September 29, 2004

Green Houses

"Boomers have revolutionized music, food, fashion, childbirth and sex. Finally, they are on to something important. Nursing homes. " writes Lenore Skenazy of the New York Daily News.

Ronni Bennett looks at the numbers and says the Hilton Inn is less expensive than a nursing home in Let's Retire to the Hilton. Some of my favorite college memories center around the dining rooms and meals at the houses at Smith College. So much was it a part of the experience of being at Smith that any attempts to change it were always met by howls of the alumnae. I thought this would be a great way to grow older - friends living together, each with a private space, taking turns to prepare meals to enjoy together and lots of good conversation.

Green Houses sound a lot like that. The Green House project

From Lenore's piece

    “I aim to close every nursing home in America,” says geriatrician William Thomas, 44. “And I have 77 million allies. (Boomers) are going to resist being institutionalized on a massive scale.....
    “Residents are expected to surrender autonomy and personal dignity in return for their reliance on the staff,” Thomas writes in his electrifying new book, What Are Old People For? No wonder the residents get depressed. But what's the alternative?

    Frat houses. Or, as Thomas calls them, Green Houses. Same deal (minus the kegs): A group of people choosing to share a house and the activities of everyday life.

    Rather than “getting services” — the nursing home goal — the Green House goal is “convivium,” Thomas says: relishing good food with good friends. In fact, the whole day is organized around preparing meals.

    In Tupelo, Miss., you can see his first 13 Green Houses, which cost no more to run than a traditional institution. They’ve been up for 18 months, filled with former residents of a nursing home that was torn down to give Thomas' plan a try.

    “We liberated them!” Thomas says of the more than 100 elders. “And one of the first things we had to do was run out to the store for sun hats!” Some of the residents hadn’t been outside in years.

    Even though 80 percent of the elders have Alzheimer's, it's clear they are living a much better life.

    “One woman,” says Jude Rabig, the project director, “makes her cornbread once a week.” In another Green House, seven of the 10 residents used wheelchairs when they arrived. Today, only three do. It's easier to walk when you don't have to travel long corridors.

    The elders spend their days breaking bread, celebrating when they can and mourning when they must. In other words, they live a human life. As revolutions go, this is one we've all been waiting for.

Posted by Jill Fallon at 10:15 AM | Permalink

September 22, 2004

More Health Plans Embrace Alternative Medicine

The Wall St Journal (subscription only) today in In Health Plans Embrace Alternatives reports that more employers are offering coverage for alternative care

    About 47% of employees with health benefits had acupuncture coverage in 2004, up from 33% in 2002, according to a 3,000-employer survey released earlier this month by the Kaiser Family Foundation and Health Research and Educational Trust. Chiropractic coverage increased to 87% from 79% of workers with health benefits, the survey showed....
    Still, the increases in coverage for acupuncture and chiropractic care are part of a trend over the past decade in which alternative medicine has gone more mainstream while more employers have come to see the option as, at the least, a relatively low-cost addition to benefits packages....
    "There are some employers out there who are saying, 'No new benefits of any type,' " says George DeVries, chief executive of American Specialty Health Plans Inc., which offers alternative coverage that is added to traditional insurance policies. "But there are many employers who are saying, 'Adding a low-cost [benefit] actually helps us in a time when we're increasing deductibles and co-pays and coinsurance.' 

Posted by Jill Fallon at 3:47 PM | Permalink

September 12, 2004

The Pharmacist who says no to Drugs

Does your doctor or your parents' doctor understand the interactions of prescribed drugs better than a consulting pharmacist?

Armon Neel believes that most patients in long term care facilities are over-medicated and he's on a crusade against it. Neel is one of a few thousand consultant pharmacists nationwide who specialize in "identifying, resolving and preventing medication-related problems that affect and afflict older people. " Go to The American Society of Consultant Pharmacists for information and a list of the 10 most dangerous drug interactions in long-term care.

Neel says the problem is that few doctors who treat the patients in long-term facilities have a specialty in geriatrics. "They're not up to date with the physiology of the geriatric patients as it relates to the chemistry of the drug. That's the easiest way to put it," says Neel in an interview with AARP Bulletin.

Posted by Jill Fallon at 5:57 PM | Permalink

September 7, 2004

Stress is Worse than you knew

Stress is taking a larger toll on our lives than we knew. The The American Institute on Stress calling stress the number 1 health problem in the US estimates that 75-90% of all visits to primary care physicians are for stress-related problems .

The New York Times has a page 1 story on Workplace stress which costs some $300 billion year in health care costs and missed work. The changing workplace - non traditional (part time and self-employed) employment and increased hours are major factors as is what one expert called the "the work ethic of fear" and downsizing and surprisingly workforce expansion.

Workers who feel a sense of control experience less stress. But those who experience stress at work and stress at home get more than a double whammy. Psychiatrist Jeffrey P. Kahn, president of WorkPsych Associates, a consulting firm in New York, says. "Stress at home plus stress at work doesn't equal two units" of stress, he said. "It equals five."

On a very simple level, stress compromises the body's immune system

    "The physiological changes associated with stress are part of a complex system that once saved the lives of human ancestors, warning them of danger, said Dr. Bruce S. McEwen, director of the neuroendocrinology laboratory at Rockefeller University.
    But human physiology, Dr. McEwen said, was not intended to handle the chronic stress that is an inescapable accompaniment of modern life. The wear and tear of long hours, ringing phones, uncertain working conditions and family demands lead to what he calls "allostatic load," a stress switch stuck in the half-on position. The result: fatigue, frustration, anger and burnout.

Links are being found between stress and disease at the molecular level

    At Ohio State University, for example, Dr. Ronald Glaser, a viral immunologist, and his wife, Dr. Janice Kiecolt-Glaser, a psychologist, are reaching across disciplines to understand how stress causes illness...

    "What we know about stress is that it's probably even worse than we thought," Dr. Kiecolt-Glaser said.

    Their most recent work focuses on cytokines, molecules produced by white blood cells, and in particular interleukin 6, which plays a beneficial role in cell communication. Like cortisol and adrenaline, interleukin 6 can damage the body in large and persistent doses, slowing the return to normal after stressful events. It has been linked to conditions that include arthritis, cardiovascular disease, delayed healing and cancer, Dr. Glaser said.

    The immune systems of the highly stressed subjects, Dr. Glaser said, "had the levels of Il-6 that we saw in the controls that were 90 years old," which suggests that their experiences "seemed to be aging the immune system" drastically.

Posted by Jill Fallon at 11:20 AM | Permalink

September 5, 2004

If you're not prepared, ready kits are for you

After Hurricanes Charley and Frances, after a series of terrorist attacks in Russia -two planes down, truck bombs in Moscow, and the even more horrific school hostage tragedy in Beslan, and coming up on the 3rd anniversary of September 11, you can expect a number of news stories and features about disaster preparedness.

More than 80 organizations -t he Department of Homeland Security and the American Red Cross among others - and are joining together to launch national preparedness month to encourage Americans to take simple steps to prepare themselves and their families for any possible emergencies.

The American Red Cross is now offering a variety of survival kits online. 1 ARC safety tube %$5

The Safety Tube is designed to velcro stick under your office desk. Inside the six-inch tube is a dust mask, a light stick, a water packet and a whistle -cost $5.00.
Emergency Preparedness BackPack is enough for 72 hours for 2 people and costs $50.
The Deluxe Emergency Preparedness Kit is $65.

2 ARC 2 person disaster supply

The Red Cross is also beginning a new "Connect" program. For a $19 individual membership or $34 family membership, you get 1.a starter kit (a connect emergency card, a first aid & emergency preparedness compact guide; 2. discounts on courses and products and a unique URL for medical personnel to access additional contacts.

Other companies are selling "ready kits" . HomeGuard began marketing survival kits after 9/11 and says "make a plan, get a kit, be informed" CPR, founded by emergency safety service personnel, sells emergency and survival kits to consumers and businesses.

Posted by Jill Fallon at 6:11 PM | Permalink