A Senior Housing Forum post brought an issue forward that I’ve been yelled at in conferences for even bringing up! Resident prejudice against those with disabilities and the SL Industries complacency. It’s far past time for senior living to just say NO to disability discrimination. Besides being an ADA issue for communities (lawsuits are being filed and won), it underscores a prejudice that SL has enabled for fear that potential residents won’t move in if the “see” frail residents. You would not allow residents to insist that no-one of a different race or religion should be allowed in the dining room so why allow disability discrimination? I know residents can be very vocal about this issue, but the world has changed and age is no excuse to be inappropriate!
SL can drive change when it: 1- invests in strategic initiatives to create not just socialization, but connection and community among residents of all abilities/disabilities (i.e. working together on purpose-projects in the broader community), 2- makes it clear from DAY ONE that every resident is valued equally and treated equally (i.e. marketing professionals proudly declare how inclusion supports their mission statements), 3- embraces the disability movement model of providing adaptive strategies to overcome disabilities and live fully in-spite of challenges (rather than strategies to merely “cope” with disabilities), 4-confronts disability discrimination head-on with residents, families, and staff (have policies in place to address issues).
I attended the Colorado Alzheimer’s Symposium in Denver last week. I was humbled to see so many professionals learning, collaborating, and sharing their commitment to the well-being of people challenged with cognitive impairment. The Denver association is also involved in a unique collaboration with the Denver Broncos. What a great way to get the message of help and hope to so many families affected by Alzheimer’s! www.alz.org/co
Dr. Henry Emmons was the closing keynote speaker. A psychiatrist who integrates mind, body, spirit and natural therapies, he has forged a distinguished career as an expert in resilience and living mindfully. I’m looking forward to reading his books; The Chemistry of Joy, and the Chemistry of Calm. You can learn more about his work at www.partnersinresilience.com
On October 1st Medicare started to penalize hospitals for patients who are readmitted into the hospital within 30 days of discharge for the same diagnosis. This is initially designed to curb the percentage of Medicare patients who are routinely readmitted for three primary conditions; heart failure (24.7%), heart attack (19.7%) and pneumonia (18.5%). The healthcare industry is tracking all diagnosis readmissions, and bracing for other diagnosis to be added to the penalty list.
There’s no doubt serious issues will arise within this new accountable care environment, one being that some hospitals are choosing not to officially “admit” Medicare patients, instead classifying them as “under observation”. Unfortunately, to the patient there is no clear indication they are just under observation, and many older adults have found themselves with large bills for post-acute rehabilitation stays because since they were never officially admitted to the hospital they are not eligible to receive Medicare reimbursement for rehab services. Be aware and ask for clarification of the satus of any hospital stay.
On the positive side, this is quite simply the biggest boost to the business case for prevention and wellness promotion that I’ve seen in the 20+ years I’ve been in the field of older adult wellness. For the past 5 years I’ve been advocating for senior living to take a leading role in changing the way people view and experience aging. And this is a golden invitation for senior living to become the champions of recovery, re-claiming vitality after a health crisis, and reframing possibilities – regardless of challenges. All the pieces and parts are there – it’s just a matter of claiming that “space” in the healthcare continuum.
The "X" Factor
Age has less to do with who a person is and what they're capable of than almost any other single factor, yet it often becomes a direct or indirect barrier to an individual reaching his or her personal potential.
For example, consider that young people with disabilities receive resources, opportunities and social support to overcome disabilities and excel in spite of them. Yet adults who are challenged with a disability later in life are often simply given tools to cope with disabilities. There's a profound difference between a mindset of coping with, versus overcoming, challenges – one that directly impacts expectations, interactions and outcomes.
The successes of the disability movement come from their mindset of looking at possibilities rather than disabilities. As individuals and as a society, we can work for the same kind of positive change in expectations and opportunities for older adults challenged by functional limitations.
"I believe the health care crisis is not going to be solved by government programs," Kay continues, "but instead by individuals inspired into action for their own well-being, and by companies worldwide who mobilize resources to reach out to their customers with healthy lifestyle strategies."
I recently started reading about something called the nocebo effect (meaning will-do-harm). I'd heard of it's kind cousin, the placebo effect (do-no-harm), in relation to drug trials. Brain scans show that beliefs and expectations "I believe these pills will help" can cause biological changes like reducing heart rate and blood pressure, improving immune function, and changing gastric secretions. That's why researches use two study groups; one group gets the real drug and one group gets a placebo. Negative expectations and beliefs can have an equally powerful effect. It's been proven that patients will feel more pain, take longer to heal, and even believe they are incapable of healing, due to negative expectations. That's the nocebo effect.
When you realize how powerful beliefs and expectations are, then you start to understand why the negative aging myth can be so detrimental to well-being. It can undermine aging expectations and manipulate what a person believes is possible and probable. What if we all believed that living well through the full lifespan was a probability rather than just a possibility?