Situation
The existing care infrastructure in the United States cannot sustainably meet the needs of aging/disabling community-dwelling people. People are getting hurt, they are suffering, and they are dying — and much of it is from potentially avoidable causes.
Background
While we all march toward our collective expiration dates, we’re indefinitely approaching the need for care from another human at some point in our lives (and especially in our later years). Much of the care burden is currently falling on Modern American Healthcare (hospitals, nursing homes, home health agencies, doctor’s offices) in the form of:
Unplanned rehospitalizations (resulting in financial penalties from Medicare)
Rising costs of products and services, in addition to billing compliance for inpatient, outpatient, and hospice services
Worldwide increase in longevity and disease/condition complexity (Thanks a lot, Science!)
A national loneliness epidemic
Healthcare workforce shortages (make Illinois a Compact State!)
Suffering related to the “diseases of despair” and potentially preventable diseases like hypertension, Type 2 diabetes, obesity, and Chronic Heart Failure related to sedentary lifestyles, high sodium/simple carb/saturated fat diets, and social isolation (yay for screens?)
Assessment
Based on my nursing assessment, United States of America needs a rapid response team. Our vital signs are unstable. We are crashing.
Do we have a national advanced directive?? Is it time to request orders for federal hospice services, palliative care, or MAID? Do we have any fight left in US?
Have we just had enough already?
Depending on where you live, how you were raised, and your perspective of the world… your assessment and mine could be very different. So now what? How do we find our way forward, collectively?
Can we agree on a path forward?
I think we can.
I have a plan. It’s centered around the care needs of our most vulnerable populations: aging and disabling people living in the community, and those whose service keeps them safe (caregivers & healthcare workers).
Recommendation/Request
While a storm rages above, it’s time that American citizens zoom IN on local opportunities. Find and cultivate the fertile ground of community. Do something together every day, working towards the future and you’d like it to be.
I find hope and guidance through people and organizations paving the way and shining a light on what we should be doing. People, books, and organizations like:
The Greenhouse Project — transforming elder care through grassroots initiatives and sustainable infrastructure
The Pioneer Network — changing the culture of aging in the 21st century
Atul Gawande and his book Being Mortal: Medicine & What Matters In The End — noting the pain points of the healthcare industry, and pointing towards agencies and people who actively improving what it means to thrive as we age
Rainn Wilson’s book (and movement) SoulBoom: Why We Need a Spiritual Revolution — giving us permission to retire old ideas and antiquated systems no longer serving the needs of the masses. Reminding us of the opportunity in building something new that makes the old systems obsolete
And, of course, doses of self-care through Narrative Medicine activities like the 3-Minute Mental Makeover
Mission Critical: Ensuring the thriving of all citizens & communities, indefinitely, in a way that doesn’t rely on health insurance for sustainability.
What’s a Dreamer to Do? WE PLAN!
Plan, Do, Study, Act — Learn, do, learn more, do more.
The Center for Innovation Conference is coming to St. Louis, MO in August. My attention was particularly drawn to the August 14th agenda item: Tour Innovative Small-House Eldercare Communities. I’m intrigued, and have some thoughts on how to scale this down to be more cost-effective and environmentally conscious.
Additionally, The Greenhouse Project has a workshop specifically called “Beyond the Blueprint: Creating the Future of Small-House Eldercare Design” on June 3 & 4 in Loveland, CO.
These conferences have cost a significant amount of money to attend (and travel) and they’re both are offered by organizations geared toward innovating eldercare at a time when this is our nation’s mission critical. While I think “small-house” and “innovative eldercare” are steps in the right direction, I wonder about scaling down.
Can municipalities do something with existing buildings and infrastructure (using vacant office buildings and/or industrial spaces) — transforming community dead-zones into effervescent congregate micro-communities and social/gathering spaces?
This is my dream. Pie-in-the-sky.
What would it take to convert old office buildings into living quarters? Planning, People, and Resources.
While organizations like Lombard’s Outreach House (food and service pantry) are expanding beyond capacity again to meet the daily needs of our citizens, the needs continue to grow.
We need a pilot workgroup made up of stakeholders from local NFP’s and community organizations, as well as Healthcare companies and colleges. We need a building. We need a plan for the building. And we need people to rebuild and then run the building, so the people inside can feel safe and have their needs met consistently, and sustainably.
Oh yeah, we’re going to need support from our local lawmakers and representatives to change the way we do things across the state (and region).
Imagine it with me… Then consider the necessary tasks to bring this to life.
Action Items
Connect with a municipality (Lombard, Berwyn, Glen Ellyn?) TBD
Converse with stakeholders in community — A Bedside Campfire, May 19 at 7PM (a lyceum, chat, conversation — now offered virtually via ABC Lyceum Discord!)
Identify an ideal space(s) that meet minimum requirements for residential congregate living and community activity/social/gathering centers
Request to rezone (I need an adult…)
Collaborate with an architect (I need another adult)
Draft pilot proposal, and present to stakeholders (I need all the adults)
Do the dang thing!
Opportunity & Equity & Belonging
By Jessie Hammersmith
my America in a peanut shell
work hard and give’m hell
pull your own self up
get a crew of give-a-fucks
eat, rest, play
the unpromised day
turn shit into sprouts
learn to cast away doubt
turn towards neighbors and others
siblings, aunties, and Mother
A song for the road
He Was in Heaven Before He Died
By John Prine
Now the harbor’s on fire
with the dreams and desires
of a thousand young poets
who failed ‘cause they tried
I love you too much not to try. Take good care, and let’s talk soon.
Love,
Jessie
Share this post