Friday, July 08, 2011

How To Form an Aging in Place Group

I was recently involved in a discussion about the best way to form an Aging in Place or a "Village" organization. Nonprofits that enable seniors to stay in their homes as they age are growing all over the country. Many are following the Beacon Hill Village (BHV) model. BHV charges dues, has a board and a staff, and provides direct services and referrals to services, as well as ongoing social events. This is a very popular model that is gaining ground rapidly and is large enough to have annual national meetings and an online group to join (Village-to-Village).

But when we started Aging in Place in Darien (now Aging in Place+Gallivant) we took a different approach. 
We began as a pilot program sponsored by The Community Fund of Darien, which is like a United Way. Our focus was to provide information and referrals to all of the agencies that are already in place and ready to help seniors remain independent in the community and their own homes. We did surveys and focus groups to determine what needs were being met -- and not being met for our local seniors. We then hosted a summit of service providers and enabled all of them to learn about one another and how we could tap their services. We looked to find ways to fill in the gaps, and from our summit attendees, we created committees to handle the top areas of need: transportation, handyman services, ways to end isolation and to get the word out about what's available.

Having excellent ties to agencies and service providers has helped establish a really useful organization that is making a true difference for seniors in our community of Darien, Connecticut. The ties also helped us find a really great board. We became independent this year and merged with the local senior transportation provider, Gallivant -- making us stronger and in a position to better meet one of the top needs. Learn more about us at: www.aginginplacegallivant.org.

Friday, July 01, 2011

Who's Got Your Back? (Spinal Health)

Backs and spines are on my mind. It always gets me when I read about therapies that really don't work that well, but doctors and hospitals keep talking them up and advertising them. In the past week, I've gotten a glossy marketing piece from Greenwich Hospital extolling the virtues of spine surgery, spinal fusion and bone growth; read an article in the New York Times by Jane Brody on spinal fractures and caring for your back; and read a New York Times business section article on spine specialists repudiating Medtronic's bone growth product primarily used in spinal fusions. "Spine Experts Repudiate Medtronic Studies".

My conclusion from all this is that my mother was right. Avoid surgery. Be wary of doctors who are looking to make money from expensive procedures. Don't twist. Don't do stomach crunches. Don't do bending and touching your toes exercises. Lift things carefully and properly. I also have listened to my primary care physician who gave me back-strengthening exercises similar to ones written up by Jane Brody. 

As Ms. Brody points out, vertebrae can just crumble from compression when you have weakened bones. And two out of five women over 80 have had such fractures. Half of the 1.5 million fractures due to bone loss are fractures of the vertebrae. Sometimes, you don't even know you've had the fracture, which can occur even if you don't have osteoporosis. The columns says that bone strengthening medicine, calcium and vitamin D can help prevent the breaks, however. And experts warn that you should not rush into invasive procedures like bone fusing or bone strengthening. These procedures are risky and may not have much benefit.

The business section article about Medtronic's product backs up Ms. Brody's column. It tells how an issue of The Spine Journal was devoted to the topics of bias and conflicts of interest in corporate medical research and sponsorship of scientific studies. The articles singled out Medtronic's Infuse, which is used in 25% of the 423,000 spinal fusions performed in the U.S. annually. Questions of morality and public safety are at the core of The Spine Journal's investigative journalism, questioning Medtronic's research as to the effectiveness and the safety of Infuse. Medtronic makes about $900 million a year from sales of Infuse. (And you wonder why our health care system and Medicare costs are out of control.) The entire article is well worth reading and goes into far more expert detail than I can. If you or a loved one has back problems, I commend all these pieces to you.