Tag Archives: Culture Change/Paradigm Shift

Culture Change/Paradigm Shift

Portland Radio Project Show Considers Older Workers

June 21, 2016 Anthony Antoville

Anne Conrad-Antoville recently appeared on Portland Radio Project’s Biz503 to discuss some of the challenges and advantages inherent to Boomers in the workplace and that subsequently exist for their employers.

Anne shared her insights on topics ranging from: age-aware worksites are for all ages, to technology as a useful tool for the older worker, to how female employees and their employers benefit when caregiving needs are proactively addressed. Click here to listen to the podcast of last Friday’s show that aired on Portland FM-99.1.

By creating workplaces that utilize the fundamentals of Universal Design, both older and younger employees reap the rewards.
Boomer workers are tech savvy and technology is actually a boon for them; not a burden.
Female employees who are caring for an older parent or aging spouse could recover, on average, over $300,000 in lost earnings and missed benefits over their professional careers, when their employers make some considerations.

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Anthony Antoville is Care Manager, Certified and COO of Champion Advocates LLC in Portland, Oregon providing geriatric case management services.

Age-Quake!

Caregiving: Major Impacts to Work and Health for the “Boomer Generation”

June 13, 2016 Anne Conrad-Antoville

An unprecedented number of Baby Boomers, that is people approximately between the ages of 50 and 70, are providing care for an aging relative – usually an aging parent. The substantial costs of care provided by these Boomer generation caregivers, while often considered “free” for the care recipient, translate in terms of the caregiver’s own financial, psychological and physical health.

Caring for an older family member requires time, energy and money. Often these burdens are taken on unexpectedly as a result of an accident (like a fall), health incident (a stroke for example), a chronic medical condition (such as diabetes or dementia), the progressing years of aging or a combination of any or all of these contributing factors.

Why Boomers Are More Likely to Become Caregivers

Advances in medicine and medical technology, as well as social advances, have significantly increased longevity in the US. Compared to their parents’ generation of the same age-span, the Boomer generation is more likely to have parents or older relatives who are still living. These longer living relatives are now living with chronic conditions and dementias, at never before seen rates. Furthermore, the longer a person lives with chronic conditions and/or dementia, the more likely that person will require care. ¹

Multiple studies have shown that adult women are much more likely than their male counterparts to be involved in ongoing care responsibilities. ² These duties range from managing finances, to managing medications and medical appointments to providing hands on care such as bathing or dressing a person.

Financial Issues for Caregivers

Nearly 70% of caregivers report the need of having an employer make accommodations because of their caregiving duties. These workplace accommodations include arriving to work late and/or leaving early, taking unexpected time off or cutting back on work hours. Ultimately, and employee who is a family caregiver may have to change positions, change jobs or stop working entirely. ³

A MetLife study found that the 10 million caregivers over 50 who care for their parents lose an estimated $3 trillion in lost wages, pensions, retirement funds and benefits. Costs are higher for women who lose an estimated $324,044 due to caregiving, compared to men at $283,716.⁴

Cost to Caregiver Health

Family caregivers are often suffering from chronic stress, which can comprise their psychological and even physical health. In fact, caregiving fits the formula for chronic stress so well that it is used as a model for studying the health effects of chronic stress. ⁵

An extremely high percentage of caregivers suffer from depression due to caregiving. Many caregivers report that they are experiencing stress and/or panic attacks, pain, aching, headaches and weight gain/loss. Many report that their own self care is in decline and that they have missed their own health care appointments. ⁶

When caregivers’ responsibilities and concerns are taken in the context of the responsibilities they have for their own lives, including work and family; they are often completely overwhelmed. Caregivers believe that the stress they are experiencing takes physical form as increased blood pressure, heart attack scares, arthritis flare-ups and other conditions. People who care for a person with dementia often suffer even more severe negative psychological and physical health effects than other caregivers. ⁷

The total reproductive system buy cialis no prescription is given strength and energy. The main ingredients of diuretic and anti-inflammatory pill are herbs cheap cialis soft including Houttuynia cordata, Plantain Seed and Pangolin. Additionally, with a bolus of Provestra, no-one tadalafil online mastercard can say that there isn’t any affection for adulation for a girl. You will have to be aroused to feel the effect of this medication which last for viagra for 4 to 6 hours For the jelly to work, you need to learn to open up. Cost to US Productivity

The cost to US businesses is becoming enormous and will only continue to rise as the more of the population lives even longer.

According to a 2015 Cerridian study, U.S. businesses lose an estimated $38.2 billion annually in lost productivity due to workers’ caregiving responsibilities. These costs are often associated with replacing employees, absenteeism, workday distractions, supervisory time, and reductions in hours from full-time to part-time.

The study indicates that employers could be doing more to support employees with caregiving responsibilities. For example, only 56% of study respondents report that they have the support of their direct manager in their caregiving role and only 20% of study respondents claim that their employer offers all four of the following support programs: paid time off, unpaid time off, the option to work from home and a flexible work schedule. ⁸

Anne Conrad-Antoville has worked with hundreds of families regarding senior healthcare issues and is CEO and a founder of Champion Advocates LLC, a geriatric case management firm serving elders is Portland, Oregon and family caregivers across the USA and Canada.

¹ AOA-Older Americans 2012 Key Indicators of Well-Being;The Federal Interagency Forum on Aging-Related Statistics

² Unpaid Eldercare in the United States-—2013-14 Summary, Bureau of Labor Statistics

³ Valuing the Invaluable: 2011 Update: The Economic Value of Family Caregiving. AARP Public Policy Institute. – Updated: 2015

⁴ MetLife Mature Market Group. (June 2010) and National Alliance for Caregiving, Study of Working Caregivers and Employer Health Costs: Double Jeopardy for Baby Boomers Caring for their Parents- Updated: November 2012

⁵ Vitaliano PP, et al. Is caregiving hazardous to one’s physical health? A meta-analysis. Psychol Bull. 2003;129(6):946–72. [PubMed])

⁶ Evercare Study of Caregivers in Decline: A Close-up Look at the Health Risks of Caring for a Loved One, National Alliance for Caregiving, Evercare 2006

⁷ Physical and Mental Health Effects of Family Caregiving Richard Schulz, PhD and Paula R. Sherwood, PhD, RN, CNRN

⁸ Ceridian Study Reveals The Challenges Of Caregiving & Its Significant Impact On Productivity & Engagement In The Workplace – 2015

Aging and Spirit

Compassionate Aging Series: Happiness in Aging – Mind, Body and Emotions

September 13, 2015 Anne Conrad-Antoville

Every one of us is in the process of aging. How do we age in a way that is compassionate to our minds, bodies and emotions? In this interactive presentation, we will explore pathways to happiness in aging.

Join in conversation: Anne Conrad-Antoville, BM, MM CEO of Champion Advocates LLC, Geriatric Case Management Services

Wednesday, September 30, 2015 5:30-7:00pm

-heavy hors d’oeuvres will be served-

West Hills Village
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Please RSVP to (503) 245-7621 by Friday 9/25

Anne has been a professional aging services provider for 15 years and has been the recipient of local, state and national awards for senior health care advocacy. She has worked directly with many hundreds of older adults and their families. She has appeared as a senior services expert on radio and television news programs and has been a speaker at California Association of Area Agencies on Aging, Rotary International, California State HICAP Association, California Health Advocates, Humboldt Medical Association as well as numerous senior and community centers and local businesses.

Future Vision

Champion Advocates Supports New Medicare ACP Coverage

July 29, 2015 Anthony Antoville

Champion Advocates LLC geriatric case management services endorses the plans announced in July 2015 for Medicare to reimburse medical providers for having Advance Care Planning conversations with their patients.

Champion Advocates LLC joins numerous other organizations that have called for this proposed change, including: AARP, Alzheimer’s Association, American Geriatrics Society, American College of Physicians, American Medical Association, American Nursing Association, Gerontological Society of America, National Academy of Elder Law Attorneys, National Alliance for Caregiving, National Council on Aging, National Partnership for Women & Families, The Pew Charitable Trusts, among many others.

Dr. Patrick Conway, the chief medical officer for the Centers for Medicare and Medicaid, which administers Medicare stated in a July 8 New York Times article, “We think that today’s proposal supports individuals and families who wish to have the opportunity to discuss advance care planning with their physician and care team.”

Dr. Conway clarified that the proposal will not limit the number of conversations to be reimbursed to qualified medical professionals.

“The reality is these conversations, their length can vary based on patients’ needs,” he said. “Sometimes, they’re short conversations – the person has thought about it. Sometimes, they’re a much longer conversation. Sometimes, they’re a series of conversations.”

As reported by the Associated Press, “Medicare is using a relatively new term for end-of-life counseling: advance care planning. That’s meant to reflect expert advice that people should make their wishes known about end-of-life care at different stages of their lives, as early as when they get a driver’s license.”

Even though some private insurers have been providing reimbursement for Advance Care Planning, this new rule change would open these meaningful conversations to almost 55 million Medicare beneficiaries. According to The Kaiser Family Foundation, about three-quarters of the people who die each year in the US are 65 and older, making Medicare the largest insurer at the end of life.

Christian Sinclair, MD and Assistant Professor of Palliative Medicine Division Internal Medicine Department at the University of Kansas Medical Center, Sinclair is one of the leading US authorities on palliative care and advance directives and was on a national committee that last year produced a report called “Dying in America.”

The Kansas Health Institute news service reflected Dr. Sinclair’s enthusiasm for Medicare to cover advance care planning, as other private insurers are likely to follow. “That’s important,” Sinclair said, “because Medicare primarily covers Americans age 65 and older. Making decisions about resuscitation and living on feeding tubes or ventilators is something everyone should do once they’re mature enough to understand the choices,” he said.

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Last year’s National Academy of Sciences’ report titled “Dying in America” clearly summarized that, “As much as people may want and expect to be in control of decisions about their own care throughout their lives, numerous factors can work against that desire. Many people nearing the end of life are not physically or cognitively able to make their own care decisions. It is often difficult to recognize or identify when the end of life is approaching, making clinician-patient communication and advance care planning particularly important.”

The report further outlines, “Advance care planning conversations often do not take place because patients, family members, and clinicians each wait for the other to initiate them. Understanding that advance care planning can reduce confusion and guilt among family members forced to make decisions about care can be sufficient motivations for ill individuals to make their wishes clear. Yet even when these important conversations have occurred and family members are confident that they know what the dying person wishes, making those decisions is emotionally difficult, and families need assistance and support in this role.”

Since its formation, Champion Advocates LLC has been focusing on end of life conversations as one of our core areas of care planning to support an older individual or couple’s ability to aging in place in their own home. Routinely, we discover elders may have documented advance healthcare directives but with no practical or specific understanding as to what life sustaining measures they would actually desire when unable to speak for him or herself at a critical time.

We view this proposed Medicare change to be a good initial step for older persons considering what medical actions they would want to have performed, including the potential ramifications (positive and negative) from such procedures. Therefore, advanced directives will have more worthwhile meaning for everyone involved.

Champion Advocates recognizes that the next significant, yet more complicated, step is to ensure that agreed upon actions are timely and properly taken by creating a process whereby the patient, the medical provider and the designated healthcare agent are all on the same page before the end of the patient’s life is ever confronted.

In a future posting, we will will continue this topic by distinguishing the purpose and effectiveness of Advance Health Care Directives and the Physician’s Orders for Life Sustaining Treatment (POLST).

© Anthony Antoville 2015

Anthony Antoville is Care Manager, Certified and COO of Champion Advocates LLC in Portland, Oregon providing geriatric case management services. Anthony is a published expert on long-term care with Edwin Mellen Press and co-created the Action-Compassion!Technique as an innovative approach to geriatric case management. Currently, he serves on the State Plan for Alzheimer’s Disease in Oregon (SPADO) Taskforce to Optimize Quality Care and Efficiency.

Questioning Aging Answers

Advanced Directives May Not Prevent Aggressive Medical Treatment

October 7, 2014 Anne Conrad-Antoville

Aggressive medical treatment for Medicare patients at the end of life has been on the increase according to studies published by Medicare¹ and by JAMA².

This aggressive treatment leads to more people receiving care in intensive care units and more people being shuffled between hospital, home and skilled nursing care in their last several months of life.

Unfortunately, the aggressive medical care is not helping those patients studied to live longer, nor are they experiencing a better quality of life than people who receive more conservative treatment.

When polled, people do not generally want this type of care. A Stanford School of Medicine Study³ found that more than 80 percent of patients say that they wish to avoid hospitalizations and high-intensity care at the end of life.

In fact, aggressive treatment can cause chaos and pain for patients and their families. Consumer Reports⁴ notes that families who have lost loved ones after aggressive treatments often say they regret not having recognized sooner that aggressive treatment was not beneficial.

Are physicians working with the intention of Advanced Directives?

Interestingly, both the Stanford study and a recent poll on the physician social media site Sermo⁵ both indicate that physicians, regarding their own medical care, would very rarely choose aggressive treatment. On the other hand, these same physicians tend to pursue aggressive treatment for their patients facing the same proposed prognosis.

The Stanford study noted that advanced healthcare directives had little impact on aggressive treatment:

“In fact, the type of treatments they (the patients) receive depends not on the patients’ care preferences or on their advance directives, but rather on the local health-care system variables, such as institutional capacity and individual doctors’ practice style…”

Why are physicians pursuing aggressive treatment?

Physicians have a focus on diagnoses and treatment of disease, so this singular focus can also cause a major blind spot. A person is much more than his or her condition or disease, and yet in the medical treatment process, the person can be “lost” in favor of a focus on their condition.

As noted by Dr. Periyakoil, author of the Stanford study, “Patients’ voices are often too feeble and drowned out by the speed and intensity of a fragmented health-care system.”

Physicians are not generally trained or paid to deeply examine a patient’s personal life philosophy, personal history and life experience, emotional life, cultural influences, spiritual beliefs, or family and personal relationships.
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To put it another way, what doctors know about a patient may represent very little of what a patient may consider to be essential to “who they are.”

It makes sense that a physician, who knows herself as a person, would choose less aggressive treatment for herself and pursue more aggressive treatment for her patient, whom she knows primarily by condition or disease. This outcome is probably unrelated to whether or not the physician is a caring or compassionate person and is rather a result of the constraints of time, function and capacity.

What can you do to have your healthcare preferences followed?

Patients and their families must recognize the limitations of physicians and of medical systems, in general. These systems and professionals cannot have a complete understanding of patients’ personal lives and issues.

When faced with significant medical decisions, it is essential to seek out as much family, friend, professional and spiritual support as may be needed.

An advanced directive is an excellent starting point, but having a professional or family member who can successfully advocate for its intentions to be followed may be most important.

Anne Conrad-Antoville is CEO and a founder of Champion Advocates LLC, a geriatric case management firm serving Portland, Oregon and Northern California. She has worked with many hundreds of families regarding senior healthcare issues for the past 30 years.

¹The Medicare News Group: “The Cost and Quality Conundrum of American End-of-Life Care”

²JAMA: “Change in End-of-Life Care for Medicare Beneficiaries
Site of Death, Place of Care, and Health Care Transitions in 2000, 2005, and 2009”

³Stanford Medicine News Center: “Most physicians would forgo aggressive treatment for themselves at the end of life, study finds”

⁴Consumer Reports: “Too much treatment?
Aggressive medical care can lead to more pain with no gain”

⁵SERMO: “How Doctors Die: Only 7% Choose Extraordinary Measures”

Aging and Spirit

Self Compassion and Aging

August 6, 2014 Anne Conrad-Antoville

Let’s be clear. Aging begins from the moment we are born.

In contemporary western society, we tend to view the aging process as positive up to a certain point. The turning point is somewhere in that upward “moving target” that counts as mid-life. From that point, we tend to view aging as a negative process and something to be fought against.

We have all become strongly influenced by advertising for a plethora of “anti-aging” products, counterbalanced with a youth-obsessed focus. Medical efforts and campaigns to cure countless conditions and diseases have been woven into our everyday experience, which can create for us a strange unspoken expectation that western medicine will someday cure us of all diseases and even overcome death itself.

We may experience unwanted reactions to these “anti-aging” and medical messages. The reactions can include unrealistic and unattainable expectations for ourselves and for those we may care for. If our baseline is unrealistic, we can be much too hard on ourselves.

For example, for the person who is a caregiver of an older family member; guilt can become overwhelming when the older person’s health goes into decline. The flawed expectations of a treatment for aging and eventual death cannot be realized. This form of guilt can become self-debilitating and detrimental to the caregiver’s physical and mental health.

For those of us who are passing the mid-life point, our own thoughts can become self wounding and cruel as we find it increasingly difficult to fit ourselves into the a youth-based straightjacket as we age.

Moreover, other cultural conditioning can make it difficult for us to allow ourselves to be self compassionate. At a recent leadership training that I attended, the accomplished female speaker noted in an offside comment, “I have always found it easy to be compassionate for others, but difficult to be compassionate to myself.”
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Why be self compassionate about aging?

Self compassion allows us to be present in the true moment. It helps us to forgive ourselves, to heal our wounds and to appreciate our own best efforts. It allows us to be truly compassionate in our service to others. Self compassion frees us of unnecessary burdens, allowing us to age from our center of being with grace and with wonder.

Anne Conrad-Antoville cared for her disabled mother from her pre-teens through her mid-thirties, when her mother passed away. This experience inspired Anne’s eventual work in professional aging services. Anne is currently CEO and a geriatric case manager for Champion Advocates LLC and manages Working Woman Aging Parents.

Future Vision

Aging and the Futurist

July 18, 2014 Anne Conrad-Antoville

I just attended a talk with Intel’s Futurist, Brian David Johnson. Earlier in this week, I had read through a futurist magazine filled with articles extolling child bearing robots and brain downloads and my expectations were low for meaningful content.

I was pleasantly surprised to hear Brian’s view that the future he envisions is about humans, not technology. It is not technology that guides us, but we who should be guiding technology. As we enter an era in which we can manufacture molecular-sized technology and literally anything can become a computer, it is up to us to decide what we stand for and what we stand against.

What stuck me most was this statement Brian made:

How do you change the future?
Change the story that people are telling themselves about the future they will live in.

In that light, what story are we telling ourselves about aging?

Aging is not only in our future, it is happening to all of us and now! If we are allowing the aging story to be shaped by medical technology companies, which of these technologies will enhance our experience of living a human life and which will dehumanize us over time?

Are the advertisements put forward by pharmaceutical corporations helping or warping our understanding of the course of life? Is the aging story told by residential care conglomerates and investment brokerages meaningful and true to what you stand for?

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Be aware of what you stand for and what you stand against, and change the story you are telling yourself as much as you need to.

Anne Conrad-Antoville is CEO of Champion Advocates LLC in Portland, Oregon. She has helped hundreds of families with professional geriatric case management services and other supportive services for seniors. Anne is also President of Working Woman Aging Parents.

Intel – Brian David Johnson and the Tomorrow Project

Photo- Damien Hirst, Hoorsenbuhs — The Cathedral Collection – Pill Rosary

Age-Quake!

Caregiving: A National Workforce Crisis in the Making

June 27, 2014 admin

A study from the National Alliance Caregiving and AARP determined that about half the workforce will be providing some type of eldercare by 2017. ¹

This stunning statistic has been steadily increasing over the past few decades due to increased longevity of people with increasingly significant medical and care needs.

In 2006, the MetLife Mature Market Institute determined that the annual cost to US employers for worker accommodations due to caregiving topped $33 billion. ² This is a significant chunk for the US economy.

On the individual front, caregivers who need to take time off work, cut hours, change jobs or even stop working entirely can significantly impact their personal income, career goals and lifetime financial health.

Working caregivers who cut hours or change jobs may also lose benefits including company health insurance, potentially affecting their personal health over time.

Unfortunately, my experience as a geriatric case manager in the field reveals that family caregivers often spend time and energy in misdirected actions.

These misdirected actions are often the result of unreasonable expectations, lack of knowledge and expertise and absence of meaningful support. The wasted time and effort negatively affects a large circle including the caregiver, their spouse and family, the employer and work teams, and most importantly the family member who is receiving the care.

The possibility to head off a national crisis begins by addressing the implicit and unreasonable expectation that all responsibilities of care must default to the family caregiver.

The “default to the family caregiver” concept is promoted by government, medical institutions, medical providers, cultural institutions unwilling to fund multifaceted support and members of older generations who have not had the experience of parents with these current longevity issues.

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¹2012 AARP Fact Sheet – Understanding the Impact of Family Caregiving on Work

²MetLife Mature Market Institute®National Alliance for Caregiving
July 2006The MetLife Caregiving Cost Study:Productivity Losses to U.S. Business

Questioning Aging Answers

Illuminating Better Pathways for Aging

June 20, 2014 admin

Compassionate Aging is a conscious and intent-driven approach to an inherent process of life. To move from an outward view of living, aging and eventually dying, to move towards a revitalized vision that seeks to gain deeper insights as to the inward journey of a life lived, requires us to individually pause, breathe and feel.

To feel beyond our basic physical pleasures and pains and to reach past our surface emotions is not often a practice in our daily lives. We are taught to subjugate, relegate and isolate our feelings and to conceal them from ourselves and others at all costs, except in the most banal forms of expression.

Look around at any moment in your day and you will find much you or I would rather choose to avoid to experience and feel. Our lives are surrounded by visuals and sound bites filled with pain, cruelty and misery. So why feel more deeply, when feeling anything at all touches upon such potential agony?

Because avoidance will only postpone what cannot be denied during the stillness that awaits each of us at that hour of death. Either, our own death or the death of a loved one will reveal regret, sorrow or guilt that has been repressed. Why then accumulate what can be released and recycled into more healthy emotions, thoughts and actions?

Buleylu oil reduces dullness of levitra uk the skin on skin, the softness, relaxing, tender time between mother and child forge a bond that can last a lifetime. Over the counter drugs have the benefit to choose from various brands and also the advantage of discounts and offers. viagra online online Ginkgo is said to be particularly useful for people who experience sexual dysfunction due to the side of the jet or a restricted leaflet motion on the side canadian viagra store of caution if you must. Maybe you never heard that natural cures and viagra tab the medical cures. CompassionateAging.org and the blogs posted on this site are intended to spark contemplation, consideration and conversation as to what each of us can discover at any point in a person’s life as sacred, why respect between generations should be a sustained practice and how compassionate aging is ethically and vitally interwoven with caring for our planet as a core principle for every generation.

If serious contemplations and considerations regarding aging issues emerge out of the din of the pervasive knee-jerk reactions to our current and ever burgeoning aging population scenario, then this website and its articles will have achieved an intended goal. And yet, it will be only a starting place from which to initiate this quest for compassionate aging.

Anthony Antoville is COO of Champion Advocates LLC and Co-Founder of compassionateaging.org

Are physicians working with the intention of Advanced Directives?

Why are physicians pursuing aggressive treatment?

What can you do to have your healthcare preferences followed?

Cherishing the Future of All Generations!