Thursday, July 31, 2008

Giving Gifts

I walk to work every day. It’s nothing righteous or even green, but it’s my time to get the blood flowing to my brain, think through the day’s projects and hopefully work off enough calories so that I can eat a real dinner. Besides, one advantage of being the owner of the company is the privilege of choosing the office location - just down the hill and across the bridge from our home. So my walk takes all of 15 minutes every morning. They are 15 minutes that I treasure, too. I count my many blessings, take deep breaths of clean, pure air, and plot new challenges for my team.

Yesterday, I was given a gift on my way to work. Totally out of the blue, a man ran up to me and handed me a card. It happened so quickly and so unexpectedly (not to mention the fact that I was in my own little world of thinking, planning and probably talking out loud) that I didn’t even get a good look at the man.

The card contained a hand-written note. In the note were some very nice comments made from someone who had, unbeknown to me, watched me walk to work every day for the past several weeks.

Weird, a little, but nonetheless, it was a nice gift.

I remember when I first started running for exercise. I started late in life – actually, the week before my 40th birthday. I was determined not to let myself age into a heavy, sedentary person, so I joined a running team and began preparing to run in the Hood-to-Coast, a local event that is very challenging and fun.

Those first runs were tortuously difficult. Within a mile or so, I was feeling ragged and exhausted. But then, out of nowhere, another runner would pass by me. If that person slowed down a little to smile and say, “You’re doing great,” or some other encouraging word, I found a new reserve of energy. It completely changed how I felt at that moment.

After my own little “aha” moment I determined to smile and say something positive to people I met every day. I realized that this is one of those rare and precious things: a gift, unexpected, from a stranger. And it can change the way the entire day proceeds.

I like to apply this concept in my work, too. As a boss, I sometimes have to remember that my own smile changes the work environment completely. A little joke, a small compliment – these are gifts I can give every single day.

I think of this, too, in terms of the people who provide direct care to seniors, either in a facility setting or in the home. Their work probably feels like my 6 mile run some days: exhausting, difficult and pretty unrewarding.

Taking just a minute to smile, say “Thanks” and make a comment: “You’ve got such a gentle touch,” for example, is an easy, free gift we can give that might just make a world of difference.

Monday, July 21, 2008

Sleeping Well at Night

I was touched by the entry written yesterday by a family member who had just moved his loved one into a care center.

He talked of the pain of leaving his wife, but the joy when he came to visit a few days later to see his wife happy - dancing, even.

His closing comment was the most poignant:
This good news has lifted a huge burden from me. I now sleep through the night for the first time in eight years.

This is a comment I've heard countless times over the years. Families agonize about finding care for a loved one. They feel deep angst about moving a mom, dad or spouse out of the family home. Of course there's a little guilt. Of course there's grieving what once was, and is now lost.

After it's all said and done, however, the dominant feeling is relief.

It's all about balance. What works for one family is not the same as what will work for another. In this era, we need to be open, accepting and supportive of the solution that each individual family chooses. Not everyone should move into a care community. Not everyone should stay in his or her own home.

The true beauty of living in the age we do is that we have the choice. It's no longer home or nursing home - many options exist in between.

Here's to finding what works for you, and what lets you sleep well at night.

Friday, July 18, 2008

Medicaid is NOT the solution

Today's promising headline read, "Solutions for elder-care issues." in the, the Journal News of the Lower Hudson's news site.

Among the solutions? Transfer all mom and dad's assets to your own bank account, so that Medicaid will pick up the cost of their care. Takes all the stress off the sandwich generation kids, and - hey, the government can pick up the tab!

Here's my response:

It's a solution for one individual family to transfer assets and make mom or dad eligible for Medicaid - but it's a societal nightmare. Imagine the implications if all 18.2 million individuals over 85 paid no portion of their own care, but left it all up to the government in the form of subsidies and Medicaid. No longer would the individual family benefit - we'd all be paying the cost through tax rates through the roof.

I believe it is time to look for more creative solutions that benefit not just the heirs but the greater society as well. Perhaps if we start by recognizing those who provide care in this country and honoring, training and valuing these individuals, more people will be willing to take on this work. We need honest discussions about best ways - and places - to provide care to individuals, whether they need just a little support or are fully dependent.

Being a tightly squeezed member of the sandwich generation myself, I know that this is not a battle for me alone. We're facing these issues with both sets of parents, at the same time we're having discussions among ourselves, our siblings and children about how we want to handle our own aging needs when they arise. While we don't have unlimited assets, we all have some ability to plan, to pay and to creatively address these challenges - not to leave the solutions to "the government."

As we boomers age, we may rediscover the commune - now for mutual caring purposes. We may find that we can afford the services we need (and want) best by joining together with others. We may find other creative options that work for many, and are affordable in cost.

We WILL need individuals from the younger generation who find personal meaning and societal value in providing care. We WILL need to invest in their training as well, if we want quality care for our parents today, and ourselves tomorrow.

For my part, I've dedicated my time and resources to developing training programs, accessible via the internet, to train not only the minds but also the hearts of the next generation of caregivers. It's a professional focus, but it's also very, very personal.

Join me for creative solutions to this challenge,

Sharon K. Brothers, MSW
aQuire Training Solutions

Thursday, July 17, 2008

A Lesson from Joe Louis's Sister

In the news today is a story about the great boxer, Joe Louis’s sister, who died in February after wandering away from her care center and freezing to death.

It’s a tragic story; one that encapsulates every family member's fear when mom or dad loses the ability to remember and reason, and is moved into a care setting.

Will she be safe? Will anyone pay attention to him? Will she feel lost, alone and worried?

For many folks with memory loss the feelings of confusion, loss and anxiety are present all the time. No place seems familiar anymore. No one is recognizable. Every place – and everyone – seems strange, uncomfortable and foreign.

What we call wandering is usually just an attempt on the part of that person to return to a place where things make sense again – and it clearly isn’t the place they currently reside.

For Joe Louis’s family, this story ends tragically. According to the allegations in the lawsuit, the facility had neither monitoring nor alarms on the door; truly, an lapse that is hard to explain or excuse if true.

For families everywhere, familiar with this scenario, the truth is often more challenging. Doors with alarms can feel safe, but what happens when the attendant (or family member) is vacuuming or in the restroom and doesn’t hear the alarm? What happens when the person slides out with someone else, like another visiting family member?

It’s happened to me in my own alarmed, secured memory care communities. A resident walked freely out on the tails of a visiting family group who was so absorbed in conversation no one noticed the tag-along.

An experienced nurse told me the story just the other day of an incident when she actually let the person out of the secured facility – held the door for her. She looked so “normal” and had asked nicely if the new nurse would please hold the door – so she did.

Security in the best of situations is not foolproof (witness prison breakouts); far better to focus on helping the person feel comfortable, safe and at home – no matter where you are.

And set the door alarms.

Wednesday, July 16, 2008

In the Game

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Caregiver Shortage to Affect Everyone

Here’s the headline that hit my inbox today: “One Million New Direct-Care Workers Needed by 2016.”

This fact was taken from a recent report by PHI, an advocacy group for direct care workers, that also noted that home care and home health aides are among the fastest growing occupations projected for the coming decade.
That number is an incredibly large number, especially when it is accompanied by the miniscule growth in the pool from which these workers are typically drawn – women ages 25-54.

This level of shortage will likely affect nearly every community – and many, many families.

What can we do? Here are some ideas that we all can participate in implementing:

1. Start a small movement in your work, home, and community to improve the respect caregivers experience. If you work with caregivers, go out of your way to thank them. Tell others what a great job they do for all of us. If the job begins to have more social rewards, perhaps it will begin to attract more individuals, male and female.

2. Support caregiver training. If you employ caregivers (whether on a family level or a corporate level), invest in their training. This not only helps the individual caregiver build skills and knowledge, it also supports training efforts that are available in the community. Free training opportunities are out there (here’s a sample that came into my inbox today); many caregivers, however, need support in the form of payment for their time or other compensation to be able to take advantage of these opportunities. Find a way to help this process. Our company is supporting caregiving training by posting “How-To” videos on the internet on a website called Howcast. Check out a few samples: Blood Pressure, Wash Hands, and more. We're also actively involved in developing and providing more online training for CNAs and caregivers, increasing the access which will, in turn, increase the supply of qualified caregivers.

3. Support bills, regulations and initiatives to improve the pay and benefits of caregivers in your state.

Small steps, but the payoff will be huge – and personal – some day.

Monday, July 14, 2008

It Takes a Village, Part 2

Thanks to Bruce Craig for his comment:

Clearly your parents have options. Many older adults do not have the option of selling their home and moving to another location. That is why we see a growing movement towards neighborhood and community programs for older adults which retain the intergenerational mix with an emphasis on socialization, wellness and access to services. The baby boomer trend to move to segregated communities when nearing retirement can increase societal tension when they ask for the polities they have separated themselves from for the new services they will need to remain independent.

You're correct, Bruce. My in-laws DO have options that others don't have. It's not because they're wealthy, however. They are a solidly middle class family. My mother-in-law stayed home and never worked once the children arrived; my father-in-law worked at a print shop his entire career. He saved every month, paid off their 2 bedroom 1 bath bungalow, and, in general, were frugal. Now, they have a home with no mortgage, that, even in this housing market, will give them the cash they need to pay for their retirement center apartment likely for the rest of their lives (barring any other unforseen cash needs).

I like the concept of neighborhood based programs that offer socialization and support in a variety of ways. It's pretty hard, though, if your neighborhood hasn't been organized. In my family's case, their neighbors - several of whom had lived in the neighborhood as long as the in-laws - have all died or moved out. New neighbors are busy with their own jobs and families.

I love the idea of options. I love the idea of community. I truly believe that the village is needed to support our elders as they age. The village can be neighborhood based, or it can be in a community of individuals who have pooled their resources to hire a full staff of support people - oh wait, that's exactly what a retirement community is!

I'm very interested to learn if anyone else has had success with a neighborhood-based community support network for seniors - anyone out there want to share?

Thursday, July 10, 2008

New Features from Wellsphere

Look over to the right...down a little..see the two new features we've just added to this blog? They're called "widgets" and they provide a message that changes every day.

The first one, called Wellevation, has a daily motivational quote. If you're like me, sometimes they'll seem a little cliche' or, as the kids' say, "lame" - but other times they're right on target. I'm a firm believer in focusing my mind on things that reflect my goals and my values. Motivational sayings sometimes help with that process. It is a process...a journey.

The second new block is one called WellTip of the Day. It is, likewise, a daily changing idea to give you motivation and encouragement. I've selected the topic of stress management. I think, maybe, it's more appropriate than the rock-climbing topic, at least for people like us!

Here's another reason I'm adding these features: I've been invited to join the Wellsphere family of bloggers, sharing with their larger audience my perspectives on caregiving issues, training and how we, together, face the challenges of today's aging society.

Thanks for traveling through this part of the journey with me. Get motivated, get relaxed, get involved!

It Takes a Village

You know the saying, “It takes a village to raise a child.” It’s a saying that recognizes the importance of many different individuals in providing the care, training and nurturing that a child needs to grow and to thrive.

I’d like to purpose a slightly different version of this saying: “It takes a village to support a senior.”

Despite all of the work being done – good, important work – to help individuals prepare their homes for aging in place, I believe that this is only one part of the important set of tasks involved in supporting an aging population.

One of the biggest health and wellness – not to mention quality of life – indicators is social connectedness. Even with a fully accessible home, social isolation, loneliness and lack of mental stimulation are real concerns.

According to a study recently published in the Personality and Social Psychology Bulletin, social interaction was “just as effective as more traditional kinds of mental exercise in boosting memory and intellectual performance,” according to lead author Oscar Ybarra (as reported in Medical News Today).

We know, both from our own experience working with seniors and from more recent research that the keys to a longer, healthier life can be found in simple things: physical exercise, good nutrition and social interaction.

All three of these things can be compromised when a person (or couple) is living alone in increasingly isolated surrounding.

Physical exercise? Does walking from bedroom to bathroom to the La-Z-Boy count?

Good Nutrition? Cooking for one (or two very light appetites)? Ha – try eating out of the can, standing over the sink.

Social Interaction? If you count talking back to the TV announcers.

In my in-laws case, all of these areas have been so significantly compromised that their decline became readily evident. This couple, both active, gregarious individuals throughout life, now have no surviving neighbors or friends, find the public golf course too difficult to navigate most days, and don’t drive much anymore anyway.

For them, the social isolation has dramatically reduced their quality of life. Hence, our push to encourage them to join a community of other older people – a retirement living community.

They’ve made the decision to move now. All that’s left is to sell the house. Their faces are already brighter; their moods cheerier.

The rest of the story remains to be written, but for now, we’re voting with the village as the solution to the challenges of this stage of life.

Monday, July 7, 2008

It's Called Moving Up, NOT Giving Up

Last week we met my in-laws for lunch at a new retirement community in town. This time, they're really interested...they think.

As you may recall, my in-laws (90 and 95 years old) have been fighting the idea of leaving their home, despite becoming more and more bored, lonely, depressed, overwhelmed by home maintenance - all those things that signal the rest of us that it's time to do something different. They would, we all believe (all the kids, that is) love all of the social activities and new friends at a retirement community.

So we've been gently, and not so gently, encouraging this step.

Now the plumbing is going in the house, and it just might be the final straw.

As we were touring the building, I kept telling my mother-in-law, "This is a step UP, not a step down. Think about what you're gaining, not what you're giving up."

She looked around at the beautiful new building, complete with a dining room, maid service, maintenance and names they recognized on the doors of neighboring apartments and sighed, "You're right. If I can just get my brain to think that way - I know you're right, but old ways of thinking are hard to change."

She's right, of course. Old ways of thinking ARE hard to change. We're so programmed in our culture to focus on trying to keep older people in their own homes that sometimes we don't see when it would be a step UP for them to leave their homes.

All I want, as a family member, is to see them actively enjoy whatever years they have left. And they're not likely to do that feeling like their home is an anchor and an isolation chamber.

Thursday, July 3, 2008

Sandwiched but Strong - sort of

Last night I had a dream. I was all alone in the house, fixing myself dinner and picking up after the kids. No big deal, just relaxing and enjoying an evening alone.

All of a sudden, a mass of bad guys began breaking in – coming in through windows and doors, on both floors, all at the same time. The bad guys were breaking apart handrails and furniture, pulling out any metal pieces (thanks, media folks, for those story on druggies stealing metals for drug money…).

I’m tackling the bad guys right and left and then – the phone rings.

I stop what I’m doing, pick up the phone, and it’s my mom.

“Hi mom,” I say.

“Hi.” She replies. “I just wanted to talk with you about some things,” she says with a quiver in her voice.

“I’ll call you back a little later, Mom, OK?” I say, and hang up the phone to go back to fighting the bad guys.

About then I woke up and thought, “Wow, if that doesn’t exactly express how the person stuck in that ‘sandwich generation’ feels!”

It’s not like the visual of nice comfort food between two yummy slices of bread.

It’s more like beating off the “bad guys” (work, kid worries, money – you probably have your own list) on the one hand, and pausing – just for a second – to be there for the parent, knowing that you’ve got to get back to those pressing issues – NOW – but your parent still needs you…and so it goes.

My favorite part of the dream was the fact that I, single-handedly, fought off all the bad guys.

It was probably because of the one little thing I forgot to mention – the red “Supermom” cape I happened to be wearing that evening.

Know where I can order one in real life?

Wednesday, July 2, 2008

E-learning Addresses Healthcare Workforce Crisis

We've officially launched our new OHCA/aQuire online nursing assistant course. Even before launch, with no publicity and no way for people to find the online application website ( we were attracting 3-4 new applicants daily. It'll be fun to watch what happens in the coming weeks and months.

Why is this course so important?

It's important because, at the same time the senior population in our country is poised for the fastest growth ever, the workforce who typically provides care is shrinking.

Nurses and caregivers occupy 4 of the top 10 occupations with the largest job growth projected over the next 10 years. according to PHInational. The labor supply isn't growing fast enough to meet this demand - not even close.

Nursing schools are turning away applicants for lack of adequate instructors.

So how can e-learning help?

With e-learning, not only can more students enter the training pipeline but they can also receive consistent training throughout the system, regardless of where they choose to access the course.

E-learning can be a powerful tool, as well, to train individuals to meet the changing needs of the senior population. Specific approaches can be used to help the student better understand the human needs of the population, for example, and to train them on emerging challenges and approaches.

Finally, e-learning is the perfect tool for training a workforce that is diverse and includes immigrant workers who don't understand spoken English well. E-learning allows the student to learn at his or her own pace, and lets the student hear and see the words as well as the visual illustrations, representations or video examples. Students can use immediately accessible online translation programs, too, to help them better grasp concepts in their own language.

Online nursing assistant courses are only the first step to increasing the availability of healthcare workers to meet the coming demands. Our creativity, imagination and ability to employ effective e-learning approaches are tools that will help us solve this crisis, starting with this first small step.