It’s Not Over

Wilma StanleyItems of Interest

Acute post-hospital care at home?  The Pandemic has changed healthcare for good, and for the better  That's promising.
Virtual assisted living at home?  Assisted Living That Doesn't Involve Real Estate    I'm encouraged.
Skilled nursing? Nobody WANTS to Live in a Nursing Home  Bring on the unconventional, please.

OK, But what about the toughest situation of all - dementia care?

The Danish documentary "It Is Not Over Yet brings audiences inside a dementia care home that does things differently. ... At Dagmarsminde, the staff work to make residents’ final years comfortable and pleasurable, with as little medicine and as much cake as possible. Their approach of “compassionate care” subverts the standard approach to treating dementia, which relies heavily on medication like antipsychotics and attempts to re-ground patients in reality." - Madeline Lines, POV (Point of View) magazine

Read the full overview of the documentary:  
https://povmagazine.com/it-is-not-over-yet-pictures-a-new-kind-of-nursing-home/
Or, just to see the trailer:
https://youtu.be/EmVlqF6NZBA

People who attended the June 2021 Full Frame Documentary Festival in Durham, NC had the opportunity to view "It's Not Over Yet".

Bree Kalb, one of those lucky Festival goers, provided the following review: "The documentary "It's Not Over Yet," is an absolutely stunning, moving film about a sweet and loving dementia care center in Denmark. It seems so close to what 2T would like to provide for ourselves." AND “I just watched this and had tears in my eyes the entire time. I would be much less fearful of dementia if I thought I'd have this kind of care. The movie, and the place, is just beautiful. It could be a model for 2T."

Want to see the documentary yourself?  Unless you can find another documentary film festival that is showing it, you must wait for it to be made available for private viewing in the U.S.  2T Board director, Mareah Steketee, tracked down the distributor in Denmark and hopes to know when it becomes available in the U.S.  When it does, we will post the details here.

Nobody WANTS to Live in a Nursing Home

Wilma StanleyItems of Interest

NOBODY.

.

If you have a digital subscription to the New York Times (or haven't yet read your three free articles), click the link below to read an overview of the problem with nursing homes - why we don't want them, how the pandemic just made our aversion even greater, the problem with the payment system, the aging infrastructure, and the advantages of unconventional care models, such as Green House facilities. No solutions, but a good overview of the problems.
https://www.nytimes.com/2021/08/01/opinion/aging-nursing-homes

We don't consider ourselves conventional, and it's going to take an unconventional model to satisfy us.

We have long been interested in the Action Pact Household Model.

There is no “licensed” Green House facility in NC yet.  Perhaps they might be interested in partnering with 2T.

Assisted Living That Doesn’t Involve Real Estate

Wilma StanleyItems of Interest

The previous  post (The Pandemic has changed healthcare for good, and for the better) focused on changes in the delivery of acute medical care following a hospitalization.

But what about longer term care, for example, assisted living?

Joseph H Coughlin has written an article (This Senior Living Business Model Doesn’t Involve Real Estate that not only introduced me to the word "disintermediating", but to the acronym VAL - for "Virtual Assisted Living".  Although the article might be targeted towards the business community, it offers us insight into how assisted living services might be delivered within our community.  

"The pandemic experience and the evolving effectiveness of technologies is disintermediating the idea that care must be linked to place. Increasingly it will be all about the the capacity to provide quality services that are effective, affordable, and excite and delight wherever the older person (and their family) decides to call home."

These changes can also impact the delivery of assisted living services within our community - the place we decide to call home.

The Pandemic has changed healthcare for good, and for the better

Wilma StanleyItems of Interest

Ah, Online conferencing. It enabled us to meet with our co-workers, family, friends and fellow musicians during 2020 and 2021.   It also enabled us to keep some of our medical appointments.

Telehealth already existed in 2020, but most of us would not yet have experienced it were it not for the COVID-19 pandemic.  The desire to avoid the spread of COVID-19, combined with a change in Medicare/Medicaid home health regulations during the COVID-19 public health emergency, led to much quicker adoption of remote medical appointments than previously anticipated.

In June 2020, Centers for Medicare and Medicaid Services proposed to permanently finalize the amendment to the home health regulations that allowed telehealth to be covered under the Medicare home health benefit, beginning January 1, 2021.

Also in June 2020, Mayo Clinic announced a new at-home advanced care model, in a collaboration with Boston-based technology-enabled services company Medically Home.
https://www.healthcarefinancenews.com/news/mayo-clinic-announces-advanced-care-home-model-medically-home

“Using a new technology platform to enable this care-at-home framework, patients with conditions that once had to be managed in a hospital will have the choice to transition to a home-based setting, where they will receive a combination of virtual and in-person care, as well as recovery services.”

In May 2021, Mayo Clinic and Kaiser Permanente announced that they will collaborate to build capacity for “hospital-at-home” care.  They have invested $100 million in Medically Home Group.   These players are some heavy-hitters.
https://www.healthcareitnews.com/news/mayo-clinic-kaiser-put-100m-toward-hospital-home-care

https://www.forbes.com/sites/brucejapsen/2021/05/13/mayo-and-kaiser-invest-100-million-in-hospital-care-at-home-venture/?sh=3c35e9c26063

Medically Home describes it (short video)
https://www.youtube.com/watch?v=1d4XcdQqACA

Representatives from Medically Home, Kaiser, and Mayo Clinic announce this partnership in great detail with Q/A. (54 minute video):   https://www.youtube.com/watch?v=-hVxkH6OqXw

These changes not only promise the improvement of care to underserved areas, but they also mean that within a supportive community such as ours, hospital stays can be as brief as possible, with recovery among family and friends.

‘Zoom’ your partner! Fans of contra and square dancing have moved online.

Wilma StanleyUncategorized

Some of us have figured out ways to play and sing FOR others using Zoom, or even WITH others using Jamulus, but apparently there are dancers who have found ways to DANCE remotely!

https://www.washingtonpost.com/local/contra-square-dancing/2021/04/27/11e192b4-a772-11eb-bca5-048b2759a489_story.html

In fact, Triangle Country Dancers Spring Dance Romance 2021 weekend is virtual this year, and about to begin (May 14-16). Triangle Country Dancers (tcdancers.org)

Building – Prefabricated Construction – Deltec

Wilma StanleyUncategorized

We were introduced to Deltec Homes by way of Cozy Home Community™ (https://www.cozyhomecommunity.com/about/#deltec). “Cozy Homes are based on a housing unit designed and built by Deltec Homes of Asheville, NC.” (https://www.deltechomes.com/renew-collection/ridgeline-e-f/)

Deltec Homes designs homes for which they build the shell of prefabricated panels that are assembled locally at the building site. These panels are designed for high quality, low maintenance, energy efficient and environmentally responsible housing. https://www.deltechomes.com/learn-more/about-us/

Initially, Deltec Homes primarily built hurricane resistant round homes. Might our Arts Center be “in the round”?

Although Deltec Homes takes energy efficiency and environmental stewardship seriously, they clearly have a sense of humor. Enjoy their April Fools Day video: https://www.youtube.com/watch?v=5uz40RvqsmE

Designing a Community – CozyHomeCommunity

Wilma StanleyUncategorized

One of 2T’s Mission goals is to build an affordable, environmentally sustainable community. That goal is shared by Matt Thornhill, Founder & CEO of Cozy Home Community™, with a target audience of “middle-income Boomers between the ages of 60 to 80+”. Energy efficient houses designed by Deltec Homes are clustered into Colonies (pocket neighborhoods) that are configured into multi-Colony Communities – with the emphasis on Community.

We look forward to meeting Matt soon to learn more about his vision, which has much in common with our own.
https://www.cozyhomecommunity.com/about

Building – Modular construction

Wilma StanleyUncategorized

As we build a team to develop our new community, we have begun learning about builders and developers.

The pandemic has affected us all, and developers are no exception. This NYT article identifies advantages of modular construction as well as the types of projects in which modular construction is being used.

Modular Construction Meets Changing Needs in the Pandemic

Educating ourselves about what works (and what doesn’t.)

Bree KalbUncategorized

This NYT article is sobering and educational. Even the comment section has some useful information. We believe that aging in community, with a household model, will reduce and ameliorate the unpleasant and distressing experiences some have as they grow older and more frail.

Social connection rather than social isolation

Bree KalbUncategorized

Aging in Place is the first choice for many as they plan for their future needs.

We are a group of people who want to age in a warm and friendly community that feels like home and includes our favorite activities–music, dance, and other creative pursuits.

We continue to meet monthly to educate ourselves about our options. It’s a long process; we hope you’ll stay interested in our dreams as we learn more.

This article comes from a site that encourages and offers good advice to those who do decide to age in place. It takes an awful lot of effort to connect with others for those who make that choice.

Do you or a loved one have Medicare?

The EditorItems of Interest, Uncategorized

Medicare provides a range of benefits for outpatient and inpatient care. But, an effort to prevent premature discharges from hospital stays has resulted in unintended consequences that can cost the patient thousands of dollars. We include information about this glitch in our Educational Workshops. NPR offers some even more detail. Some have found it effective to repeatedly insist on being admitted. A good reason to have a friend or relative as an advocate when going to the ER.

https://www.npr.org/sections/health-shots/2018/04/20/583338114/how-medicares-conflicting-hospitalization-rules-cost-me-thousands-of-dollars

Benefits of Dance, Music, Creativity and Social Contact

The EditorItems of Interest, Uncategorized

Here’s a NYT article with good information about aging well, including dancing.

https://www.nytimes.com/guides/well/how-to-age-well

And this article is specifically about the effects of contra dancing. ” A new study that compared the neurological effects of country dancing with those of walking and other activities suggests that there may be something unique about learning a social dance.”

https://www.nytimes.com/2017/03/29/well/walk-stretch-or-dance-dancing-may-be-best-for-the-brain.html

 

Reference Guide to all CCRCs in N.C.

The EditorItems of Interest, Uncategorized

Here’s a link to an incredibly informative Reference Guide from the NC Insurance Commissioner’s office, comparing ALL the licensed CCRC’s in the entire state!
You probably don’t want to peruse all 99 pages. These are the pages we identified as most useful in the 2016 guide; we think they are numbered the same in this year’s version:
pdf pp. 4-8: explanation of terms
pdf p 9:  map and names (with reference numbers) of all NC CCRC’s
pdf pp 68-71:  summary of contract and refund options
pdf pp 71-74:  summary of other services and features
To find an individual CCRC pdf page, add 9 to its map number.
We recommend that you check the map on p. 9; look at and compare the ones in Durham, Chapel Hill, Raleigh, and perhaps Burlington and Greensboro, as well as Pennybyrn (#27, pdf p. 36), which uses the Household model.  In addition, the fee ranges on the individual pages can give you a sense of current local pricing.
When you click on the link it may automatically download the PDF to your computer, depending on your settings.

Home Funeral and Death Care Midwife Training – The Center for End of Life Transitions, May 2016

The EditorItems of Interest, Uncategorized

Based in Western North Carolina, the Center for End of Life Transitions offers Home Funeral Guidance and Assistance, as well as End of Life Educational Opportunities through workshops and retreats. See the website at: https://ceolt.org/

 

Information about upcoming workshops: https://ceolt.org/events/home-funeral-and-death-care-midwife-training/

Book and Film Recommendations, April 2016

The EditorItems of Interest, Uncategorized

Both this book and DVD reflect the philosophy and motivation of the Traditional Music and Dance Retirement Society and our pioneering vision of how we want to live in old age.

Many of us have seen a clip from ALIVE INSIDE; now the entire film is available to purchase or to stream from Netflix or I-tunes.

ALIVE INSIDE is a joyous cinematic exploration of music’s capacity to reawaken our souls and uncover the deepest parts of our humanity. Filmmaker Michael Rossato-Bennett chronicles the astonishing experiences of individuals around the country who have been revitalized through the simple experience of listening to music. His camera reveals the uniquely human connection we find in music and how its healing power can triumph where prescription medication falls short.

This stirring documentary follows social worker Dan Cohen, founder of the nonprofit organization Music & Memory, as he fights against a broken healthcare system to demonstrate music’s ability to combat memory loss and restore a deep sense of self to those suffering from it. Rossato-Bennett visits family members who have witnessed the miraculous effects of personalized music on their loved ones, and offers illuminating interviews with experts including renowned neurologist and best-selling author Oliver Sacks (Musicophilia: Tales of Music and the Brain) and musician Bobby McFerrin (“Don’t Worry, Be Happy”). An uplifting cinematic exploration of music and the mind, ALIVE INSIDE’s inspirational and emotional story left audiences humming, clapping and cheering at the 2014 Sundance Film Festival, where it won the Audience Award.

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Being Mortal, by Atul Gawande, is groundbreaking and brilliant. Many of you have already read it. If not, this might pique your interest.
Here’s a summary from a NYT review and a link to the full review. This should be easy to find at your local book store.

“Being Mortal,” is a personal meditation on how we can better live with age-related frailty, serious illness and approaching death.  It is also a call for a change in the philosophy of health care. Gawande writes that members of the medical profession, himself included, have been wrong about what their job is. Rather than ensuring health and survival, it is “to enable well-being.”