevity that views the elderly as central to the collective pursuit of happiness in society. His question is, “What if nearly everything we think and know about aging is wrong?” Dr. Bill’s book published March, 2014, is called Second Wind: Navigating the Passage to a Slower, Deeper and More Connected Life. His book examines the lives of Baby Boomers and their second “coming of age.”
This extraordinary physician is also a farmer, musician, entrepreneur, teacher, and founder of ChangingAging.org. In simple terms, Dr. Bill says that the same old thinking produces the same old results. This country physician recommends common sense ideas for changing the way we view the elderly and care for them. He advocates for a culture change. Like many Baby Boomers, he is exuberant, energetic, and multifaceted. An author, musician, and traveling with his Age of Disruption Tour to cities around the country, he wants to make a global difference and change the perceptions of aging. This change agent is transforming lives and communities by teaching that aging is an opportunity.
Ms. Gail Sheehy published the book, Daring: My Passages: A Memoir in June, 2015. In an interview on NPR during October of the same year she discussed how there is less to lose with aging. There is a greater need to speak up for those who cannot speak. She talked about the postmenopausal zest that Margaret Mead, the great anthropologist, pointed out in her lifetime. Women who are beyond the need to prove sexual attraction now concentrate their energies on what they want to do and the difference they want to make in a lifetime citing Congresswoman Nancy Pelosi and Senator Dianne Feinstein as examples. Ms. Sheehy said that all Boomers now realize they are going to get old, but it is important to try new things. In her own words, “When I fear, I dare. Back away, I feel weak.” She further explained that it is easier to see the positive of better judgment that comes with aging. She talked about the importance of helping at risk children, or volunteering to make a difference in the lives of people less fortunate. If something goes wrong during the later stages in life, there is always someone around to lend a hand. “If you fall down, you will meet other people along the way who will pick you up.”
Ms. Cindy Williams with a 1947 birth year and fame from Laverne and Shirley which aired 1976 through 1983 was interviewed on Growing Bolder, NPR in
November 2015. Her book is called Shirley, I Jest: A Storied Life was released May, 2015. She talked about how aging was like going away to college and trying to connect with
other people as well as figuring out how to stretch money. When asked about aging and Hollywood, she responded by saying, “I don’t like it. It just sneaks up on you. It’s all of a sudden.”
Mr. Paul Henderson of GreatTransitions.com urges people to plan now for what happens all of a sudden. His perspective in November, 2015, is the reality that there was a need for 30,000 nursing beds in Orlando, Florida and it now has increased to between 100,000 and 120,000 nursing beds. The biggest shift of population age in the history of America is underway. The demand for continual care is far greater than the supply. He urges discussing with parents what they would like in the way of long-term care placement. Certainly this is more difficult if there are mental problems or dementia. According to Mr. Henderson, even more difficult in society now is the fact that if you do not plan, someone else does it for you and that can result in even greater devastation.
If the worst happens and someone else has to plan for you, which you prefer a toxic taker or generous giver? Dr. Adam Grant publishes many columns in the New York Times. March, 2014, he published the book, Give-And-Take: Why Helping Others Drives Our Success. Dr. Grant, a Professor of Management and Psychology at the Wharton School of the University of Pennsylvania is an organizational psychologist who described three types of people which are the givers, the takers and the matchers. These people can influence whether or not an organization is joyful or toxic for human beings. Are you in the process of looking for a long-term care facility that is joyful? This might help.
The realistic perspectives from people experienced with long-term care make information exchange even more vital before deciding on assisted living, skilled nursing, or dementia care for a family member or loved one.
On October 19, 2015, Mr. David Cravey wrote about a Florida nursing home. The statement was, “Our patients don’t need hospice care. We can provide the same level of care without their help.” Mr. Cravey works in hospice and said that translates to, “We don’t want the oversight and accountability.”
Ms. Jane Albertson wrote on October 18, 2015, that, “It is insane what goes on in these places in Indiana. They are so understaffed. I have a neighbor who gets called on her vacation and is expected to come back in because the facility is running short. Management has no regard for her well-being. They keep making people work two shifts. No one can work 16 hours and do a good job. No one! There are bound to be problems and mistakes. Someone is going to suffer. You cannot do good work when you are tired and disgruntled. Even 12 hour shifts are difficult, but would be better. I’m just glad that my sisters and family all agreed that we will look out for one another. I’m so glad I’m not living in a nursing home. I saw what happened to my husband’s parents. We visited every weekend. My mother-in-law absolutely loved the deviled eggs I took her. Here she was with a bed and some books in a bookcase after being a journalist with a newspaper and a librarian. Heartbreaking. These places are a rip off. People at the top keep getting richer while elderly people get less care.”
On October 14, 2015, Dr. Ronald Phipps wrote about long-term care, “It is an overwhelming and sad picture.”
Ms. Jessica Growden, from the Millennial Generation corresponded on September 21, 2015. “It’s important and the issue gets more and more chilling for me as we face our parents and their aging processes - the expense, the possible aid they might require later on, how to choose that and manage their care from a distance. It's not something I'm looking forward to facing. :(“
During October, 2015, Ms. Lynn Crowder wrote in several email exchanges about experiences with long-term care. “I look at the bathing room in nursing homes and it is bone chilling. It reminds me of the autopsy room. I envisioned a man in blue surgical clothing getting ready to dissect a body. It was the most cold and eerie feeling as I looked into the bathing areas of these nursing facilities. There was a chill that went throughout my entire body and it reminded me of my parent’s death. Why can’t these places be more homelike? No living being should be treated so poorly as if their existence has no meaning. I have been working with elderly for more than 12 years. So many of these long-term care facilities are in a downward spiral which tolerates incompetence and acts oblivious to the conceited management who are people on power trips.”
Questions for Consideration:
1. Is there a parent or loved one in your family that is in need of continual care? Be prepared to take time and visit facilities when no one is expecting the visit. This may mean dropping by in the middle of the night. Make note of how many nursing aides are on duty. Is there a licensed practical nurse or registered nurse on duty? The recommended national ratio is one nursing aide for seven residents or patients. Does the facility meet that ratio? If not, care for the loved one will be very limited.
2. Talk to the CEO or manager in person. It is easy to spot a toxic taker which is better known as a toxic faker. Notice a lack of eye contact, twitching, avoidance and rushed behaviors to get to another issue which probably does not exist. Investigate the background, training, and education levels of management. There are numerous healthcare degrees and administration degrees in healthcare that are helping provide better education to people who are genuinely interested in caring for the elderly. Even education is not a guarantee of a quality, caring person running a facility, so it is best to meet in person with people at every level of management.
3. Request to see the list of state citations given the facility. This may be some indication of problems with the facility, or worse, with the state inspection system. Most states have cut back at every level including ombudsman positions, which means it is even more important to see the citation listings. There is no doubt that where there has been a citation, many more reasons for citations exist and were not caught by the state inspectors.
4. Try to get an idea of how management handles criticism. Talk to other people who have been in the facility with their loved ones. Be sure there is a Family Council meeting, not just a Resident Council. Family members need to speak up for the loved one that may have some dementia or is fearful of retaliatory behaviors from staff.
5. What is the atmosphere like in the facility? Does it look industrial or austere? Does it look friendly? Is there a comforting homelike feel to the resident rooms and dining areas? Too often family members will bring far too much furnishings and decorations from their loved one’s home. A small room can be homey without being cluttered and cramped. A crowded room creates dangerous situations that may cause falls.
6. Try to discern if core values are in place. Faith-based facilities are no guarantee of a humane treatment of the elderly. Question opinions
and perspectives on treating the elderly with dignity and respect. Watch how the members of the staff interact with one another and with residents or patients. Are there meaningful exchanges when communicating? Do members of the staff hurry
away from a conversation without closure? If so, loved ones will be treated the same way. In that case, look for someplace else that values aging and is part of the paradigm shift promoting the spirit and life of the elderly.
December, 2015