If it takes a village to raise a child, does it also take a village to keep an elder out of a nursing home? That’s the idea behind a new grassroots movement described in the New York Times article, "A Grass-Roots Effort to Grow Old in Your Own Home"(August 14, 2007). The article describes how elders across the country are organizing themselves, their neighbors, and friends into support networks, with the Avenidas Village (Palo Alto, Calif., starts in October 2007)
John Sink, director of programs, JSink@avenidas.org, 650-289-5421

Palisades/Foxhall Village
Alicia Juarrero, vice president, aliciajuarrero@gmail.com

Washington D.C. Area
Capitol Hill Village
Gail Kohn, executive director, info@capitolhillvillage.org, 202-543-1778

Transition in Place Services (Clifton and Fairfax Station, Va.)
William W. Cole, secretary/treasurer, wwcole@cox.net, 703-764-1300

Mount Vernon at Home (Alexandria, Va.)
Arnold Edelman, vice president, jaedelman@cox.net, 703-765-0369

Staying Put (New Canaan, CT)
Tom Towers, board president, tbtowers@optonline.net, 203-966-7917

Gramattan Village (Bronxville, N.Y.)
Christina Staudt, vice president, staudthome@aol.com, 914-337-3968

Center for Aging in Place Support (Resource center for groups in Westchester County, N.Y.)
Robert Waldman, president, rwaldman@aipsupport.org, 914-833-9654

Cambridge at Home (Cambridge, Mass., starts in October)
Kathy Spirer, executive director, 617-864-1715

Beacon Hill Village (Boston, operating since 2001)
Judy Willet, executive director, 617-723-9713, bhvillage@aol.com

The Washington A.A.R.P. has information about other area groups. Email Mimi Castaldi, dcaarp@aarp.org

E-mail listerv put together by attendees of conference at Beacon Hill Village (not an official B.H.V. site)
beaconhillvillagemodel@googlegroups.comobjective of staying in their own homes as long as possible.

Interviewed for the article were George Allen (pictured here) and his wife Anne, both 82 years old. They struggle to remain in their three-story house and neighborhood, despite what the article describes as "the frailty, danger and isolation of old age."

These groups refer to themselves as “Aging In Place” “villages,” and there are more than 100 of them across the country. They are part of a movement to make neighborhoods safe places to grow old. By pooling their collective talents, citizens may be able to provide for each other’s needs and thus put off the need to move out of their own home to an assisted living facility or nursing home. These groups register as nonprofit corporations, set membership dues, and line up reliable providers of transportation, home repair, companionship, security and other home or care services for their members. "The villages address what can be a premature decision by older people to give up their homes in response to relatively minor problems: No way to get to the grocery store. Tradesmen unwilling to take on small repairs. The isolation of a snowy winter, etc."

For a role model, the new groups looked to Beacon Hill Village in Boston, which pioneered the approach six years ago. "Beacon Hill has 400 members who pay yearly dues — $580 for an individual and $780 for a couple, plus à la carte fees — in exchange for the security of knowing that a prescreened carpenter, chef, computer expert or home health aide is one phone call away."

The amenities of an assisted-living center are thus far more expensive than a village’s membership fee.

These villages are not just located in wealthy neighborhoods. A few villages are cropping up where low-income families live, such as in the Richmond District of San Francisco, Falmouth, Mass., where year-round residents struggle when the summer crowd is gone; and in pockets of Westchester County, such as Yonkers, with middle class populations.

The reporter also interviewed Marie Spiro, 74, and Georgine Reed, 78, (pictured here) who share a house together, which they insist they will only leave “feet first.” Between them, they have already endured three knee replacements and other ailments. They're hanging in there, though.

"Marie describes huffing and puffing while grocery shopping; Georgine is increasingly reluctant to visit friends across town. Both women, who are childless, would already welcome help with meals, transportation and paperwork. If they need home care, Capitol Hill Village (scheduled to start services in October 2007) will be able to organize that."

“I’ve never had to rely on other people, and I never wanted to,” Ms. Spiro said. “But I’d rather pay a fee than have to ask favors.”

This is the first I have heard of these "Villages." If you are part of an Age-In-Place Village, I would love to hear from you, and help you get the word out to others in your community.

Would you like to find a village in your neighborhood, or get help with starting one? These are some contacts to follow up with:



To read the New York Times article click here.


Felicia Curran
www.ElderAdvocacyLaw.com

Bankruptcies are increasing faster among Americans 55 and over than in any other age group, according to a recent article in the Herald Tribune. People 65 and over accounted for nearly 5 percent of bankruptcy filings in 2002 -- nearly double the 2.5 percent figure from 1994, a report published in the American Bankruptcy Institute Journal found.

More older people are carrying more debt, from mortgages to home equity loans and even credit card bills, than ever before. The article quotes analysts who say the trend signals underlying problems with the country's health care, economic and elder care systems, which have implications for the next generation.

"If you have older Americans who are spending much of their money and savings for health care and general cost of living, they're not able to pass on that wealth to subsequent generations," said Deborah Thorne, an Ohio University professor who co-wrote a major 2001 study on aging and bankruptcy and is working on another.

A 2001 research study tracked a rise in the total number of older people filing for bankruptcy in the 1990s and a doubling since 1994 in the rate at which older people filed.

Reports by the National Consumer Law Center, the nonprofit group Demos, AARP and others have tracked the bankruptcy increase and potential causes in a series of reports.

They have noted that incomes for many older Americans have been largely stagnant -- the median income for older households is less than $25,000 -- while living expenses have escalated.

"For many retirees, Social Security and pension income are simply no longer sufficient to meet day-to-day needs," the National Consumer Law Center stated in a July 2006 report. "In rapidly increasing numbers, elders are using credit to pay for necessities like groceries, drugs and urgent house repairs."

A case in point is Brenda Broadbent, pictured above, who filed for bankruptcy at 59, a time she expected to be planning her retirement. She was self-employed as a real estate agent, and could not afford health insurance. A heart attack, which required bypass surgery, left her buried by nearly $100,000 in medical bills. She lost her house, her car and any sense of control. "It was a very dark time in my life," said Brenda.

"I was trying to get my ducks in a row" to retire at 65, she said. Now, "I'll be working probably until they put me in a pine box," she added.

Unable to work after her surgery, Brenda could not satisfy the mortgage, car and utility bills, or the thousands of dollars in charges for house repairs and new furnishings. Impaired by post-surgery memory loss, she could not return to handling real estate transactions. She is working only part-time now.

"My phone rang every six minutes, from 8 in the morning until 9 at night," Brenda said of the calls from creditors. "I knew I had to do something."

She filed for bankruptcy in the spring of 2004. Though much of the debt was eliminated over the next few months, she was hardly relieved. "I was devastated. I didn't want to go out of my house," she said. "I felt the whole world knew. You feel like you've committed a crime."

Carrying debt is a bigger danger for the older population because they have fewer years to recover and are more likely to be disabled, face age discrimination and confront other problems that preclude working to pay off bills.

Younger people can take second jobs or put more family members to work, but older people don’t have that option. Brenda is still applying for jobs. More than once, she has left a job interview certain that she would receive an offer, only to hear nothing. One prospective employer, she says, asked in a job interview about her "five-year plan."

"I almost laughed in his face," she said. "I should have said, 'To be alive and well.'"

President Bush and the Republicans foolishly say the solution is for people like Brenda to set aside money for health insurance. Brenda might as well try saving for a Lamborghini. For many older Americans the cost of healthcare insurance is out of their reach.

Healthcare is a right, not a privilege. Instead of protecting our elders, we protect the insurance industry's strangle-hold on healthcare insurance. Do your part to make 2008 the election year in which we take control of our healthcare system and guarantee health insurance for everyone.

To read the excellent article, click here.

Felicia Curran
www.ElderAdvocacyLaw.com

Are you interested in proposed laws affecting Medicare? The National Committee to Preserve Social Security and Medicare has an excellent blog, www.entitledtoknow.blogspot.com that is regularly updated regarding proposed laws affecting Medicare and Social Security. There are oodles of information on the blog, from the last month, relating to Medicare Advantage plans, the marketing tactics used by insurance companies pushing those plans, and the cost of these plans.


Felicia Curran
www.ElderAdvocacyLaw.com

A California neurologist, Dr. William Rodman Shankle M.D., is reported to be using the drug Exelon to successfully treat patients diagnosed with early stage Alzheimer disease. The FDA approved Exelon in 2000, and it reportedly stops the breakdown of a chemical transmitter in the brain. According to the Orange County register, Dr. Shankle believes that early detection is the key to halting the disease’s progression.

The article describes Dr. Shankle’s treatment of retired obstetrician Dr. Marvin Sando, M.D. Marvin (pictured to the right) retired in 1999. A few years into retirement, his wife noticed some strange changes in her husband. Marvin, who once added rows of numbers in his head, struggled with calculations. An avid reader who juggled five or six books at a time, he could no longer follow when he turned to his place in a book.

"It was frustrating as the devil," Sando recalls. "(Before) I might begin a book and pick it up three months later, and after one or two sentences know exactly where I was." He also found himself forgetting who people in his life were.

In 2002, he saw Dr. Shankle (pictured here with Marvin), who, after testing, diagnosed him with AZ. Dr. Shankle put him on a regimen of medication, including Exelon, as well as lifestyle changes --mandatory daily walks, a glass of wine only on rare occasions, and Sudoku instead of crossword puzzles to give his mind a new challenge. Reportedly, within a few months, Sando's memory test score improved to 100 percent. A PET scan at five months revealed much more activity in the memory storage parts of his brain.

Nearly five years later, on a regimen of medication, he is virtually symptom-free, confirmed by his scores on memory tests, images in brain scans and the ease of his everyday life.

"Every day when I take that little pill, I think of how lucky I am to be here," says Marvin Sando. "I'm enjoying every day." "You can't get any more dramatic than completely reverting to normal," Shankle says.

Dr. Shankle says that most AZ patients aren't diagnosed early enough to fully benefit. Because early diagnosis of AZ is the key to the efficacy of this treatment, Dr. Shankle believes that everyone should have an annual memory test, starting at age 65, to screen for early signs of Alzheimer disease.

You can read the article by clicking here. If you or a family member have early stage Alzheimer’s, show the article to your family physician, and ask for a referral to a specialist who would be qualified to advise you on the best course of treatment.


Felicia Curran
www.ElderAdvocacyLaw.com

A cat named Oscar, who was raised in a nursing home, has an uncanny ability to tell when someone has just a few hours left to live, according to the Associated Press. How Oscar wound up in a nursing home, the article doesn't say, but he certainly is making the most of it. Oscar, who was adopted as a kitten by the nursing staff, began to make his own rounds in the nursing home after he’d been there about six months. Normally, he is quite stand-offish. However, the nursing home staff has learned that if he jumps up on a resident’s bed, and stays there, that means that the resident has less than four hours to live.

Over the past year and one-half, Oscar has made the correct call in 25 cases.

“He doesn't make too many mistakes. He seems to understand when patients are about to die," said Dr. David Dosa in an interview.

Dr. Joan Teno of Brown University, who treats patients at the nursing home, is quoted as saying that she was convinced of Oscar's talent when he made his 13th correct call. “While observing one patient, Teno said she noticed the woman wasn't eating, was breathing with difficulty and that her legs had a bluish tinge, signs that often mean death is near. Oscar wouldn't stay inside the room though, so Teno thought his streak was broken. Instead, it turned out the doctor's prediction was roughly 10 hours too early. Sure enough, during the patient's final two hours, nurses told Teno that Oscar joined the woman at her bedside.”

So, how does Oscar do it? Check out a discussion of this point in Medicinenet.com, in which Dr. Teno is quoted as saying that it is possible that "he is following the patterning behavior of the staff. .. . This is an excellent nursing home. If a dying person is alone, the staff will actually go in so the patient is not alone. They will hold a vigil. . . .Oscar has seen that pattern repeated many times, . . .and may be mimicking it."

"Animals are intuitive," she says. "We don't give them enough credit." One of the first cases, Teno says, involved a resident who had a blood clot in her leg. "Her leg was ice cold," Teno says. "Oscar wrapped his body around her leg," she says, and stayed until the woman died.

This suggests that Oscar was trying to save the woman's life. The thing that struck me about the reporting of Oscar is that no mention is made of Oscar saving anyone's life. If Oscar lived in a hospital, or some other type of health facility, he would be able to alert a doctor or nurse in time to save a patient's life. Because he's in a nursing home, it apparently goes without saying that all these deaths are expected and unavoidable. I wonder if he is frustrated that his vigils don't seem to prevent the deaths. Don't let it throw you, Oscar. You may not realize it, but just making sure that no one dies alone is enough.

Click here to read the article, which also discusses other possible explanations.


Felicia Curran
www.ElderAdvocacyLaw.com