Hospice and end-of-life care: thanks Grandpa!

Today I discovered that one of my neighbors had been a hospice nurse for a number of years.  He visited his patients at home or in nursing facilities (this being a key principle of hospice care - to bring care to the dying person rather than transporting the person to a new location.)

In his experience death and dying are taboo subjects.  People are generally unwilling to talk about death and the process of dying.  "God forbid!" you are supposed to say if the subject of death accidentally comes up.  This lack of conversation and real communication about death and dying makes the whole process much more painful for families and much more complicated and awkward for everyone involved.

I look forward to talking openly about death as a part of life, as a transition from this world we know to the world beyond death.  Regardless of what people believe about an afterlife, the end-of-life process will be more manageable, if no less challenging, as we talk things through.  Hopefully before-hand.

What's the standard in the senior living industry?  Do marketing directors mention the dying process when selling the continuing care retirement community concept?  From what I've seen there is lots said about the care continuum from independence to assisted living and skilled nursing, "if the need arises".  But how do they communicate about death?  Or do they?

It reminds me of my 2 years working for a financial planning firm, selling life and long-term care insurance.  Our sales training encouraged us to skirt the issue of death, because although death sells in the media and on soap operas, it doesn't actually sell life insurance.  Even calling it 'life' insurance obscures the fact that you are not insuring life, rather you are insuring against the economic consequences of death.  Although death was rarely mentioned to prospective clients, the organizational culture where I worked sometimes used death for emotional leverage, to stimulate fear or shame (when appealing to love or duty failed), and hoping to sell insurance as relief.

I understand that the term 'life-care community' has gone out of fashion (now everyone is a CCRC instead) precisely because 'life-care' implies death.  But as my neighbor the hospice nurse pointed out: life is a terminal illness.  Everyone dies.  I'm not saying that death doesn't frighten me a little.  I am afraid to die: partly for myself - I don't like pain and don't want to 'miss out' on this familiar life; and partly for my family, my wife and kids who will be sad when I go.

But I am certain that death and the process of dying are not the worst things that can happen.

My maternal grandfather died this past Monday morning.  He was very dear to me and I am sad to lose his physical presence in my life.  But he was not surprised.  He was ready.  He had already embraced the process, which accelerated rapidly over the preceding 7 days.  He was in his own room, looking out on his beloved church across the valley with an ancient sycamore towering in the foreground. He was eager to be reunited with his wife of nearly 60 years, with whom he was more strongly connected than ever, despite the 5 years since her death.  And he was at home, surrounded by loving children, visited by friends and tiny babies, basking in the prayers and fond remembrances sent his way by others who could not be physically present.

I missed my grandfather's last week of life.  I was not at his bed side.  I was in the Outer Banks with my in-laws, on the annual beach trip that my wife and kids look forward to all year.  And I am content.  In the several years before my grandfather's death I frequently walked down my street and through neighbors' yards to visit him.  I had spoken to my grandfather at length the week before, and I had what I needed.  I told him that I was embarking on a new career.  He expressed his love for and confidence in me - and let me know that his previously-held concerns about my life-direction were gone.

So as my grandfather was dying these past months and this past week I experienced peace.  I knew he was in our Creator's tender care, and I was certain that his family's loving hands were supporting him during his transition.

I am determined to find ways to help others experience their own version of this remarkable process of dying.  Along with the sorrow or pain, I wish for others to experience the death of their loved ones as an opening for peace, healing, and unexpected blessings.

New Career: Creating Community in the Senior Living Industry

Today I launch a new career. I've been investigating the senior living industry for the past few weeks  - as an offshoot of my broader survey of the commercial real estate industry. Today it's official.

I am pursuing a career in the entrepreneurial creation of genuine community. The senior living field brings a number of services, helping professions, and business disciplines together in a conscious attempt to deliver the experience of community. It's my hunch that the most successful senior living operators are those that can effectively invite people to participate in a thriving community AND consistently deliver a community experience to residents and their (very important) loved ones.

I'm especially drawn to the continuing care retirement community model (CCRC, also called a life-care community). CCRC's integrate a comprehensive array of services along the continuum from independent living, to assisted living, to skilled nursing care. I look forward to learning how the pieces fit together and which elements are key for developing and sustaining a sense of genuine community among residents, staff, and family/friends who live elsewhere.

In my next few posts I'll touch on the following:

• An inspiring example that steered me onto this career path
• Perspective from a Care Coordinator with decades of experience in assisted living
• A 5-10 year outlook for the senior living industry from a CCRC marketing specialist
• Updates as I learn about senior living and CCRC's in my area (Philadelphia region)
• Pertinent discoveries during my job hunting process
• Impressions as I visit senior living communities - surprises, what I like/loathe, comparisons, interesting people

My first significant goal: secure a challenging job with advancement potential in a thriving community in 5 weeks (by Friday, July 30, 2010)....Here we go!

Bryn Athyn could easily be resilient

Well, maybe not 'easily'...but a lot easier than many places!

Check out John Robb's description - sounds pretty close to my hometown, Bryn Athyn, PA... especially with the Cathedral shops, the new Redmile teaching garden, and ongoing discussion/support for creating a nearby CSA:

http://globalguerrillas.typepad.com/globalguerrillas/2010/04/journal-what-makes-a-home-valuable.html

Robb says in part (referring to what makes a home valuable in the current 'depression'):

New model:

• Is the home located in a viable community? One that you could work with to solve problems as they emerge?
• Is there a strong tradition of entrepreneurship in the community such that it allows the fast formation of new ventures?
• Is the community defensible? Considerations include geographical footprint, proximity to cities, entry/exit, etc.
• Does the community have arable land available for food production? There are so many factors here, it would take a book just to explore them.
• Can the home produce energy? Does it have solar PV or solar hot water? Does it use geothermal heating/cooling?
• Does the home have sufficient space for or already mature gardens?
• Is the home's connection to the electricity grid bi-directional?
• Is the connectivity to the global network both redundant and fast?
• Does the home have room for a workshop?
• Are the real estate taxes low enough to avoid liens in the event of inevitable job loss (by at least one of the members of the household) or a reduction in pay?

Workshop: Tools for Creating a Culture of Virtue

Tools to Create a Culture of Virtue

A Socratic Practice Workshop - Thinking for Yourself, Integrity, Service to Others

Michael Strong

Author,

The Habit of Thought:

From Socratic Seminars to Socratic Practice

Thursday, March 18, 2010, 1-5:30 pm

3051 Buck Road, Bryn Athyn, PA 19009

Adults $40, Couples $60, Family $75, Children (ages 7-14) $10

Registration 12:30 pm

Contact Landon or Michelle Synnestvedt 267.222.2409 LandonSyn@yahoo.com

Workshop Schedule:

1 - 1:30 Introduction to Socratic Inquiry and Socratic Practice at Home

(For adults, though if older children want to be there that's fine.)

1:30 - 2:30 Socratic demonstration with adults

(It’s always good to start with an experience as a learner oneself and experience the norms directly before trying to develop them in younger people.)

2:30 - 2:45 Debrief of adult session

2:45 - 3:00 Break

3:00 - 3:30 Demonstration with younger children (age 7 & up)

3:30 - 4:00 Debrief demo with adults

4:00 - 4:30 Demonstration with older children

4:30 - 5:00 Debrief demo with adults

5:00 - 5:30 How to craft a custom Socratic program for your children.

Michael Strong is the Chief Visionary Officer of Conscious Capitalism, Inc. and FLOW, exploring and documenting ways that organizations can make the world a better place. He recently co-authored Be the Solution: How Entrepreneurs and Conscious Capitalists Can Solve All the World’s Problems along with John Mackey, CEO of Whole Foods Market, Muhammad Yunus, 2006 Nobel Peace Prize Laureate, Hernando de Soto, Co-Chair of the U.N. Commission on the Legal Empowerment of the Poor, and others.

Prior to founding Conscious Capitalism, Inc., Michael spent fifteen years in K-12 education, where he founded several schools based on Montessori and Socratic principles, including a charter high school in New Mexico that was ranked the 36^th best public high school in the U.S. by Newsweek. The author of The Habit of Thought: From Socratic Seminars to Socratic Practice, he has provided Socratic educational consulting for hundreds of groups around the world. He was educated at Harvard, St. John’s College (Santa Fe), where he was valedictorian, and the University of Chicago (where his dissertation advisor was Nobel Laureate economist Gary Becker).

Business framework for resilient communities

John Robb discusses markets that could be served by a business that creates a community structure:

* An already large and growing group of people that are looking for a resilient community within which to live if the global or US system breaks down (ala the collapse of the USSR/Argentina or worse). Frankly, a viable place to live is a lot better than investing in gold that may not be valuable (gold assumes people are willing to part with what they have).
* A larger and growing number of prospective students that want to learn how to build and operate resilient communities (rather than campus experiments and standard classroom blather).
* A large and growing group of young people that want to work and live within a resilient community. A real job after school ends.

Triangulating these markets yields the following business opportunity:

* The ability of prospective residents of resilient communities to invest a portion of their IRA/401K and/or ongoing contributions in the construction and operation of a resilient community...
* An educational program, like Gaia University's collaboration with Factor e Farm, that allows students to get a degree while building out a resilient community...
* A work study program that allows students of the University to pay off their student debt and make a living...

Marauders Map: neighborhood-watch, crowd-sourced, real-time location, & social networking

Who knows how to take existing technology and make Marauders Map into a useful reality? John Robb speaks about using an MMO (massive multiplayer online) game platform to develop a real world enterprise or economy in a recent post on Global Guerrillas.

Here's a working draft of what I call Marauders Map:

Imagine a location-based service inspired by the fictional Marauders Map of Harry Potter fame. Harry Potter and his friends find a magical map that shows the entire grounds of Hogwarts School - complete with tiny figures of all the teachers, students and other creatures, and showing their real-time locations. The Marauders Map was an ideal tool for sneaking out of dormitories to make magical mischief. What if something similar was developed as a blend of social networking, GPS mapping (including perhaps tying into some of Google’s powerful services), GIS (geographic information systems), and neighborhood-watch efforts? How could one answer ethical concerns about privacy, discrimination, or abuses of power? I hope to show that, rather than fearing surveillance, one should embrace transparency-enhancing tools such as Marauders Map, welcoming the more civilized society that may develop as a result.

A local layer of Marauders Map could be crowd-sourced from a collection of users – anyone from busy-bodies who like to exchange gossip, to drivers on local roads updating traffic conditions, to teens who want to let their friends know where they are, to parents who want to keep tabs on their kids, to pastors and social workers who want to know who needs help or who needs to be checked on in the neighborhood. It could be used by urban birders or train-watching enthusiasts. It could be linked to micro-climate data by gardening networks, urban farmers, and permaculture practitioners. Homeless activists or neighborhood-watch members could tag and share data on needy people, vulnerable sites, or suspicious activity.

Marauders Map could have a game-inspired interface, perhaps appearing as a parallel world built on Google Maps/Earth and familiar to anyone who lives in that area. But it would also have layers added, such as: best gas prices; traffic flows (perhaps sourced from cell phones streaming past cell towers); volunteer opportunities; shut-ins who need to be visited; recent crime or traffic accident locations – so that anyone interested could contribute to or learn from the data. Anyone with a mobile device could appear in his or her true location in real time. (This is already available on Google Latitude, for example.) This location data could also be keyed to one’s social networking status (twitter, myspace, Facebook, etc).

People could capture and instantly upload location-keyed video, photos, or other content based on what is happening now – with archival layers available to show what had been posted, searchable or sorted by date/location/topic/type of event/etc. This user-generated content could be used in limitless ways. (What uses are coming to you, dear reader?) Marauders Map could facilitate pick-up games or sports. (Anyone for a game of checkers or ultimate frizbee?) It could facilitate spontaneous visiting or meals for people who are sick, suffering a hard time, or with a new baby, etc. It could be a real-time way for citizens to report potholes, fallen tree branches, bridge damage, neglected parks, etc. to municipal government…and it might make it easier for citizens to get together to solve these same problems on their own, without interminable waiting if where political resources and capacity are stretched thin, as is increasingly the case in many places.

Local law enforcement and citizens could use Marauders Map to be, literally, on the same page regarding crime and threatening behavior. In my neighborhood, for example, people already pay attention and will call the police if they see an unfamiliar car slowly cruising residential streets. This actually led to police arresting someone responsible for a string of burglaries in my town. Building on natural neighborhood vigilance, Marauders Map could allow neighbors to ‘bell the cat’ by electronically tagging a suspicious vehicle or problem person – either with a radio frequency transponder or other device, or by actively updating the ‘cat’s’ location on Marauders Map, complete with incriminating video or identifying photos.

Marauders Map won’t just be a suburban or upper class tool – nor limited to the developed world, North America or Europe. Consider a neighborhood – barrio, ghetto, favela - where pimps, pushers or other bullies run the streets. The police are often unwelcome in these places, often with good reason. Past experience teaches people that police are as much to be feared or avoided as private criminals. But the decent folk in any neighborhood want to live in peace and safety and would rid themselves of such threats if they could. Many millions of people currently live in neighborhoods where they are forced to endure the erratic and dangerous behavior of local criminals – both official and freelance. Marauders Map can be a self-help tool for these people, even in the most neglected neighborhoods where red-lining makes them no-go districts for police – or where police are themselves a threat.

Similarly, Marauders Map could be used by Afghan villagers or Iraqi shopkeepers and housewives to subtly resist Taliban or Al Queda members who violently trespass on the community’s hospitality. Marauders Map allows local people to quietly bell the cat.

Bullies and criminal thugs thrive in the shadows, and in the ambiguous edges where they can threaten and overpower their intended victims one at a time, isolated from their natural supports in friends, family and community. Imagine that a local criminal (drug lord, corrupt official, foreign fighter, violent religious zealot – it doesn’t matter) suddenly finds that he can’t reliably hide. What if his movements are being tracked and recorded – not by a distant spy satellite or state informant – but potentially by anyone he sees, and plenty that he doesn’t see behind curtained windows? Imagine neighborhood disapproval or outrage at past abuses building incrementally among the many weak or fearful people who would never directly challenge the bully regime, now empowered to help deny sanctuary to the offender. The bright light of transparency or the power of social ostracism might be effective on its own. If not, a rival criminal/government agency might easily capitalize on the offender’s vulnerability. And perhaps most powerful, the community might converge to physically end the bully’s reign of terror – maybe even creating an ad hoc ‘truth and reconciliation’ process to deal with collaborators and to heal neighborhood wounds.

I’ve included just a few of the possible uses for such a platform, a Marauders Map that allows users to use the power of location-based networking to create any imaginable application that others will actually use. But what of the ethical dilemmas posed by such a tool? What about loss of privacy? What if the system is used to discriminate against certain people? What if private individuals or corporations use this to track people and target marketing based on their location and likely activities? What if the Marauders Map super-empowers Big Brother so that agents of the state can track where we go and with whom we associate? If the Marauders Map concept becomes ubiquitous, we will leave a digital trail of our past travels in addition to showing where we are at any moment. How will that lack of anonymity and lack of privacy affect our lives and how will it change our communities?

It is important to understand we will soon live in either a highly transparent society or a surveillance state. Private organizations and states already gather huge amounts of information about each of us. The key issue: how the information is used, by whom, and whether we consent to its use and can opt-out. It is already impossible for a normally active person to keep her personal information secret. Personal privacy is elusive in a digitally connected society. Most people voluntarily and knowingly trade their privacy for a variety of services that are tailored by entrepreneurs to respond to their personal preferences and habits. On the other hand, transparency and having ‘nothing to hide’ could become effective antidotes to abuses by powerful or corrupt people.

A transparent society could become a more civilized society. One will begin to ask: How can I live my personal and business life with integrity? How can I consistently operate within the context of perfection (in the sense of being whole and complete) – with my roles and parts integrated. Hypocrisy could become less prevalent as evidence of a double life becomes more difficult to hide. This will not come as good news to people who make deception a professional or personal habit. But such a reality already exists, for example, in word-of-mouth recommendations or disapproval that spread rapidly to hundreds, or millions of interested people in a matter of hours via various networks.

Businesses, individuals and all manner of organizations may discover that in order to be profitable, effective, or influential they must operate with nothing to hide. They will have to discover how this fits with business, political, and social prudence. But they will be generally obliged to adopt principles of honorable and just action – so that if their actions were made public they would have no reason to be ashamed (or sued!). Additionally, the transparent society of the future will likely provide less room for scandal-prone celebrities and politicians than exists today. In this process Marauders Map will play the part of neutral facilitator of local norms and legitimate behavior. It could empower traditional morals in a family-oriented community to thwart ‘people behaving badly’ or it could encourage those same behaviors in an entertainment district.

Marauders Map will be a very powerful tool for social ostracism and for discrimination of many kinds. A few kinds of discrimination are widely recognized as offensive and anti-social. But it is essential that people exercise their individual free will and rational judgment to make discriminating choices about how to support their mental and spiritual health and that of their families. Marauders Map, in keeping with its organizing fact of transparency, will highlight what forms of discrimination are being exercised. People who engage in socially unacceptable discrimination will find themselves isolated and ostracized. At the same time, people who are subject to unjust discriminations will be able to use Marauders Map to band together with others like themselves; to seek and receive support from fair-minded people who sympathize with their plight. As outlined in this essay, Marauders Map could open one’s eyes to the fact that ‘those who are with us are more than those who are with them’, as was the Biblical case for Elisha’s servant when his spiritual eyes were opened and he saw a protecting army of angels in chariots of fire (2 Kings 6:16-17)!

Some may object further that a system such as Marauders Map could protect bad guys as easily as good guys. This is true in the following limited way: bad guys will be protected if they are perceived as good guys in their own neighborhood or region. Whether a person counts as a bad guy or good guy largely depends on one’s point of view and proximity. For example consider Osama bin Laden, and certain Hamas or Hizbollah leaders who have evaded death and capture for years. They are surrounded and supported by loyal, loving friends who value the services and leadership these hunted men provide. And they continue to frustrate the best efforts and highest technology of the most powerful states in the world. It is true that Marauders Map could make terrorists even more secure in a local area where they are loved and respected. But at the same time it would empower local people to protect themselves and respond to threats or recover from actual harm more effectively than currently possible. This is especially true where the state does not provide an effective umbrella of security or justice. In any case, a bad guy must actually be a good guy in the eyes of enough local people in order to benefit from the positive reinforcement that Marauders Map will afford those who provide their communities with a high level of useful service.

Marauders Map might allow democratic and popular support to rise spontaneously to support or shield a beloved figure from detection and harm. Imagine supporters of a high-profile Iranian dissident tagging themselves as the dissident on the Marauders Map…to the confusion and chagrin of Iranian secret police tasked to watch or arrest her. There would be a continual dance between those who have nothing to hide and those who try to subvert the platform in order to harm or control others. For a glimpse of how a crowd-sourced platform could be self-repairing consider Wikipedia.org’s remarkable resilience against malicious or self-serving edits on significant or high-profile entries. Volunteer vigilance by many networked individuals can catch and repair such tampering within minutes or even seconds. On the other hand, people in the network can work together to shelter or protect each other as needed. It will be an expression of social democracy – where criminal efforts of any kind will immediately be met with creative work-arounds or direct resistance and evasion. By the same token, inappropriate action (as judged by the individuals using Marauders Map) by rulers, bureaucrats, or greedy corporations will wash harmlessly over the people, or come up empty – like a net with big holes closing over tiny fish.

Transparency or surveillance – the struggle is underway. A variety of platforms like Marauders Map are being actively developed and something very like it will be widely available in the near future. It is time to embrace transparency and work for a more civilized society. Top-down controls and bullying of all kinds are doomed to failure in such a society – and the sooner the better!

Local Economy - Thrift shops & consignment sales

The local division of labor is essential to maintaining a good living standard in our community. We have a thrift shop that is an informal interface between our local church and surrounding neighborhoods. It draws shoppers and donations from far beyond the congregation.

The Bryn Athyn Thrift Shop is a terrific source of furniture, clothing, electronics, household & kitchen items, toys, light hardware, books, sports equipment. Community members (including my family) make BATS a regular stop during their week. You never know when that perfect item will turn up.

The Cozy Tots Consignment Sale is coming this weekend to our community. It has become a twice-a-year tradition, bringing hundreds of local consignors and shoppers together. A small team of local moms (with husbands to help setup) have created a mutually beneficial market that improves the living standards of those who sell their extra stuff and those who can find just what they need at a good price.