May 2030–Rethought

10 May
May 10, 2013

NOTA BENE: Look I don’t know anymore about the future than you.  I can’t predict what’s going to happen in May of 2013 much less May 2030.  But I do know this, our planet’s in Congestive Heart failure; some days it’s a challenge just to balance the enormous amount of negative energy  from eight billion people and catch it’s breath while it watches it’s resources raped and pillaged by the infamous 1%.

Having said all of that let me go out on a limb to make a prediction.  There is a line we cross as human beings.  Most of us never see the line but I assure you it’s there.  It has no name and yet despite its anonymity it plays a surprisingly large roll when we cross it.  I call it the lifeline.  And for two decades using simple observation, stillness, and intuition I’ve watched many of my fellow residents cross the line.  Sometimes it’s dramatic, sometimes it’s not. But the outcome is certain, always the same. Death.  I’ve seen people cross the line at ten years old with leukemia, at 45 years old with MS, and at 60 years old well. . . you fill in the blank.  For human beings–and that’s the only race I can speak for, the desire to live to protect that spark of life within us for centuries has saved us in precarious situations, it would appear at times that we are all cats, or so we’d like to think.

But in truth, whenever I see and feel and hear a fellow resident cross that line I feel a twinge of sorrow knowing fully well what lies ahead.  Sometimes the end maybe months away, sometimes hours, but once they cross the line death chases them like a thief in the night and they are only too willing to oblige.

Now for the truly sad part.  I have watched planet earth cross that line as if she lived and breathed.  I saw her wipe back tears as she made the decision to let it be and now we are in free fall. plummeting toward the same earth that produces raspberries, cotton and healing herbs.

I hope I’m wrong. I hope it was all a dream, that people will somehow pull it together. Maybe Rodney King wasn’t so far off the mark after all.

Martin Bayne

MAY 2030

06 May
May 6, 2013

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It’s 2030 and I just celebrated my 80th birthday in one of three resident lounges in AGCOM #43, an Aging Community in upstate New York, just south of the Canadian border. Unlike the assisted living and skilled nursing facilities of the past, with their manicured lawns, on-site and remote activities and 450 square-foot private rooms, today’s AGCOMs are managed by the US Dept. of Aging, and are little more than warehouses with two coats of paint. The building itself is an aircraft hanger-like structure with a corrugated steel roof, and the residents live four-to-a-room in 1,400 square-foot “quads” – each resident has 220 square feet of private space and shares a kitchen, bathroom, and living room with the three other residents.

Every quad also has an RC (Robotic Companion). RCs are the brainchild of Dean Kamen, the man who gave us Segways at the turn of the century. The Companion, made primarily of plastic and other cleanser-friendly materials, cooks, gives showers, cleans and assists with any Activity of Daily Living. Fully operational by voice command, the front of the RC can even fold out to provide an emergency wheelchair.

The conditions I described in the previous two paragraphs are the result of two dramatic changes in the American aging algorithm. Demographics coupled with a massive global financial depression in 2016 was the first. When the Euro finally caved in 2015, China called in a sizable chunk of US debt. And for the first time in this nation’s history, we were unable to meet our obligations. That set off a domino effect and within two weeks – after a sizable and very violent run on banks in this and other countries – most global stock exchanges halted trading indefinitely. The NYSE came back online three months later, but with massive restructuring.

The second change – and without doubt the most startling and dramatic – was the Timble Fergeson Act – named after the senators who introduced the bill when it became clear in 2017 that Medicaid and Medicare were nearly bankrupt. The situation called for drastic measures and Timble Fergeson narrowly passed in Congress.  Here are some of the most contentious (and most say) onerous provisions of the legislation.

Effective 12/4/2018 everyone 70 and over automatically was assigned a Primary Care Physician in a national managed care plan. ANY patient plan of  care, acute or protracted that was likely to cost over $5,000 was assigned a “cash transaction” status until an appeal could be filed. This, in effect, shut down the medical system for those 70 and older who were without financial means. A Congressperson from New Jersey said the Bill was “thinning the herd” and had an ulterior motive — to not only dramatically lower acute care costs, but also long-term care costs . . . to be continued . . .

The Grand Journey

28 Apr
April 28, 2013

In the assisted living community I call home, when a fellow-resident begins to physiologically “shut down” in preparation for death, I try — whenever possible — to visit the resident while they are still alive. I’ve never been big on post-mortem communications, regardless of how ethereal. When a person’s “essence” or soul moves on, so do I.

cemetaryI avoid sitting Shiva, wakes, funerals, burials, mortuaries, cemeteries, and cremations like the German Measles. And if that makes me insensitive, disrespectful, and socially crude, then so be it. The dead sure as hell don’t care, why should the living?

I pray our National Cemeteries, with row upon row of headstones as far as the eye can see, will be seen by future social anthropologists for what they truly are: fields of terror, pain and sorrow.

Last night I sat for an hour at the bedside of Father W, an ordained Franciscan priest. Father W is one of the kindest, most sincere and intelligent Catholic priests I’ve ever had the good fortune to know. He began his professional life as an engineer for Bethlehem Steel at their main plant and corporate headquarters in Bethlehem, Pennsylvania, and was in his thirties before he entered the seminary to study for the priesthood.

Now he lies, peacefully, in a coma, waiting for the first bus Home.

And If I know Father W, he’ll get a window seat; like any ten-year-old school boy, unwilling to miss a thing.

STILL RUNNING

27 Apr
April 27, 2013

evil

It’s a beautiful day in Boston, Jim. as our cameras pan the crowds that have lined the streets for this race, you can feel the excitement . . “

Jim?”

Bob, cue a 60-second spot and CUT the feed. NOW. “

“Jim, what the hell is wrong with you?”

Sorry, Richard, I was thinking about the airport”

What about the airport? God damn it, Jim, look at me when I’m talking to you — we’ve got 20 million viewers and you pick this morning to fall off the wagon?”

Bullshit. I haven’t touched a drop.”

Then tell me — what’s wrong with you?

The airport. . ..”

For the love of God, man, what about the airport?”

The passengers that flew out of Logan. They started the real race.”

Jim, what are you talking about?”

Nine-eleven was the real race day, but it’s not over yet. Not by a long shot.”

OK, that’s it. GET HIM OFF THE SET and don’t make me say it twice.

Ladies and gentlemen, we’re experiencing some technical difficulties, we’ll be right back . . .

I SAID I WANT HIM OFF THE SET. Bob, please: call security if you must, but get him off this stage.”

Richard, there’s no need for Bob to call Security. Just hear me out for two minutes, then I’ll leave peacefully.”

All right, Jim, you’ve got ONE minute, not two. That’s it.”

“lLogan was just a warm-up, Richard”

Yeah, right. You now have fifty seconds.”

It didn’t stop that day, did it Richard?”

What the hell are you talking about?”

They’re still running.”

Who are they?”

They. We. Us. We’re still running, aren’t we Richard?

I don’t know what you’re talking about.”

Suicide has surpassed car crashes as the leading cause of injury death for Americans. Even more disturbing, more U.S. Soldiers died in 2012 by suicide than in combat.”

Jim. Your point?”

As our churches empty and the the psychiatric wards and crack houses fill to capacity, we are in darkness. There’s no light. Look at the legacy we’re leaving our children.”

Times up. Enough bullshit. You want to believe the world’s in a dark place and our children will . . . [A tremendous explosion] WHAT THE HELL WAS THAT?”

[A second explosion from a pressure cooker bomb decapitates Richard.]

[Lying on the floor, covered with dust and glass, a camera man slowly makes his way across shattered equipment and broken bodies to Jim. “Who is it we’re running from?” he asks in a hoarse whisper.]

What difference does it make what you call him today. Like a virus, he’ll just mutate tomorrow”

The Devil?” he asked.”

Jim turned away and stared at a smoldering disconnected hand lying on a desk.

How do we find him?” the camera man said.

Just look in the mirror, friend. Just look in the mirror”

 

 

 

 

 

 

 

THE MACHINE THAT ATE MY GREAT-GRANDMOTHER

24 Apr
April 24, 2013

Lorna-Gobey_1589754c

I’m sure most of us have heard at least one grueling story recounting the horrors of an innocent farm hand who accidentally caught a loose piece of clothing in a hay baler or perhaps it was a seed planter built completely of Ginzu knives. The story invariably turns ugly in the second paragraph, and by the end — after thrashing, yanking and terrifying screams — we’re left with a shirt collar and a prequel for a recurring nightmare.

Thank God this is not one of those stories.

In fact, to be completely honest, my great-grandmother was not actually eaten by a machine. She died of complications of pneumonia and heart failure. But that makes for a slow-witted title and a bored reader.(Or a prospective reader who skips over my story entirely! I can assure you, this does not sit well with the Pulitzer Selection Committee.)

Fortunately, I’m a savvy, sophisticated writer, and, thus, am allowed to use bait-and-switch headlines. We call the pick-and-lock sets that give us that extra “literary license”: metaphor, simile, euphemism, and allegory.

Back to G-G. The last time I saw her — the woman who introduced me to incense, Pecan Sandies and comic books — she was in a skilled nursing facility — restrained in a crib-bed, with sunken eyes that reflected her pain and terror.

That experience haunted me for the next half-century. And then there was the diagnosis of Parkisons 19 years ago. This is my eleventh year as a resident in an assisted living community. I live every day surrounded by more death, despair, disability and depression that most see in a lifetime.

But the days of the patient restraints are all but over, and I honestly believe the quality of life in Institutional Aging Communities is improving every day.

Incremental victories. A future with hope.

 

DIVINE INTERVENTION?

17 Apr
April 17, 2013

 

 

 

10:46pmDiagram_of_the_human_heart_(cropped)

J. arrives for the 11-7 shift. Pokes his head in my room and says “hi” on his way to the private dining room – the “Operations Center” for the handful of Personal Care Attendants(PCAs) and Med Techs(they dispense resident’s meds) who will work the graveyard shift tonight at the assisted living community I am part of.

11:09pm

I look at J., “You don’t look your usual upbeat, Bob Marley wanna-be, self this evening. What’s wrong?

“I hope nothing,” he says, “but I’ve had a pain in the middle of my chest for most of the day . . .”

“Whoa. Back up.

Where exactly is the pain?” I ask, suddenly worried about my friend.

He points to a spot about 3 inches below the Sternal Notch.

Now, alarm bells are starting to go off in my head, but I’m in no mood to argue. I had my first round of physical therapy in three years earlier in the day, and I am one tired puppy.

“I’ll be fine he says,” and the day’s exhaustion finally catches up to me and I barely make it back to my room before sleep overtakes me.

5:00am

J. walks in my room. “Shower time.” he says. I rub my eyes for a minute or two and the previous evening comes rushing back at me like a large wave. “How is your chest pain?” I ask.

“It’s livable.” (that’s not the answer I’m looking for).

After the shower, as he begins to dress me, I notice a grimace on his face as he bends over to put my sneakers on. Then, the obvious physical manifestations of someone who finds it hard to breathe.

“That’s it,” I say, “time to call the ambulance.” But J is unmoved.

J.’s as stubborn as I am, and I’m afraid we may not have much time left

And then, a random thought/voice drifted through my pre-frontal cortex: “Find the PostEm note with ‘Carol’ written on it.”

Yesterday, as I was cleaning up, I came across the note with just “Carol” written on it and a phone number. I took a guess that maybe the number was Carol Bs’s. She’s the facility’s Director of Nursing. A tall, lithe woman who is efficient with her decisions and has a great sense of humor. Mind you, I didn’t actually know the number on the note was Carol Bs., but I knew I had to call it anyway. She had the juice to convince J. to call an ambulance.

Long story, short — it was Carol B’s number, I called her, and she convinced J. to call the ambulance.

Divine intervention?

You betcha’

 

Study: Bill Thomas Is Aging

03 Apr
April 3, 2013

dna

Well, of course Dr. Thomas is aging. We’re all aging. We all begin the extraordinary process of cell growth, senescence and death while we’re still in the womb. Imagine that! We actually begin “growing old” before we’re out of the womb.

So, then, what’s all the hub-bub about aging?

I’ll tell you what it’s NOT about. It’s not about adopting common-sense life styles that would enhance both the quality and quantity of our exploratory missions to this planet: we eat the wrong foods in quantities that are truly startling. We smoke, chew tobacco, snort cocaine, inject heroin etc., etc.

And it’s not about finding the optimal housing arrangement for our 88-year-old mothers, either. Since the dawn of man, our elders have managed to find housing. Yes, today there are unique circumstances that challenge our village, but if we can land men on the moon, we can certainly come up with a way to care for our parents.

So, again, why all the noise NOW about aging?

I was watching a rerun of The Sopranos today (I haven’t owned a TV for 25 years. Thankfully, the Internet provides a broad range of entertainment options.)

Anyway, during one of his psychotherapeutic sessions, Tony Soprano said, “We’re the only country where people expect to be happy. And despite everything we’ve been given, happiness eludes us.”

That’s it! That’s the answer, the REAL answer to the question, Why all the noise? Now.

Happiness.

Think about it . . .most of our parents (I’m 63; my parents, mid-eighties) never found their Golden Years. After a Depression and a brutal World War, most worked, retired and either scraped out a modest living from Social Security and meager savings, lived with their children or just died.

Remember how our parents sacrificed, scrimped and saved to give us “a better life” than they had?

Well, we’ve tweaked the algorithm so WE can have what THEY never did. Besides, we’re Boomers, and Boomers practically invented change on a massive scale.

So, Get Ready!

They’re coming.

And they’re selling happiness.

And they know where 60% + of this country’s wealth is. In OUR pockets.

So, before they knock on your door, ask yourself . . .Is it possible to grow old – with chronic disease, loneliness, isolation, – and still be happy?

Well, is it?

 “Most people don’t grow up. Most people age.

They find parking spaces, honor their credit cards,

get married, have children, and call that maturity.

What that is, is aging.”

– Maya Angelou

True that.

Martin Bayne Copyright (c) 2013

 

 

 

 

 

 

 

 

“COME ON DOWN . . .”

01 Apr
April 1, 2013

 

price

R. was dying. Ever so slowly.

I know, I’ve shared both living and dying with fellow residents for more than a decade, and there are times it’s hard to distinguish between the two. This was not one of those times.

R. had been sleeping continuously for the last three weeks; quietly, like you’d expect an angel to sleep. She would slip in and out of her coma gracefully, like a majestic swan.

When my brother was sixteen, he was in a very bad automobile accident. Ejected from the car, he would spend the next four weeks in the hospital in a coma. It was touch and go for those four weeks.

Amazingly, he joined the Navy some years later, saw action on a firing line in Vietnam, and returned home with enough mental illness for four or five men. He would spend the next years in and out of Veteran’s Psychiatric Hospitals, and then one day – he just disappeared. Never again to be seen.

In 1995 I completed the necessary paperwork in Surrogate Court, Orange County, New York, brought it before a judge, and within twenty minutes my little brother no longer existed. Legally.

I assure you he still exists in my consciousness and will until the moment it is my turn to touch the Face of God.

It was a sunny day. I was in R’s room in a large lift chair, sitting as I often did with the television in the background. I could hear the Price is Right as I drifted into the twilight between waking and sleeping.

The next words the announcer shouted were “R., Come on Down” and as I lifted the corner of my eyelid, I was sure I saw her running, arms flailing, with the beaming smile that was her trademark.

I bolted straight up, almost falling out of the chair, just in time . . .to catch a man from Indiana running down the aisle.

Oh well, a little excitement for the day. I put my head on the chair and began to close my eyes.

And that’s when I saw it.

On R.’s face.

The outline of a faint – yet definite – smile.

Want to Boost Revenues? Pay Every Employee a Commission

28 Mar
March 28, 2013

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Particularly in the current economy, how can a small company safely and effectively grow? Much has been said recently about the impact of higher taxes — should the company postpone hiring? Rely more heavily on on part time or contingency staff?

Our company, Fishbowl, is sitting at approximately 100 employees. However, while our employee base has stayed relatively stable for the past two years, our revenues have soared by more than 60 percent year over year since 2007.

How have we accomplished it? Having an excellent product and hiring the right talent is key. However, much of our success is due to our highly unusual compensation strategy that motivates everybody in the business to help the company grow.

We put every member of the company — and we do mean everyone — on commission. In our opinion, every employee contributes to sales, so we pay everyone based on company revenues, instead of using a more traditional bonus or profit-sharing plan. The commission ratios vary from development to marketing to finance, administration, sales and customer support, and in the various areas are based on the metrics the individuals are most able to directly control. In some respect, every person’s compensation is configured as a base plus commission. Consider the advantages of this compensation plan:more, the commission is paid every month.

• Every employee is inherently motivated to help the company focus on creating revenue.

• Job security and company stability increases, as the company’s greatest cost — payroll — rises and falls automatically along with revenue creation.

• In a company that can’t offer stock options, this is a structure that acts like a stock dividend, motivating teams to pull together and to pull harder as they think of the company’s good.

• It closes the inherent gaps and divisions between departments by ensuring everyone is focused on revenue, profit, and savings, versus individual department agendas.

The commission structure encourages transparency and team participation. Everyone knows what the monthly operational “nut” is. Each day the employees get a report on how how far we are toward that revenue goal. Beyond the break-even sum, two-thirds of additional revenue goes to the commission pools for each department to share among its members. One-third goes to the company.

Yes, we are entrusting employees with sensitive and confidential information. But in our model, the team is highly engaged as compensation decisions act as an invisible “belt” to hold our decisions in check. Every team decides as a unit how to distribute their portion of profits. Do we need another programmer to meet a critical goal? As the developers look at the discretionary fund they’ll divide, they help to decide if the time is right for an additional programmer who can help to drive new features for future profit, or if they are able to “crunch it up” a little to keep the funds for themselves and accomplish the work on their own.

Towards the end of every month, we see individuals from every department offering extra resources and help to other divisions. A developer or member of a support team may go to the sales department, for example, to say, “I have an extra half hour. Is there anything I can do to help you finish a sale?”

Are there any disadvantages to this structure? Only a few:

• The commission plan is different for every role and for every department. Ratios range from 10 percent salary and 90 percent commission for salespeople to 80 percent salary and 20 percent commission for programmers and engineers. This can make for a complicated structure at times. We’re perpetually improving our ability to adjust and adapt.

• Is payroll difficult? In theory, it could be — but in practice, as long as we ensure the commission numbers are accurate, each department can submit its list of amounts within the payroll software and the automated payroll system takes care of the rest.

• Are there legal technicalities? Yes. It does require support from HR to build a program to ensure that we are compliant at all times with overtime pay requirements under the FLSA (Fair Labor Standards Act). We continually receive counsel from compensation professionals to ensure our programs are sound and correct.

• The structure of commission is so foreign to many employees that we’ve actually missed some prospective hires. Because of the commission structure, our base salaries are typically lower than average (by perhaps 20%), and in a very lean month there will perhaps be no commission at all. However, in fruitful months, the commission can increase employees’ income by as much as even 40-50%. Even so, there are admittedly some individuals who are unable to adapt to the prospect of compensation that may vary by as much as 50% every month.

Here are some specific examples to illustrate our structure. For a junior programmer who might make a market-rate salary of $60,000, we’d offer perhaps $48,000 plus commission. Then we would show them our revenue history, pointing toward the strong possibility that, based on this record, that they will actually make $65-75,000 per year. For an administrative employee, perhaps we would pay $10 an hour coupled with a 30-40% commission. In many months, the individual would make $15 an hour and even as much as $20 an hour, with commission actually matching their salary. (While skeptics might wonder how and admin can drive sales, in fact these employees have significant power to assist directly and indirectly in helping us close our company’s sales; they are often the ones that touch our customers the most.)

Overall, we pay more than market compensation through our commission model, by 20-50 percent. Yet in a lean month, we have sufficient revenue to cover the core expense “nut” without depleting savings or relying on borrowed operational funds.

On the whole, our employees have applauded our structure. In hindsight, we realize the hires who wouldn’t join Fishbowl due to their perception our compensation system seems risky probably aren’t as entrepreneurial and highly motivated as those who have joined us.

After a short while on this program, we have found the majority of our employees to be highly resistant to going away from this plan.

Interestingly, our structure has made it easier for potential stars to determine and to control their rising wages. We seldom need to change a base salary. Individuals who are ready for an increase are ready to build, sell, train and support to a greater degree (in other words, to produce more revenue). This means that the rise in income is something our team members can largely influence and control on their own. As a point of reference, as incomes for the majority of incomes actually decreased in 2011 and 2012, our employees’ incomes increased by an average of 19% in 2012. We considered it a profound achievement for us as a company, and for them.

If we ever considered changing our base-plus-commission plan, we suspect we’d have a mutiny on our hands. We believe this structure could benefit every small company in 2013 that is looking for an effective way to stay safe in the current economic climate while also accelerating their ability to grow.

More blog posts by David K. Williams and Mary Michelle Scott
More on: Compensation

DAVID K. WILLIAMS AND MARY MICHELLE SCOTT
David K. Williams and Mary Michelle Scott are CEO and President, respectively, the paired leadership team of Fishbowl, provider of Fishbowl Inventory Software, and one of Utah’s and America’s fastest growing companies. Fishbowl is based in Orem, Utah.

 

REPLIES FROM 3/13 BLOG

27 Mar
March 27, 2013

 

number3

 

 

DWPhilly
This is just wonderful.

March 26, 2013 at 9:29 a.m.REPLYRECOMMEND

 

L PierroNew York
Kudos Marty for stimulating this dialog on one of the defining issues of the next 50 years – the aging of the Baby-Boom generation. The comments show just how personal this issue is, and how it impacts all of us, uniting us in our desire for life until death. What some of those commenting don’t realize is that Marty’s eloquence masks the struggles he has faced, and conjures up images of a scholarly professor in an ivory tower. Nothing could be further from the truth.

 

Entering the long-term care world before age 50 is unimaginable for most, even worse with your mind fully in tact but your body ravaged by Parkinson’s. How ironic that it happened to someone who was already fully engaged in long-term care as a pioneer in the insurance industry, a twist worthy of Kafka. But Marty believed deeply in what he did, and bought a policy in his early 40′s. It has served him well, and we can all learn from that, too.

 

For me, assisted living was experienced through my mother, who had Alzheimer’s, and was lucky enough to find a good facility when living at home became impossible. And through Marty, who was not so lucky the first time around, but has found a place he can live comfortably in. We have been friends for 25 years, and I have learned a great deal from him, both before and after his illness. Now, his unique perspectives from inside the LTC world shine a light on the need for humanity to embrace the aging process, revere it, and give it the attention it deserves.
March 26, 2013 at

 9:29 a.m.REPLYRECOMMEND

 

Berkeley BeeSan Francisco, CA
Mr. Bayne writes quite accurately, and with poignance, when he calls us all out as “This culture of people with tiny hearts who live on glaciers of ambition.” Sadly, on target. I will not forget this column or this phrase soon. Thank you, Mr. Bayne.
March 25, 2013 at 4:08 p.m.REPLYRECOMMEND1

 

rssteinAmherst, MA
My wife who suffers from Parkinson’s and is recovering from some broken bones from falls recently returned home from an Extended Care facility. The facility was excellent and, being retired, I could spend several hours a day with her and join her for lunch. Despite this being good, she enjoys being home where I and my daughters can provide caregiving, and we can afford to have people come in to help. Hoiwever, Medicare does not pay for such home help, even though it is cheaper than nurding home costs. We need better ways to make it possible for such people be at home where the environment is often more enjoyable and stimulating. I believe adequate home care, with necessary help is a better solution than intitutional care. As an 87 year old, I think of what I want in the future. I certainly would prefer to be at home. A saving grace is that I’m a “computer nerd” and enjoy keeping up with the world’s events and having electrtonic contact with friends. My hope is that I can continue doing this as long as possioble. I have met the famous physicist, Stephen Hawkings, who continu

es to produce and make important contributions despite a debilitating illness. His is a fortunate way to satisfy one’s needs.

March 25, 2013 at 8:25 a.m.REPLYRECOMMEND3

 

P.Ellen KChicago
With no disrespect to Mr Bayne, his Q&A responses are clueless at best and elitist – the product of a man who ran a successful business. Most people don’t fail in that category. If the gate keeping question to get into assisted living is whether and what your passion is at that time of your life, most would fail. The elderly in my acquaintance- my parents, my aunt and uncle, the friends of theirs I have known for more than 50 years have reached the point where any passion could be better described as an effort to not just slog through a day..

 

I get that he wants to live with people who are mentally vigorous, but by the time most people choose or have to go into assisted living, that is one more item that does not work very well any more. It is not the Little Old Lady chorus line of Mel Brooks out there

 

The majority of middle class/professional /formerly white collar people with whom I am acquainted struggle financially at life’s end. His criteria would have them pressing their faces to the glass while people like Bayne, who had money and some remaining energy and ability for social interaction “maximize their potential”.

 

Don’t forget t toss

them a piece of cake on your way out , Marie, er, Mr Bayne.

March 24, 2013 at 2:20 p.m.REPLYRECOMMEND1

 

mkbayneCenter Valley PA
Elitist? Why is it that the most vigorous challenges are always from those who have no solutions of their own? (and have never actually lived one day in an institutional aging facility.)
March 25, 2013 at 8:21 a.m.RECOMMEND2

 

Berkeley BeeSan Francisco, CA
I am delighted that Mr. Bayne has expressed himself so well AND, I am sure, he reflects the perspective of people of the 20th and 21 century as they age.

 

I know that I have heard many of the same comments from my mother who will turn 87 later this year. She did not have a high-powered career, but was a long-time administrative assistant (until the age of 72!), and a mom and a wife.

 

Mom still lives i

n the same house where all four of us kids grew up and it is becoming more of a “job” that an joy.

As we all start to look at options, she wants and needs to live in a place where she is challenged and there is a lot of stimulation. We want her to have that kind of environment, too!
March 25, 2013 at 4:08 p.m.RECOMMEND2

 

CaseySanta Ynez, CA
Mr. Bayne is speaking for himself and what would work for him. I’m sure there are many people who would benefit from implementing his ideas.

 

My mother lived in 2 assisted living places before she finally died last April. At the first one she had a small 1 bedroom apartment. She was quite ambulatory and enjoyed many activities, mostly Bridge which she played at least once a week. But I don’t think she would have liked doing small jobs in the community. She did do her own laundry for years and I think that was enough. Nor would she have wanted to participate in a group meeting every week to talk about how things were going. That was not her style. Maybe not her generation’s style.

 

When her health deteriorated she moved to an assisted living, special care facility She had her own room. There were many people at that place that were in similar circumstances. There was 1 woman who loved to help the care givers sort laundry. Others played bridge (my mom), played in a Bell Choir (my mom) and were involved in various other activities, depending on their

 abilities. Some were just content to stay in their rooms.

 

I don’t think a 1 size fits all approach will work for everyone. My suggestions: More caregivers, tasty food and a large private room. If some people want to have a “job” make that possible. But many enjoy the extra activities like bingo, art classes and making music, lectures etc.
March 23, 2013 at 6:03 p.m.REPLYRECOMMEND1

 

emToronto
Is it feasible for 3-5 people to pool their resources, rent or buy a home and hire staff to assist them? Would government pay for part of all of this as it would be many times cheaper yet more humane than larger institutions?
March 23, 2013 at 10:11 a.m.REPLYRECOMMEND5

 

bebarEast Coast
No matter how good the facility is, the most important thing family can do to make life more bearable for any care-needing person is to visit , and touch, and listen, almost EVERY DAY. This means p

lacing the person in a nearby facility, of course. No one matters more than family.

 

Most people say they would prefer to stay home or live with relatives. But that is not always best or even practical. So plan ahead! Choose your own place. Based on what I have seen of various senior living arrangements among our family and friends, I can say that IF I live to be 80 I will be shopping for a facility for myself (near my kids) and move in before I am 85. From what have seen, one key is to move into a continuing care facility (one that offers independent living with some amenities, assisted living, rehab/nursing, dementia care, and hospice) when you are still active and well enough to make friends and join in the activities. Most people wait too long – until the issue is forced upon them.

 

Please don’t let money be the only thing that matters.
March 23, 2013 at 10:10 a.m.REPLYRECOMMEND3

 

MarinaSouthern Cal.
You are so very right and I hope to make sensible decisions around the same age you do.
In contrast, my in-laws clung to their single family home into their 90s, critically evaluating family members and friends who realized they were aging and needed to move to more suitable housing when they were younger (say, late 70s or early 80s.) So then, when my father-in-law died rather unexpectedly (after a very short and never really diagnosed illness), my nonagen

arian mother-in-law still figured she’d stay put. After awhile, thankfully, she did finally realize she was now A L O N E in a big house that she did not know how to take care of. After moving, however, into the local very nice CCRC (an an independent living resident) she lamented that she and her now-deceased husband should “probably” have moved sooner. No doubt about it, they should have, particularly because my father-in-law was by far the more gregarious of the two and would have facilitated their both making friends. Moreover, they were both physically agile in their 80s. Now, in her early 90s, my mother-in-law is far less mobile, though still remarkably healthy and mentally alert. And she is making a remarkable adjustment, but it is much harder than it would otherwise have been, and she’s having far less fun than she could be having if she had the chance to become more integrated when she could participate in more activities (especially off-site trips). At any rate, Bebar, it pays to plan ahead.

March 26, 2013 at 9:29 a.m.RECOMMEND

 

TrentonWashington, D.C.
“A good litmus test for when things really turn around will be when they stop paying sub-par wages to personal attendants, many of whom are women of color who work like crazy. That’s when we know there will be a change. Making sure that employees in these facilities are treated like human beings — like we would want to be treated. Until that happens, we’re going nowhere.”

 

Amen.

 

March 23, 2013 at 10:07 a.m.REPLYRECOMMEND13

 

train rydernorth America
I spend almost 6 months of the year (in 4-5 week increments) in the “retirement home” where my Canadian partner lives full time.

 

For a while I was depressed because of the need and loneliness around me and the fact that I don’t “go home”.. I learned to connect by sitting, listening. As a female, I’m careful about touching men. altho, they DO need touch as much as the women do. I do as much as I have the energy to do. I still live my own life.. that’s very important. I remind some people of who they still are. I congratulate some people for just making it down the hall. the self-discipline and effort is equal to that of an athelete and I celebrate that.

 

The time will come when my William is gone. I’m beginning to search for my own solutions. The task of clearing out my home is already becoming overwhelming.
March 23, 2013 at 10:04 a.m.REPLYRECOMMEND2

 

peaceatlanta
My parents, at gre

at expense, were in assisted care before their deaths. I agree that the general staff are greatly underpaid and they are understaffed and the care is low level. Like many of our problems here in the US, it comes down to corporate greed. In addition, my complaints to the authorities in PA, the overseers of nursing homes, went unheard. Taxes paid by us go to these for profits and they should be made to use more funds for care. Bottom line, if your rich, you can have good medical care. And, for those of you think socialism is a bad thing, I suggest you investigate how the rest of the developed nations care for the elderly and compare. By the way, those countries also have national child care, enabling non-skilled workers to go work.

March 22, 2013 at 4:10 p.m.REPLYRECOMMEND4

 

BarbaraLong Island, New York
Could someone set up Martin Bayne on a YouTube video and help him broadcast his insights to a wider audience? And how about interviewing him for a TV special report on the needs of aging boomers? There are more and more of us everyday.
March 22, 2013 at 4:10 p.m.REPLYRECOMMEND15

 

mkbayneCenter Valley PA
Barbara, contact me at mkbayne@alum.mit.edu
March 25, 2013 at 8:

21 a.m.RECOMMEND

 

Tess HardingThe New York Globe
As Boomer begin to age out in staggering numbers, Mr. Bayne’s interview was a like the canary in the coal mine. Isn’t it about time we woke up to the next phase of life and what it could be if mindful people like Mr. Bayne can help guide us?
March 22, 2013 at 4:10 p.m.REPLYRECOMMEND4

 

mkbayneCenter Valley PA
I’m ready when you are
March 25, 2013 at 8:21 a.m.RECOMMEND1

 

harryocolumbia

, sc

I ‘m a group therapist in a geropsychiatric outpatient program and It’s amazing the curative power of the group in freeing members of pent up feelings and Breaking through their isolation. They all gain so much in sharing and. Connecting with others going thru the same things–anger, rage,helplessness, powerlessness. This man expresses it so well.
March 22, 2013 at 4:10 p.m.REPLYRECOMMEND2

 

MLBoston
My mother spent two-and-a-half years in a nursing home. She had me to visit every day and bring her new stacks of large print books, that she spent all day, every day, reading. Without that stimulation, I’m very afraid she would have sunk into the torpor and despair I saw overcoming most other residents.

 

There are so many problems with nursing homes, but the overwhelming one I saw was that well over half of the residents–I’d guess seventy to eighty percent of them–had dementia. Those still mobile were in locked wards, but once they were in a wheelchair, they were down in the regular wings.

 

This presence of huge numbers of patients with dementia exerts incredible influence on the care of everyone. Underpaid, poorly trained aides tend to treat all residents as if they were not mentally a

cute. There is little effort made to provide books. The administration left the air conditioning on well into the fall so they could be comfortable in their suits. Meanwhile, the residents were freezing at night. I had my mother dressed as if she were camping in Maine. But so many of the residents have not the capacity to understand or complain.

 

I don’t know the answer. I just know I am doing everything I can to ensure no one of my family ever has to suffer through that experience again.

 

http://teachloveofreading.blogspot.com/

March 22, 2013 at 8:53 a.m.REPLYRECOMMEND15

 

Judith E GrahamDenver
In our conversation, Martin Bayne recommended that people looking at assisted living centers and nursing homes find out what portion of the residents have dementia. This greatly influences the character of these facilities, as you’ve noted. If your older relative does not have dementia, it’s a good idea to think twice about putting him/her in a facility with a high number of residents who do have dementia.
March 22, 2013 at 4:10 p.m.RECOMMEND3

 

buffalogapBuffalo Ga

p, Virginia

Several years ago I met a lady from the AFL-CIO whose goal was to organize nursing home workers to press for better pay and basic benefits. It was very difficult, she said: “These women are so committed to their patients that they can’t imagine endangering them by opposing management.” She also said that I would be surprised to realize how very many of these women have disabled and/or needy family members at home…for whom they also care.
March 22, 2013 at 8:53 a.m.REPLYRECOMMEND11

 

emToronto
In highly labour-intensive fields, unionization should be a snap as there is no way management can do the job. Go on strike for a day or two and let them try!
March 23, 2013 at 10:01 a.m.RECOMMEND1

 

Mary Shelley KleinFern Park, Florida
Mr. Bayne is performing a helpful service in telling what is expected in assisted living and how it might be improved. I’ve always wondered about the amount of sedation used since many of the patien

ts appear to be unresponsive. It would be wise for younger people to think about their futures before the unexpected hits them. We managed to keep my parents in their home and didn’t have money problems, but it was difficult and costly. I think we should just decide not to get old.

March 22, 2013 at 8:53 a.m.REPLYRECOMMEND3

 

justcuriousoregon
Interesting comment, “decide not to get old”. My own elderly mother (and most of her cohort) constantly say they fear being dependent with dementia . . and yet they repeatedly seek medical intervention for every flutter, which pretty much guarantees they will end up dependent with dementia.

 

I myself live in a rural setting with limited access to health care. I used to think I should be responsible, and relocate to a better situation for health care as I age. Now, I think perhaps it would be wiser to just stay put, and die a more normal death when the time comes, without being saved time and again only to experience dependence with dementia.
March 22, 2013 at 4:10 p.m.RECOMMEND13

 

PDXPortland, OR
Assisted living is a little like an elephant being described by people wearing blindfolds: What it is differs depending on the perspective. Mr. Byrne describes more advanced assistance than what is typically available if he receives individual help several hours a day. Some facilities won’t accept people using wheelchairs, or who are incontinent.(I am not assuming that either is

 true for him.) If you need help dressing, bathing, transferring, receiving your medications, you pay more — fees get assessed piece by piece.

As for attitude, someone moving in may not be ready to “seize the day” immediately. He/she/they may be moving under pressure from family or because of a partner’s difficulties. Adjustment takes time. But I agree — attitude of the other residents and staff means everything. And the importance of not becoming a passive recipient of care/services cannot be overstated.
March 22, 2013 at 8:53 a.m.REPLYRECOMMEND4

 

Melo in OhioColumbus Ohio
When my late mother-in-law was at an assisted-living facility here in central Ohio, I used to spend a few minutes of each visit chatting with other residents in their rooms down the hall, and also came to lunch occasionally and engaged with her tablemates. It was fun for them and for me. If each visitor invests just a little time in the ‘community,’ it helps residents to keep connected with the larger world.
March 22, 2013 at 8:53 a.m.REPLYRECOMMEND11

 

Unhappy camperPlanet Earth
Perhaps the most i

mportant role that government could play is to keep private long term care insurers from ‘cherry-picking’ clients, as regular health insurance had previously done but will no longer be able to do beginning next year. My husband and I tried to get LTC insurance in our mid-50s. He succeeded, I did not.

March 22, 2013 at 8:53 a.m.REPLYRECOMMEND4

 

RosenaIowa
My own father spent time in 2 different nursing homes before he died of Alzheimers. The care in the first one was dismal, at best. Had my mother not gone each and every single day to feed him each and every single meal, the man would have starved to death. The second one was better, but a family member was still there every single day to ensure good care.

 

My husband and I are trying to make sound choices now to prepare for our elder years. We have been trying to buy a decent insurance policy to cover home health, assisted living, nursing home expenses. What we are finding is ridiculous. One particular sales rep went on and on about how her company wanted to help people stay in their own homes, so you could use the coverage for home health…BUT, the insurance would only pay 50% of the expenses.

 

When are we as a society going to address this issue? For most, there is not an acceptable answer for what to do with our seniors. Aging facilities and poorly educated and over-worked staffs are n

ot the answer. I do not have hope for the future as our population ages.

March 22, 2013 at 8:53 a.m.REPLYRECOMMEND15

 

Helen ElderWashington state
I am particularly enlightened today by Mr. Bayne’s answer to the question “What would you do if you were in charge?” Seems like many of your wonderful suggestions would not cost a dime to implement. So why is it so hard for management, in this enormously profitable business, to take charge of such simple and graceful ideas?
March 22, 2013 at 8:53 a.m.REPLYRECOMMEND13

 

C.Z.X.East Coast
If there were more of the supposedly exploited aides in these places and fewer administrators, that would already be an improvement.
March 21, 2013 at 10:57 a.m.REPLYRECOMMEND9

 

Carol A. PreeceWashington, DC
My daughter worked in one facility where she was assigned 25 patents. She was constantly running to get the basics covered. With 15 years of experience and multiple skills including phleboto

my she earns no more than a first year CNA(certified nursing assistant) Medicare hourly rate for CNA services is $20 ph: my daughter receives $10. from the nursing home that retains the other 50%. A national disgrace! Yes, but there are so many disgraces, and so many millionaires that need car elevators in their multiple mansions.

March 23, 2013 at 10:01 a.m.RECOMMEND3

 

LauraColorado
Martin Bayne’s voice is very important. I’ve read him elsewhere and listened to him on NPR. We need him and others telling it like it is.
At the same time, what he shares doesn’t help me with the horrible guilt I feel in having placed Mom in one of those fancy assisted living centers that looks to be great but in all reality is just OK.
March 21, 2013 at 10:57 a.m.REPLYRECOMMEND8

 

BevNew York
A worker (a RN) at th

e place where my mother placed herself (good of her) told me she was leaving the assisted living facility to work with sick children. She said working with old people was depressing because you get attached to them and then they die. So in addition to working for aides to get a liveable wage we need to consider the emotional toll of this work.

March 22, 2013 at 8:53 a.m.RECOMMEND14

 

suzanneNew York, NY
I would like to know where Mr. Bayne resides and what the labor pool is in the area for assisted living facilities.

 

There is not one decent assisted living in the Washington DC area. Not one. It is a total disgrace. The wages are disgraceful. I especially enjoy knowing that HCR Manor Care is owned by the Carlyle Group, I’m sure they’re funnelling tons of money back into the facilities. Yeah, right.
March 21, 2013 at 10:57 a.m.REPLYRECOMMEND12
READ ALL 5 REPLIES

 

GranVirginia

 

I live in Northern Virginia and am very familiar with many of the various assisted-care options here as a family member and volunteer. Like many states, Virginia has weak regulations concerning care in assisted living, unlike those for nursing homes and rehab units. As a result, quality varies termendously. But, yes, there are also decent facilities both here and in Montgomery County.

 

It’s fallen to consumers and family members to judge quality of life in a facility BEFORE entering a facility. Ask to see an actual activity calendar, not just a general description. What are the staffing ratios at various levels of care? How about staff turnover rates? When you observe the unit (not just on a tour with the marketers), how are the interactions between staff and residents? In talking to the residents, what do they like? dislike? What about their dining companions? Roommates, if any? Ask to see the library, check the hours, and its a

vailability to people in assisted living. Etc., etc., etc.

 

Check things like inspection reports, ombudsmen’s reports and follow-ups, etc. Many states make such info available on-line, just as they and private sources do for plumbers or roofing companies. Medicare.gov has good info on nursing homes and home health agencies, as does your local Area Agency on Aging. So, too, do other health professionals in the community.

 

So, yes, good choices exist. They’re not cheap (understatement), and they don’t necessarily have the prettiest wallpaper.
March 22, 2013 at 4:10 p.m.RECOMMEND1

 

DNNorthern Virginia

 

To Gran: Nursi

ng and assisted living facilities can seemingly meet the various criteria you mention and still have very serious problems (that will not be caught by state inspections or dealt with by state regulations). The information from Medicare.gov and other government sources only goes so far. I have dealt with the state regulatory agencies and what I have been

 told repeatedly is: “Your complaint is valid and important, but we are limited in what we can do by state regulations and statutes.” When I spoke with the ombudsman, she spent most of the time talking about how much worse her parents’ care facility in another state had been. I could go on but my point is that people should not presume that because a facility seemingly meets certain criteria that they have the full picture and that it must be a good choice.That was the mistake my mother made.

March 23, 2013 at 10:01 a.m.RECOMMEND3

 

suzanneNew York, NY
FLAG

 

It’s really not quite that simple. Really. It’s a full time job doing what you suggest and not everyone has the luxury of doing things BEFOREHAND. Good for you. A lot of these places have devolved into places that are more like nursing homes than assisted living. They are so greedy just to get bodies in. No one should take care of the elderly for profiit and NO, there are not a lot of nonprofits. People are more particular about where they put their animals.
March 23, 2013 at 10:01 a.m.RECO

 

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