Doctor Shortage Endangers Seniors

Seniors have Medicare, so they have health insurance. But it's getting harder and harder for them to find primary care physicians. The same thing is going to happen to the rest of us as more and more of the general population gets health care coverage. There just aren't enough doctors because the pay isn't good enough. The New York Times ran a terrific article on the problem yesterday. I'm pasting a synopsis and link below.

I know this is a problem because my own doctor is struggling with the low payments from insurers. My daughter, who lives in Massachusetts, has told me stories of the doctor shortages brought about by the universal coverage that state has instituted. In Massachusetts, you're fined if you don't have health insurance. People who can't afford insurance must apply for it from the state. (It's like Medicaid.) But my daughter's friends who wound up with Mass Health coverage can't find doctors who will take it. They are going without.

This same problem is likely to hit the whole country if we have universal coverage. Medical school is expensive, so there are fewer doctors who want to become primary physicians where the pay is lower than it is for specialists.

So what should we do? I believe our country should subsidize doctors who will become primary care physicians, particularly ones who go out to serve the under-served. We need something like the Teach for America plan, only for doctors. I'm also hoping that lower salaries and bonuses and fewer jobs in finance will draw the best and brightest into medicine and science. I was so sad to watch my kids' classmates who were brainiacs in math and science all flock to Wall Street instead of the sciences. (Although one went to Google in marketing after majoring in chemistry at an Ivy League School.) The financial incentives simply have to change, or we will be paying more and more for medical care and getting less and less.

This will really affect the growing population of seniors adversely.

From the New York Times -- Health / Health Care Policy
Shortage of Doctors an Obstacle to Obama Goals
Published: April 27, 2009
One proposal -- to increase Medicare payments to general practitioners, at the expense of high-paid specialists -- has touched off a lobbying fight.

The Power of Friends

I think we've all sensed it, but the New York Times ran an article saying it was so. Friends matter. People with friends have better health and live longer. I think that's why seniors move to assisted living or to retirement communities seeking a new community of friendship and support. But it's also why seniors want to age in place and stay in the community they love near their friends. Any aging in place group needs to do things to foster healthy friendships.

What Are Friends For? A Longer Life
Published: April 21, 2009
Many people overlook a powerful weapon in the quest for better health: their friends.

Who is our target?

We have several sets of seniors in Darien. Can Aging in Place in Darien serve all of them? Should we? What needs can we fill?

It's hard to know when seniors really don't want to call for help.

More Beacon Hill Type Villages Springing Up

The folks who started Beacon Hill Village -- the nonprofit organization in Boston that enables seniors to age in place -- are traveling the country touting their model. They've had a meeting in Denver, CO, and soon they'll be in Oakland, CA. The meetings are over-subscribed.

It seems that communities of seniors are dying to have a nonprofit service do everything for them that assisted living would do, without having to move out of their homes to assisted living. What fascinates me is that these seniors don't seem to want to pay the full price of that service. Half the operating costs come from community fund raising. That would not be the case in assisted living.

I'm curious. What do you all think of this?

Please post your opinions.

Norwalk Senior Center

A friend of mine gave me the newsletter from the Norwalk Senior Center, which is a 501(c)(3). They seem to coordinate all the stuff in Norwalk that is there to help seniors, plus they run a vibrant social network with tons of activities. On May 20, they're running "Should I Stay or Should I Move?" and on April 22 at 10:30, they're running "Helping Seniors to Remain in Their Own Homes" Call 847-3115, if you want to attend.
Visit their website and see all that's going on and all their services --

Membership is only $10 per year. To me, it looks absolutely fantastic. I've copied and pasted their mission page. Read on:

Mission Statement
The Norwalk Senior Center is a nonprofit 501(c)3 adult activity center. The Center's mission is to improve the quality of life for older adults in the greater Norwalk area. The Center coordinates programs and services for healthy, active seniors as well as providing lunch, Meals on Wheels and transportation for frail elders. All programs are designed to promote dignity and independence through the aging process.

Norwalk Senior Center
11 Allen Road
Norwalk, CT 06851
Phone: (203) 847-3115
Fax: (203) 849-1285

The Norwalk Senior Center is open
Monday through Friday from 8:00 a.m. to 4:30 p.m.
Norwalk Senior Center South is open
Monday through Friday from 9:00 a.m. to 2:00 p.m.

Yearly membership of $10.00 includes home delivery of the bimonthly newsletter, a discount coupon for Super Grade A Shop Rite, special discounts on classes, programs and trips.

The Norwalk Senior Center is member-supported. We count on your donations to provide essential services to all of our members. We also count on you to tell us what you would like the Center to offer. So tell us! Your suggestion might make next month's calendar!

Our goal is to make the Norwalk Senior Center a premiere information and referral resource for issues on aging. In addition to providing a safety net for older, frail seniors, our mission is to promote independence, dignity and quality aging by keeping our members connected to the Norwalk community and providing them with educational growth opportunities.

What Do Seniors Want?

I'm getting frustrated. Seniors want to stay in their homes as they age. Some are willing to pay big bucks to do this, but not too big. None of the Beacon Hill Village members are willing to pay full freight for their memberships. So they need to fund raise 50% of the operating costs to support the organizations. Fund raising to support the wealthy in the style to which they have become accustomed. Go figure...

Then, there are those seniors who refuse to join an organization that can help them or to even ask for help from churches or other organizations. They may ask their friends to rides when they really need them. But they'd rather just stay home than call and bother someone.

This is a conundrum. What can be done? Help me figure this out.

What do Seniors Want?

Seniors say they want to age in place, yet they are reluctant to join or call groups that can help them do just that. Why? I think it's just a strong desire to be independent.

I'm also wondering what adult children want for their parents? Do they encourage aging in place, if a support system is in place? Or would they rather have their parents move to assisted living or even a nursing home?

I wish that lots of people read this blog and could weigh in on the subject.

As Aging in Place in Darien tackles our strategic planning, I just wonder what we really should be doing. Is it worth the effort? Is what we are doing really adding any value?

How can we offer the most value at the lowest cost? And by cost, I mean time, money and effort.

Beacon Hill Village Model

As I continue studying the various aging in place models, I am fascinated by the fact that the Beacon Hill Village Model costs far more to operate than its members seem willing to pay. 50% to 60% of operating costs must come from fund raising. Is this right? It reminds me of colleges. They need endowments and annual appeals for funds, plus tuition, room and board to keep going. But professors are doing research, and a university has a huge infrastructure to support.

Why do these aging in place models need so much so operate? Why do they only attract a small portion (a few hundred) of the thousands of seniors who could sign up? Why won't the members pay full freight? I understand having reduced fees for low-income seniors. But most members of villages are middle to high income.

I am continuing to wonder about this. What is wrong with this model? Is there anything wrong with this model?

The Beacon Hill Village model is a concierge service bureau for seniors who want to remain in their homes. The seniors join and then can call the village executive director for anything they need -- handyman services, transportation, shopping, health care....

The village also supplies all sorts of social activities and outings, thus keeping seniors active and ending isolation.

It's a great concept with a great mission. I just question the business model. I write business plans for entrepreneurs, so the financial aspects of a business (even a nonprofit) are of great interest to me. ( (

Senior Villages

I'm working on a strategic plan for Aging in Place in Darien. My job right now is to look at other aging in place organizations that have sprung up locally and across the country and ask, "What models are they following? How are they doing?"

This will help us sort out how we want to move forward. What model would work best for us?

Anyone out there got ideas?

Transportation for Seniors in Darien

The transportation committee is meeting today to discuss taxi vouchers, Gallivant and new transportation services from the Red Cross.

I'll be posting the news later this week.

Meanwhile, I've started using Twitter. Look for my tweets. Follow me.


This stands for Aging in Place with Grace. (Thanks to Olive Hauser, who came up with the name.)