Remembering Pearl Harbor today, and that we, as a nation, have sacrificed much over the years to have freedoms: speech, religion, press, the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.
Whatever your political persuasion, take a moment today to think of how you can best ensure that we continue these freedoms so that our nation and our people can be strong and leave a legacy to our children and grandchildren of which we are proud.
Do you have grandkids or have exposure to those at differing ages and interests than you? Do you spend time each day in some kind of mental exposure to things outside work, or drudgery? Can you say that you enjoy life and have a smile on your face most times during the day? Turns out that some good old fashioned fun in life may be one key to keeping the mind (and body) healthy.
When I was assessing frail elders for their options for care in the home, I had a wrinkle rule that worked 100% of the time. That rule was to look at the lines on the face, and if those lines were pinched around the mouth, that meant the person was, indeed, a sourpuss. The face lines do not lie. At rest, a face is either a reflection of happiness or a reflection of the pain, suffering, hardship, meanness, or cruelty that has imprinted itself after a lifetime of living those feelings and actions. And, working with those pinched-faced folks, was, indeed, a lot harder than working with those who had smile lines and took life easier.
There is research emerging now that spans the spectrum of things that may help or harm the brain, but, it is clear that doing things differently, trying new things, getting outside, moving, eating healthier and socializing are all good for the brain and the body. Barring genetics and some predisposition to disease, the world is a place to continue to explore as you age. The world is a place where you have to take chances and do things outside your comfort zone. The world is a place meant for multi-generations to mix and mingle.
We have somewhat lost the extended family component of our society, but you can make your own family. All is takes is a smile, over time, and some kindness, and you will find that others gravitate to that kindness, and sooner or later, you will be rewarded with kind acts in return.
If you live alone, see where you can go to help others. Start finding time in your day to mix with those not just like you, either in age or socioeconomic status or ethnicity. Like to cook? Take some cooking classes. Like to garden? Make some raised beds and try new vegetables or exotic flowers. Like to read? Go to the library and read to some kids, or to a hospital and do the same.
Got the trend? Mind games, body games, people games. Think about how you can add some levity and playfulness in your life and your relationships and, I guarantee you will find it rewarding now, and if the new research is right, well into the future.
First you have to realize there is a problem. Then you have to accept the responsibility to do something about it. We all live in today and the near future, but, what if we looked ahead 10-15 years and imagined a life with altered outcomes because we aimed at making change, positive change, and we set about trying to make our outcomes different? That is the premise of “Healthcare2030”, an interactive presentation that Sam Smith, VP Business Development, AXXESS and I presented at the Minnesota HomeCare Association technology conference this past week in Minneapolis. We polled the audience as we spoke as to what they felt were the biggest challenges to our being able to meet the demands of the demographic, technological and regulatory changes that are happening and that will all collide around 2030 when the boomers hit 80-85 and the stresses and strains on our system will become overwhelming, unless we set about to make different outcomes.
Technology is the biggest driver of change. We see it all around us. Mobile communication is pervasive and becoming more so. If you cannot do it, reach it, buy it or communicate with it on a mobile device, you are left behind. Communication and businesses alike are all focusing on mobile, and, as the world becomes more connected, the importance of mobile will continue to increase. This instant access, and micro-marketing moments of possibility changes all. The “uberization” of business is also eliminating the middle man. Now, in home care there are some limiting factors, but, the ability to connect those who provide service with those who need service increases the chances of getting service where it is needed, when it is needed, and, that will, no doubt be a model that just continues to grow and gain acceptance.
There are lots of other insights to be gained, and many questions to be asked and left unanswered, as we explore this futuristic exercise that will, hopefully, be a catalyst for change in our industry. We all know that as we age, and become frail, we want to remain in our familiar and comfortable home settings. How we do that is really left up to us to figure out, since we are in the industry and should be charged with those things. Simply sitting back, accepting the regulations, restrictions, limitations and reimbursement refinements that are coming our way will not get us there. It is going to take an army of dedicated, professional and committed people to create our own future for healthcare at home. Are you up to the challenge?
Exploring the unknown is akin to the home health landscape for 2016
At this exact time of the year 4 years ago in 2012, I was sailing to Antarctica on a National Geographic Expedition with some folks from NOAA who were tagging killer whales. One of the many joys of that once-in-a-lifetime trip was getting to stand watch on the bridge while the ship churned and rocked to look out for bergy bits and growlers. These small icebergs can be very dangerous to ships, because, as we all know, the tip of the iceberg is what one sees, and the mass is below water. Not a recipe for a good meeting between ship and berg.
Yesterday ended the Northeast Home Health Leadership Summit in Boston, and I could not get bergy bits and growlers off my mind as the realities about industry changes set in. At present, there are nine states that have been chosen to participate in the Value Based Purchasing trial. The baseline year for measurement for improvement in the chosen outcomes was 2015. That means that, for those nine states, their payment (reimbursement) for services in 2016 will be tied to their performance improvement in the chosen outcomes. So, the image of bergy bits and growlers in my mind is because this really is the tip of the iceberg for many home health companies. If a company does not know how they measure up against these 24 selected measures in both process and outcomes, then they have no clue as to what their reimbursement will be. Can you imagine running a business without knowing what you are getting paid for the service you are providing? That is exactly what is happening to these nine states. And, I truly believe that this pay for performance model will be extended to all healthcare in all states in the future.
So, think about being on the bridge and scanning for bergy bits and growlers as you plan for the future for your home health agency. Seems the government is serious about providing quality care at lower costs and making our population healthier as we continue down this path towards an aging society.
My latest presentation which will premiere at the MN Home Care Association’s Future of Home Care conference in Minneapolis next week is “Healthcare2030: Are You Prepared?” This interactive workshop takes the participant well into the future to envision life 15 years from now, and then backtracks to what we can do today to be prepared to meet the future. VBP is just one item that healthcare at home has to think about. Demographics, transportation, workforce, housing and technology are all pieces of the equation for the future.
Holiday times are notoriously and consistently difficult for families. For, so it seems, there are always those who wildly anticipate (and are surely to be disappointed at) events, and carry nostalgic memories of past celebrations that bring a false hope to the present. Those with the true spirit of the season come with open hearts to accept the ones they love for who they are. The true spirit folks have warm hearts, accept the failings of others without thinking it is an opportunity to correct an imperfect soul. This mix is the flavor for the pot that cooks up holidays that are stressful and probably contributes to being opulent as well. Gifts just might decrease the guilt for actions. Really? Presents might smooth over the hateful looks and fake smiles? Seriously?
I propose an annual (until you get it right) pre-holiday exercise that deals with issues up front and then agrees to leave them at the door. If you start early on working on how to do it better next year, it might just work. The key is discussing the issues and dealing with them. Whatever it is that makes the dread for the holidays a dread for you. Express it. Deal with it. Move on. Your sister always got more than you for Christmas and you always feel things are unfair when opening gifts? Your father, now deceased, loved the season and his specific traditions and you feel abandoning them somehow is disrespectful? Your mother does not tolerate small children and loud noises well, and it hurts you that she will not get down on the floor and play with your children when you so clearly remember her doing so for your older brother’s children?
How can we just put the issues on the table and discuss them. Rationally, only with facts, and agree how to have a celebration that is as good as it can be for everyone. And what about agreeing to totally discard the “bad” memories when they have been discussed and a plan of action agreed upon? Make it unfair to hold that grudge ongoing so its impact is lost instead of reinforced? After all, we cannot change the past. Whatever hurtful things happened, we have to move on. The only way to avoid continuing to feel the same way is to change the outcome.
We have to create a future that works for us and those around us. We have to make each moment meaningful and positive and work towards making each day the best it can be. None of us knows when life as we know it will end, so focusing on the now instead of the past and appreciating the now that you have before you is certain to be more positive and less stressful.
So, if you are having any of the strangling memories and issues on the holidays, I suggest some insights and possible solutions:
The unequal gifts issue. Make a gift exchange drawing so only one gift is given per person. Set a limit on spending. That way each gift is special, monetarily valued the same, and there cannot be unequal giving. And stick to it. The gifts we give for a special occasion should be more about the love and kindness behind the physical gift instead of the gift itself. You cannot take it with you, so why not give more of a gift that keeps on giving: your time to help in the kitchen, in the yard, with errands, and your presence mentally and joyfully as well as physically at family get-togethers.
The deceased parent issue. If the traditions are so very important to you, find a way to keep those traditions in-house, or simply internal. Appreciate and understand that everyone has different traditions and as marriages, children, divorces and death naturally occur in families, traditions change by necessity. Open up and find a way to keep something alive in your father’s tradition that satisfies you and adds to the celebration and traditions of others who are in your current family. Adhering to rigid traditions that exclude those present who love you now will only cause or increase a rift, and possibly decrease the opportunity of more family holidays with all together. And, if you feel you must celebrate alone or with a small portion of the group that is present, understand that it has to be discussed, planned and accommodated so that all feel included in some way, and you are not creating a hurtful or excluded experience for someone else.
Children need attention issue: hearing loss, less flexibility to get down and up from the floor may be the reasons your mother is not so willing to play. Find something that works for her, and that she will enjoy. And, if the noise level is just too high and the number of people overwhelming, find a quiet place with some good holiday music for her to retreat to when she needs to do so. And take photos of the warm interactions that do happen and post those so the memories are of the good times. Also, realize that there may be a discussion needed on ways for her to live independently, perhaps with help, so that her needs are being met all year, and the family is understanding the ravages of aging and how to deal with those.
In a nutshell, not only for the holidays, but for each and every interaction, enjoy the ones you are with. Take advantage of the times available to you with your family to know them better. Be kind to one another. Be courteous and respectful. Listen. Learn. Share. One of my favorite Facebook posts is “I did not know getting old would happen so quickly.” For you never know when the last time you see someone might really be the last time.
If your holidays were more stressful and cold this year instead of joyous and warm, think what you can do before next year to change the outcome. There may have to be some hard times in between as you make your feelings known, but if that conversation happens and all work towards a better time together, next year instead of that dreading feeling, you may be saying “Ho, ho, ho and a Merry Christmas to all.” And really mean it!
