I don’t know if I have a favorite season of the year anymore. I used to say it was fall because the air was so crisp and colors so vibrant. I seem to cherish them all as I grow older – maybe hoping that appreciating them will slow their inevitable march.

It feels like just yesterday that our long, cool spring gave way to summer. That change felt abrupt to me this year. Suddenly there wasn’t any need for heat and you could wander out after dark in shirt sleeves and sandals and feel the soft warmth of the evening air with no hint of chilliness. We’d have to remember to shut the windows and patio doors at bedtime as nothing in the temperature would remind us. Coats became a thing of the past.

Now coming back recently from a music filled weekend of camping with friends and listening to outstanding music, I felt the change in season. It struck me as abruptly as the transition to summer did. Shoes, socks, sweaters, sweatshirts, even a fleece jacket and extra blanket suddenly were needed as we sat under the stars listening to a night concert while sipping hot drinks from a thermos. Tapping hands and feet to the rhythms helped too.

Along with the march of seasons and years come inevitable changes in the extended friendships, now spanning over thirty years. Things happen slowly, over time, but the evolution is real and at times hits me more than others. This was one of them.

The friendships span multiple generations with the expanse of campsites taking on the feel of its own community. Kids abound. I learn what’s new. A ball you can flatten temporarily by pushing on it pops suddenly back to round form bringing shrieks and giggles from the toddler set. Older kids work their crafts for sale or pleasure. No matter the age, all are equally included in conversation and fellowship.

It’s also hard not to notice the original core of campers, now often grandparents, evolving to the minority. Perhaps this felt more apparent because not all could be there. Health kept some away and they were missed.

Catching up with friends now inevitably involves catching up on health as well. Jokes are made. “Do you remember your parents talking about their health all the time? Look at us – we’re doing that!” Laughter.

What I didn’t see when I was young is that having health issues to talk about is a universal thing. As a child health issues seemed unusual, unfortunate events happening in isolated situations. That isn’t the case.

It’s so natural for people that care about each other to want to know how the other is doing. That means catching up on health. While going on and on about one’s health may not be good, it’s important to catch up, share knowledge and teach each other in the process. The practicality of what we might have considered a strange pastime when young becomes apparent with age.

In a truly age integrated society we’ll see all people’s health issues as our own – “there but for the grace of god go I”. We’re not there yet. We can’t seem to see that even simple patterns, like older people talking about their health are simply extensions of where we’ll inevitably be if we’re lucky enough to live that long.

Wonder if we’ll ever get to the stage of not thinking in terms of age or disability, but simply seeing all as people? I don’t know - but my little group of friends does pretty good.

My parents were reared during the Great Depression. Their families believed in hard work, personal responsibility and the value of a dollar – values I’m grateful they impressed strongly on their children. They did very well.

I remember my mother, who always had good business sense, talking about increasing costs years after they’d retired. She looked at me and said, “A pension won’t get it; save your money, you’ll need it”.

A recent study by AARP found that bankruptcy among elders is growing at alarming rates. AARP found that “Of the more than 1 million Americans who filed for bankruptcy last year, nearly a quarter were 55 and up.” In the 75-84 age groups, bankruptcy filings rose 433 percent from 1991 to 2007.

The percentage of employers providing health insurance to retirees has spiraled downward to a new low of 21 percent. Even once solid employers like GM are finding a way to drop coverage retirees thought was secure.

“The recent economic downturn impacts all Americans, but older adults are particularly vulnerable, said Sandy Markwood, CEO of the National Association of Area Agencies on Aging (n4a), the trade association of nearly 700, mostly private not for profit corporations and Native American organizations charged with helping communities plan for a booming elder population surge. A national survey conducted by n4a looked at the rising cost of fuel, food and other essentials on the availability of community services designed to help people stay independent in their homes for as long as possible.

The findings? At a time when more people are looking to see what help might be out there, the availability of help is being cut back dramatically. Over half of Area Agencies on Aging report increased waiting lists for services supported by local or government funded resources. A full 90 percent expect to make massive cutbacks in 2009 in response to rising fuel costs if funds for programs are not increased. Over 73 percent of agencies reported it is more difficult to retain and recruit volunteers.

This is particularly fearsome in the area of home care. Most people turn to family and friends when they need help. A study by the National Institute on Aging in 2002 revealed that approximately 8.7 million older Americans received long-term care in the home, meaning they needed assistance with one or more activities of daily living in order to remain home. Of these, 2 million were classified as severely disabled, meaning they needed help with three or more daily activities. To put that in perspective, that means roughly four times the number of people receive long-term care in their own homes than receive care in nursing homes.

A full 75-80 percent of the persons providing assistance in the home are unpaid family or friends. It’s been estimated that this group of “caregivers’ saves the country up to 257 billion annually. When families can’t keep up with the demand for help, they turn to community service and home care agencies to assist.

Already we’ve seen cutbacks. Some agencies have to curtail how far they let their employees travel, or how far volunteers are able to go to deliver a meal. In some cases you may be required to buy an increased amount of service to justify the trip costs. In some cases workers have just called it quits and found a job that doesn’t require travel.

A study released in June by the National Association of Home Care and Hospice documented that the nurses, therapists and home care aides who provided care in the home in 2006 drove nearly 5 billion miles to serve 12 million people who could not live home without assistance. The study pointed out that the distance traveled equated to over 1.3 million trips across the U.S. at its widest point; or 192,920 times around the earth; or 10,017 roundtrips to the moon; or 52 trips to the sun; or more than double the 2 billion miles driven globally by UPS.

Anyone want to predict what the cost of gas will have on this infrastructure?? Ouch - not me.

The Area Agency on Aging is formally advised by a number of wise people. One of them, a retired physician, approached me after an Advisory Council meeting. He said it had been a good meeting, but I needed to know that his mind couldn’t compute as quickly as it once did and that the staff had a tendency to get enthused and talk rather fast. When they did - he couldn’t follow. Maybe we could slow down our speech a little he suggested. A reality check - I was so glad he’d said something.

It’s easy to get wrapped up in a fast pace. A recent article in the Atlantic talked about how our lifestyle, possibly even the patterns of our thought processes have been shaped by the incredible pace of the information age. It suggested the somewhat terrifying thought that with everything presented to us in constantly shifting, tiny information bites, we might be programming our brains to respond only to rapidly shifting ideas, making attention spans shorter and real contemplation difficult and rare.

As I bounce through my day bombarded with voicemails, emails, news alerts and a never ending parade of issues to address, I find I appreciate major stories reduced to two sentence synopses and other shortcuts that help me keep up. Is this really a good thing?

A friend of mine, in his late eighties thirty plus years ago and now long gone, summed up the trend for me. He told me people seemed smarter than they did when he was young, but he didn’t think they were any happier. I don’t know if they were any smarter either. The same friend also told me life only got faster as you age – another frightening thought. His comments fit well today.

It feels like the pace of change is quickening. When I was a kid I learned about “glacial speed”. The idea of huge rivers of ice that appeared stationary but that were in reality “flowing” a number of inches every year was fascinating. When my husband and I visited the Mendenhall Glacier in Juneau, Alaska a few years back, we were shocked to learn it had receded 600 feet in a single year – wow.

In today’s world massive change seems the norm. Climate change is altering patterns of whole ecosystems. The middle class is shrinking with the rich getting richer, the poor, poorer. The global economy puts business and profit interests above humanitarian interests. Health care is embarrassingly and increasingly out of reach for tens of millions of Americans. Basic precepts like adequate income, health care and education have become issues of charity rather than the presumed common good.

I know change will also force some good things. High fuel costs increases demand for a rebirth of mass transit systems. Already people are bicycling and walking more. But transitions take time and the interim pain will be real.
Sometimes I wonder – do all generations feel some sense of foreboding as they age? My friend of decades ago was feeling a quickened pace. I wish I could talk to him again and hear more of his thoughts. Doomsayers have predicted everything from automobiles, to rock ‘n roll, to television and computers as a sure means of man’s demise and loss of morality. Nowadays some of those fears sound pretty silly.

Is it simply a product of age to live long enough to see trends and worry? I suppose it’s a little simplistic to write off the problems of the world as a trend of aging minds.

A recent article in the New York Times by Abigail Zuger highlighted a new book entitled “My Mother, Your Mother” by Dennis McCullough, a family physician and geriatrician at Dartmouth Medical School. Zuger draws a parallel between the Slow Food movement and what McCullough sees as a need for Slow Medicine.
Slow Food is an international movement diametrically opposite of fast food, emphasizing slow, convivial and deliberate meals using natural or indigenous foods. We have a wonderful chapter here in southwest Michigan.

Slow Medicine, as Mr. McCullough points out, is about families recognizing and embracing the eventual declines of advanced age. The article pointed out that Slow Medicine “…is specifically not intended to save lives or to restore youthful vigor, but to ease the inevitable irreversible decline of the very old.”
It resonated well with me following Memorial Day weekend.

Memorial Day is a gathering of sorts for some members of my family. In the early 1950s my parents bought property and built a lakefront cottage at the tip of the thumb of Michigan where Saginaw Bay meets Lake Huron. It’s a special place for us. My brothers now have additional property there; my father is interred there. It’s a weekend of work, memories, and planning for the future.

With all of us living in different towns, I often haven’t seen my brothers and their families for many months. A favorite time is when the day’s work is done, we pick a place to gather for dinner and catch up over a long, leisurely meal full of talk, humor and news – slow food.

The slow medicine concept hit home as part of our discussion focused on each other’s health and my mother’s planned return to Michigan, actually to St. Joseph and The Whitcomb, in July. Now in her eighties and ever careful about her health, I don’t ever recall my mother being in the hospital other than for the hip surgery required from a fall last November. Even so, my siblings and I want to support her in whatever way makes the most sense.

McCullough’s primary slow medicine challenge is to adult children to help make today’s fast paced health systems work for parents of very advanced ages. He suggests that families must realize that vitality changes and sometimes low tech is better than high tech in user friendliness. He gives examples of a home test for blood in a stool rather than the draining process of a colonoscopy, or a manual breast examination rather than mammogram as possibly being sufficient.

McCullough goes on to talk about other aspects of health and medical care, but his overarching thought is of tailoring a system to meet the needs of a person, not the other way around, and that simple is sometimes better.

It seems to me that a huge component of health care is simply active engagement in life - about slowing the pace to simply connect with people or whatever one is drawn to. Health declines – but what we do and how we adapt to change seems the larger factor. Denying change seems self-defeating.
My father always prided himself in his ability to adapt to change. Now I see that resiliency coming out in my mother. A daily newspaper reader, she always focuses on the locale in which she’s in and wants to know the local news; wants a map to see where the towns referenced in stories are.

Now she’s undertaking a major move in her eighties – we should all hope to be so resilient.

When I was a kid we lived a half block from my grade school and two blocks from a small but well stocked market. It was common for my mother to ask me to go down to the market in the afternoon for a couple pounds of ground beef or some other item.

It was interesting to sit and watch the butcher grind the meat for my order and listen to the banter. The owners came to know me and gave me the high honor of sometimes manning the extensive penny candy counter when they were busy.

Though I know the area has gone through many changes over the years, on a trip back to the neighborhood last summer I was delighted to see the market remained. Nowadays I understand why a little better. A quality market in the middle of a residential neighborhood is a user friendly thing. You didn’t have to drive to it, special orders were common and people got to know you. Home delivery could be arranged for those who needed it.

User friendly is an important concept. America and its communities are aging and aging rapidly. User friendly is good for everyone and critical if we’re going to capitalize on the assets and talent that come with age.

The Maturing of America – Getting Communities on Track for an Aging Population is a project undertaken by the National Association of Area Agencies on Aging in partnership with MetLife Foundation and several notable others including the National League of Cities and National Association of Counties. The point is to help local leaders understand and better prepare for vibrant communities comprised of many older people – Livable Communities for All Ages.

The first phase of the project surveyed 10,000 local governments to determine their age readiness in a number of ways. It found that “…only 46 percent of American communities have begun to address the needs of the rapidly increasing aging population”.

Building Livable Communities for All Ages takes a serious look at options in housing, transportation, healthcare, easy access to information, and a physical environment that encourages physical activity and social interaction.

Are there single level residential options with supportive services available if needed? Are communities walkable? Are there alternatives to dependency on a car? Do people know where to turn when circumstances result in their needing a little more help?

A recent issue of The Atlantic underscored the return to the advantages of urban living. There’s a growing trend away from car dependent suburbs and the creation of “urban living centers”; small, sometimes newly created walkable communities with services close at hand. Why? Because they’re user friendly.

The number of people aged 65 and older has increased tenfold since 1900. Over the next 25 years that number will double and one in every five Americans will be over the age of 65. Every day decisions are made that impact how well a community will support its own aging population.

Recognition of aging will help local planners and leaders steer their communities towards a successful future. A number of tools are available to help. One example is the Aging in Place Initiative; a joint project of the National Association of Area Agencies on Aging and Partners for Livable Communities. Check out their website at

Before I worked in the field of aging I worked with adults with disabilities. There are a lot of parallels in the life issues people face. How to get around if you can’t drive. How to get dressed, run errands, do chores, cook if you can’t use your arms or can’t walk. Some blind friends showed me the world from their perspective and taught me a lot. They made me stronger by showing me their strength.

In aging, the life issues may be similar, but the path to solutions can have notable differences. The Area Agency on Aging’s mission is to Offer Choices for Independent Lives. The goal is to help people know what their options are when they need help. With the right information, most folks can take it from there. When stress or fatigue overwhelms, or mental sharpness declines, many people can’t do it on their own. They need a little help.

A woman I know was caring for her husband who needed someone with him all the time. He was increasingly confused, needed help with bodily functions and could not be left alone. Their social life shrank as friends stopped coming around. Outings became impossible. Initially his wife occupied her time with hobbies she could pursue at home. Over time she became depressed and was beside herself with loneliness.

About that time the Area Agency on Aging was offering vouchers as a way to educate people about the value of adult day care and to encourage people to arrange their own care rather than relying on professionals.

Adult day care is usually a day facility where someone who cannot be left alone can spend the day in social activities with others. While they’re at day care, the caregiver gets a day off and relief. It’s invaluable. The wife in this case was desperately in need of relief. When she was given some vouchers and told how to use them, she didn’t. Stress had overwhelmed her. The idea of another set of tasks to master was overwhelming. Her plight taught me a lot.

While the goal is to empower people with information, many people need extra assistance to act on that information. People usually know when they’re not as sharp as they used to be. People in pain have a hard time focusing beyond the pain. Folks who can’t do the things they used to do, or caregivers who must give up some of their own needs for another, can be overwhelmed with frustration and anxiety. People who are “crazy busy” as a colleague of mine says, simply can’t take on another set of tasks. Empowering them with information can ring a little hollow.

It’s been interesting over the years to watch advocates of disability and aging work together. Both have similar goals – to have people live their lives as independently as possible despite obstacles in their path. Sometimes it’s been surprisingly difficult to find common ground.

Adults with disabilities have been so disrespected by society their advocacy takes on an appropriately strident tone – demanding respect for their capability and independence and disdaining professional oversight of their affairs.

Aging has also been disrespected in society, enough so that some younger disabled folks don’t want to be allied with age-related issues. And the extra assistance managing service that’s often helpful in aging can be intrusive to a younger disabled person.

It’s been interesting watching these worlds come together. Educating and adapting society to accommodate people with special needs is the common bond. Communities are richer when the contributions of all members, including those with disabilities and the very aged, are embraced. Maximum independence is the goal – it’s the American dream.

On a recent trip I found myself sitting on a plane next to two young professional men. Both were from Michigan, both were moving away. One was in construction. Work had dropped off and he had taken a job in another state. His wife was searching for a job in the new locale so they could complete the relocation. The other had seventeen years at GM but was flying home from an interview he was feeling hopeful about. If it panned out, his wife would also begin a job search and they would move.

The state of the economy is on most people’s minds, particularly in Michigan. I’m not an economist. I hope that there are smart folks out there that can help direct a way out of this mess. I can’t see the logic behind some of our recent moves.

There are calls for more tax relief, yet we’ve been playing that card for years. The Federal Reserve Board supports tax rebates. This was quite a discussion on the plane. How $300 or even $1200 one time spending is supposed to turn things around is baffling.

These seem like too simple solutions to complex problems. One problem that’s not getting enough debate is health care. Now this would make a difference – everywhere.

A recent report entitled Too Great A Burden: Michigan’s Families At Risk by the consumer advocacy organization Families USA, points out that between 2000 and 2008 the number of people in Michigan spending more than twenty-five percent of their pre-tax income on health care increased almost forty-two percent. Most of these folks, four out of five, are insured. Health is a big ticket item for families.

What if you don’t have health insurance? The uninsured use emergency rooms if a health crisis hits. Service is provided, costs are passed on to insurance and private payers - the cost of premiums rise. Employers have to either increase the price of their product to cover costs, reduce coverage to a less expensive benefit, pass premium costs to employees, all of the above, or discontinue coverage altogether.

And there is no limit on the level of profits we’re asked to build into the equation. The number of employers discontinuing health insurance coverage for their workers and retirees is skyrocketing which increases the number of uninsured people. The cycle accelerates.

Berrien County boasts the highest rate of uninsured in the entire state. Over twenty percent, more than one in five, are without health insurance. Healthy Berrien Consortium points out the annual number of emergency room visits per one thousand population in Berrien County runs almost twenty two percent higher than the state average and twenty three percent higher than the national average.

Books have been written on the crushing effect of health care costs on business, the U.S. car industry in particular. Globalization is fueled by companies looking to get away from our broken health care system in order to stay competitive.

The American Association of Retired People, AARP, has launched a Divided We Fail Platform as a national challenge to all Presidential candidates. AARP’s platform does not promote any particular solution but frames the debate in terms of outcomes that must be achieved. It’s based on the premise that “…the opportunity to have access to health care and long-term financial security is a basic need that all Americans share” and that this opportunity “…is the foundation for future generations”. Amen.

Health care cannot be borne by either government or employers alone. The 2005 Commonwealth Fund Biennial Health Insurance Survey found that “The notion of joint responsibility was endorsed across party lines, economic strata, and regions of the country”. The problem is we don’t seem to have the will to force change for the greater good. Instead we cling to the familiar and offer incentives to join a crumbling system.

My grandmother was born in 1891. She and a number of her nine children have lived well into their eighties and nineties. Her oldest son, a ninety-four year old widower, has lived alone until just recently. Time however, does catch up. In 2006 and 2007 I lost my father, three uncles and two aunts.

I always loved the discussions, stories and reminiscence at holiday gatherings and other family events. Particularly in a big family, there was lots of fodder about who did what. Aside from being entertaining and funny, the stories by their nature were embedded with the reality of the times and made history come alive.

Although I fell towards the younger end of twenty-nine grandchildren, my grandmother and I were close. I visited as often as I could. When she died I remember feeling the loss not only of her, but of my personal connection with a totally different era.

She was a teenager in 1907. Looking at government statistics for that year, only eight percent of American homes had a telephone and our average life expectancy was 47 years old. There were only 8,000 cars in the whole country and only 144 miles of paved roads. Alabama, Mississippi, Iowa and Tennessee were each more heavily populated than California which boasted only 1.4 million people and ranked 21st in state populations. Arizona, Oklahoma, New Mexico, Hawaii and Alaska weren’t yet part of the country. The population of Las Vegas, Nevada was 30.

The average U.S worker in 1907 made between $200 and $400 per year - sugar cost four cents a pound. More than 95% of all children were born at home. There was no Mother’s or Father’s Day. Crossword puzzles, canned beer and ice tea hadn’t been invented yet. Two out of every ten adults couldn’t read and only six percent of Americans graduated from high school. It was a different world.

Nowadays I’m sensing the same feeling of loss with the next generation slipping away; history on the move. My parents, aunts and uncles were and are part of the “greatest generation” - my own parents being married in 1940. Their stories span World War II, the invention of jet airplanes, space exploration, television, calculators, interstate highways and air conditioning. I don’t like having to say goodbye and it feels a little foreign to slowly transform into being the next older generation. You wonder if you listened well enough. It makes you cherish every remaining member.

Now in my fifties, I catch my own grandkids listening with amusement to stories in my own life – of milkmen delivering milk and me being pushed through a milk chute to unlock the door to the house because I was the only one little enough to fit. Or the birthday in the 1970s when my husband delighted me with an FM converter for my car so I could listen to FM as well as AM radio. The eyes rolled at that one.

The pace of change seems to continually quicken. Looking at changes in the past twenty, fifty or a hundred years, it’s hard to imagine what daily life will be like in the next twenty, fifty or a hundred years. It’ll be a totally different world. I can’t imagine.

In 1899, Charles Duell, Commissioner at the U.S. Office of Patents stated, “Everything that can be invented has been invented”. He was wrong.

We make ourselves a place apart
Behind light words that tease and flout,
But oh, the agitated heart
Til someone find us really out. - ROBERT FROST

Years ago I had the pleasure of listening to Maggie Kuhn, a fireball of advocacy well into her eighties. Founder of the grey panthers, Maggie was tiny in stature but her fiery eyes and booming voice could raise a room to its feet in response to her unflagging promotion of personal independence at all ages. She was one of the most prominent leaders of women’s and age-related issues of the last century.

When I saw Maggie it was late in her life. Physical and medical issues were taking a toll on her body. Never wanting to be dependent on anybody for anything, she needed assistance to come to the stage and was in fact dependent on others to assist her daily with many activities. It was a huge transition for her. I was so impressed.

Her message was still staunch, her passion still intact. The fire in her eyes still burned strong. Her impassioned call to action still motivated. She challenged her listeners not to slow down, not to falter in our work.

She admitted however, that she’d underestimated the interdependency of life. She shared her frustration with the changes that time and age had brought to her and her growing dependence on others. But she focused on the lesson her dependency brought; that we are indeed interdependent beings. She found value there.

A recent study by Clarity and The Ear Foundation found that when asked what the four top fears of the senior population were, the top fear was loss of independence. Aging in place was rated very important to eighty-nine percent of those interviewed.

I watch staff at the Area Agency on Aging scurry to assist, inform or however help persons in personal transitions of their own. I feel the urgency of the emails and phone calls racing among my own family members concerned with helping our eldest members in a recent crisis. Holiday travel plans about when who will be seeing who fly through cyberspace. My own Christmas trip to Florida takes on a new tone as my own mother struggles with physical issues.

I’ve been fortunate in that many years ago I worked with persons with severe physical disability. They taught me what Maggie learned much later in life; that we’re all interdependent. Those of us fortunate enough to go through life without physical or mental restriction are slower to learn this - that interdependence can be a tool rather than hindrance for personal freedom and continued independence.

Our spirit of individualism in America propels us through life, but it comes with a cost - difficulty in reaching those that have placed themselves apart.

Rose Kennedy once said, “Life isn’t a matter of milestones but of moments”. The holidays abound with potential moments. This holiday season don’t let yourself be placed too far apart. During holiday visits look for struggles with daily routines or favorite pursuits by loved ones and don’t be afraid to talk. Embrace help when needed as a tool to independence.

Amid the food, spiritual reflection and merriment make time to reach out and find the agitated heart. You may be able to help.

“Americans are in denial about long-term care” pointed out Jim Emerman with the American Society on Aging a few years back when releasing results of a study comparing perceptions of future need against actions to prepare for that need. “Until the issue hits home for people, often when they are challenged by caring for an elderly parent, they would just as soon not think about it.”

At the Area Agency on Aging we spend a lot of time thinking about long-term care. People are living longer, including folks with severe disability or chronic disease. Growing numbers of people need some help to stay as vibrant and independent as they can be.

We spend a lot of time working with and encouraging private business to respond to an increasing demand for development of products and services people need on a daily basis. We also work to catalog all the great no cost, low cost community services available across Berrien, Cass and Van Buren counties.

What we find however, is how the obvious manifests over time. If you need regular, perhaps daily care over the long haul, it’s expensive. As a service to the public we counsel people over the phone on what’s available and brainstorm options. Some people want custom consultation in the home and we can provide that. The problem is, when the money starts to run out, the options get considerably fewer. Very few people have long-term care insurance and mistakenly think their regular health insurance will cover their needs. It doesn’t.

Eventually many people run through their nest egg. If disease or severe disability hits a younger, working couple, it can become impossible for the working spouse to work enough hours to cover the cost of care and the household. These are tough situations.
Families or individuals who exhaust their resources often turn to Medicaid for help, the public insurance for the poor. Medicaid is a combination of state money used to match, or bring in federal money to make a total budget.

Michigan spends a little over two billion dollars a year on Medicaid long-term care. It funds both nursing home care and a variety of services to help someone stay in their home. Nursing home care costs Medicaid an average of about $53,000 per year per person. Home based care costs Medicaid an average of about $15,000 per year per person.

A little over eighty percent of Michigan’s Medicaid money for long-term care is spent on nursing homes, ranking it as one of the worst states in the country for its investment in home based services. This is a problem. We need good nursing homes, but we must have other options as well, particularly for those running out of money who must ask for assistance. It only makes sense to offer them a range of options.

When we encourage businesses to get involved in home based long-term care services, they can be paid by private money or insurance, including Medicaid. But in Michigan only five percent of Medicaid’s long-term care budget is spent on these businesses. This is a big problem.

Robert Friedland of Georgetown University comments that “Even though Medicaid eligibility is targeted to the poor, the program helps support the health and long-term care infrastructure vital to everyone”. It also provides a way for people of limited means to stay in their homes longer, making it a popular as well as cost efficient program.

A 2005 poll by the Kaiser Family Foundation found that “Medicaid enjoys widespread support from Americans across party lines.” “A majority of respondents in the poll (56%) reported having some contact with Medicaid…40% knew a family or friend who had fallen back on the program for assistance. An overwhelming 78% of survey participants said they would be willing to enroll in Medicaid if the need arose.”

The change of seasons found its way to the beach, even in a September week of mid-summer like heat. The warm weather drew me down for several long evening walks. After a number of chilly nights, I expected the water to be cold. It wasn't. A barefoot walk ended with a wade. I was tempted to swim.

The temperature was in the 80's, but there was a fall difference. The sun was farther south. Twilight came earlier. Evening and the passing of day felt quickened. There were few people; most walkers were alone. Those I passed smiled and nodded; an unspoken camaraderie soaking up the soft warmth, knowing such evenings were on the wane. There was a quietness, a lack of boats or voices. Gulls flocked on the beach, silently edging away as one walked by. Even the glittering lake seemed quieter.

Fall has always been a favorite time of year. The air is crisp - the feeling of change and transition is everywhere. Life seems so cyclical, full of contrasts. It's a time of ending, yet full of energy. Crisp apples and a bountiful harvest showcase life while the fields wither and go to sleep. Both death and life seem to pick up their pace. Beauty shifts. The green and blue of summer give way to hues of red, yellow, orange and brown that daily greet us with evolving intensity. Summer haze gives way to clarity.

Daytime heat contrasts with a surprising nip to the morning, making soft, warm evenings a thing to relish.

Human contrasts are poignant as well. Young people go back to school and the neighborhoods quiet until late afternoon and weekends. The omnipotence of youth contrasts with the struggle of decline from disease or age, while the peace and wisdom that comes with age contrasts with the angst of learning and finding one's way apparent in high school and younger students. The spirited wisdom of an elder's humor sets well against the joyful shriek of a toddler. Age equates to confidence and comfort compared to the zany intensity of peer-pressured teens. The diversity is rich.

Life changes and migrates in fall, a means of preparing for winter. Favorite birds slowly disappear on their long journeys. Hummingbird feeders sit half full and silent until someone notices they no longer need filling. Squirrels scurry for winter stock.

People migrate too. Snowbirds anticipate the return to their winter nests. My mother longs for her Florida home. Questions to retired friends and colleagues about how much longer they'll be around reveal plans to leave. I'll wish them well and miss them. Homeowners trim and plant and try to think of the preparations needed for winter.

While I love to visit warmer climates when the cold seems long, I'd miss the seasonal cycle if I wasn't here. The earthy tones of fall are a favorite. Like late fall when the black of tree trunks contrast against bright pockets of remaining leaves, evergreens regain dominance on the landscape, and hoar frost turns early morning into glistening dawn - one of the few advantages of rising early for work.

And winter when ice and snow bring brightness and a pallet of pastels onto the ice of the lake, the secret beauty the summer tourists miss. The nights are bright and full of stars, and all the trees reveal their stately countenances stripped of leaves. And life finally slows down a bit, waiting for spring.

All that from a simple walk. The leaves are still green, a splash in the lake still feels good - but change is in the air.

On a recent vacation my husband and I had a chance to visit Yosemite National Park in California. Not having visited since I was a child with my family and forever a fan of Ansel Adams’ photographs of Yosemite, I’d always wanted to visit as an adult.

Knowing that Yosemite in August can be crushed with visitors, I made lodging reservations way in advance. Even so, the only lodge within the park with availability was the Wawona Hotel at the far southern end of the park, far from popular Yosemite Valley. This turned into a piece of luck I didn’t anticipate.

Yosemite Valley was as breathtaking as I’d imagined. What I didn’t expect was the tranquility and simple pleasures of the Wawona and its surrounds. It was like stepping back to a simpler time.

Built in 1872, the hotel works to stay true to its roots of gentile elegance and the simple pleasures of an old time resort. Comprised of a series of white wooden buildings, we were assigned a room in the annex. The addition of the well-appointed annex, along with a “swim tank” and golf course were considered “the word in modern comfort” when they were added to the resort in 1912.

While horse and buggies, long dresses and top coats have long been replaced by cars, shorts and sandals, there was a different feel than the usual resort or hotel experience. A number of differences struck you right away. There was neither air conditioning, nor television, nor telephones. There was no cell phone or internet access for anyone, anywhere. A pay phone on the back of the main building was the only link outside. Less than half the rooms had private toilets or showers. We splurged for the privilege. Guests without private facilities were given robes to use walking to a common toilet or shower area. There was nothing commercial nearby to visit and a strong scent of pines filled your senses the moment you stepped out of the car.

Though nestled on a hillside of tall California redwoods, the temperature in mid afternoon was about ninety. The continuous and covered open air porches surrounding each level of each building were full of guests sitting out to catch the breeze, read a book or chat after a day of hiking or sightseeing. All windows were opened wide, lace curtains fluttering softly.
Feeling the heat, we asked a group of neighboring guests playing a game on the porch if the rooms were pretty warm. “Oh no – it cools down in the evening. You shut the windows and it stays pleasant.” Oh - okay.

One got into the routine pretty quickly. No one wanted to be inside. Before or after a dinner in the hotel dining room you strolled your porch, met and chatted with neighbors, or headed to the main lodge to listen to the piano player in the lobby. Everything felt interactive. Adirondack chairs were everywhere. You found a place to sit and relax while the sun went down and the day cooled. All windows and doors were wide open. People talked softly. After dark it cooled considerably; people went inside.

The second day there was a barbeque on the lawn. By the third day we were sad to leave. Strangers thrown into an environment of simplicity and sense of community – it worked.

It made me wonder if the spirit of community was stronger in simpler times, before all our modern conveniences; before the noise and lull of television; before air conditioning kept our pace elevated and our bodies indoors; before computers. I don’t know, but it reminded me simpler is often better.

Ever since I was a child I’ve enjoyed a good swim. Not the disciplined, distant marathon swimming, but rather the frolic, play, swim hard, then rest swimming. An old photo of my father and me as a little girl shows him standing in Lake Huron’s rough surf swinging me by the arms through the tops of breakers; big smiles on both faces. Playing in the waves would be a passion that never died out for us.

Living close to Lake Michigan, a couple years back I realized I wasn’t taking full advantage of the lake. Life had gotten busy, maybe a little too busy. At the end of a work day I felt like doing small chores, reading the paper or resting, not swimming. Now I’ve never been as big a fitness buff as a certain local legislator who runs daily all over town, but perhaps I’d become a little lax in the exercise arena.

I lost my dad over a year ago now. He lived to 90 but in the last years of his life was plagued by cardio-vascular disease. He was never heavy and maintained an active lifestyle. But active doesn’t necessarily mean cardio healthy. I think his decline helped me rethink my routine.

Nancy Whitelaw of the National Council on Aging points out that in the United States four chronic diseases cause almost two-thirds of all deaths each year: heart disease, cancer, stroke and diabetes. Three of them can be helped by a regular cardio fitness regime.

Chronic diseases are treatable but not curable. They are very costly. According to the National Council on Aging chronic diseases accounted for 75% of the $1.4 trillion the nation spent on healthcare in 2001 – an average of $5,039 per person. That number is expected to grow to $2.8 trillion by 2011. Taking preventative steps can help both the cost and the condition. Even when the diseases don’t cause death they can cause serious disability.

Last year the Berrien County Health Department published a report on a countywide Behavioral Risk Factor Survey. The report looks at a host of behaviors and reports on whether Berrien County residents are or aren’t making good lifestyle decisions. For example, the Centers for Disease Control & Prevention recommend at least 30 minutes a day of moderate physical activity for at least 5 days a week. About a third of Berrien residents meet this goal with the number decreasing as we grow older. Women are less active than men. Not good – particularly when the percentage of obesity in the county is about 5% higher than the state average and almost 7% higher than the country as a whole.

The survey also shows the rates of preventative testing for health conditions. We’re down in a number of those areas as well. Diabetes is the fifth leading cause of death in Berrien County yet the survey showed 64.8% of diabetics had never taken a course in management of the disease.

Many folks over the age of 65 don’t realize that Medicare will now pay for prevention services. Thanks to the recent Medicare Modernization Act a variety of services are now covered by Medicare. These include flu, pneumonia and Hepatitis B shots; screening for cholesterol, diabetes, bone mass, and glaucoma, as well as colorectal, breast, cervical and prostate cancer; diabetes self-management training; medical nutritional therapy services; smoking cessation; and a “welcome to Medicare” one-time physical exam. Ask your doctor about it.

The adult son of some French friends of ours is in the United States for the first time, doing some traveling with his company. He stayed with my husband recently while I was out of town. Discussion was easy and roamed from politics to culture to Lake Michigan. It was a nice visit.

In a subsequent e-mail from his parents, there was a comment that my husband had a "very American accent." That made us smile as we often think of the Midwest as not having an accent. Of course we have an accent, but beyond that, we also don't speak textbook English.

Metaphorical phrases and slang are taken for granted in American speech. Many of our phrases come from our history and cultural base.

One of the most popular presents we've every given our "kids" was a photo book we made of our years together and the history of the family going back as far as we practically could. We are a blend of so many cultures - a nation of immigrants.

When I was growing up I described myself as German-Irish. But then there was this matter of an Italian-based maiden name and visiting my mother's ancestral town in Switzerland. Hmm, other national roots creep in, so I guess that means all American. I like the conclusion.

I find some of our American trends, however, unsettling. The contrast in the news between the struggle to settle our immigration laws and the total compensation packages of the highest paid corporate executives - nearing $1 million per day - feels too severe. Perhaps it's my work, but I don't think so.

Our ability to distance ourselves from social issues is diminishing. Lack of a universal health care system with fewer and fewer people covered by health insurance every year already is a train wreck impacting private and business life alike. In Berrien County, more than one of every five persons is without health insurance - the worst percentage in the state. The cost of transportation impacts our entire infrastructure. Our ability to afford public education for all is increasingly a problem.

What do we do? So far we seem to proclaim concerns as someone else's problem. Sometimes we seem drunk with success. Even with our shortcomings, our lifestyle is far superior to most of the world.

I belong to a local Rotary club. A Rotarian who led a volunteer group of Rotarians to India to help with polio immunization spoke the the club. His words still haunt me. He commented that so much of the world was poor, how could they help but eventually grow angry with America if they know the richness of our lifestyle and we did not help?

The thoughts of one of my colleagues on the East Coast also haunt me. He commented in an e-mail: "One of the major problems facing our cities is the poor feel the American dream no longer includes them. People who become hopeless do desperate things. Perhaps that could be the reason why the world now looks at us with a different take on the situation. With the global economy, we outsource the work and receive the rewards of the world's labor."

As I see the steady growth of gated and walled housing developments, I worry that the erosion of the middle class could evolve to a profoundly different look of America in the next generation if we don't take stock and action.

I'm thankful for international friends who give me a different perspective on the world. It's easy to become passive when issues don't feel close to home. They're closer that we think. We can't afford to be passive.

My mother lives a long ways away from me – over 1200 miles. I wish I could see her more. Now a widow at age 86, she lives quietly and independently in her home in southern Florida. Though she has her struggles, her positive, matter of fact outlook on life has been and continues to be a wonderful example for me.

Positive people are good examples. A colleague of mine has been struggling with cancer for nearly sixteen years. Her job brings her into contact daily with all kinds of people. She hustles about – her sense of cheer and helpfulness infectious to just about all she meets. You’d never know of the personal fight she’s waging. When her health suffers, she stays supportive, even cheery to those helping her out and ends up brightening their day. She’s a role model to many.
I’ve seen both of these women remain positive and caring in the face of adversity. No complaining. They’ve changed the lives of others for the better because of it.

Mother’s Day may be a time to honor mothers - but it’s also a time to honor women. Though the old Virginia Slims adage “You’ve come a long way baby” does apply, in general women still travel a rough road. In 2002 about two thirds of women working full time earned less than $30,000 per year.

While women live longer than men, they earn less. The wage disparity between what a woman and a man will make for the same job is getting better. Women made 63 cents on the dollar in 1979 when compared to men’s wages and 76 cents on the dollar in 2004. The progress is painstakingly slow.

According to the Institute for Women’s Policy Research and the Grand Rapids-based Nokomis Foundation, in Michigan we’re lagging behind in the wage disparity at only 67 cents on the dollar as of 2004. Additionally, Michigan State University’s Institute for Public Policy and Social Research found that Michigan’s wage gap between men and women is even wider at the top of the wage scale – 49 cents to the dollar for women in the top five publicly-traded companies. Not good.

The prospect of retirement for boomer women, now beginning to turn sixty, presents challenges. Alicia Minnelli of Boston College comments, “Women boomers have grown up in a much different world than women currently in retirement.” In general they married later, have more education, worked more years and received better wages. However, steady replacement of defined benefit pensions with 401K plans, longevity, boomer trends towards less saving and more debt, and a greater chance of living alone through divorce, is reason to predict boomers will live on comparatively less in retirement than their predecessors.

One of the primary reasons women fall behind financially is because of their role in society as nurturers. On average a woman will stay twelve years out of the workforce for family caregiving and never look back, contributing significantly to her own financial risk. The instinctual compassion of women is often unrewarded in our financially driven society.

I visited a home recently where a young woman worked as a minimum wage caregiver. She cared for a young mother with a severely debilitating disease, enabling that mother to stay in the home and raise her daughter, which enabled her husband to continue working. The bond was clear, the result impressive. We need to raise the wages of this incredible sector of our workforce – but that story is saved for a different day. Many caregivers are heroes; most are women.

Today is Mother’s Day. In addition to the mothers of the world, so many women have been nurturers, supporters, positive role models for the people in their lives. Take time to let them know they’ve made a difference.

A flash of motion caught the corner of my eye. I turned and saw the back side of my little neighbor boy zipping out our driveway on his two-wheeler. It must be spring.

I love the hibernation of winter in Michigan - though it only seemed to last a couple months this year. The weekends aren’t so full. It’s common to stay home or go home early. It’s quiet – inside and out. And it brings fullness to the pleasure of spring.

Being away a bit recently, spring seems to have burst on the scene while I was gone. I was surprised to find myrtle and daffodils blooming at my house. Spring growth reminds me that I never cleared away all the remains of plants from last summer. The pansies I just couldn’t pull in fall somehow bloomed in the January warm up. And here they are again already – well deserving a second year of prominence.

The quiet of the ice is replaced by birds, evening crickets, children and the sound of laughter. Having the widest driveway in the neighborhood has always made it a good turnaround spot for kids on their bikes – if puddles occur, even better. We’ve watched little Max go from stroller to tricycle to daredevil on a pint-sized bicycle. If ever there was love between a boy and his bike, he’s got it.

Spring opens up neighborhoods and brings them together again. One neighbor has a new puppy. Another is just getting out after a bout in the hospital. Others haven’t emerged yet. I’ll look forward to seeing them.

For me the sense of rebirth also brings poignancy to the passing of time. Perhaps it’s because of Easter - a time of reflection. I don’t know. The change of season brings home that another year has passed. It’s been a year of change. I can’t help but think of those I’ve lost and will forever miss – and those who daily face changing health with courage and hope. I feel unduly fortunate – aware that the circumstances of life can change on a dime.

Then I hear the shrieks of the kids playing, my dog nudges me and the birds create a ruckus at the feeder just outside my door. It pulls me back to now.

Spring, Easter and rebirth are about life - about love. It’s a time to cherish what we have, reflect on our blessings and continue to do the best we can.

The lake is starting to have the glittery look of summer. I guess it’s time to think about pulling some weeds.

Do you know someone who needs ongoing help with routine activities of daily living? Think about friends, family and neighbors. It can be a seemingly minor thing like taking someone to a doctor’s appointment or assisting with household chores. Or it can be significant - like helping someone out of bed, to dress and bathe, or preparing food.

Ongoing is the key word here. Whether someone needs a little or a lot of help, it’s family, friends and neighbors that fill that void eighty percent of the time. It’s the right thing to do.

Thankfully, people live much longer than they used to. And none of us can predict the onset of a disabling disease or an accident that might cause sudden disability; all of which may result in the need for routine assistance.

What happens when the need for assistance outstrips what family, friends and neighbors can do? People start thinking about the help they need and look for ways to find it, usually hiring professional help. Health insurance usually doesn’t help with the cost unless a special “long-term care” policy has been purchased. Traditional health insurance pays for treatment and recovery from illness, not ongoing or long-term assistance with daily needs.

Particularly because we live longer than we used to, and also because medical advances now can keep disease and traumatic accidents from killing us, every year more and more people are hunting for solutions to help them with routine activities they no longer can do themselves.

Especially if someone is older, nursing homes often come to mind. While nursing homes are a godsend to many families, particularly for short term rehabilitative stays, they are a costly first choice and can run through a family’s savings in short order. When savings are gone, families turn to Medicaid, the public health insurance for the indigent – and the government picks up the tab.

This causes dilemmas on a couple fronts. The first dilemma is that many people aren’t aware that so many people are searching for routine assistance that a whole industry has spawned to help people solve their problems. There are countless gadgets, special services and creative living arrangements to help folks meet their needs. More are being designed and put on the market every day. It’s a growth industry.

The second dilemma is that if families turn prematurely to nursing homes, or avoid support until a crisis hits and a nursing home is the only option, this adds to the growing cost of Medicaid for the state. Michigan already invests over eighty percent of its available Medicaid resources for long-term care in nursing homes and less than twenty percent in less costly alternatives – way behind other states.

Michigan recently took a definitive step to help. Passed unanimously by the House of Representatives last fall, the Senate in December and signed by the Governor in January, Public Act 634 is now a reality. This Act paves the way for a statewide toll-free number that people can call for unbiased, accurate information about long-term care options in their local area and eventually will require folks looking to Medicaid to call the number to make sure they’re making an informed choice.

Using less than half of one percent of Medicaid’s current long-term care budget, four areas of the state are developing the new service. Other states have found that by making a slight investment of Medicaid dollars for an upfront public service for everyone, people become aware of options available. The result? A slowing in the growth of Medicaid costs. It’s an important direction for Michigan.

Southwest Michigan and the Area Agency on Aging (AAA) are part of this effort. The new toll-free number is 1-866-642-4582. Previous information lines at the AAA also link to the new service, now called Southwest Michigan Long-Term Care Connection.

Heading back across the state from Detroit, sitting in the passenger seat with a computer on my lap, I tried to think of topics as my column was due. I couldn’t get my mind off the funeral I’d just attended. Uncle Ed died just short of his 92nd birthday. Sharp as ever, just a few days before his death he was sharing Alaska stories with a daughter-in-law anticipating her own trip. One can only hope to do so well.

The generations mingled, gave hugs, told funny stories and tried to keep the younger generation straight. My own thoughts at the funeral made me think of the different perspectives that come with age.

A few months back my niece Lexi wrote some prose remembering her first thoughts about a funeral. She wrote, “My Grandfather was sick for years. In seventh grade during a shopping trip… my mother made me try on black dresses, “Just in case”, she told me. I was used to neon pinks and multi-colored hearts…the black dresses looked foreign to me. I fingered through the racks not knowing what to wear to a funeral. I thought of myself standing in front of a doorway, about to walk through and into a world that finally had death in it. And I was supposed to be wearing black. I looked too young in the funeral dresses, awkward, like I was trying hard to be older and wiser. But I tried them on. I was twelve and he was dying.”

My own generation extending well into their sixties, we all seem to be catching on to the sense of transition, internalizing it. Our elders are already becoming masters at it - they’ve learned to be.

Over time, death becomes a more frequent visitor to our lives. In our middle years we are shocked by death, especially when friends or family of similar age are suddenly gone. “Too young,” and “tragic” really mean unusual. But it’s not unusual. In reality, not everyone lives to a ripe old age. We’ve just reached an age when we can feel suddenly the beginning of a trend. After all, as Bob Dolsen used to say, “The death rate is the same as it’s always been; one per person.” The frequency in our own world has to pick up as we go along.

Funerals make us reach out to the living, make us want to be closer. Particularly with a wonderful life and death like my Uncle Ed’s, the sense of celebration comes out. The joy and comfort in each others company was palpable during the day’s activities. The presence of those that couldn’t make the trip was still felt by those that could. Those that hadn’t seen each other in years found the commonalities and basis to reconnect. It was good.

The sadness of not seeing someone you love is clearly there. But amid the tears come the stories, the personality traits and the humor. The frugality learned by Ed and his six siblings as young adults trying to “make do” during the depression years made for some wonderful stories – like considering a pair of pliers a critical bathroom utensil to get all the toothpaste out of a tube. But it brought along some hard learned lessons as well.

A strong sense of fiscal conservatism, frugality and personal responsibility still runs through the family. Growing up, nothing was thrown away. Household items often surfaced years later with new or revised purpose. Repair rather than replace was the norm. Great lessons.

Holidays bring home the passage of time and the altering of traditions over the years. It’s been a year of transitions in my family with the passing of my father, an aunt and the birth of four new grandchildren. As the noise level grows, out comes the booster chair and somewhat antique toys once again.

For who knows what reason I still have some Disney puppets my parents gave me when I was little girl. Well worn as they are, they’re still one of the first choices when little ones hit our basement. An electronic “pong” game my brother gave us thirty years ago sits wired into a small black and white TV in the corner. It keeps its allure despite the latest video craze and the sound of a tennis match often works its way up the stairs.

I think it’s in part the “play” that comes out over the holidays that we remember through the years. Play takes different forms.

One Christmas Eve night, my siblings and I were in our bedrooms with doors closed, an honor system strictly in force while my parents took presents down to the living room from the attic. Suddenly there were crashes and bangs and scrambling sounds. We all listened in shock and worry wondering whose presents had been ruined. My father would forever laugh over that night for they had tossed marbles, shoes and who knows what else down the stairs just to give us all a fright. It worked.

At my aunt’s funeral, my cousins found some laughs remembering our “sockee” wars – an annual ritual for several years. We would gather all clean, bundled sock pairs, set up pillow blockades and have an all-out indoor snowball fight using socks instead of snowballs. The trick was not to knock anything inappropriate down and to regain possession of wildly thrown socks as quick as possible - certainly before the adults told us to pipe down.

Times change. With grandchildren comes reminiscing about memories from my own house. Dice games, food, walks after a big meal, coloring pictures for prizes and singing are part of our history. It’s a pleasure and a gift to one another to be part of a joyful memory.

Generally our house is pretty quiet. I haven’t wanted to give up having a traditional Christmas tree. Having a tall ceiling, ours usually tops near ten feet. I have to use the eight step ladder to decorate it. But when it’s done, it’s cozy. It’s great to watch a tot stand at its base and look up – mesmerized for a moment. At that age from my bedroom window I once saw Santa Claus flying on his sleigh far out in the night sky above our neighbor’s house. I wonder what these little ones see.

Patterns of visiting change over time. People die, grow up, move away or have other commitments. Numbers of people grow and shrink. It’s not possible to repeat the same cycle forever. Houses get quieter, or louder. Traditions change, evolve.

Religious reflection brings peace to the season – helps us to remember to cherish what we have and not to mourn. I wish you peace.

Many people know me as an alumna and unabased promoter of Western Michgian University. It's easy to be a Bronco. For the second year in a row, WMU has made the Princeton Review annual list as one of the best universities in the Midwest. For the eight year in a row U.S. News and World Report has named WMU as one of 100 best buys of public universities in the country.

To top it off, Western made a great move in hiring recently Maureen Mickus, Ph.D., a gerontologist who spent the past 10 years teaching at the medical school of Michgian State University. Gerontology is the study of aging. She now teaches as part of WMU's College of Health and Human Services.

Maureen spoke recently at the Area Agency on Aging's annual meeting. Asked to speak about aging in Michigan and the future in general, she started by comparing the aging of our population to global warming. Both issues have enough evidence that people recongize that something is happening and perhaps have a sense that something more dramatic will happen in the future. But - both issues tend to be ignored. And both issues are ignored at our peril, as solutions to a changed environment cannot be accomplished quickly; it takes planning.

We were reminded that "today's 35 million persons over age 65 will double by 2030 and that Michigan will no longer look like Michigan but will instead resemble Florida's current population of older adutls, that every facet of society will be touched by this demographic upheaval - not just health care, but business, educcation, housing, law and certainly the economy."

Throught her teaching, Maureen is a steadfast recruiter for what she views as the "army" of trained professionals needed to prepare and resond to the surging demographic shift. Yet she laments that "it seems counterintuitive that we should have an unprecedented number of elders, and yet fewer persons trained or inspored to work in the field."

In geriatrics, the study of medicine in advanced age, we have only 7,600 board-certified geriatricians acress the whle county when the estimate of current need to 14,000. This need will more than double to 36,000 in the next 20 years, yet numbers of medical students choosing the field remains low. Federal incentives in place to encourage students toward geriatrics were actually dropped earlier this year. Similar scenaios exist in nursing,m where nursing schools struggle to maintain intrest in geriatric nursing.

Professinals like Maureen and staff at the Area Agency on Aging are encouraged strongly to share their knowledge and expertise with local governments and community planners to assure that economic development strategies take into consideration the environmental and product needs of older and disabled individuals - an ever increasing share of the consumer market.

But professionals in the field can only spread so far. We need to grow this army, and soon.

Sometimes people say that the baby boomers are such a social force that thier needs will force society to make necessary adjustments as they are. But as Maureen points out, "We are not rational actors(in this life)."We buy Hummers when we know they're not compatible with environmental concerns. We build three and four level homes when our children have left home and our bodies are aging.

I'm afraid awareness for needed change will come only after we are in crisis. Professional schooling, houseing, transportation systems, accessibility to public places and needed services - all of these take time. Maureen commented, "Our charge is to start preparing now, not when our older population had doubled."

The filed of aging is everchanging and always something you can relate to throught family and firends. It attracts talented people and can be addicting. The stability and quality of the people I work with attests to that.

At the end of her talk, Maureen referenced the staff and many affiliates of the Area Agency on Aging as pebbles in water creating concentric circles that touch many lives. She challenged us however "not to be pebbles, but boulders - boulders that make a deafening splach soaking everyone nearby as you proclaim the urgency, the timeliness and the reqards involved in creating a better workd in which we can all grow old."

“Life is its own journey, presupposes its own change and movement, and one tries to arrest them at one’s eternal peril” LAURENS VAN DER POST

Change is what you make of it. An article in the Palladium recently spoke of a restructuring of services by the Office of Michigan Works and the award of employment services contracts previously held by the Area Agency on Aging (AAA) and the Lewis-Cass Intermediate School District to Lake Michigan College.

It was a change - one that we didn’t choose. But a sub-headline suggesting that the decision “hurt” the AAA went a bit too far. While the decision did mark the end of a long history of providing quality employment services, such services were just one expression of the AAA’s mission to Offer Choices for Independent Lives.

We at the AAA wish Lake Michigan College and the Office of Michigan Works all success with their new business model of employment service and are confident they’ll do well. We are also very proud of our staff and their professionalism in the face of change.

Change seems continual and does burn bright. Oprah Winfrey comments, “When I look into the future, it’s so bright it burns my eyes.” I like her perspective.

Beginning this fall and reaching full implementation over the next two years, the AAA is embarking on an exciting new venture in long-term care services. We are partnering with our colleagues to the east to reach out over an eight county area to provide unbiased, quality information to the public about long-term care options when a loved one needs assistance.

A new information and planning service called Long-Term Care Connections will be marketed by the State of Michigan in four initial pilot areas. Southwest Michigan is one of those areas.

Southwest Michigan Long-Term Care Connections will become what is referred to as a Single Point of Entry into long-term care. In other words, when families or individuals are concerned whether or not an adult, aged 18 or older, can remain in their home, or return to their home following a hospital or nursing home stay, a single contact will gain them access to information on options available locally from private pay to Medicaid, from home care to nursing home care.

The new effort will be an expansion of the information services available through the Senior Infoline that logged close to 5,000 calls in Berrien, Cass and Van Buren counties alone over the past year. While experienced staff is available now to answer calls and questions, full implementation isn’t expected until January.

Between now and January we will be working with the many service providers involved in the delivery of long-term care services to make sure the start-up of Long-Term Care Connections is the best it can be.

It’s frustrating to periodically hear, “Oh I wish I knew about your services earlier”, or, “The AAA is the best kept secret around”. We are excited about our new partnerships that will hopefully make those kinds of statements a thing of the past.

Stay tuned…

My stepson is a talented artist on the guitar. He and his family were visiting recently, an occasion that usually prompts the guitar coming out. Later in the evening, after a number of original scores, he lapsed into some mostly 1960s and 70s music - James Taylor, Jim Croce, Janis Joplin. His wife, my husband and I found ourselves humming and singing along. The tunes pushed away the stresses of the day. I quipped, “How could that music belong to an age cohort, everyone must love it”. They laughed.

While much music seems ageless, we’re all affected by the music of the time when we came of age – usually in our teens and twenties. Other loves will grow, but music of that particular era in our lives will hold a special place. For me that’s primarily in the 1970s.

I’m very fortunate however. Through my husband’s eyes, and his being a little older than mine, I’ve been able to get in touch with other eras beside my own. And I’m grateful - big band, Johnny Mercer, swing and jitterbug are just too good to be missed.

Other music seems ageless. Classical and pops concerts by the symphony are a good example. Growing up in southeast Michigan with a connection to the Detroit Symphony, coupled with a mother who encouraged use of one’s imagination while listening, I learned to love a symphony. We’re privileged to have the Southwest Michigan Symphony here. They can lift you away from any dragging spirit. Check out their schedule if you haven’t already.

Another timeless venue is folk music. Stories of life told through a song can touch us deeply – either recognizing the poignancy of life, or making us laugh at ourselves. There is no generation to this one. Again we’re fortunate locally. The Box Factory for the Arts brings in good talent every Saturday night, including many folk musicians. It’s a regular for me.

Slightly further away, last weekend I was able to attend the 5th annual Cooper’s Glen Music Festival at the Kalamazoo Nature Center. Two days of acoustic music with outstanding national performers in a beautiful outdoor setting was great.

Listeners of all ages and all walks of life came together to simply relax and absorb music. The timeless draw to this music went from theory to reality. Old friends greeted each other, exchanged sympathies, admired babies, laughed and tapped or danced to the rhythm.

Friends I’ve had for more than thirty years were there, and their children, and now their children’s children. It was almost hard to keep up with all the babies. One friend who had moved to London 26 years ago was in town, heard it was happening and came out to be greeted. There isn’t an era to this type of music. It binds people together with good feeling.

Whatever the venue, music is a great stress reliever. The pace of the day at the Area Agency on Aging can be high with lots of good work going on. Periodic escape into music feels just right – hard to beat.

I don’t watch a lot of television. There never seems to be the time. But one show I often tuned in when it was on was The West Wing about work in the White House. The fast paced mix of global to personal issues, the resulting ethical and personal dilemmas, and the human, sometimes humorous challenge of ordinary people charged with extraordinary responsibility and pressure was fascinating. Boy – those folks were smart.

In the final episode when a new President is coming into power, C.J. Craig, the Chief of Staff, is asked to stay with the new administration to try to further societal goals being worked on. She’s tempted. But then an extremely wealthy philanthropist offers to put her in charge of ten billion dollars to move forward whatever societal agenda she sees most appropriate. She weighs the two. No more convincing people, no begging for money, just do it. She chooses the philanthropist.
Broad social agendas are a difficult sell nowadays. Status of the economy seems to over-ride any humanistic issue with the assumption that if one is doing well, the other must be doing well too. But is this true?

An interesting debate in the United Kingdom focuses on happiness versus economic growth. Conservative party leader David Cameron questions whether government should focus on economic growth as an end in itself or should it consider whether it’s making people happier? Interesting thought.

Economist Andrew Oswald at Warwick University conducted years of research on the importance of happiness. His work is a topic of popular debate in Europe. His conclusions - that “happiness levels have remained flat, while incomes have been rising sharply.” We ever pursue material gain, but towards what end? Is self-interest our ultimate goal?
The writings of 18th century economist Adam Smith discuss the balance between the desire for personal gain and the desire to help others. Smith concludes that man has an instinctual desire to be sympathetic and helpful to others. Or said differently, the happiness of others is necessary to our own. And it fits. Most people talk about their greatest achievements in terms of the good they’ve done for another person, family or community.

How does all this fit into today’s world? It tempers political debate with concern for the broader common good. It focuses our social conscience.
It already has focused the consciousness of real philanthropists, not just fictional ones on TV. The Gates Foundation, with over ten billion in giving to societal issues, focuses primarily on health and education goals.
Closer to home, the Upton Foundation focuses attention on teaching youth the interdependence of society, on setting aside self-interest for the benefit of the community. They hope to teach youth the importance of the nonprofit business sector, volunteerism and philanthropy.
The Upton foundation website comments on the lack of such education now. “When economics is taught, the curriculum frequently does not directly discuss the 13% of the economy represented in the activities of the nonprofit sector as it does the value of government and manufacturing.” “Education in civics often does not elaborate on the nonprofit sector as the source of new ideas that lead to social policy changes…the place that develops the skills that are needed for public discourse and democratic compromise. The relationships between social activism, a healthy democracy, and active engagement of citizens in government are seldom discussed.” And they set their wealth to the task of fixing this – a laudable goal.

Can happiness be a benchmark for measuring our success as a society? I don’t know, but it sounds a lot better than counting toys.

The “Last Frontier” is an appropriate title for Alaska. No matter where you are, continual vistas of unbroken wilderness remind you that your own occupied space is a mere speck in relation to nature. From a plane it’s apparent that even a city is tiny in relation to the vast wilderness that surrounds it.

Visiting Alaska last year, my husband and I and a close friend rented a small open fishing boat for a few hours. We tooled around some waterways near Sitka and found ourselves approaching the mouth of a salmon spawning stream. The bounty blew me away.

We slowed the outboard down to its slowest idle. Still a hundred feet or more from the river’s mouth, the water was virtually solid with fish. Side by side with no space in-between and swimming hard for the river, their bodies touched and pushed each other in a wriggling mass, hundreds of fins breaking water. The boat was like a pool in a dense fog; the fish staying away from the motor only by a foot or so. Barely moving, we worried fish would be hit by the prop and turned back. We were amazed at the richness of nature without man’s massive impact.

What was even more astounding was the realization that this was a likely picture of what the “lower forty-eight” must have been like before development. It’s hard to fathom America as a forested wilderness anymore. When you fly over the lower forty-eight, you see mostly cities, towns and farms. No more than comparative patches of open trees and rivers remain. Only the harshest climates aren’t sculpted by man. Old rivers, long gone, are still apparent in the winding trail of trees and fertile soil that follow their ghostly path. Where did all the water go?

It got me thinking about what the different views of our landscape must have been from the perspective of different generations. Looking at those fish, it was obvious that taking some wouldn’t make any difference – there were plenty others to replenish whatever was taken. If all America was as rich in wildlife and natural resources as Alaska, no wonder use of natural resources seemed so absolutely worry-free.

Could our forefathers have imagined a tamed and sculpted country from sea to shining sea? Could I imagine Alaska’s wilderness neatly packaged into parks as it is in the lower forty-eight? I doubt it.

We’ve always interacted with nature for our own consumption. We’re human. Technological advances help mold the environment to our needs. But with massive increases in population and use of technology, now we affect nature’s patterns, some permanently. We seem to ignore that we’re part of an ecological balance. Is our progress the natural evolution of things or is there a horrific price to pay someday?

Are we a wanton animal, reckless enough of its environment to eventually destroy its home? With no significant natural predators other than each other and our human needs, could we do ourselves in as a species? Or in gentler thought, will nature mold around our global tinkering with its ever evolving adaptations?

None of us will know. Maybe someone in the future will muse someday about what we thought – way back when.

Someone from one of our local radio stations called me looking for a quote. After being ass

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