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Barack Obama and John McCain on Long-Term Care Financing

Tonight is the second debate of the presidential candidates. It will be a town-hall forum. Wouldn’t it be nice if one of the citizens - or Tom Brokaw (the NBC moderator living fully after 50) asked about the candidates' ideas on the future of financing long-term care and aging services in America?Here’s a question that AARP Magazine recently put to the two candidates:

How would you shift long-term care services and financing so that people can afford to stay in their homes and communities as long as appropriate? (Below are their answers to the AARP questions . .; . do you agree … disgree … or would you like to see a different answer?)John McCain: I am confident in the pioneering approaches for delivering care to people in a home setting, and would look to them first as models for how we need to approach this issue. There have been a variety of promising state-based experiments such as Cash and Counseling or The Program of All-Inclusive Care for the Elderly (PACE). Through these programs, seniors are given a monthly assistance which they can use to hire workers and purchase care-related services and goods. They can get help managing their care by designating representatives, such as relatives or friends, to help make decisions. it also offers counseling and bookkeeping services to assist consumers.Barack Obama: The long-term care system is heavily biased toward institutional care -- even though most people would rather remain at home -- and the quality of care is often poor. Moreover, nursing home and home care are very expensive, and Medicare coverage for both is limited, making catastrophic expenses routine. As President, I will work to give seniors choices about their care, consistent with their needs, and not biased towards institutional care. I will work to reform the financing of long-term care to protect seniors and families from impoverishment or debt. I will work to improve the quality of elder care, including by giving our long-term care and geriatric workforce the respect and support they deserve and training more nurses and health care workers in geriatrics.

Support or Oppose

AARP also put three statements in front of the candidates and asked if they supported them or opposed them:1. Increasing consumer choice and control for people needing long-term care.2. Improving standards and incentives for quality care.3. Providing family caregiving initiatives, such as respite care.Barack Obama supported all three; John McCain chose not to answer. (No clue as to why McCain chose not to answer.)

Want to read more on long-term care financing? Visit our special section devoted to the subject.

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Bob Said He Was Growing Down

Anne Simpson and Laura Crosby had the opening of their exhibit at the Aslan Institute last Thursday evening. What spirit and energy there was. The exhibit runs through October.Following is the second narrative from Anne’s book 'Growing Down,' the Alzheimer’s journey of a husband and wife. Following the narrative is a poem from Anne’s book. You can read earlier installments here and here of this very personal and beautiful story.

II. Growing Down

One day, when I took Bob for a check-up, our local doctor motioned me aside and very gently said, 'It’s time.' I knew what he meant. It was time for us to leave our small community and move to Duluth where we would have more services available for help with Bob’s care. It had been our contingency plan for almost six years.We went to a continuing care community on the campus of St. Scholastica. There was adult day care available for Bob as well as additional help from some wonderful college students. We participated in monastery and college events, and we lived within a community of lively seniors.As the disease progressed, inevitably, it took more of our lives. Some of the changes and losses were painful indeed - especially Bob’s loss of vision. Bob was aware of what was happening to him; he said that he was 'growing down.' But still we were lucky because for almost four more years the decline was so gradual that I was able to keep Bob at home.

Bob’s Poem

Of me there is three -the one I amthe one you seethe one I want to be.

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America’s Nursing Home Problem is Just Beginning if America Doesn’t Step Up

Swamped by the news of Monday’s failed bailout vote on Capitol Hill, was the report by the U.S. Department of Health and Human Services that more than 90% (yes you read that right, more than 90%) of U.S. nursing homes were cited for violations of federal health and safety standards last year.In the New York Times report by Robert Pear, inspector general Daniel Levinson of the department broke down the stats in his report by non-profits and for-profits:

• The inspector general said 94 percent of for-profit nursing homes were cited for deficiencies last year, compared with 88 percent of nonprofit homes and 91 percent of government homes.
• About two-thirds of U.S. nursing homes are owned by for-profit companies, while 27 percent are owned by nonprofit organizations and 6 percent by government entities.

UNACCEPTABLE. Americans need, want and deserve better. So do so many professionals in the long-term care profession. In this country, one should be able to live with the utmost dignity with the best possible care to the very end of life.Simply adding band-aids of more rules and regulations on top of mega fractures isn’t going to get the collective body working the way it should. Major change demands collective innovation and collective leadership. This issue is all about the 'common good.' We’re all aging, and more of us are doing it than ever before in our country’s history.We invite you to read two perspectives on this by two leaders focused on changing aging in America. Download here Ecumen CEO Kathryn Roberts' article entitled 'An Incredible Opportunity for Candidates Who Desire Change in America' and Larry Minnix’s (CEO of the American Association of Homes and Services for the Aging) interview today with Jane Gross in The New York Times' blog 'New Old Age.'Related information is available at the top of Changing Aging in these two categories: Innovation in the Age Wave and Long-Term Care Financing Reform.

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I’m Still Here - The Alzheimer’s Story

Photo Copyright: Laura Crosby

Twin Cities Poet Anne Simpson and photographer Laura Crosby have collaborated on a new book and exhibit entitled 'I’m Still Here.' The exhibit will open this Thursday, October 2nd with a reception from 6 to 8 p.m. at the Aslan Institute in Eagan. The exhibit runs through October 31. Above is one photo from the exhibit, and below is a poem entitled 'Visitation' also featured in the book and exhibit:

VISITATION

In the Alzheimer’s homewhere the young mother has come to visit,her baby is crying.You hold out your arms.

You sit on a cold, metal, fold-up chairby the nurse’s desk,sit calmly as you hold the flailing bundle --

purple screwed-up face,fists and feet pummeling the air,tiny lungs forming screamsthat pierce old deafened ears.

Bent over the child, you sit,gently rocking,stroking her,speaking sounds no others understand.

You murmur the language that comes before speechthat she, so recently arrived,and, so close to return,can speak together.

- By Anne Simpson, 'I’m Still Here' - The Alzheimer’s Story

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Ecumen Invites You to Tomorrow’s Twin Cities Memory Walk

For our Twin Cities residents, join the Ecumen team and hundreds of others at tomorrow’s Alzheimer’s Association Memory Walk in Bloomington, Minn. It will be a beautiful day in more reasons than one. More information can be found here.

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Successful Aging Profiles - Tomoji Tanabe

At Changing Aging, we are proud to announce our latest feature titled 'Successful Aging Stars.'Each month, we will profile those who are living examples of successful aging, from the famous, to the not so famous.These profiles could include just about anyone and we proudly invite our readers to nominate any successful agers to be profiled here via the comments below.Our first profile is on 113 year old Tomoji Tanabe.Tomoji Tanabe, who was born in 1895, celebrated his 113^th birthday last Thursday in Japan. He told reporters he wants to 'live another five years or so.' That’s changed a bit since last year when he said he wanted to live 'for infinity.'

He sticks to some lifelong habits: He rises early. He exercises his mind daily by reading the newspaper. He drinks milk every afternoon and eats regular meals (very little snacking and few fried foods). He also doesn’t drink alcohol or smoke.
Japan has one of the world’s longest life expectancies, nearly 86 years for women and 79 years for men, which is often attributed to the country’s healthy diet rich in fish and rice.The number of Japanese living past 100 has more than doubled in the last six years, reaching a record high of 36,000 people this year. The country’s centenarian ranks are dominated by women, who make up 86 percent of the total.Japan’s centenarian population is expected to reach nearly 1 million - the world’s largest - by 2050, according to U.N. projections.Tomoji has hit quite the milestone, but there are actually 10 people older than he is. The world’s oldest person is 115-year-old Edna Parker, who was born on April 20, 1893, and lives in Indiana in a nursing home.Next month, Changing Aging will profile 85 year old Kate Stahl who works tirelessly in her quest to provide reasonably priced medication to seniors, in a piece sponsored by Ecumen’s latest whitepaper Long Term Care Financing Reform: An Incredible Opportunity for Candidates Who Desire Positive Change in America.

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I. Diagnosis

The beginning of Anne’s and Bob’s journey in Anne’s words (intro post here) followed by the poem FINDING HOPE:

'Our local doctor suspected that Bob had pre-senile dementia for several years before he was formally diagnosed with Alzheimer’s disease by the Mayo Clinic. He was 62.At first, the news did not dramatically affect our lives. We lived in the small community of Grand Marais on the north shore of Lake Superior where we had many friends, a good support system and a nurturing physical environment. We were able to stay involved in community affairs, to visit our families and spend precious time with grandchildren, even to take extended vacations.Bob understood what was happening to him. He talked about it openly to individuals and groups. Together we wrote a book about the first years of our journey, Through the Wilderness of Alzheimer’s: A Guide in Two Voices, published by Augsburg/Fortress.Though our pace was slow and life became gradually more and more confining, we learned to pull over sometimes and fully appreciate the moment. Though there were definitely times of fear and anger and deep sadness, Bob was determined to show us that there were also 'blessings' in his disease.'

FINDING HOPE

For monthsmy soul has been in winter,hardened by icedeep and cold and strong enoughto support all the worries of the daystanding there at once.They shuffle through my mindgrumbling, shifting weight,bundled against hopelike all the bitter womenI resolve not to become.Now, suddenly,you smile at methe way you used to do --eyes soft and twinkling,mouth turned up at one corner --and you reach out your hand.I hold it tillI feel the sun grow warm,feel hope bubble to the surface once againfrom those dark waterswhere poems, sluggish swim.- Anne Simpson

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Growing Down: Poems for an Alzheimer’s Patient

Last Friday I received a beautiful gift. Poet and Changing Aging reader Anne Simpson sent me her book of poetry called Growing Down: Poems for an Alzheimer’s Patient. That patient is her husband, Bob, who was diagnosed with Alzheimer’s in 1995 and today lives in the Wellstead care community in Rogers, Minn. Over the next few days, we’re going to share several narratives and poetry from each section of Growing Down: I. Diagnosis II. Growing Down . . and III. End Stage. We’ll also share news of a new work that she and photographer Laura Crosby have collaborated upon and is making its debut at an exhibit opening next week.Anne wrote Growing Down to promote understanding and support for the many families and communities that are caring for people with Ahlzheimers. Proceeds from sales of the book go to the Minnesota/Dakota Alzheimer’s Association.As the journey continues - a journey of the heart, mind and spirit - Anne’s work explore the feelings of both patient and caregiver. There are poems of loss and grief, certainly, but there are also vital undertones of hope.

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Take Our Changing Aging Poll: Will Baby Boomers Be Called Seniors?

A colleague the other day and she thinks the word 'senior' or 'senior citizen' will go away and be replaced by 'boomer' when boomers become seniors. Her premise is that we will be known by our generational identities. So, when Gen Xers and Millennials become seniors, they’ll still be known as Gen Xers and Millennials.What do you think?Take our Poll.[poll id='4']

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Senator Dean Barkley on Long-Term Care

I believe that we must provide additional resources to home care toreduce the need for nursing home care. Nursing homes should be a lastresort. We need to everything possible to allow elderly Americans theopportunity to stay in their homes.My Mother was forced into a nursing home three years ago. It was not apleasant experience. She did not want to go into the nursing home andwas very unhappy until her death. She was also forced to spend her lifesavings on paying for the service. There has to be a better way.

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