Category Archive

Congress today voted to override President Bush’s veto of the Medicare Improvements for Patients and Providers Act of 2008 (H.R. 6331), legislation that would extend the Medicare therapy caps exceptions process for 18 months as well as place a moratorium on a 10.6 percent cut to Medicare’s physician payment rates.

The House approved the override with a vote of 383 to 41, while the Senate results were 70 to 26. The Senate, which previously rejected a cloture motion, reached the veto-proof majority of 60 votes last week after Sen. Edward Kennedy (D-Mass.), who is recovering from a brain tumor, returned for a second attempt at cloture.

Before the second cloture vote, Sens. Harry Reid (D-Nev.) and Mitch McConnell (R-Ky.) agreed that if the motion passed, the bill as a whole would be considered approved. The House approved the bill with a veto-proof majority on June 24.

Explaining his veto, President Bush said in a statement that while he is not opposed to the “primary objective” of preventing reductions in physician payments, he said that the bill’s proposed cuts to Medicare’s privately run insurance plans, known as Medicare Advantage, were essentially “taking choices away from seniors to pay physicians.” The president described the bill as “fiscally irresponsible,” and said “it would imperil the long-term fiscal soundness of Medicare by using short-term budget gimmicks that do not solve the problem.”

However, at AAHSA we believe the bill will ultimately protect the elderly by helping to, as Rep. Rahm Immanuel (D-Ill.) said before today’s vote, “preserve the doctor and senior patient relationship.”

Larry Minnix, AAHSA’s president and CEO, said, “Thanks to Congress’ decision today, millions of Medicare beneficiaries will continue to receive the physical and occupational therapy they need without fear their care will be rationed or capped.”

We’ve unveiled our 2008 Award winners. Each year we honor individuals and organizations for their excellence and innovation in aging services. The awards, which will given during our annual meeting in Philadelphia, Pa., on Oct. 12, 2008, include the Excellence in Leadership Award, the Excellence in the Workplace Award, the Leading-Edge Care and Services Award, the Hobart Jackson Cultural Diversity Award, the Dr. Herbert Shore Outstanding Mentor Award, the Public Trust Award, and the Outstanding Advocacy Award.

This year’s Award of Honor will be bestowed upon Laverne R. Joseph, president and CEO of the Retirement Housing Foundation in Long Beach, Calif. Mr. Joseph has a long-standing record of leadership in aging services, particularly affordable senior housing.

“Our award winners combine leadership, creativity and commitment to make great strides for the people they serve and those who serve them,” AAHSA President & CEO Larry Minnix said. “We honor them for their commitment to quality and more important, the inspiration they offer our members to create the future of aging services.”

Public health emergencies were declared by Department of Health and Human Services (HHS) Secretary Michael Leavitt in the states of Iowa and Indiana, after heavy flooding began affecting health care services.

Leavitt, who is empowered by the Public Health Services Act, said the move will assist Medicare beneficiaries by enabling hospitals and nursing homes in neighboring communities to expedite the intake of evacuees by allowing facilities to act “under a presumption of eligibility.”

Centers for Medicare & Medicaid Services (CMS) Administrator Kerry Weems said that certain operating procedures of the agency “will be relaxed to speed provision of health care services to the elderly and persons with disabilities who depend upon these services.”

According to CMS, the agency will “waive certain program requirements” for Skilled Nursing Facilities, including the “three-day prior hospitalization requirement for admission for evacuated patients.” The agency will also ease “limitations on the benefit period for those evacuated patients.” In addition, CMS said it will broaden the definition of “home,” allowing alternative sites to accept Medicare beneficiaries receiving home health services.

To read the more about the CMS emergency relief effort, visit: www.cms.gov.

AAHSA’s hopping on the Facebook bandwagon, and we want you to join us! Click here to join the AAHSA Facebook group. As a group member, you can connect with your colleagues near and far, watch videos, read the latest news in aging services and find out how AAHSA’s changing the face of aging in America. Send us your contact information and we’ll make you a friend of AAHSA’s too. Let the social networking begin…

First, it was the “The Village at Penn State.” Then came Kendal at Oberlin. Now, going moving on campus to retire is a national trend… and AAHSA and its members are the experts on how to do it right. Check out this article from Sunday’s New York Times about how dozens of colleges and universities are helping their older alumni come back to their college stomping ground for their retirement. Who knows, maybe my alma mater will be next!?!

I’ve been watching with interest TIAA-CREF’s new advertising campaign, the powerof.org.  TIAA-CREF is leveraging its status as a not-for-profit provider of financial services to draw a distinction for customers.  Their point is that because they are a .org, people should trust their motives and mission.  I think this is an excellent model for aging services providers to embrace.  Over the last couple of months, I have asked several AAHSA members how they use their not-for-profit status in their marketing, and the answer often comes back that they just haven’t figured out how to do so.  Some who have done market research find that potential residents and clients like the values that being not-for-profit convey, like being focused on people over profits, dedicated to staff, and stable for the long-term.  Do you accentuate your not-for-profit status in your marketing materials?  If so, I’d love to hear about it.  I’m leading a session at our Annual Meeting on this topic and would be delighted to feature your efforts.

 Check out TIAA-CREF’s Web site at www.powerof.org. 

Congratulations to Morningside Ministries of San Antonio, for some wonderful media coverage in the San Antonio Express-News about their advances in design for the aging.  Though senior-friendly design and home-like environments are old news to most people working in aging services, we have a ways to go before the media and the public understand  that living in a senior housing community doesn’t mean living in a hospital. Every story like this one helps break down old stereotypes  of what growing old means for where you live and how you think. We like to see all the coverage like this that’s out there.

What are you doing to tell your story through the media?

In my letters to you, I usually tell the stories of how AAHSA members are working hard to create the future of aging services. Today is different. This letter is about how AAHSA member organizations are showing, and telling, their story in a new way.

Eliza Bryant Village began in 1896 as the first nursing home for Cleveland’s African-American seniors. Today, the organizations continueto live that mission under the leadership of their CEO Harvey Shankman. He and his dedicated staff work hard to ensure that residents like Mary Lou Williams can enjoy her daily walk and the “good food” in the dining room. But there I go storytelling again. Watch and hear from Mary Lou herself.

Take seven minutes out of your day and YouTube with Harvey (http://www.youtube.com/watch?v=OJ5CQiUOzns).

In our increasingly complex media world, YouTube is a fantastic way for non-profit providers of aging services to tell how you live your story. Let me know if you already have a “YouTube story” of your own to share.

Larry

For the past two years, we’ve been all about storytelling here at AAHSA. Why? Because telling stories turns numbers into names and facts into faces about our members mission-driven work for older adults. And it makes a difference for members like Del Zook. Here’s an e-mail he recently wrote to Larry about a story in our FutureAge magazine he shared with his county’s tax appraiser.

What’s the “bottom line?” That telling your story can mean a happy ending in your community, on the front page of the newsletter, at the statehouse and even on your organization’s tax return.

Dear Larry,
Just an interesting happening to share with you. First, I appreciate so much AAHSA’s emphasis on the “mission” and “not-for-profit” focus. I sense a real connection with AAHSA to our mission where I don’t with other other organizations such as the local Chamber and other organization where I serve on the board.

I have been dealing with the Yamhill County tax appraiser on placing our new care center on the books the last few months. It seems when new appraisers are hired it is a whole new cycle of training about what “not-for-profit” really mean to a community.

Frustated after several visits from a new appraiser around the discussion of a 501-c-3 having “nothing” to do whether the care center is tax exempt, I picked up the July/ August issue of AAHSA’s Future Age. I turned to the short article “Home’s Focus on Community Ensures Public Trust” written about Rock of Ages regarding our fire suppresent system, walkways, and fundraising. I asked him to read the article and walked out of my office to regroup. When I returned in a few minutes it was as if a light had went on. A well paid tax attorney could not have said it better. He seemed far more sympathetic towards what Rock of Ages is all about and that there is a force (AAHSA) bigger than just us working to help communities just like Rock of Ages. The next morning I received a call from the elected Tax Assessor who said I need not worry about his position on the new care center’s tax exempt status. Thanks to Larry and crew for helping with our position. You, or at least I never know how AAHSA and it’s work may help school communities, including appraisers, what a mission focused, not-for-profit, organization can do for community.

Thanks Larry and hats off to the AAHSA staff for all your work and support for us “little guys” out here serving our communities.

Del Zook, CEO
Rock of Ages Mennonite Home

Sharing your story can also win you a trip to AAHSA’s Annual Meeting in Philadelphia! Submit your story online or print out a form to use. We also developed a form that you can share with your residents. Please fax all printed entries to us at (202) 783-2255. All entries from your organization will be entered in a raffle to win either an all-expenses paid trip to AAHSA’s 2008 Annual Meeting & Exposition in Philadelphia or free registration to this event for your entire board of directors. Submissions will be accepted until Sept. 10.

I know you were as riveted as I was to the live television coverage of the Minneapolis bridge collapse. Unbelievable how such a symbol of strength on which we depend every day without a thought of concern for our personal safety could collapse so completely under the duress of flaws virtually invisible to the eye. It’s like the broad shoulders of commerce broke as we ride on them like a child on their daddy’s back. A kid can’t imagine those shoulders would ever be unable to carry us. Yet, the total collapse of a bridge.

How should we respond? Similarly to how we’ve done so in other recent catastrophes. First, we call to check on the whereabouts and safety of those we know and love. In the Minneapolis situation, we have talked with our state executive, Gayle Kvenvold, and other member colleagues and determined that as I’m writing, we know of no member losses of residents or employees connected to those close to us. Some of you have asked if there’s anything we can do for anyone affected. Besides praying for all concerned – known and unknown to us – there is no physical need we as the AAHSA family can meet right now. If needs arise, we will pass them on to you… But remember, prayer is always the least AND the most any of us can do for anybody. So, pray for comfort, safety and recovery.

Secondly, we can learn from the response of the city of Minneapolis’ emergency systems. The people and plans were immediate, effective and smooth. Every community should be as well prepared and rehearsed. A community leader interviewed said that emergency preparedness planning and drills paid off. Lessons learned for cities, facilities and families. As much as we all view fires and emergency preparations as a pain-in-the-neck, the old adage that chance favors the prepared mind has no more dramatic example for us than the Minneapolis situation.

Thirdly, we should admire our every day heroes. Every community has them. One that has captured my attention in the Minneapolis situation bridge collapse is the 15-year old kid who helped save lives of counselors and much younger children from the school bus on its journey from day camp to home. Not just an example of physical preparation, but an example of character preparation. Find ways to identify and recognize your local heroes everyday at the fire station, police department and scout troops for their devotion to our safety, comfort and the betterment of human kind.

Finally, let’s examine our policy priorities. We cannot have a healthy and prosperous nation ignoring our infrastructure — whether those be health, family, education or transportation. One headline said that there are thousands of similar bridges at risk. As we celebrate the golden anniversary of our nation’s interstate highway system, we can’t let politicians fund bridges-to-nowhere while bridges to and from day camps collapse beneath our children. The same can be said the other components of those broad shoulders of American society on which we depend every single day without thinking about it.

But the politicians say that unless they hear from us, they don’t feel much urgency to fund such fundamentally important programs and priorities.

Which gets me back to prayer - for our nation. Let’s not forget to pray that we do the right things for the people who live here as well as those around the world whose lives our leadership priorities impact. Because we are often the architects of bridges for many who are looking for ways out of oppression, poverty and ill health. The world depends on our broad shoulders, like it or not. We have to make sure those shoulders are strong in character, in policy and in the practice of life. We can learn a lot about all of this from our neighbors in Minneapolis – and from a 15–year old kid who knew what to do. And he didn’t hesitate to do it.

Larry

William L. Minnix, Jr., D.Min.
AAHSA President and CEO

We had better know how to connect with consumers. Our scenario planning document, “The Long and Winding Road,” shows that consumer behavior is one of the two biggest uncertainties for the next decade. (The other is talent availability, which will be addressed in another letter.) What will consumers need? Want? Expect? Will the people be available to provide the services the market needs?

I’d like to comment on consumer connections in two dimensions: the science and the art of understanding and responding to basic human needs in our work. I’ll spend more time on the art because there is an abundance of resources on the science.

Of course, market studies are now an essential part of strategic planning and day-to-day management of current and future service. Regular, daily consumer feedback and response are rapidly becoming the norm, and the ability to analyze that information to generate effective and satisfying consumer service may be the most important management work we can do. There are numerous tools and business friends that can help with the most important driver of our work: understanding perceptions of the people we serve and those who serve them. The science of marketing is complex, but we must master it.

While the razzle-dazzle of marketing science is increasingly critical in our increasingly sophisticated work, I hope we can remember the fundamentals of the art because the fundamentals continue throughout our ongoing service relationship with the people who call on us to help them. This hit home to me recently through a colleague with a mother in crisis. Demented, frail, combative, falling apart, this elder went through a saga that began in an assisted living facility and continued through hospitals, nursing homes, a mental health unit, a rehab facility and a home health agency. My friend and her sister went with her. You know from your own experience that this typical family predicament is difficult in the best of conditions.

As my friend reflected on the situation, she said, “Maybe I’m expecting too much…” I picked up on that statement, perhaps thinking she and her sister were unrealistic—wanting cure where there could be none, wanting an idealistic relationship with their mother that will never exist again, wanting restoration to health where irreversible damage has taken its toll. So I asked her, “What did you expect?” She had no trouble in responding — these are mostly her words—so listen carefully—it is the market speaking through this daughter, who is YOUR colleague—and they apply regardless of the types of service you offer.

1. I expected my mother to be offered a good quality of life for the condition she was in. I expected that she not be avoided because she is unpleasant.
2. I expected her to be clean, well-fed, have interaction and receive the attention the facilities said she would be given and that we paid for.
3. I expected her to be treated with dignity even if she is beyond understanding her condition.
4. I expected staff to let me and my sister take the time to tell them what a wonderful person my mother used to be because all they see now is a crotchety, difficult demented woman.
5. I expected them to believe us when my sister and I said something was wrong.
6. I expected the long-term care facility to know my mother’s medical problems well enough to know that there was a developing crisis.
7. I expected the hospitals where she was transferred to diagnose and fix what they could—not discharge her with an infection she didn’t enter with.
8. I expected my mother to be released from the hospital when her medical problems were resolved, not when she ran out of coverage.
9. I expected professional guidance from professional staff, with a doctor who takes leadership responsibility for coordinating medical care and nurse leaders who would advise me and my sister on what we should do.
10. I expected nursing staff to recognize that cleaning my mother or giving her a treatment and putting her back into a soiled bed isn’t good. Simply saying another department didn’t do its job is not acceptable.
11. I expected on-site advocates—not 1-800 numbers.
12. I expected someone to empathize with me when I sobbed about my mother’s obvious state of affairs—not ask me what’s wrong.
13. I expected to be able to trust the people and institutions to provide good professional care and support my sister and me through all of this.

Too much to expect? Maybe all of our marketing, hospitality, sales and consumer relations programs should begin and end with asking people like my colleague and her sister what they expect throughout the service delivery process… Is that too much?

The great organizations stay closely connected to expectations and needs of the people we serve—connected most closely and intimately in the midst of crisis, not just through the perspective and distance of sophisticated science, though both are essential. No, that’s not too much to expect of us, is it?

Larry

William L. Minnix, Jr., D.Min.
AAHSA
President and CEO

In 1973, my mentor and boss, the late Scott Houston, sent me to visit the late Dr. Herb Shore of University of North Texas long-term care leadership fame. Truth be known, Dr. Shore probably has more disciples in long-term care administration than anyone.

My objective in the visit with Dr. Shore was a report on “philosophies of administration” as part of my own administrative internship experience. As we began a tour of Golden Acres, where Dr. Shore served as CEO, I asked him to define his fundamental philosophy. “Very simple,” he said. “If I take care of the staff, they’ll take care of the residents.”

An enduring truth! Now, 34 years later, AAHSA’s Institute for the Future of Aging Services just completed a multi-year grant called Better Jobs Better Care (BJBC) funded by the Robert Wood Johnson Foundation and The Atlantic Philanthropies. Our March/April issue of futureAge summarizes the experience of the multiple BJBC sites and projects throughout the country. I urge each of you read that issue cover-to-cover and make a human resources plan based on it.

I was also struck by a speech I read from an event at Phoebe Ministries in Allentown, Pa. Though the President and CEO, Rev. Rodney Wells, is an eloquent clergyman, the speech actually came from Louise Santee, a certified nursing assistant (CNA) at Phoebe. Ms. Santee delivered the speech at a celebration of Phoebe’s success with Better Jobs Better Care.

In that speech, she said: “A CNA must have love in her heart for the residents, because it is more than just a job. When you leave work, you think about it all the way home, and then some. If, after you have done your care, the resident is smiling or has a twinkle in the eye, that is all the thanks you need. ” She says BJBC helped her “make things better” by “working together as a team,” which she says is “the Phoebe way.”

So, here’s what we can learn from Dr. Shore, Better Jobs Better Care and Louise Santee:

1. Nurture the love in your heart.
2. Conduct employee satisfaction surveys, act on the findings and measure employee recruitment and retention.
3. Discuss what respect means to everyone in the workplace.
4. Offer competitive wages, family-friendly benefits and career ladders and lattices.
5. Teach and mentor people on leadership.
6. Create a multi-cultural sharing program.
7. Create an ongoing team-building program and teach continuous quality improvement-TOGETHER-at all levels!
8. Invite policy leaders into your setting and let them hear from employees about the importance of the role of the care and service professions.
9. Have fun, celebrate events and share sorrows.
10. Oh, yeah… remember to nurture the love in your heart — because it’s not just a job.

All these have stood the test of time. If we take care of employees, they’ll take care of the people we serve. Or, better jobs generate better care. It’s the right thing to do. And remember what Louise Santee says about the unique rewards of a great day’s work. Bigger hearts, better jobs, better care!

LarryWilliam L. Minnix, Jr., D.Min.
AAHSA President and CEO

Learn more about Better Jobs Better Care.

March 28, 2007

Yesterday, my friends Sydney, Colline and Susan moved their mother, Frances, to an assisted living facility. I’ve know them for years. They’re like family to me. I came to know the family through Frances, who cared for her own mother at home for years. Frances helped to start a support group at Decatur First United Methodist Church 30 years ago. They asked me to lead it because of my experience at Wesley Woods. The founders were five women who, like Frances, had the responsibility of caring for mothers at home. They laughingly and lovingly called themselves “Dutiful Daughters.”

The group grew over the years, served hundreds of “daughters,” and later, a few sons and couples. It met monthly, and I was privileged to meet with them. The group was open to anyone. Word of mouth channeled new people to the group. The original five “Dutiful Daughters” became expert supporters as they lived through the deaths of the mothers they so responsibly served. They found themselves comforting others in aisles at the grocery store, over the back fence and in Sunday school. They were naturally therapeutic people who’d “been there.”

As Frances aged, you could begin to see signs of the ravages of brain disease. Sydney and her husband, Bill, began to coordinate shared responsibilities with the other sisters all doing their part as they were able. This phase lasted several years until yesterday — when the time had come. Frances’ condition was irreversible; it was affecting the health and well-being of the family. It had caused clear and present dangers for herself. And she didn’t really know anybody anymore.

Sydney wrote me last night —

“This is too hard!!! Make it stop! I guess today went ok. Colline was ready to bolt and run with her, and Susan almost threw up. They led her away and then led us away. The lunch time report was that she was talking and laughing with her table mates and that she’s a dear. My head knows she’s ok. My heart is broken.”

The irony in all of this is that Frances faced these same issues 25 years ago with her mother, Sydney’s grandmother. Frances wrote about it in a booklet entitled “Dutiful Daughters” that the support group produced. Frances’ story was called “…loved me the most.” Here’s what Frances — a generation ago — had to say:

At age 87 my mother came to make her home with my husband and me.We had felt that keeping her in her own home as long as possible was best, and we did that with help for a number of years. As her health failed and symptoms of Alzheimer’s disease increased, we chose to bring her into our home to live.She was gentle, quiet, loveable and as easy to care for as a person in her condition could be. However, we were not prepared for the changes in our lives that having her with us made.

My husband and I had just retired from our jobs and we had looked forward to having time to travel and pursue other interests. Of course this was impossible now, because Mother could not be left alone. Consequently, we both became frustrated and I began to feel conflicting emotions. I wanted to take care of my mother, and at the same time I felt resentment for having the responsibility.

My sister and two brothers helped with her care for a time but as her condition worsened I was not given the help or support I needed. This was very discouraging to me.

In retrospect I realize this conflict with my family was as much my fault as theirs. I had chosen to care for Mother — thus they saw it as my responsibility. I failed to expect or require enough help from them.

If, in the beginning, the decision for Mother’s care had been ours, rather than mine, and a plan made with all of us contributing and sharing, I think we could have avoided much misunderstanding and heartache later.

I cared for Mother because I really wanted to, even though I was drained physically and emotionally with her constant needs night and day. I felt tenderness and love for her and received a great deal of satisfaction in caring for her. I kept her clean, dressed her in pretty clothes, put a ribbon in her hair and made her room attractive with pretty sheets. I used lots of color, plants and flowers and potpourri for a nice fragrance.

It was particularly frustrating not to be able to communicate with Mother. There was so much she could not understand. But even in her confusion she never lost her gentle and cooperative spirit. She lived in a time long past, and I discovered if I took her seriously and entered her world too, I could often relieve her anxiety and give her comfort.

If Mother was worried about her mother (long deceased) we would talk about what we could do for her. If she concerned herself with some job in the past she thought she hadn’t done, we would plan (pretend) to do it together, etc.

It was a challenge to cook and provide nourishing meals for her. I felt tremendous satisfaction in discovering new ways to prepare her food. One was a delicious fruit shake I would make for her by mixing several different fresh fruits and pureeing them in the blender.

Mother had difficulty chewing a tossed salad and I learned to put all of the ingredients in the blender and serve it as a cold soup.

There was no way she could get this kind of attention in a nursing home and I wanted to keep her as long as possible. But I needed help!

One great help in learning to cope was the understanding that our support group at church provided. We became a group of friends, all with aging parents, who almost felt like a family. We listened, we shared experiences, we cried and we laughed together, we supported each other and gave comfort and suggestions. Most of all, the understanding of our common problem helped us through these tedious and trying times.

More help came from Wesley Woods Health Care facility. When I learned they would take Mother for respite care I felt a great load roll off my shoulders. I knew I had a place I could take her for a short stay. I could get a much-needed rest and have time to do some traveling. I found tremendous help also in having sitters come in for several hours a week.

The most special and appreciated help was from my husband. His love and support were never-ending. He didn’t complain but listened and understood when I complained. He let me cry when I needed to cry. He calmed me when I was overwrought. He learned to do almost everything for Mother that I could do, and she responded to him very well.

Our children were a source of needed support. They gave their “Granny” extra love and attention and showed in numerous ways how much they cared. They missed having us free to take part in their family activities, but they were behind us one hundred percent in what we were doing for Mother.

As her condition worsened last year, we had to have nursing care part-time in our home. Through a family member I knew of a practical nurse who would come in a few hours each day.

Then the last six months of Mother’s life, a move to a nursing home was a necessary decision, though very traumatic. In some ways, the experience I’d had with respite care with Wesley Woods took some of the fear away and helped me make the change. At this point, Mother was aware of very little. I continued to look after her carefully in the nursing home but they were able to give her nursing care I could not provide at home.

Mother died peacefully at age 93. I had lost the one person on Earth who loved me the most, but I was ready for her to go. I had given her more than five years of my life, but how much more she had given me!!

Though this was one of the most difficult periods of my life, it was a time of growth, of practicing patience, giving love and understanding and receiving love. My faith was deepened, learning to depend more on God, and I was given an insight into family relationships I would never have had otherwise.

I have felt very little guilt, though I remember the times of despair, the times I was short-tempered and impatient. I see mistakes I made and the way I could have done better. However, I know I gave Mother much loving care and I focus on this rather than dwell on what might have been.

I was blessed in so many ways and I am thankful to God for this time he gave me with my mother.

There are generations of “Dutiful Daughters,” some of whose lives we’ve touched, and many others that are hidden to us. Our job is to support them — and to see that their stories get told so that it gets easier in this country for families to shoulder the burden and for people like you to help them do it.

Frances, you were a dutiful daughter — and you raised dutiful daughters, sons-in-laws and grandchildren. You did your part — for the person who loved you the most! (Though Sydney, Colline and Susan run a close second!)

We have a duty to tell your story.

Larry

William L. Minnix, Jr., D.Min.
AAHSA President and CEO

Share your “Dutiful Daughters” story.

Feb. 23, 2007

You may be tired of hearing about Hurricane Katrina. I’m no social scientist, but I believe that “tragedy fatigue” sets in after a while. Even the most sensitive of people become immune to bad news. That’s why celebrity shenanigans fill up so much media space so quickly. “Tragedy fatigue” gets the better of us, and we put bad situations out of our mind through mindless, relatively unimportant diversions like who’s entered rehab or shaved her head or fathered a child.

“Tragedy fatigue” happens when bad news seems so pervasive or a situation so overwhelming or a predicament so hopeless.

What’s the cure for “tragedy fatigue?” People like Leslie Knight, an AAHSA regional vice president, her friend Christina Karamesines and our members in the Gulf States. People who don’t give up and who show up to help.

Recently, Leslie visited our New Orleans members for a week to lend a hand and spread hope. She took Christina Karamesines with her. Christina, who is from Michigan, is a massage therapist and is blind. They stayed at Lambeth House, one of our New Orleans members. A great story there of survival, revival and endurance for Scott Crabtree and the residents, staff, volunteers and board.

Christina set up shop and offered free massages to our members for an entire week. Leslie says Christina has quite the healing touch. One of our leaders, John Tieperman of Chateau de Notre Dame and Wyndhoven Retirement Apartments, had suffered a brain aneurysm last September and has miraculously recovered. Leslie said John “looked like a different person after Christina worked on him.”

Leslie’s meetings surfaced the daily challenges of a mammoth recovery: inadequate medical services, a crazy insurance market, slow and uncoordinated government response, preparation for the next disaster. There are stories like Melanie Baker’s, director of nursing (DON) at Chateau de Notre Dame. She’s serving as DON, charge nurse and occasional certified nursing assistant while her organization struggles to find enough staff to meet needs. She couldn’t even find time to make her own massage appointment! All of this occurs in an atmosphere of not knowing the long-term fate of a great city. Eighteen months after Katrina, there are still blocks and blocks of destroyed homes and businesses.

Yet, in the middle of the tragedy fatigue, there is hope and growth. People like Dennis Adams are finding creative ways to capitalize low-income housing. Karen Contrenchis, the Gulf States executive, still works hard knitting together complex political pieces while living in her FEMA trailer. She, with the help of AAHSA staff, is planning the Gulf States annual meeting. The National Caucus and Center on Black Aged worked with Leslie and AAHSA’s Colleen Bloom to help relocate a nursing home resident closer to her family.

Members are getting creative together on recruitment and retention of employees. AAHSA staff like Barbara Manard continue to escort religious groups to the area to muck out one house at a time. Catholic Charities, Wyndhoven, Volunteers of America, National Church Residences, National Baptist Convention U.S.A., Inc. and St. James Place of Baton Rouge are working on their strategic plans. The Association of Jewish Aging Services will hold its meeting in New Orleans in a few weeks to show their support — just like they did in New York after Sept. 11.

And people like Christina will continue to show up in New Orleans with healing hands to “massage” our friends and colleagues through this difficult time. They remind us that tragedy fatigue is an unacceptable state of affairs.

Thank God that for every Katrina we face in life, there are Christinas to help us hope again.

Larry

William L. Minnix, Jr., D.Min.
AAHSA President and CEO

Feb. 6, 2007

We’ve been emphasizing the need to “tell your story.” The story of aging services is not an easy one to tell. Why? The reasons are many. The frailties and indignities associated with age-related conditions are often hard to face. None of us likes to think of our parents growing old, and our culture pays a fortune to makes ourselves think, look, feel and act younger. Good care is inadequately funded, yet the public thinks that government pays for everything, so people face sticker shock when they need help. Our work forces everyone to face their own mortality.

Yes, it’s a hard story to tell, but we must find authentic ways to tell it. That’s why we introduced the “Tell Your Story” theme at our Annual Meeting & Exposition in San Francisco, and we have a follow up theme of “Live Your Story” at our fall meeting in Orlando. We’ve also started a story bank where you can share the great stories you live every day.

We often let others tell our story. On one extreme, slick commercials tell a glossy tale with graying actors who wear adult diapers while they play golf or kiss each other while you guess which one wears dentures.

On the other extreme, negative stories abound in the popular media. Recently, an issue of AARP The Magazine included a story that reflected the sad experiences of a self-defined younger disabled man who had a short stay in nursing home after surgery. He was surrounded by other residents of a more traditional nursing home population and became familiar with all the sounds, smells and personalities associated with frailty in a care setting.

His complaints focused on problems inherent in institutional care — boredom, loss of control, lack of meaningful activities and relationships, a sterile, hospital-like environment and staff with various levels of concern. All of these are the dynamics you deal with every day. They are especially difficult for people like this man, a successful writer with his mental faculties intact, who died at 68 from cancer — not dementia. A truly dismal experience for him, and he had no real alternative. We can all sympathize and empathize with him and others like him that we’ve known in our work.

I remember Gerald, a resident at Wesley Woods when I was there. A near quadriplegic at 30-something due to an auto accident, Gerald lived in our nursing home. He died a couple of years ago. On good days, Gerald appreciated staff, was an active on the resident council, could go on outings in the van and dealt with the sights and sounds of people three times his age with good humor. On tough days, he fought bladder infections, endured impactions and complained anonymously to the state, which sent a survey team to investigate. He tried to leave the nursing home a couple of times for more independent settings, but he was vulnerable to critical clinical problems that other settings were ill-equipped to handle. Our nursing home was home. Staff was family. We all fought the complaints and conditions together. We loved Gerald — and he loved us — in spite of the inherent problems of living together. Wesley Woods was home for Gerald. An imperfect home, but home. This is not a pretty story, a perfect story nor an easy story to tell. But it is real, it is loving and it is essential for the Geralds of the world. You have your Geralds too. Neither glossy nor despairing, but an authentic story of hope and care.

But people like Gerald are not the only story. Areti Staudohar from Riverside Senior Living in Kanakee, Ill. , writes of the birthday party for a wheelchair bound, 104-year-old Lois and her two friends with Alzheimer’s. Areti had rented a red Ford Mustang convertible while her car was in the shop and used it to take Lois and her friends out for a spin. Each resident told stories of their adventurous younger years. Jack, a resident who retired at age 88, told how he became a successful business man in the community after entering it on the road on which they were driving. “Punch it,” Jack yelled, urging Areti to drive faster. She’ll never forget the smile on his face as she did.

“I am sharing this story to help us all remember how much we touch people’s lives everyday,” Areti writes. “In our own way, each of us makes a huge impact on the patients and residents we serve, and they in turn give us back their own priceless gifts.” Neither glossy nor despairing, but authentic.

Or, there’s the story from Penacook Place, in Haverhill, Mass., of an older women with multiple problems, referred by a hospital, demanding daughter in tow. The mother died within a couple of months and the daughter told staff her mother’s last year had been a tough one, but her last days at Penacook Place the best ones of the year. Not high gloss, not despairing, but authentic and reassuring.

For the many people we serve, the story is one of new-found quality of life in spite of disease or other difficulties, finding the shreds of meaning that are still available to the mind and heart. For others, it is helping them make the best of stressful and difficult circumstances in coping with a loved one.

Charles Dickens’ great novel, A Tale of Two Cities, brilliantly describes the same city from two starkly different sets of experiences, making one city seem like two. You and I have the challenge of telling the tale of two cities in the work we do. And we can’t let just one set of experiences — as real as they are — be told. We must continue to make the experience as meaningful as we possibly can for all the residents of “our cities.” So the tale gets better in the telling as we address quality of care and quality of life for an aging population who would rather think they will be perpetually youthful and will never need our services.

And when it works, the tale and the telling can be magical for those we serve and for ourselves. Take this story from Mary Ann Johnson of Lutheran Services for the Aging in Salisbury, N.C. She wrote us about Tim Setzer, a 45-year-old father of three who came to the Lutheran Home after blowing out both knees at a softball game:

Though he had only seen it from his car, Setzer had admired the Hickory campus every time he traveled down Springs Road.

Now, after a 27-day stay there, he admires the inside too.

“I can’t tell you how good people were to me,” he said. “My housekeeper, John, the activity directors, aides, everyone. The place is absolutely spotless and everyone was so kind and helped me so much.”

Strolling the halls (yes, strolling on two good knees) during a recent visit, Setzer couldn’t find enough adjectives to describe the respect he has for the staff and his therapists. “They worked me hard and they pushed me, but they never hurt me,” he said.

Setzer also grew quite fond of the residents, especially a group of men who frequently gathered outdoors on the patio or in the courtyard. They were fascinated by my legs,” he said. ” They’d point and say, “Look there, that boy’s gone and broke both his legs.”

Many of those same residents stopped by his room each day to offer words of encouragement. Setzer credits that encouragement for his recovery. “Seeing their age and how much pain some of them were in, that took all the self-pity right out of me.”

It also changed his outlook on nursing homes. “I still have half a life to go, but if I didn’t, I’d be here. In fact, I’d like to come back here now and then just to rest. I know I’d find nothing but kindness.”

Tim’s visit dispelled all the negative stereotypes he had about nursing homes; and he had plenty. He had a huge extended family and dozens of friends that visited him and came to feel positive and comfortable in the nursing home. His 92-year-old grandmother even enjoyed visiting him. The moral? “We’re not just for old folks anymore” or “Don’t believe everything you read” or perhaps, “Seeing is believing.”

Like a Dickens novel, we have a classic human story to tell. It is a tale of two cities. We must tell both. It is incumbent upon us to improve the conditions associated with the tragic tales and illuminate the tales of hope. Gerald’s life was a tale of two cities. Authentic, tragic, hopeful. You live these stories every day. Tell them!

LarryWilliam L. Minnix, Jr., D.Min.
AAHSA President and CEO

Share your story with us.

Jan. 26, 2007

Dear Mr. President:

Your State of the Union message surely highlighted fundamental and enduring American ideals reflected in our “commitment of conscience,” so eloquently stated. Our members, mission-driven care and services providers who serve the elderly and disabled, support your assertion that a “future of hope and opportunity requires that all our citizens have affordable and available health care,”… and that “government has an obligation to care for the elderly, the disabled, and poor children.” Well said, sir!

You then mentioned the challenge of “entitlements.” Please understand that remarks like that have become code for cutting Medicaid, social programs and senior housing for the very same populations that commitments of conscience should be faithful to. So, lest we all talk of commitments in one breath and cuts in another, perhaps this is the time for you and Congress to clarify what you believe all Americans are entitled to.

America’s early historical principles say we are entitled to life, liberty and the pursuit of happiness. Noble, universal, enduring umbrella ideals forged in the crucible of the great American experiment of self-governance, freedom and promotion of the general welfare. Our existing entitlements did not come easy. A century after the Civil War, it took major national unrest to assure equal access to the ballot box for all Americans.

Over time, other apparent entitlements have evolved. For example, we now require all children to attend school and receive immunizations, and we afford them universal protections from abuse, neglect and exploitation. It is safe to say that we as Americans believe they are entitled to be educated and protected, as we decided that seniors are entitled to prescription medication two years ago — a long overdue benefit.

But we quickly reach the limits of entitlements for children because not all of them have health care. Are not our children entitled to health care? You made that a priority in your speech. I suspect virtually every American would support that as an entitlement. Mr. President, you and Congress, as the elected representatives of our commitments of conscience must make it so.

What of other vulnerable populations? Are they not entitled to basic health care as part of Americans commitment of conscience? As a matter of practice, do we turn them away at our emergency rooms and public health clinics? No, usually not, but we often don’t make it easy for them. In fact, we often channel them through a two-tiered great divide system of inner-city mega-facilities and the blue chip insurance hospitals. The former is chronically under-funded and take in our difficult, uninsured and Medicaid populations. Then, some politicians complain that the tax burden to support them is too great, so we cut their funding. Yet, no major city or rural community can survive without these large and small oases of health for all citizens. Are these services an optional commodity or a basic entitlement? Our collective conscience would say the latter, I would wager.

So, why not recognize what we, in our hearts, already know and believe — that all Americans are entitled to basic health care as a right? It took 400 years for people of different races in America to agree that we all are entitled to vote, socialize, shop, worship, dine, ride and be educated. So, is not the time long overdue that we should all finance, support and have equal access to the considerable, miraculous and advanced health resources of America? Let’s do it in two years—not another 400.

Mr. President, do you, your family, members of Congress and federal employees have immediate access to excellent health care? Of course—and you deserve it. The American people have a moral obligation to see that you have it. But, how then do you differ in status from a convenience store worker, a nursing assistant, a domestic worker, a teacher’s aide, a new graduate looking for job, a homeless person or a family down on its luck? I’d bet your upbringing would say we are all equal in the eyes of the Almighty. If so, isn’t it time to declare that all Americans are entitled to health care?

Health care feasible as an entitlement, pundits might ask? The money to cover the cost might be found in a surprising place: the restructuring of long-term care financing. Many American families face the cost of practical obligations of a family or friend chronically impaired. The demographics say that the majority of this growing group of American citizens are elderly, but one third are younger. They all need care and support.

The conventional wisdom is that Medicaid’s problem is greedy families wanting to hide assets and the solution is tax breaks to buy long-term care insurance. Neither conclusion reflects but a minuscule amount of truth. Yet, there are existing long-term care financing models in Europe and successful experiments in the United States that could create a sound and viable long-term care financing model that could save Medicaid and help us fund health care as an entitlement. Mr. President, there are solutions to financing of health care beyond the current, and narrow, scope of inquiry and the protection of special interests health care businesses. Yes, health care in general, and long-term care in particular, can be affordable entitlements!

Mr. President, you made no mention of Katrina and Rita recovery. A surprise for many who listened to you. Are the people of the Gulf Coast region entitled to funds and support to restart their lives? We made them a promise to rebuild their community, and money was committed. Yet, efforts are slow and priority of national interest seems weak. While your attention is focused on unimaginably complex issues, surely there must be a surge plan to catalyze the Gulf Coast recovery. Are not all Americans entitled to the opportunity to recover from great tragedies? Surely we are.

And, Mr. President, you made no mention of housing policy. Not surprising with the press of other issues. Isn’t housing, either rented or owned, a basic entitlement for all Americans? Certainly your leadership has made it easier for more people to own their homes, and the economic climate you have created has made it easier to obtain affordable loans. Both great achievements. But what about low-income elderly people unable by personal circumstances of health or pocket book to live alone in a home? Two generations ago, the U.S. Department of Housing and Urban Development created subsidized housing to address this emerging need for senior housing assistance and low interest capital to stimulate construction. A very successful program. Now, there are 10 low-income seniors on a waiting list for every unit that becomes available. Yet, funds are continually squeezed, the bureaucratic barriers to new construction and renovation daunting and the mechanisms to coordinate housing with services to keep older people out of nursing homes and emergency rooms are limited — all of which have negative impact on health and the cost of health care. The loop circles back to health care.

So, Mr. President, isn’t it time we decided that all Americans are entitled to health care, housing and recovery from catastrophe as the new era manifestations of enduring and hard-earned, assured American ideals of life, liberty and the pursuit of happiness? None of us can feel secure at home without these essentials. To deny them sears our souls and masks the real costs of inevitable conditions and untreated sickness. A moral failure and bad business. Not what makes America great.

We’d support your leadership on these matters the last two years of your Administration. That would be quite a legacy. You could be remembered for your “commitments of conscience.” I like that phrase a lot.

Thank you, Mr. President. AAHSA will help you fulfill these commitments. We believe that Americans are entitled to them.

Sincerely,

William L. Minnix

President & CEO
The American Association of Homes and Services for the Aging

Nov. 14, 2006

As you know, I had the distinct honor of interviewing Walter Cronkite at our Annual Meeting & Exposition. A wonderful man. He made me feel like we’ve been friends for years. I marveled at his deep, soothing voice, compelling eyes and authoritative eyebrows. And what a chuckle. It is how I might imagine God would chuckle.

Who is this man Walter Cronkite and how did he earn the “most trusted man in America” designation for more than two generations? The ingredients are no doubt journalistic talents, an engaging personality, the right mix of humility and self confidence, a strong work ethic, a lucky break here and there, integrity and a certain wisdom that comes from experience and mystical realms.

You and I know people — residents, clients, relatives, friends old and young — who were born wise. I call it the “Wisdom of the Ages.” Yes, Walter Cronkite possesses the Wisdom of the Ages. He could have been a commentator in the era of Socrates, or during the Renaissance, an advisor to Washington or Lincoln.

People with Wisdom of the Ages help us find meaning in life, rediscover or clarify enduring values and put things in perspective. They redefine paradigms we live in. They ground us in truth and reality, yet compel us to grow beyond where we are. Some of those “Wisdom of the Ages” people live and work in our facilities, though they aren’t famous like Walter Cronkite.

For me, Walter Cronkite helped redefine the aging paradigm. I asked him two questions outside the bounds of what is traditionally asked of him.

• Does he think of himself as retired?
• Does he think of himself as old?

His responses: No, he doesn’t even use the “R” word. He complained that he isn’t busy enough. He wishes CBS would use him for political commentary but he stays engaged in the media through other outlets. He thinks of himself as a journalist, and he voluntarily commented on the Iraq war, as he once did on the Vietnam War.

Fully immersed in the issues of today — and tomorrow. Not just yesterday. Though his hearing is impaired and his gait more cautious, he is clearly a man living to the fullest. No retirement, only adjustments to how he’s engaged.

His response to thinking of himself as “old” at 90? “It depends on what I’m trying to do at the time,” he chuckled.

His messages to me are that retirement is becoming an antiquated term and chronology is irrelevant. To be replaced by vitality of spirit, ability to stay engaged and refocus of interests.

We should consider a replacement term for “retirement.” Instead, let’s say we will all enter the “Walterian” era of life, where engagement is adjusted for time, interests and capabilities — God willing.

The Old Testament story of Abraham and Sarah are part of the Wisdom of the Ages reflected through Walter Cronkite. God asked Abraham and Sarah (I’m taking liberties with the original text) if they’d be willing to be the father and mother of many nations at an advanced age. Sarah laughed and said they were too old. God responded that he didn’t ask them how old they were, he asked them if they’d do something really important. Put that way, they agreed. As I recall, the “retirement” word isn’t used in the scriptures.

AAHSA’s recent scenario planning study about the future envisions that people like Walter Cronkite are the new archetypes of aging role models. Personally, I hope I live long enough so that when someone asks me how old I am, I can respond, “I am not only old enough for the AARP discount, but I am in the Walterian era of life…I forget exactly how many years that is. Why? Is age important? Do you have something important for me to do?”

“And that’s the way it is,” to quote Walter Cronkite.

Walter Cronkite’s job at 90 is to be the distributor of Wisdom for the Ages. That’s a really good job for any of us in that era of life… Ask some of your residents and clients to share the Wisdom of the Ages with you. You might be surprised how it changes your perspective.

LarryWilliam L. Minnix, Jr., D.Min.
President and CEO

AAHSA
2519 Connecticut Ave NW
Washington DC 20008

Nov. 8, 2006

All week long at our Annual Meeting & Exposition, we’ve focused on stories. Hearing them, collecting them and telling them to convey the value of our work for older adults. During our time together in San Francisco, I’ve heard stories of teamwork. Stories of innovation. Stories of leadership. Stories of transformation. Not just in our field, but in our society.

Stories of people like Todd Murch of Eskaton and Eric Dishman of Intel working together to test potential products to make life better for many. Stories of people like Jackie Harris of Trinity Continuing Care Services, who envisions her job as creating “sanctuaries,” places of well-being that nourish body, mind and spirit and honor the sacredness of soul. Stories of people like Norma Lesher from the Glenburn Home in Indiana, which joined a county-wide coalition to reduce stroke, diabetes and obesity. Stories of people like Kathy Bakkenist and David Gehm, who’ve led the way to introduce federal legislation that will accelerate technology to our field and reform the survey and certification process.

But the most important story of all is the one you have yet to tell. Whether you were with us in San Francisco or not, our most sacred responsibility is to tell the stories of the people we serve. It’s what we know how to do better than anybody else. We must share the stories of the passage and continuities of life. We must make them come alive for our policy makers, in our communities, with our staff and in the media. Because ultimately, these stories evoke the people that we are.

Take Jay Leno. He does more than tell jokes. He tells stories. And they delight us. And our stories also delighted him. As I walked in to the auditorium to meet Jay, Sister Mary Assumpta from the Jennings Center for Older Adults gave me a dozen “Nun Better” cookies to give to him as a thank you for his visit. A simple gift, but a memorable one.

The next day, Sister Mary Assumpta received a call on her cell phone from Jay thanking her for the cookies and the work she does for Cleveland’s elders. One person’s story sparks another person’s interest in our work. That’s what we need to do every day.

My greatest story from this week is about meeting Walter Cronkite. Though, it is not his recollections as the most trusted man in America that I will relay. It is his sense of humor and ability to laugh at himself that I will remember. When I tell stories about Walter, I’ll tell of a 90-year-old icon of a man who defies the stereotypes of aging. He refuses to use the “retirement” word. He complained to me that he’d like to be busier.

Each of us knows someone like Walter. Someone whose wisdom inspires us, and whose actions motivate us to transform the way we serve. Someone who refuses to accept the status quo and challenges us to be our best.

These are the stories we must share. Stories of wisdom, achievement, innovation, values and FUN. These are the stories of the power of community. These are the stories that will help us create the Future of Aging Services.

Larry

William L. Minnix, Jr., D.Min.
President and CEO

Share your story with us.
See photos from AAHSA’s Annual Meeting & Exposition.

AAHSA
2519 Connecticut Ave NW
Washington DC 20008