The Value of Saying Thank you!

By Steven Mattingly 

This past week, September 9-15 was a special one in the world of Assisted Living Communities. It was National Assisted Living Week.  Our community used a large poster to say thank you to our staff and encouraged staff members, residents, and family members to personalize it with notes and encouraging words.  It was great to see as the week went along the growing and glowing tributes that appeared.  We also used this week to honor two members of our staff for their “above the call of duty” care giving skills.  They were honored at a Happy Hour event in which all members of the community participated.   I felt that we had hit a home run in the thank you game for the week.

It was with a concerned ear this past week that I listened to one of our healthcare vendors tell our concierge how glad they were to see our poster since in their visits to most assisted living clients they serve, they saw nothing in observance of National Assisted Living Week.  I made a point of seeking out that vendor during their visit and ask them if that remark was really accurate.  Sadly they said yes.  We commiserated about what the caregivers in locations where there was no observance might feel.  The buzz words of under-appreciated, un-feeling, and we need to do more were tossed about and we both felt better afterwards or was it perhaps our smugness showing.

This incident in so many ways forced me to reflect on how I as a manager perceived my staff.  Were they worthy of some special acknowledgement during National Assisted Living Week; absolutely.  But are they also worth my time and energy to say thank you each and every day; again the answer should be absolutely.  Do I say thank you each and every day?  I have to admit to my shortcomings and say no I don’t.  I mean to, I really do!  But then that report comes due, I get a call from my boss, a family member needs answers, a resident walks into my office with concerns, etc.  I think you get the picture.  Like everyone else I have constant distractions from my good intentions.  To quote my now infamous mother “the road to hell is paved with good intentions”. 

Lots of business schools graduates and experts have spent lots of time coming to the conclusion that the one thing managers can do that motivates employees the most is show real and genuine appreciation.  Public appreciation like the poster we used, the recognition in front of the community for some, and happy hour for all certainly were signals and signs of appreciation.  But those same experts have told us that quiet moments and simple words of appreciation have an even greater effect.  In my upbringing we were reminded regularly to say our please and thanks yous.  I can remember all too well my parents at the dinner table not serving us food until we used the “magic” word please and we often heard the phrase did you forget something when we didn’t say thank you.  Now I understand and appreciate those gentle and even not so gentle urgings of my parents all the more when I think about saying thank you and asking staff members in an appropriate way to work harder and do more.  The phrase “how much more our parents know as we get older” keeps coming to mind.

There has been a general (do I dare used the in-the-news-word) bounce in good feelings around and about the community following last week.  I hope our tracking polls show it as more than a bounce and something that we can continue to build.  I hope that my good intentions don’t send me to hell but I do have a plan to say thank you more to our care giving team in some way every day I am in the community.  Little did I know that my parents were as smart as or perhaps even smarter than the business school crowd when they taught us good manners?

Contributing author Steven Mattingly is the Executive Director of Pacifica Senior Living in San Leandro, CA.

Our Aging Parents Continue to Change

By Steven Mattingly

One of the most difficult tasks you face as an Executive Director of an Assisted Living Community is talking with family members about changes you and your staff see in their loved ones.   It’s never easy for family members to see the changes or as is more often the case, to process how the changes are affecting their loved ones daily life.

I’ll give you an example from personal experience.  All other members of my family are located near our ancestral home in Kentucky.  I moved to California more than 15 years ago and as a result I didn’t see my mother regularly the last 12 years she was alive.  Unlike my siblings I didn’t get to enjoy her Sunday fried chicken, watch her consistently lose at cards, or for the umpteenth time ask “which hand are we on” in Shanghai (a rummy type card game).  The image I instead saw during my semi-annual visits was how much my mother was changing as she aged.  When I tried to talk to my siblings about the things that I saw they were always either surprised or defensive.  I was the person who informed my younger sister that our 80 year old mother could no longer safely provide free childcare for her two children after school.  You can imagine how well that was received.  I added a different and at times not welcomed perspective to the family dynamics, not unlike what I often do with family members of residents of our community.

Perhaps the most important role of an Executive Director and his/her team is to be the objective viewpoint in the family dynamics that envelope every single resident in a community.  I often tell family members that we are the people who now live with their loved one 24/7/365.  We are better suited to know a resident needs because we see and experience the difficulties their loved one encounters each day.  Family members sometimes tell me that their loved one saves all their complaints and sad stories to share when they visit; I think that is not the case in most instances.  What our team most often observes is the “gearing up” for the visit phenomenon.  Residents, even those with advanced dementia, go into a different functionality when loved ones visit.  They are more engaged, more alert, participate in the conversation more, and exhibit their “best” behavior when families visit.   What happens when the visit is over I describe as the “crash”.  Even residents who normally have great coping skills when dealing with their daily challenges experience, albeit small in some instances, some diminishing of their coping skills.  That’s when my staff sometimes tells me “I wish their son/daughter/friend could be here now”.  The implication is the family needs to see and hear what they are experiencing after a visit.

A few years ago I worked with a family who adamantly maintained that their mother was not incontinent and how could we charge them for that level of care and the accompanying undergarments.  After many rounds of discussion I finally in a moment of great exasperation told the family fine, take Mother to live with you for a week and if you don’t come back with an understanding that she is incontinent, I’ll not charge you rent for a month.  It took less than 24 hours and mother was back in the community.  As much as I wanted to feel a sense of triumph I couldn’t.  What I had done was remove one more element of the dignity that Mother had in the eyes of her children.  It was needed to make sure their mother got the care she needed and we were correctly paid for providing that care, but it was hardly something that I saw as a victory in any sense.

Many of you by now have realized that I often use my own family to illustrate situations or problems.  I find it is often easier to talk with a family about a problem or concern if you use a third party to illustrate the point.  But I also think I use my own family stories so that our resident’s families can know my empathy is real.  I too have had to face a world with aging parents.

Contributing author Steven Mattingly is the Executive Director of Pacifica Senior Living Assisted Living in San Leandro, CA.

Senior Fraud Hits Home

By Steven Mattingly

We all hear about and read about fraud committed against seniors and it’s exactly that, something that we hear and read about.  Most of us pay little heed to the discussion most of the time. Even though I work with seniors each and every day like most of us I tuned out the various commercials and internet pop ups thinking them little more that auditory and visual pollution.

I have changed my nonchalant attitude rather quickly in the past couple of weeks when our community was called upon to assist one of our own residents fight an ongoing case of identity theft and financial fraud.   A former business acquaintance of the resident had gathered enough information ranging from bank statements that were altered to included additional names, copies of a state issued ID, and other personal information.  This individual was using the information to represent herself as the caretaker of the resident and was attempting to lease an expensive home in the bay area in the resident’s name. 

The good news is that an alert property manager for the potential rental property sensed something out of the ordinary and reached out to our community for help.  Because of privacy laws we do not respond to questions asking if a resident or staff member is part of the community.  Our standard response is that we cannot confirm or deny that information.  Fortunately in this situation the property manager was persistent and a manager on staff made the appropriate decision to cooperate once she learned a bit more about the nature of the inquiry. 

With cooperation from our community, the resident affected, and the property manager, the police with jurisdiction over the case set up a “sting” operation to apprehend the individual.  It was somewhat surreal.  It was like being involved in a scene from “Law and Order”.  The good news is that the sting worked, the individual attempting the fraud was apprehended and will be prosecuted.  The bad news is that our resident has to do the leg work to restore her good credit status with the various with the credit bureaus, no small feat, but she is determined to put things right.

There are numerous sources where you can get information about how to prevent senior financial fraud.  Most of it is simply good common sense.   Here are some suggestions you might want to consider:

·        Identity thieves love aging parents because they think they are so vulnerable. Social isolation, loss of a spouse, early dementia, general memory loss or confusion set up our elders and aging parents an easy mark. Add to that, seniors tend to be friendly and trusting, and you have a combination that can make your aging parent a sitting duck.

·        How can we help them protect themselves?    We need to educate our aging parents that trusting strangers on the phone is very dangerous. We need to warn our aging parents that even their own children can rip them off if they are desperate. Drug and alcohol abuse, serious financial trouble and mental illness can lead an adult child to steal account numbers when visiting and later raid his own parents' bank account and steal from the ones most likely to trust him or her.    Can we thwart the attempts at stealing our aging parents' identities? We can at least take protective measures. Some of the simplest protections are the best.

·        First, buy a cross-cut shredder. Shred or have your aging parents shred sensitive mail, credit card solicitations, and outdated personal documents such as bank statements, rather than throwing them in the trash. Thieves go through the trash looking for anything they can use to steal.

·        Guard credit cards. Watch sales people, staff in restaurants, and anyone who asks for your credit card. Thieves use tiny scanning devices called skimmers to steal the numbers and then use the cards. Get rid of any rarely used or unused cards. The fewer your parent has, the better.

·        Mail letters at a mail box or the post office, rather than leaving outgoing mail in the mail box in front of the home. Thieves steal checks and payments slips, taking the information and using it to attempt to steal the entire identity. They take out new credit cards in the victim's name and rob them of everything they can.

·        One should never, ever give out personal information or financial account information over the telephone. Telephone solicitors offer prizes and rewards to trick the person into telling the solicitor his bank account number, social security number, and mother's maiden name. With that, the thief can wipe out a bank account in minutes.

·        Don't let anyone copy your aging parents' driver's license. Anyone doing this can get access to bank accounts, personal data, and anything else you would want to protect. Getting the license number to verify a check is one thing. Letting someone take the entire license and have the other information on it is rarely necessary.

Senior identity theft and fraud are crimes perpetrated by individuals who see seniors as easy prey.  It is estimated that 1 in 7 seniors at some point is a victim of fraud.  You’ve been warned!

As a footnote to this recent incident, the resident involved has just gotten her fourth “check” from the Nigerian Lottery, all she needs to do to cash the check is call a listed number.  Our wise and cautious resident has given this information to the police. 

Contributing author Steven Mattingly is the Executive Director of Pacifica Senior Living in San Leandro, CA.

Exercise for Seniors

There is a fountain of youth: Millions have discovered it - the secret to feeling better and living longer. It's called staying active. Finding a program that works for you and sticking with it can pay big dividends. Regular exercise can prevent or delay diabetes and heart trouble. It can also reduce arthritis pain, anxiety and depression. It can help older people stay independent.

There are four main types of exercise and seniors need some of each:

• Endurance activities - like walking, swimming, or riding a bike - which build "staying power" and improve the health of the heart and circulatory system 
• Strengthening exercises which build muscle tissue and reduce age-related muscle loss 
• Stretching exercises to keep the body limber and flexible 
• Balance exercises to reduce the chances of a fall

It is safe for most adults older than 65 years of age to exercise. Even patients who have chronic illnesses such as heart disease, high blood pressure, diabetes and arthritis can exercise safely. Many of these conditions are improved with exercise. If you are not sure if exercise is safe for you or if you are currently inactive, ask your doctor.

It is important to wear loose, comfortable clothing and well-fitting, sturdy shoes. Your shoes should have a good arch support, and an elevated and cushioned heel to absorb shock.

If you are not already active, begin slowly. Start with exercises that you are already comfortable doing. Starting slowly makes it less likely that you will injure yourself. Starting slowly also helps prevent soreness. The saying "no pain, no gain" is not true for older or elderly adults. You do not have to exercise at a high intensity to get most health benefits.For example, walking is an excellent activity to start with. As you become used to exercising, or if you are already active, you can slowly increase the intensity of your exercise program.

If your muscles or joints are sore the day after exercising, you may have done too much. Next time, exercise at a lower intensity. If the pain or discomfort persists, you should talk to your doctor. You should also talk to your doctor if you have any of the following symptoms while exercising:

• Chest pain or pressure
• Trouble breathing or excessive shortness of breath
• Light-headedness or dizziness
• Difficulty with balance
• Nausea

Sources: NIH: National Institute on Aging, FamilyDoctor.org

Musings On Wine and Getting Old

This past weekend I went to a 40^th anniversary party for Cakebread Cellars, one of my favorite wineries in the Napa Valley.  It was a wonderful event with great wines (the 2001 Chardonnay Reserve was my favorite wine) and great food (the crab salad on top of a fried green tomato slice was my favorite food). 

As is the nature of this type of event, my dinner companions and I made polite small talk and talked about the type of work that we do.  The mix consisted of a CPA who did personal accounting, a CPA who worked for a large accounting firm, a professional banker, a school teacher, an Information Technology Officer for a startup healthcare provider, a contract management officer for the University of California San Francisco, and me, an Executive Director for Assisted Living, (insert punch line here).  I was a little surprised when the work that I did for a living became the focal point for the evening’s dinner conversation.  But perhaps I shouldn’t have been surprised since everyone at the table was of the sandwich or “tweener” generation.  Sandwich or “tweener” families are providing support for their own children, but as we see more and more often, are also providing support for aging parents.  The support is certainly emotional but for many “tweeners” it is also financial. 

We talked at length about how many from our parent’s generation even as their resources are dwindling, are obsessed with making sure they leave something behind, a final bequest to either their children or their grandchildren.  Whereas the tweener generation at the table indicated they felt no obligation to leave something behind for anyone.  One person said they would spend every last dime and that seemed to be the sentiment for most.  This sentiment signals a clear change in attitude from one generation to the next.  Perhaps equally surprising is that it has happened in such a short time span, a single generation.  A generation is usually thought to represent roughly a twenty year period.  Sociologist and psychologist who study such things are scratching their heads in wonder at this rapid change.  While the experts pontificate various explanations,  I think the “me” generation had spoken, perhaps prodded along that evening by the various wines that were being sampled. 

Trying to appear as innocent as possible, I pushed the conversation to what those at the table had done to prepare for their aging process.  After the usual I’m not going to get old comments and twitters of laughter got out of the way, I sensed a very real underlying fear among my dinner companions.  I didn’t see it as simply fear of aging but more likely a combination of many fears.  The fears of changes we expect as we get older are there for everyone to see but there are other fears that we as “tweeners” feel.  The term “tweeners” certainly indicates the position my generation has socially but it also references the push and pull we get from the generations before and after us.  The fear of not having the resources to support our children and also to support our parents can’t be hidden behind puffed out chests and driving the brightest and newest car(s).  Isn’t the question really if I meet those obligations how will I be in a position to provide for my own later years?  What I see is a disconnect promoted perhaps unknowingly by “me” generation.  We haven’t instilled the same sense of respect, responsibility, and even obligation from one generation to the next that our parents did with us.  Somewhere in the back of our minds is the fear that we’ve done something wrong that is going to suddenly come to light.

Perhaps using the illustration of the inheritance obligation felt by our parent’s generation and the lack of that same sense of obligation for our generation sidesteps a lot of the issues that surround the future of senior care.  But I do think it albeit for a brief fleeting thought represents one of the fears we as “tweeners” have about getting older.

There has been a sort of running joke in my family about making sure that one of my children became that pinnacle of the American success story, a doctor.  The undercurrent of that joke was that child or children would be the financial reserve that I could tap as I got older.  I’ve not been silent about expressing that thought out loud somewhat jokingly.  Alas, none of my children as of yet are doctors nor look to be on track to being the next Bill Gates.  Like many others of the next generation they are struggling with their own types of pressures made all the more complicated by a society that doesn’t at present offer the wide array of opportunities that faced me in my twenties and thirties.  Midlife I’ve had to change gears and re-examine my retirement plan.  I’m not sure that my children will feel the same sense of obligation but I’ve also come to increasingly having to face they most likely will not have the resources to help even if they wanted to help.  I would be willing to bet that I’m not alone in having that discussion with myself.  Like the majority of “tweeners” I approach getting older with many fears.

Contributing author Steven Mattingly is the Executive Director of Pacifica Senior Living in San Leandro, CA.

Compound in Red Wine Could Improve Mobility in Seniors

by George DaSilva

A new finding presented to about 14,000 scientists at the 244^th National Meeting & Exposition of the Chemical Society (the world’s largest scientific society), concluded that the compound Resveratrol,  (an antioxidant found in red wine and dark-skinned fruits), could be beneficial in improving mobility in seniors.  Resveratrol has been touted in the past as the “miracle molecule” by many scientists for its vast health benefits.

According to the research team leader, Jane E. Cavanaugh, Ph.D., the study based on lab mice suggests that consumption of Resveratrol through either dietary supplementation or diet itself could actually decrease motor deficiencies seen in older people - decreasing their injury risk due to slips and falls and therefore improving their quality of life. According to the American Geriatrics Society, one in three older Americans has difficulty with balance or walking.

Previous studies have shown that Resveratrol might help reduce inflammation, lower cholesterol and slash the risk of heart disease and certain cancers and perhaps have some anti-aging effects in the body. Resveratrol is available as a dietary supplement and is abundant in foods such as red grapes, blueberries and nuts.

Source: Medical News Today

A Poem

By Steven Mattingly 

The daughter of a new resident of our community sent me the following poem written by her mother’s second husband. She also shared that having her mother at Pacifica “. . . makes my life so much easier and I'm happy to be with her again". It is pure joy to see her at peace and happy at Pacifica. She knows she is safe and well cared for! 

The poem is about a community where her mother and her mother’s second husband lived for several years before he died. The daughter wished that he was still around to write one for her mother’s new community. 

This is a realistic and poignant look into the world of assisted living from the viewpoint of a resident. He seems to be expressing his appreciation for those whom he encounters each and every day and the idea that while he knows life will come to an end, he is a better person for knowing those whom he names in his poem. May we all be able to make this kind of a difference in the lives of those entrusted to our care. 

There’s place for those who seek a rest - 

It’s found right here in the Golden West.

You’ll spot it as soon as you arrive 

At Eight-O-One on Island Drive.

If your pace has slowed and you’ve ceased to roam,

It’s just the place you might call “home”.

A gracious lady runs this place

And it all reflects her charm and grace.

A greeting by Cindy; then a chance to explore? 

She’ll usher you in to see David next door.

Have a quick look around; and we’ll see you later. 

Please try not to hurry our nice elevator!

There’s a typical room! It’s nice and it’s neat!

Now let’s go and see where you’re going to eat.

Three things you will find that are no surprise:

You sleep and you eat and you exercise!

And now, you’re to meet a special wee lass - 

It’s Rosemarie and her exercise class!

She keeps us all limber and balanced and strong.

Without her I’m sure we’d not last very long.

Not to worry my friend; and please don’t be afraid,

Meet the rest of the team who are here for your aid.

Aseleph hands out the pills here each day 

As she tries to keep doctors and nurses away.

And there’s Barbara and Amber and then Saba too,

All here just to do their best for you.

And then to make life just a bit more worthwhile

Martha greets all with her bright morning smile. 

The grounds are great and the place is neat, 

And we get far more than we can eat.

Now, let’s take a look at these folks of yore

Who make up the tenants - 100 or more! 

As you get to know all these people so well,

You find that each one has a story to tell. 

Lives spent in brave service for country and God.

From office or factory or paratroop sod.

On the land, in the air or on the blue sea,

They have stood in our places to keep us all free.

There’s Cliff and there’s Art and there’s Thomas and Bill 

And Charlie and Sheldon and Herbert and Gil.

While walking and talking are harder these days,

Their lives still shine through in hundreds of ways.

Few are the places these folks have not trod,

And now they’ve come home from a long life abroad.

There’s Tony and Margaret who’ve lived far away

They are golfers deluxe, and may show you some day.

Lillian’s a hiker - very much on the go. 

While Helga still touches her toes like a pro.

There’s music here too, and in flat or in sharp,

There’s Jean with her so welcome Vibra-Harp!

We all love to hear those old songs of our choice, 

And Cecilia brings with her that bright, happy voice!

Do we all have problems - did I hear you say?

I can’t even remember the time of the day.

A cane is a must, or we’d sure take a roller,

But most of us here sport a very fine stroller.

There’s a sadness here too, for we’re all getting older

And a pat feels so good on a tired old shoulder.

Try as we will to reverse this dread trend,

We know in our hearts that it all has to end. 

~Gil Dunkin