To be idle is a short road to death and to be diligent is a way of life; foolish people are idle, wise people are diligent.

-Buddha

 It was another lovely weekend in the Pacific Northwest and I was having coffee and planning my daily activities with the local talk station as back-drop. Living in a home built in 1930 (and not the least bit handy) I tune into Around the House with Handyman Bob to pick up relevant/practical ideas on home improvement.

Today’s topic: Radon

Radon is not something I think about; in fact when we moved into our lovely money pit, we had it tested for Radon—and thought nothing of it again when the tests results showed it wasn’t an issue. Today’s program brought radon back on my radar screen. Handyman Bob began with statistics like those offered by The EPA: 

Radon is the number one cause of lung cancer among non-smokers, according to EPA estimates.  Overall, radon is the second leading cause of lung cancer.  Radon is responsible for about 21,000 lung cancer deaths every year.  About 2,900 of these deaths occur among people who have never smoked.

Bob’s delivery is kindly yet authoritative, he’s local, cares about the community and it’s palpable in every show. This edition took on a tone of warning and the statistics grabbed my attention and got me thinking about how this relates to aging in place. 

Aging in Place with Radon

Aging-in-place professionals talk of home safety in terms of the built environment and support services, seldom do I hear any one mention radon. January is National Radon Action Month and this is as important as any universal design kitchen or 24/hr alert button worn around the neck. Get your home checked—period.

Proactive Steps

1. The EPA provides maps of Radon Zones around the country—check it to see if your aging in place home is in a hot zone by clicking the link here: Radon Zone Map

 2. Find a Radon Professional in your area by clicking the link here: Radon Professionals

We lock our homes at night, use smoke detectors, remodel for bathroom safety, leave on nightlights, eat right, don’t smoke, visit the doctor and countless other measures to ensure successful aging in place in the homes we love—yet a silent killer could end it all…

Be wise, be diligent–get your home checked; I’m in favor of your aging in place for many years to come and I know The ol’ Handyman is too.

See

Radon Expert Gary Hodgden

Rutgers University/Bill Broadhead 

Listen to Around the House with Handyman Bob: On Radon The Silent Killer

Radon Show 1/12/12

Radon Show 1/14/12

Radon Show cont’ 1/14/12  

EPA: Get Your House Tested

(photo uglyhousephotos.com)

Thousands of candles can be lighted from a single candle, and the life of the candle will not be shortened. Happiness never decreases by being shared.

 -Buddha

One of my favorite songs is James Taylor’s The Secret O’ Life is Enjoying the Passage of Time; and the holidays remind me that another year will soon be past. As I hung the paper-star lanterns in the front window, it seemed like I had just put them away…and now it was time to ponder gift-giving once again. 

Something You Want

I read a post about an older adult named “Bob” whose step-son asked him what he wanted for a gift this year. His response…”I really don’t need anything.”  The step-son replied “Bob, I am going to get you something, it might as well be something you want.”  What I read next simply delighted me with its practicality and possibilities.

Bob:

I thought for a while and finally said: “Give me three light bulbs and the promise that you will install them as needed.” The beauty of the gift is that I have not been on a ladder in over a year and thus have avoided the risk of falling. 

The Gift of Aging in Place

Each year getting older adults gifts (or yourself for that matter) can actually be counter-productive; see hoarding and clutter. How many times have we heard the “I don’t need anything” line, and a desire to give gets even more clouded by feelings of obligation or tradition. And in today’s climate resources are tight for many, so here are some thoughts on capitalizing on two trends affecting all of us; the aging population and the economic downturn. Give the gift of aging in place, because according to AARP this is what 89 percent of boomers/seniors want.

Get creative and make a coupon book, or single coupons for the following aging in place gift ideas:

10 Aging in Place Gifts that cost only your time

1. One home safety inspection: Then on the coupon date, go over the CDC/MetLife foundation Check List for Fall Prevention and Home Safety with the home owner and identify possible needed home modifications.

2. To put up/take down Christmas lights

3. Be their chauffeur for a day (you will drive them in their car anywhere they desire)

4. Walk the dog each week for a year

5. Cut the grass every two weeks/or shovel snow

6. Give a caregiver the weekend off and you do the caring

7. Cook dinner in-home one night for the senior

8. A deep-cleaning of the home

9. Tech-session (computer tutoring) help them set up a Facebook page or email

10. Wash/wax/change oil/vacuum the car  

10 Aging in Place Gifts under $30

1. Home Smoke Alarm battery changes every 6 months

2. Change out lower watt bulbs with 3 higher/brighter energy-saving ones

3. Replace 3 toggle light switches with 3 rocker-style ones

4. Put in a Lever handle door opener to replace an old round doorknob    

5. Install a toilet seat raiser

6. Put non-skid strips in the tub/shower

7. Paint the steps a brighter color (or paint the ends of the steps a bright contrasting color)

8. Place 2 Sensor LED Lights; one at the top and bottom of the stairs

9. Install a Duro-Med Expandable Door Hinge

10. Add a Wide Angle Peephole Viewer in the front door

10 Aging in Place Gifts $100

1. Rubber Threshold Ramp with Beveled Edges

2. The MemoryPlus amplified BIG button phone

3. Replace old worn bedroom slippers with new with nonSlip sole ones

4. Clamp-on tub rail

5. DRILL-FREE Slide Bar with Handheld Shower and Showerhead

6. Snapfon “ez ONE” Cell phone for seniors w/ big buttons

7. Switch Sticks Walking Cane

8. Outdoor Motion Sensor Solar Security Light

9. Toro Electric Power Shovel

10. JitterBug (GreatCall) Phone

Marjorie Holmes said; “At Christmas, all roads lead home.”  This year make aging in place the gift; because home is the most important place on earth to enjoy the passage of time…

See

Tip: The Goodwill often has aging-in-place items like walkers, shower chairs, canes and wheelchairs (look there first to save)

Aging in Place Gifts

Laurie Orlov’s: Tech Gifts for Seniors

The Secret O’ Life by James Taylor

My Safe Home

NAHB Aging in Place Checklist

Hire an AIP CAPS Professional  

(photo angel-lifestyle.com)

*Note these items and actions do not guarantee successful aging in place-but they can increase the odds

“Discovery consists of seeing what everybody has seen and thinking what nobody has thought.”

 — Albert von Szent-Gyorgy

Louis Tenenbaum is the father of the aging in place movement in this country; when he speaks/writes, I for one, pay attention. Here is a guest post by Louis on being inspired in Beantown. Within these words is some gem lying in waiting; enjoy.   

I am an innovation immigrant. 

I don’t often feel inspired. But I am inspired by the incredible third annual Aging Means Business Conference held Friday in Boston associated with the Gerontological Society of America annual meeting.  This was my second time at this conference organized by Greg O’Neill and his team of Sarah Wilson and Dani Kaiserman from the National Academy on an Aging Society working with Mary Furlong and this time with the always provocative and fun (and of course, natty!) Joe Coughlin from MIT AgeLab.

I have been involved with Mary’s events for a few years…having been a semifinalist in the first year of her Boomer Venture $10,000 Business Plan Competition and on the winning team a few years ago. This time the results Mary has been working toward really came together. There was a healthy mix of long dedicated and newly interested business thinkers. The energy was palpable. Just being in this crowd was fun.

The air of excitement started at a Friday night reception hosted by First Republic….a bank that is doing things differently. As we learned in one of the next day’s presentations, they are paying attention to their customers! What a novel idea! The innovation I heard that sounds great?…NO music! (Turns out I am not alone unable to hear and concentrate with music playing in the air around me. I avoid retail and restaurant experiences for this problem. This bank listened.)

Curiously (or NOT- maybe expectably) that issue rose again later in the day. Gretchen Addie and Jose´ Colucci  from IDEO, the quintessential design and innovation consulting firm, engaged us in a process throughout the day rather than just giving a presentation. Innovation worksheets were on the tables when we came in. We were encouraged to state ideas, note the participants, explain the idea, make a sketch and then hang them on a board. Gretchen and Jose´ reviewed them, then shared their take on a few, putting our new ideas in a context of some of their previous projects. We saw how they help ideas grow.

One of these ideas related to the bank practice- Cones of Silence for restaurant tables – allowing diners to dial the background ambiance/noise up or down to balance their desire and threshold for atmosphere and conversation. BOY would I love that!

Matthias Hollwich, the keynoter was a real hit. Matthias is a co-founder of HWKN and the design leader of the BOOM senior communities. Those of us in the senior community design field for many years might say there is really nothing new here, other than wild looking/futuristic house forms. That misses the point. The point is a young, excited and out of the box designer came to this field cold, with no prior knowledge or assumptions and came to the same conceptual conclusions about lifestyle and community we have been promoting for years. That is totally validating! Second, his work is evidence of fresh and growing interest in these opportunities. Third, he brings fresh ideas for reaching the solutions. This young and really pleasant architect and…. just  plain….leader,  pulled together an extraordinary team, bringing real excitement to housing older folks in community.

True to form, Matthias would not be satisfied with the same old survey data. He engaged Hunter Tura of Bruce Mau Design, also new to this field, to develop a tool (looks like an app, folks) to gain customer insight. They hit the nail on the head.

I was excited, but not inspired, when I went to bed. I woke up ready to work, and, reviewing some materials, the inspiration hit.  What turned up the volume? Two more stories.  Do you have the patience?

1. I was so happy to see Jan Hively when I walked into the room Friday morning. Jan Hively, human extraordinaire, is lively, engaged, committed and she gets things done! Jan showed me a brochure from the European Union AAL program (Ambient Assisted Living- the EU term for aging in place or community). The EU has declared 2012 as the European Year on Active Ageing and Solidarity between Generations.  Saturday morning I downloaded the ‘brochure’, a catalogue really, of projects- and started looking for individual project pdf’s to download for reading on the plane home. I was bowled over by the sheer number of ideas they are pursuing in the EU effort.
2. That reminded me of a conversation I had at the conference with Marcus Wilhelm, Research Director from Redstar. Marcus, like Matthias, is an innovation native.  He explained the way his company building company works. They generate eight ideas a month, winnow them down through research with the goal of supporting a few startups per quarter. I had heard this sort of thing before but never got much of a handle on it.

I have been trying to get a handle on innovation for a few weeks. I thought I had it recently- thinking it was about leaving assumptions behind. That is part of it. Now I think it is about the process of rapid idea generation. That fits the pace of the digital/internet world, where I am also an immigrant.

This is exactly what Gretchen and Jose´ did with us.  It clicked for me as I paged through the plethora of ideas being pursued in the EU.  The process of innovation is to generate lots of ideas and consider them. For we immigrants it is a new way to think.

I feel inspired to generate lots of new ideas for the problems I am trying to solve, many of which are identified in Aging in Place 2.0: Rethinking Solutions to the Home Care Challenge

Trust me there was much more to think about and many other exciting, even inspiring, people at this conference. I may get another post or two out of it.

Congratulations and THANKS to those who worked so hard to pull this together. Inspiration is a gift. I appreciate it. I hope I see all of you at next year’s conference November 14-18, 2012 in San Diego.    Why miss a chance for inspiration?

See

Aging in Place Ideas

(photo cupboardsonline.com)

Life’s most rewarding challenge lies in defeating the temptation to merely exist.

- Laurie Harper,  A Taste for Life (1983)

I called my friend Frances the other day; she’s in her 90’s and residing in a traditional nursing home. Our conversation always gets around to her anguish over being “stuck in this “godforsaken place.” Her home defined her in a very real sense; it was her life’s purpose.

She now depends on a wheelchair for mobility and her mind has atrophied from the lack of stimulation. I miss our challenging conversations in her home office and watching the squirrels together, under the tree in her yard.

When Aging in Place Doesn’t Work

Howard Gleckman wrote a thought provoking piece on the challenges with aging in place. His premise was thatfactors having to do with social issues, more so than medical concerns, are often the barriers to aging in place:

-Lack of qualified caregivers

-Lack of services such as basic transportation

-Lack of housing or funds for repairs

-Lack of social networks and isolation

His solutions include more flexible Medicaid programs (they pay for NH, but limited benefits for home care) and anemphasis on long term care insurance which will provide financial resources to care for loved ones.

Gleckman concludes that we can’t keep everyone home (i.e. those with severe dementia), but postponing institutionalization of the elderly, by even months or years, is a goal worthy of our best efforts.

I agree keeping the dream of aging in place alive is not easy, and neither is telling a loved one they must leave their home…

Listen to: Convincing an Aging Mother to Take a Hard Step

See

Aging in Place is not so Easy

The Death of Nursing Homes

Can Aging in Place Reduce the Cost, Increase Quality of Healthcare?

Swedish “Night Patrols” Help Elderly Stay out of Nursing Homes

(photo photonet.com)

The home should be the treasure chest of living.

-Le Corbusier

Once in a while I’m delighted by someone else’s thoughts; so much so, I’d wish I had written them. This is such a case…A guest post by Ronny Wiskin: 

Home, a place with familiar surroundings having provided years of memorable events. Staying in your home might still be your best option.

Why are so many mature adults moving after investing a considerable amount of time and resources into their properties? Before making that decision, why not investigate options that are available to remain in the home you love. The thought of relocation begins when routines like personal hygiene, cleaning, preparing meals and social activities becomes too difficult to manage. It can feel like moving is the only option to retain dignity and independence. But does moving from a 2000 sq/ft home into a 500 sq/ft nice facility or dorm room make sense? Many people will store, sell or give away belongings and downsize to a smaller home that seems easier to maintain when home becomes an obstacle course filled with challenges at every turn. The plan is referred to as retirement or independent community living.

When moving into retirement living, people want a more manageable lifestyle. A common belief is that moving into a retirement community means that help will be available whenever it’s needed. It’s also believed that moving into an independent living building means that the environment will meet long term accessibility needs for varying levels of ability. Unfortunately, this is not possible in either scenario because barrier free design features are not a current requirement under local municipal building codes and assistance with homemaking or personal care is too costly to include in monthly maintenance or rental fees for most of these facilities. Yes there is a social appeal (people like to make new friends.) Certainly, many amenities and services are offered outside your designated living space. But community centers and other social environments and programs for senior adults are available in most neighborhoods.

Retirement living communities offer another option. However they can also present many of the same challenges as staying in the existing home. If an injury or illness occurs, performing activities of daily living can be difficult to manage independently no matter where you live. Help should be brought into the home when individual attention is needed. Moving into a nursing home is a common solution for people that require full time assistance, although this personal help will cost over and above the standard living expenses. This is why many of today’s senior adults are choosing to adapt their current homes in order to meet their long term accessibility and care needs. Bringing a mix of independent and government provided care services into the family home is a consideration that avoids having to move while natural changes in lifestyle occur.

In Ontario, housing built before and during the 1900’s was not designed with barrier free living or wheel friendly access in mind. This is largely because local municipal building codes do not specify accessibility as a mandatory requirement for residential construction. Today there is a greater demand for accessibility being recognized. The standards are beginning to improve. What can be done in order to remain in the home you love? Modifications can be made to houses, condominiums, retirement homes and long term care facilities. These adaptations are made so that residents are able to live, work and play to the best of their abilities with reduced need for assistance. Examples of how these changes can be made are listed as a resource for some of the most practical home modifications made for independent living and fall prevention to ensure long term accessibility.

Entrances and Pathways
• Upgrading lighting that surround pathways and entrances for increased visibility.
• Leveling pathways and entrances eliminates trip hazards.
• Security upgrades can keep unwanted visitors away.
• Handrails, ramps and porch lifts increase safety and accessibility for mobility devices such as walkers, canes, wheelchairs and scooters.
• Widening of doorways allows for clear passage of mobility aides and devices throughout the home.

Stairwells and Living areas
• Lighting upgrades inside the home increases visibility of trip hazards such as belongings left on the floor or even a small pet.
• Removal or securing throw rugs will minimize risks associated with falls.
• Handrails on both sides of the staircase and adding a “No-Skidding” floor surface to stair treads makes climbing stairs safer.
• Installation of stair glides makes getting up and down levels safer for those having difficulties with mobility or balance.
• Elevators or vertical platform lifts are installed between two levels or multiple levels to achieve complete wheel friendly access for multi level dwellings.

Kitchens and Bathrooms
• Installation of full extension glides in existing lower cabinets including under sinks and pantries will allow for easy access to pots, pans, dishes, glasses etc. without the need of bending and crouching or the dangerous use of step stools.
• Installation of shower rails, increases bathroom safety and ease of use.
• “No-skidding” floor treatments reduce slip and fall hazards on wet floors.
• “Safety Bath” tubs make bathing safer and easier for people with mobility challenges.
• Barrier free showers provide independent access to showering for people of all abilities.
Contacting a trained professional to perform a safety and comfort assessment can help identify risks and prevent major injuries at home. You will begin to realize that by making the appropriate changes it will allow you to live more comfortably and remain independent in your own home for as long as you want!

See
Ronny Wiskin, Aging at Home Consultant Founder of Reliable Independent Living Services® www.reliableliving.com

Email or phone for a free special report 416-502-9200 info@reliableliving.com

© 2011 the above can not be copied or published without the written consent of the author. Reliable Independent Living Services® design and install barrier-free living spaces. They have the experience and resources needed in order to transform any work or living place into a comfortable, barrier-free environment.

(photo daytoninteriordesingers.com)

The really frightening thing about middle age is that you know you’ll grow out of it!

— Doris Day

 A tweet from Kohler got me thinking: What do you think of Barbie’s new eco-friendly dream home from Mattel and;@AIANational http://huff.to/obGmER? We love the low-flow toilet! 

Seems Barbie is trending green after years of Pink convertibles and end-less wardrobes; not exactly a sustainability lifestyle (making up for past sins?). The joint effort is a synergy of The AIA and Mattel, who have teamed up for the design competition in honor of “Architect Barbie,” the newest addition to the career-themed “I Can Be” series coming soon to a store near you.

Evolution of The Dream House

I’m the youngest of three, I had two older sisters who, when they weren’t dressing me up like a doll (I got even later); were preoccupied with barbies. I have personal experience with The Dream House, by way of having to endure Barbie play-time with the neighborhood girls.

That Dream House has changed over the years to mirror social and cultural transformations:

See Video 1960 The Original Dream House was marketed in 1960, and the commercial spurred young girls on with the fantasy of some day owning a home of there own. With furniture, a big closet filled with clothes, a fashion shop for shows, and a door that really opens…

See Video 1980 Barbie Glamour House boasted a winding staircase, and front porch swing—emphasis on glamour and furniture.

See Video 2010 Barbie Glam Vacation House with balcony ladder, Flat screen TVs in “every room,” a poodle and pool, as well as the pink convertibles.

2011 The latest Dream Home is inspired by eco-friendly design. Decked out with solar panels, operable shading and bamboo flooring, this dream house also comes with a low-flow toilet (which in real life could save about 4,000 gallons of water per year) and sink fixtures, all made from locally sourced materials. Eco Barbie also gets a 1,500-square-foot entertaining space and open chef’s kitchen, a separate library and client-meeting room, a full-floor “inspiration room,” a greenhouse on the roof, and a landscaped garden for her pets. See Architect Barbie’s Dream House Design  

Barbie Aging in Place 

The dream home is now over 50 years old, my sisters haven’t played with Barbie dolls for over 40 years. Given these realities, it occurred to me that maybe Barbie should start looking into The Universal Design Dream House. Here’s 5 places to start:

 The Barbie Universal Design Dream Home

   1. Adapt main floor of the home for one level living: No-step entry, bathroom and bedroom / Kitchen and laundry on main floor

   2. Widen doorways to 36” w/ offset hinges on doors: Doorways are often too narrow for walkers and wheelchairs (or someone carrying packages, widening a plus for all)

   3. Install hand-held shower heads and grab bars: These are some of the least expensive changes you can make; great help to those with balance issues

   4. Use lever handles on doors and plumbing fixtures: Hand strength can be an issue with all ages–using a simple lever eliminates the struggle w/operating doorknobs/faucets

    5. Use “comfort height” toilets: Many people suffer from osteoporosis, arthritis, or temporary injuries and find it hard to stand up from a normal height toilet–a higher toilet (or toilet chair that fits over the existing toilet) helps with this challenge

 Pink Car Option for Baby Boomers 

    6. OK, the convertible: I hear FORD is designing new vehicles for aging baby boomers; you just have to convince them you want it in PINK!

See

A True Boomer Fairy Tale

Kohler BOLD Independence Aging in Place Design

(photo Ya/sin’s photostream)

Old age is like everything else. To make a success of it, you’ve got to start young. 

-Fred Astaire

I returned from Europe last week, which always gives me a fresh perspective on my own country. Yesterday doing pre-holiday tasks I got caught up in the bustle of shopping and completing my to-do list. I was in an old school hardware store watching customers buy plastic American flags, charcoal briquettes, portable grills, and soft drinks—the usual stuff. I began to notice a trend with the folks around me that I didn’t notice overseas—while waiting in line to check out, it struck me how heavy our citizens are. This really isn’t a revelation, but I was somehow acutely aware; obesity was everywhere…

I stopped in to get a sandwich at a local shop and the three employees behind the counter were all obese—two were morbidly obese. The lady ahead of me in line was over-weight (asking for extra toppings on her sub) as was the couple behind me…I then made my way to the car and noticed more overweight kids waiting at the bus stop.

The ironic thing to me was this is a civil holiday for the celebration of the anniversary of the beginnings of national independence. July 4 is the commemoration of the adoption of the declaration of the Congress of the Thirteen United States of America, on the 4th of July, 1776, by which they formally declared that these colonies were free and independent States, not subject to the government of Great Britain.

Yet I wondered just what does Independence mean to me and the average American? Can being in a state where your body isn’t fully available to you—be considered freeing? Or a state of independence?  So I turned to the internet for a definition:

1. (noun) independence

the state or quality of being independent; freedom from dependence; exemption from reliance on, or control by, others; self-subsistence or maintenance; direction of one’s own affairs without interference.

-Princeton’s Wordnet

Free to Make Choices Affecting Aging in Place 

With this definition it’s clear we are “free” to make choices that may not serve to further our independence down the road. In 2007-2008, the prevalence of obesity was 32.2% among adult men and 35.5% among adult women (for specific breakdown of data see JAMA: Obesity Trends link). Essentially, one third of us are obese, which is defined as a BMI of 30.0 or higher.

Despite all the information concerning the health effects of being over-weight, many continue down that path. The issues are complex and call for systems thinking when designing interventions—it’s even difficult to write about here for fear of offending or alienating readers. But if I truly believe in others having the best chance at successful aging in place, then I’m compelled to discuss obesity as it relates to living independently.

Obesity among young Americans is a serious problem that can have serious ramifications in the long run.

-Virginia Foxx

Each day we are faced with countless “choice points” about our lives; to take the stairs, order the light lunch, or stop at one dessert. These choice points have an accumulative effect—if we make the hard choices now, life can get easier later. If we make the easy choices now, life will get harder later on—and with each decision our future independence hangs in the balance.

Aging in Place with Bowling Balls

Consider this as you ponder Independence Day; at 42lbs “over-weight,” you’re negotiating stairs, bathtubs, kitchens, and chores like yard work (*ADLs)—carrying the equivalent of 3 average size bowling balls!   

Think what that does to:

1. Your energy level

2. Your cardiovascular system (extra vessels to feed all that adipose tissue = extra work load your heart)

3. Your skeletal system (knees, hips, back)

Just to mention a few systems affected…

So many of the things we blame on aging have nothing to do with getting older. What’s misuse or disuse, and what’s normal aging? Loosing 42lbs means not being burdened by 3 bowling balls! How might that improve your odds of aging in place successfully? 

There are all kinds of home modifications,  high tech gadgets, and wonderful universal design products available on the market which can facilitate aging in place—some are reasonably priced, some expensive, and some even priceless–but none as effective as mindful living and making choices that will honor your future independence.

How we live determines how we age.

See

Accomodating Morbid Obesity in the Work Place by Design

Many Don’t Believe Their Obesity Poses Health Risks

UK has Its own problems with Obesity

‘F as in FAT as in America: LA Times Report

BMI Calculator

JAMA: Obesity Trends

Battling Obesity in America (video) Nothing New Here

Time to Remodel that House

Overweight Older Women Have Less Leg Strength

Learn more about the Declaration of Independence (video)

Ray Charles America The Beautiful

(photo freshhealthyvending.com)

Design is intelligence made visible.

- Alina Wheeler

Each year I attend the ASA conference on Aging and reoccurring themes begin to emerge and persist throughout the week; this session remained true to form. One mantra I picked up early; “Design is for all.”

Design on the Brain

Each of us has a brain equipped with a tightly bundled grouping of nerve cells about the size of an apple wedge located from the top of the spinal cord into the middle of the brain. This part of our brain contains about 70% of its estimated 200 billion nerve cells; or a total of 140 billion cells—and is called the Reticular Activating System (RAS).

Your RAS is a hockey goalie to consciousness—the gatekeeper screening the type of information allowed through and filters everything else that you don’t pay attention to. And it also hones in on what’s important to you. Buy a 1966 Mustang or the new Adison leather large Marielle drawstring shoulder bag, and you begin to magically see them everywhere. Why? Your RAS has now alerted your brain to bring them to your attention.

My RAS for the conference was programmed to “DESIGN” and I was rewarded; because design matters to an aging population.

Democratization of design 

Much of the discussion focused around “Inclusive Design” or “Universal Design” that will accommodate all users regardless of age or level of physical functioning. More than once I heard speakers say: “It’s not just design for the elderly, good design helps everyone.”

Not a new idea, in fact, the barrier-free movement in the 1950s began a process of change in public policies and design practices in response to veterans returning from service with disabilities. The movement has evolved as the democratization of design for all; both in structure and beautiful aesthetics.

Michael Graves, FAIA, famed designer and professor at Princeton University, became a reluctant expert in medical equipment design when an acute neurological disease left him unable to walk or do self-care. Graves turned this into a best-worst experience for design that functioned better (structure) and delighted the senses (beautiful aesthetics).

Graves was noted to have said while lying on a gurney in the hospital in the throws of his acute illness:  “I can’t die here, it’s too ugly.”

His point speaks directly to the heart and soul of the barriers to adoption of countless potentially life-enhancing tools. Gerontophobia (fear of aging) limits my own mother from using a walker which would make possible ambulation to strengthen her muscles, stimulate her brain with exercise, and facilitate balance—and what’s most personal is most universal, she is not alone in her desire to not look old. The sad irony is that this kind of stigma which leads to adoption-failure, actually is a “secondary ager” which speeds up the aging process (atrophy). 

Design Matters: OMHU

Design matters with caregivers and patient outcomes; this has been well established in the literature on environment and health effects. And with the proliferation of new technologies for aging in place, the same barriers in design concerning both structure and aesthetics apply.

One company, OMHU (means “with great care”) exhibited an empathetic understanding and nonpatronizing approach to mobility aids. They’ve successfully combined materials from the world of performance; bicycles, hockey sticks, skateboard, and high performance athletic shoes—and from these made a cane which delights the senses.

Emphasis is on performance; not disability and yet OMHU is not denying the need—after all it’s a cane. They get it, and the underlying philosophy which infuses this product is clever and evokes the will to live…and aren’t we all in this for a better experience of aging?

Robert L. Peters said: Design creates culture. Culture shapes values. Values determine the future. This is important because the demographic transition means a future filled with more and more old people. We live in a world that will never be young again—each generation will grow older than the one before. And I for one would like to see more emphasis on matters of design, not as a nicety, but as a guiding principle of gerontology; our future depends on it.  

See

Democratic Design

Adaptability: Universal Design Michael Graves 

Michael Graves on Medical Devices 

Michael Graves Design Group   

IDeA: Center for Inclusive Design and Environmental Access

Free Subscription to HealthCare Design

Universal Design:

Video #1

Video#2

Video#3 

Video#4 

Video#5

(photo senzumbrellas.com)

Baseball is like driving, it’s the one who gets home safely that counts.
-Tommy Lasorda

With the cry: “Play Ball.” The Major League Baseball season involving both the American and National Leagues began across the nation; and from coast-to-coast fueled the dreams of young and old alike.

Longest Round-tripper on Record

“Round-tripper” is slang for home run. The longest in history is credited to Charlie “Chief” Zimmer. If you strictly measure from home plate to where the ball finally stops, then the famed catcher of Cy Young is hands down the record holder. During a game in the 1890’s Zimmer blasted one over the fence in League Park, which landed smack-dab in the center of a coal train car headed for Fall River, Massachusetts—some 50 miles down the tacks!

Safe At Home or Out?

 A key objective in baseball is to arrive at home safely; hitting the long ball is the most glamorous; yet there are many others—but there are also obstacles in the way. Such as intimidating curve balls that seem to come out-of-nowhere and force you back on you heels; other players who can impede your progress; your own conditioning and skills which can be put to the test; even weather conditions or equipment; and don’t forget those umpires—to mention only a few.

Aging in place too, has the goal of arriving home safely and the challenges are similar to those in baseball.

The signal for “OUT”

Here’s how to be “OUT” at home (not able to stay home as you age):

 1. Mental game: Poor attitude low self-efficacy 

 2. Out of shape and de-conditioned: VO2 Max less than 10ml/kg/min you can’t live independently at home

3. Nutrition: skip meals 

 4. Substance Abuse

 5. Don’t organize your finances and pay your bills on time

 6. Go it alone and don’t take advantage of team mates (community or informal networks)

 7. Hoard and live in clutter

 8. Stay isolated and mentally un-challenged (live in routine) fail to learn: Lack

    Environmental Press (things in our environment we need to respond to)

 9. Don’t plan ahead (or adapt) for physical changes

 10. Live in a Peter Pan House

 These behaviors will land you in an institutional setting and “OUT” at home.

The signal for “SAFE”

Here’s how to be “SAFE” at home (successful aging in place):

 1. Cultivate high Self-Efficacy (the inner belief you can exert control over your life) by

     meeting daily challenges and adequate Environmental Press; be creative; take a class;

     volunteer at your church or community

2. Daily Exercise: You can take the time to be healthy—or you’ll have to take the time to  

    be sick. Join groups like Silver Sneakers if possible; garden; walk; adopt a dog; use in-

    home exercise equipment; find activity friends; See your doctor and dentist regularly;

    take your medications; brush your teeth; bathe often and wear clean clothes; if you

    have a chronic illness such as diabetes, have a good treatment plan and stick with it

   go to a fall prevention class; watch your weight, blood pressure, and cholesterol

 3. Don’t skip meals; eat with others/share a meal; seek nutritional information from your

    health care providers

 4. Avoid Substance abuse; seek help if needed with groups such as AA

 5. Pay Bills on time and get help with finances many local area Agencies on Aging can

    assist with seniors who need it; family resources

 6. Use informal networks of family and friends; the government and many private

   organizations provide services to assist you, for example, there is bus service that will

   come to your door at a specified time, take you where you want to go, and bring you

   home when you are finished; there are organizations that will bring prepared meals to

  your home; you can get help with your rent or utility bills if you cannot pay them; The

   good news is that you don’t have to hunt for these services; Just call your local Senior

   Services and tell them what you need

 7. Clean out the clutter and get help if you are a hoarder

 8. Stay in the main stream; go to church; visit the senior center; read newspapers;

    volunteer; invite family; facebook a grand child

9. Plan ahead for physical changes before your needs get urgent   

10. If you live in a Peter Pan House (for people who think they will never get old)

      find a CAPS remodeler and make a home assessment appointment and find out

      how to plan aging in place remodeling.

Taking these PROactive steps can help improve your chances of rounding the bases and making it “home safe.”

 Have a successful season…

See

Safe at Home

Abbott and Costello: Who’s On First?

Field of Dreams: People Will Come

Universal Design AARP

(Photos  HKsportsfields.com and umpire.org)

“We’re really trying to think about how are baby boomers as seniors going to be different and what types of technologies and services might they use to manage their own personal health and wellness in ways we can’t yet imagine.”

-Eric Dishman

This post is a transcript from Intel’s Eric Dishman, an innovator in the field of aging-in-place technologies and part of the solution:

Last week I had the honor of speaking to the City Club of Portland, an organization founded in 1916 to highlight the diverse opinions, issues, and talents of local leaders and organizations. I often hear their Friday Forums on Oregon Public Broadcasting radio while I am driving home from work, so it was a real treat to be there in person in the grand Governor Hotel in downtown Portland. I very much appreciate the City Club members inviting me and giving visibility to the important issues of Global Aging and what I have frequently referred to in this blog as “gray technologies.”

The title of my talk was “Technological Innovation and the Future of Aging”–you can click here to find a free download of the audio cast of the speech–in which I focused on Oregon’s opportunity to lead in the development of new technologies, services, and jobs that promote independent living for our graying population. I shared some of the research prototypes and findings that Intel, Oregon Health and Science University (OHSU), and the Oregon Center for Aging and Technology (ORCATECH) have developed from our more than ten years of exploration into home-based technologies that can help people to age-in-place with good health, social engagement, purposefulness, dignity, and choice.

I promised attendees (and the many radio and TV listeners who have been writing to me ever since!) that I would post some links where you can find more information. To that end, here are a few that I referred to in my talk…

ORACTECH, the Oregon Center for Aging and Technology at www.orcatech.org, is a passion-driven, grass-roots center founded in Oregon Health and Science University to help coordinate statewide collaborations around independent living technologies amongst universities, companies large and small, non-profits, and government agencies. The funding to get this started came from Intel’s $3 million dollar donation to OHSU and a prestigious NIH Roybal Center Grant awarded to ORCATECH director, Dr. Jeff Kaye and his collaborators. You can join the mailing list by emailing orcatech@ohsu.edu or, if you are local to Portland, come join “upcoming events” announced on the web page.

CAST, the Center for Aging Services Technologies at www.agingtech.org, is a non-profit advocacy organization I helped to develop with the American Association of Homes and Services for the Aging who recently changed their name to LeadingAge. CAST is a national (or actually, now international) version of ORCATECH, designed to bring together providers, university researchers, technology companies, and others to help ignite a wide array of innovative technologies and services to help seniors to age-in-place from the “home” of their choice. Be sure to view the free CAST vision video shown to Congress and the last White House Conference on Aging.

The TRIL Center, or Technology Research for Independent Living, at www.trilcentre.orgbased near Dublin, Ireland, is Intel’s largest investment in independent living technology research with a $30M joint investment with the Irish government. TRIL includes our multidisciplinary Intel team and three universities in collaboration with St. James Hospital in Dublin to invent and test out these home health and independent living technologies. You can learn more about the falls work there at the TRIL Center site, as well as go here to read more about the Shimmer “matchbox-sized wireless computer” I described in the talk.

ETAC, the Everyday Technologies for Alzheimer’s Care initiative, a collaborative program between Intel and the national office of the Alzheimer’s Association, has published informationhere about the grants that we have funded since 2004. This was one of our first programs to start funding university research on independent living technologies and has produced a great international community of dedicated researchers and entrepreneurs focused on Alzheimer’s care specifically.

Care Innovations, at www.careinnovations.com, is the name of the newly formed joint venture between Intel and GE to produce disease management, independent living, and assistive technologies for the home. Full disclosure: I run healthcare policy for Care Innovations (in addition to my Intel role). I didn’t feature our products at the City Club talk because my focus was on the R and D infrastructure that Oregon has built, not a commercial for our products. But I don’t want to leave the impression that everything is stuck in research…Care Innovations (and many other companies) is diligently working to get these kinds of aging-in-place solutions to market worldwide!

And realizing now that I had to fly through my recommendations to the state of Oregon at the end of that lecture (I warned everyone that, without PowerPoint, there was no predicting what I might say!), I want to highlight some of the main points I tried to make last week. My overall thesis was that Oregon has some enormous advantages in trying to become an international leader of independent living technologies and jobs. Just as we have with Wave Energy and Biotech, our state needs to bluntly ask ourselves as Oregonians what future industries we could really lead in?  I argue that Oregon is already a big fish in the small pond of independent living R and D and that we should put forth a state plan to go after this opportunity.

So, why Oregon?  What are our particular strengths?

1) We have a head start: We can build upon the foundational technologies, data, and know-how of ORCATECH, OHSU, Intel and many others in our state who are recognized leaders internationally in this emerging field. Today, we already host numerous Minister of Health and other visitors in our labs, as other countries and states come to see what Oregon is doing. Now we need to make sure our own state knows the assets we have!

2) We have our own fiscal challenges: Oregon itself is already in the top ten of states with the highest percentage of an aging population, and we likely face cuts to our Home and Community Based services as we, like so many other states, try to balance a budget in the midst of a recession. We need independent living and home health technologies just to drive up quality and drive down costs of the care for seniors–and people of all ages–in our own backyard.

 3) We have flexibility. Though many of my friends and colleagues in the long term care industry in our state would like to see even more flexibility, we need to realize that we have more regulatory/licensure freedom to pilot and develop new care models for seniors than do many other states. Less red tape for us means faster innovation cycles and learnings than many other states can produce!

 4) We know high tech. There is a large information technology presence here in Oregon to draw upon–not just Intel but many other technology companies who have intellectual property, innovation methodologies, and entrepreneurs to bring to the challenge of addressing Global Aging.

 5) We are the right size. I believe we are the right size and geography of a state to develop independent living technologies and the care models to use them. It is hard to imagine a state as large as California or as small as Delaware doing this. With our four million citizens living in a mix of rural and urban environments across the state, it is conceivable and achievable to build a state-wide strategy and infrastructure to enable aging-in-place.

6) We can collaborate with Asia. Oregon is already seen as a “gateway to the Pacific Rim” with a wide range of trade and research collaborations going on with Asian countries. Having just keynoted to the APEC (Asia Pacific Economic Cooperation) meeting just weeks ago in D.C., I can tell you that the need and market for independent living solutions in Asia is significant given the longevity in many of the countries there. If done right, our state plan for Global Aging should foster collaboration and export of our Oregon technologies and services to some of these countries.

 7) We have national political leaders for aging issues. It is rare as I make visits to Congress that members know much about gerontology, but when I visit the Oregon delegation, they often end up teaching me more than I do them! Senator Wyden has a background in gerontology, as does Congressman Peter DeFazio, and both have shown a commitment to aging and health reform issues in their political careers. I believe we should be leveraging their understanding and leadership on aging issues to make Oregon the center of the independent living technology universe!

 8) We are committed to healthcare reform. I had the pleasure of hearing last week’s “Think Out Loud” radio segment on OPB that was exploring healthcare reform in the state of Oregon. Dr. Bruce Goldberg, head of the Oregon Health Authority, was clear (and I couldn’t agree more!) that we need to transform our culture and infrastructure to do health reform right. At the end of the day, aging-in-place is not about technology but about transforming our culture of care for seniors, and the technology is simply a tool to help do that. But if we are a state prepared to be at the forefront of acute care/hospital/insurance reform, let’s make sure we do the same for long term care!

9) We have a legacy to uphold. Last but not least, innovating aging is in our blood…is in our history…as a state. Oregon is widely credited as the state who invented end-of-life or hospice care, which became a national standard and movement. Similarly, we are known for pioneering the concept of “assisted living” which is, of course, now common-place and taken-for-granted. In many ways, the rest of the country is just waiting for Oregon to invent “what’s next?” for the care of seniors, so let’s not disappoint them!

We should make no mistake as a state to think that we can rest on our laurels or that we will just end up becoming the leader of independent living technologies without investment or a plan. Other states are competing to create these technologies and jobs; I have worked with officials in New York, Minnesota, California, and Florida who are trying to get their act together on this front. I am biased as an Oregonian to want to make sure it happens here, but at the end of the day, may the most organized and proactive state win!

So what would my calls to action be for Oregon? What should we be doing to capitalize upon this opportunity?

 1. I call upon Governor Kitzhaber to put together a commission to develop a state Global Aging response plan. Let’s bring together industry, community, and academic experts to identify how we can use independent living technologies to care for our own elders and families and also evaluate new business and job opportunities in this segment. I will certainly volunteer my time to participate!

2. Let’s commission an inventory of Oregon’s assets on aging-in-place…let’s show what we’ve got and what we are missing in terms of building out an R and D and new business incubation infrastructure for independent living technologies and services.

 3. We need to identify, with our nursing and medical schools, what new kinds of careworkers and curriculums are needed to enable aging-in-place care for seniors (and people of all ages). If Oregon can develop the models for training and credentialing community workers and volunteers who can use these new technologies to do care delivery in the home, community, and electronically, then we will be the likely creator of the first national call center for electronic care and support for elders. With that asset, we would be a fierce competitor nationwide!

 4. Let’s make sure that our current and future technology infrastructure investments–for broadband, for Electronic Health Records, for insurance exchanges–are being designed and built to support aging-in-place and to carry data/transactions from hospital to home. If all we do is connect and coordinate care in hospitals and clinics, then we will fail to achieve the kind of health reform required to make us fiscally, morally, and medically strong.

5. We need to build upon ORCATECH to develop the nation’s first 10,000 household cohort of seniors who can help test and prove the value of these aging-in-place technologies and care models. Today, we have about 300 households in the Portland metro area who are outfitted with these kinds of systems, but we need 10,000 homes across the state to deliver the statistical and economic data that proves which systems are most valuable, usable, and useful. If we build this kind of large-scale R and D infrastructure, it will be very difficult for any other state to supplant our position as a leader in this sector.

 6. Like many other states are exploring, let’s develop a policy framework for seniors in our state that makes aging-in-place a right. If we set that as an overarching policy goal, then it will help to guide our activities and priorities for the full range of services–meals, medication assistance, transportation, social support, mental health, healthcare, etc.–that are needed to give people a high quality of life at an affordable cost from a place of their choice.

 7. Let’s set an audacious goal–a 2020 vision–to move 50% of care in Oregon out of institutions and into homes and the community in 10 years. We may not achieve 50% or it may happen faster than 10 years, but if we set a goal that everyone knows and can aim for, then we will achieve great progress towards an aging-in-place agenda!

 In closing, I want to reiterate a message I have played over and over again in the pages of these blog entries: we need to prepare for Global Aging much as we do Global Warming. Just as our state (and our nation), are competing to try to become a leader in Green Tech industries to address Global Warming, so too, we should be competing to become a leader in Gray Tech industries for Global Aging. The issues and needs are no less urgent or pervasive; the opportunities for economic growth for the state are no less promising. And if we are truly a state committed to healthcare reform, then let’s make sure that commitment includes long term care as we figure out how to improve cost, quality, and access for people of all ages.

 See

Eric Dishman: Take health care off the mainframe (TED Talk)

Healthcare @ Intel Blog

(photo PortlandCityClub.org)