Housing options for seniors and disabled
(eldercare, changing attitudes, managing disability)


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Housing options: the big picture

Atul Gawande: "We Have Medicalized Aging, and That Experiment Is Failing Us" Michael Mechanic interviews Gawande, Mother Jones, 10-7-14) Nursing homes and assisted living facilities that over-dwell on safety fail the residents by taking too much choice and pleasure out of their hands. For example, "Introducing animals into a nursing home brought residents 'out of their shells...They became more active. They also lived longer."
Glossary of terms (LongTermCare.gov)
Eldercare locator (download helpful brochures on employment options for elders, hospital-to-home transition, housing options for seniors, Medicines for you (a guide for older adults), prescription drug options, staying in touch in crisis, transportation options for mobility independence, and staying warm and safe in the winter.
A Place for Mom , this housing referral service for older adults has introduced an affiliated site aimed at providing consumer reviews of senior care locations: SeniorAdvisor.com . Care locations are organized by type, such as assisted living, independent living, senior apartments and skilled nursing homes.
Housing Options for Older Adults (download PDF booklet, Eldercare.gov -- or read online)
New Push to Keep Seniors in Home, Community-Based Programs (Alejandra Cancino, Associated Press, ABC News, 4-4-16) The federal government is pushing states to keep more low-income seniors out of nursing homes and, instead, enroll them in home and community-based programs. The cornerstone of home and community-based programs is personal care services, such as providing an aide who helps with cooking or cleaning. Those services cost a fraction of nursing home care.
America Has a Major Misconception On Aging (SeniorCare.com infographic) What Percentage of Americans Will Need Long-Term Care? A third think they will. Two-thirds actually will. It's time for a senior care reality check. Senior care means more than nursing homes.
Senior Guides in Local Communities (scroll down to find a box listing states, click on your state, see a list of cities, click on the city of your choice, and you will find a LOT of information about what is available there. There are guides for almost every city in the country, listing helpful
elder resources and a breakdown of healthcare quality and services available for senior citizens in any area. It is not easy to find at first, but it seems very useful.)
Multigenerational Living Is Back and That’s a Good Thing ( Sherri Snelling, Next Avenue, 10-6-16) A renewed interdependence can be healthy for children and older adults.
'Elder Orphans' Have A Harder Time Aging In Place (Carol Marak, Next Avenue, Forbes, 9-8-16)
The Babayagas’ house, a feminist alternative to old people’s homes, opens in Paris (Alison Hird, Radio France Internationale, "The World and All Its Voices," 5-3-13) The building houses 25 self-contained flats. 21 are adapted for the elderly and four are reserved for students. Residents were selected partly in relation to what they could contribute to the “community” and the extent to which they shared the Babayaga philosophy. They prefer to be compared with the slow food movement. “Slow ageing? Why not!” “We want to exchange ideas, take what’s best out there.”
LongTermCare.gov ("Find your path forward. It's more than just insurance.") Questions addressed: Who is long-term care? Who needs it? How much care will you need? Where Can You Receive Care? Who pays for long-term care? Long-term care considerations for LGBT adults. Alzheimer's. Avoiding a fall.

Two-Thirds of Today's Retirees Say They're Living in the Best Home of Their Lives: New Study Shatters Stereotypes (Ken Dychtwald, Huff Post, 2-25-15). Part 1 of 2-part series. Part 2: Housing in Later Life: New Freedoms to Choose (2-26-15) Housing choices include assisted living communities, continuing care retirement communities (CCRCs), cohousing, innovative systems like the Village model.
The most and least tax-friendly states for retirees (Kiplinger, October 2016)
The Housing Project That Keeps Older Residents Out of the ER (David Gorn, Next Avenue, 6-10-16) This low-income residents' program in downtown Oakland, Calif., is called Neighbors Helping Neighbors. It’s part of an ambitious plan to help older residents, many of them Asian immigrants, take control of their health — in part by joining at least one of 14 groups intended to enhance their physical and mental well-being.
PACE. Program of All-Inclusive Care for the Elderly, or PACE. provides comprehensive medical and social services to certain frail, community-dwelling elderly individuals, most of whom are dually eligible for Medicare and Medicaid benefits . An interdisciplinary team of health professionals provides PACE participants with coordinated care. For most participants, the comprehensive service package enables them to remain in the community rather than receive care in a nursing home. Financing for the program is capped, which allows providers to deliver all services participants need rather than only those reimbursable under Medicare and Medicaid fee-for-service plans. PACE is a program under Medicare, and states can elect to provide PACE services to Medicaid beneficiaries as an optional Medicaid benefit. The PACE program becomes the sole source of Medicaid and Medicare benefits for PACE participants.
As The For-Profit World Moves Into An Elder Care Program, Some Worry (Sarah Varney, Kaiser Health News, 8-24-16) Inside a senior center in Denver, dozens of elderly men and women — some in wheelchairs, others whose hands tremble involuntarily — gather excitedly around the game tables. This is one of eight vanguard centers owned by InnovAge, a company based in Denver with ambitious plans. With the support of private equity money, InnovAge aims to aggressively expand a little-known Medicare program that will pay to keep older and disabled Americans out of nursing homes. Until recently, only nonprofits were allowed to run programs like these. But a year ago, the government flipped the switch, opening the program to for-profit companies as well, ending one of the last remaining holdouts to commercialism in health care. Hanging over all the promise, though, is the question of whether for-profit companies are well-suited to this line of work, long the province of nonprofit do-gooders. Even the program’s supporters acknowledge that the movement needs fresh momentum. But they worry that commercial operators will tarnish their image in the same way many for-profits eroded trust in hospice care and nursing homes.

Searching for Security (Kelly Greene, WSJ, 3-17-10) How to tell whether a continuing-care community will be able to keep its financial promises
Staying Out of the Closet In Old Age (Anna Gorman, Kaiser Health News, 10-17-16) LGBT seniors are not strangers to nursing homes. The difference now is that there is a growing recognition of the need to make the homes safe and welcoming for them.
Aging Independently: A Chapel Hill Perspective (PDF, Bill Herzog, Glenn Wilson, and Nan Rideout, NCMedical Journal, Mar/​April 2010). Three different types of support systems have developed across the country to meet the special needs of seniors who choose to live independently in their own homes: (1) the “Beacon Hill” or village model; (2) naturally occurring retirement communities; and, more recently, (3) university-based retirement communities....There are three general levels of need within the Chapel Hill community: those who have the financial resources and income to choose to enroll in one of the local CCRCs or live independently; those in a large middle-income group—some who could afford the CCRC option, some not; and a significant number who live at or near the poverty level.... One senior physician in our first focus group provided an insight that has guided much of our planning by pointing out that two strong motivators among the elderly are the striving to be independent and in control of their own lives and the desire not to be a burden on their children or society. Another participant added a third common motivation, that of the need to “continue to be of some use, to continue to making a contribution of some kind.”
Rising Challenger Takes On Elder-Care System (Lucette Lagnado, WSJ, 6-24-08, in Democratic Underground. Thanks to a grant from the Robert Wood Johnson Foundation, the country's fourth-largest philanthropy for throwing its considerable weight behind a 48-year-old physician's vision of "Green Houses," a movement to replace large nursing homes with small, homelike facilities for 10 to 12 residents. The $122 billion nursing-home industry arose from the 1965 birth of Medicare and Medicaid, the government health-insurance programs for the elderly and poor that provide billions in government reimbursements. The industry has suffered through so many scandals involving patient care that many elderly shun the thought of entering such institutions. Assisted living, an ambitious effort begun in the 1980s to allow seniors to live independently in apartments and other group settings, has proved very popular but it "serves the needs of people who are relatively wealthy and relatively healthy," says Dr. Thomas, the man behind the Green House movement. Generally licensed as nursing homes, Green Houses are designed to provide a full range of care to the very sick.
The Purposeless Life (Steve Moran, Senior Housing Forum, 6-13-16) All too many senior residence organizations fail to recognize the talent and knowledge of their residents, and don't let them get involved with the running of the community. An organization called In2l.com ("It's Never Too Late") tries to break down barriers and enable all residents, including those with memory loss, to share their world with caregivers and family members.
Retirement in a Community, but Which One? (Harriet Edleson, NY Times, 3-6-15) An active adult community typically does not include any centralized dining options or health care options while a continuing care retirement community typically includes independent living options, assisted-living accommodations and some type of health care component
Home in Retirement: More Freedom, New Choices Merrill Lynch/​Age Wave study looks at how freedom from work, shifting family dynamics, fewer home-related expenses and unprecedented longevity are empowering retirees to pursue a home that fits their desired lifestyle and changing priorities.'
Online Reviews of Senior Housing Options, With Caveats (Ann Carrns, Bucks, NY Times, 4-8-13)
“Just Shoot Me” Isn’t a Plan (Ellen Rand, Last Comforts, on viable alternatives to conventional nursing homes, with a focus more on “home” than on “nursing” in design, operation and management. Ellen's forthcoming book: Notes from the Forefront of Late-Life Care
Elder Orphans: A Baby Boomer's Aging-Alone Plan (Carol Marak, Elder Orphans, Huff Post, 1-4-16) he matters that need attention in retirement
Step One in the Aging-Alone Plan, learn the stages (Carol Marak, Elder Orphans, Huff Post, 1-14-16)
For A Long And Healthy Life, It Matters Where You Live (Richard Knox, NPR Shots, 7-18-13). Hawaiians can expect 16 years of healthy life after 65; Mississippians, less than 11 years.)
Pioneer Network (advocates for culture change in eldercare models, from long-term nursing home care to short-term transitional care to community-based care)
Why This 21-Year-Old Loves Living In A Retirement Home (Yagana Shah, HuffPost, 2-19-16) A pilot artist-in-residence program is giving a college senior free housing and a rich intergenerational experience. And the residents love it.
Independent Living Is Exposing Elderly To Eviction Threat (Motoko Rich, NY Times, 2-15-14) A growing group of elderly people is "fighting for the right to age how, and where, they choose. A host of challenges, social and legal, awaits them."
Someone on the Line (Paula Span, NY Times, 10-8-10). Span reviews services provided through the Eldercare Locator toll-free number, (800) 677-1116, finds it hard to get through, and worries that callers are referred to local agencies, whose usefulness may vary.
How a parent’s health-care bills could hurt you (Elizabeth O'Brien, MarketWatch, Wall Street Journal, 7-10-14) Misunderstanding the fine print could leave you on the hook for elder-care costs " The best way to separate your responsibility as power of attorney from any personal financial obligation is to sign your parent’s name as the responsible party on the contract, and after that write, “by [your name] as power of attorney,” followed by the date, said Bradley J. Frigon, an elder law attorney in Denver and president of the National Academy of Elder Law Attorneys."
In Coming Decades, Fewer Caregivers (Judith Graham, New Old Age, NY Times, 8-26-13) Who will care for me when I’m old?
Coming Together to Make Aging a Little Easier (Elizabeth Pope, NY Times 9-15-11). Innovative approaches to managing some of the difficulties of aging are bubbling up around the country, often initiated by women who want to stay independent. Pope writes about The Caring Collaborative, a project initiated by The Transition Network in New York, which has created a number of helpful, downloadable manuals, including Creating a caring collaborative and Creating a vertical village in a high-rise building.
Multigenerational Housing May Be A Good Move (Sally Abrahms, AARP Bulletin) Three generations under one roof, known as multigenerational housing, is on the rise. "“It used to be older people whose money had run out who were living with their children, and now it’s the next generation that can’t keep up,” says Louis Tenenbaum, a founder of the Aging in Place Institute, which promotes “multigen” remodeling.
Finding Your Niche Housing in Retirement or Before! (Sally Abrahms, AARP Bulletin) Gay and lesbian retirement communities are just "one part of the growing trend of niche or affinity retirement communities, where people who share similar interests, religions, professional backgrounds or lifestyles decide to live in the same place." Interesting affinity groups mentioned!
Roommates are a financial lifeline for some seniors (Martha C. White, Retirement, CNBC May 2014)
Do Seniors Turn to the Right Places at End of Life? (Andrew Seaman, Reuters, 10-1-12). Palliative or hospice care, associated with hospices, should be incorporated into Medicare’s nursing home benefits; nursing homes are typically geared to rehabilitation and long-term care, not comfort care.
Moving Toward Person- and Family-Centered Care (Lynn Feinberg, Public Policy Institute, AARP, March 2012)
How to Choose Between Home Health Care, Assisted Living, and a Nursing Home (Ilana Polyak, Health.com)
Hospice care and palliative care (a full set of links to various aspects of comfort care for the dying)
Compare Cost of Care Across the United States (helpful Genworth database, showing median costs, per state, of home care, adult day health care, assisted living facility, nursing home)
Costs of long-term care (LongTermCare.gov)
John Hancock survey of long-term health care costs (2013). Calculating the cost of care locally (based on figures from Hancock survey)
Elder Abuse: A National Tragedy (Ashley Carson Cottingham, Compassion & Choices). A rarely discussed form of elder abuse occurs when an older adult’s expressed wishes at the end of life are ignored, and as a result they are subjected to unwanted and invasive medical treatment. See section on Preventing elder abuse and scams
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Aging in Place

(naturally occurring retirement centers, or NORCs)


Aging in Place: Rethinking Solutions to the Home Care Challenge (MetLife report by Louis Tanenbaum, Sept. 2010). You can download the report (PDF) and the workbook, free.
Connected to the Community: Current Aging-in-Place Choices (Susan Poor, SecondJourney) Excellent history and overview.
The Future of Retirement Communities: Walkable and Urban (John F. Wasik, Retiring, NY Times, 10-14-16) A new paradigm: the walkable, urban space. Pedestrian-friendly communities promote walking to a grocery store, cafe or other services such as a dry cleaner or library.
Managing hospitalization and after
Managing chronic pain
Managing ordinary (not chronic) pain
Communities Seek to Be Age Friendly (Susan B. Garland, Kiplinger Retirement Report, Oct. 2016) More retirees are looking for places to call home that can accommodate their wants and needs, but aren't assisted living facilities. Garland provides a great overview of initiatives and factors to improve the quality of life of older adults, including "Lifelong Communities," proximity to services and other people, "zoning codes to encourage multi-family housing near shops, senior centers and entertainment," age-friendly communities with "walkable amenities and convenient transportation,” and Purposeful Aging departments to consider "changes in regulations to increase affordable senior housing, an expansion of wellness programs, and strategies to promote employment of older residents."
Walk Score. Plug in an address to learn a neighborhood's walkability and availability of public transportation.
Where to find help when you’re grappling with an aging parent’s needs (Alisa Schindler, WaPo, 2-29-16) Places you can turn for expertise, help and understanding include senior advocates at the local office on aging, nurse practitioners who make house calls, accessible ride services, senior/​community centers, pharmacies that "package" ("blister packs" instead of several confusing bottles), senior housing, services such as Meals and Wheels provided by local charities and religious organizations, social workers (" they were the best resource! They gave me numbers, organizations, guidance, support."), and good friends.
Share Common Ground (Sally Abrahms, AARP Bulletin) More boomers are opting for smaller neighborhoods with a bigger sense of community. “Not only are people looking for alternatives to the suburban model, but boomers want smaller, smarter, community-oriented living environments...;Instead of a street separating the $225,000-to-$400,000 homes that face one another, a landscaped courtyard divides them. Visitors walk to the front door of each home through a common walkway.” See Pocket Neighborhood slide show (AARP Bulletin, 5-3-12)
Hospital at Home: Patient Care Model of the Future? (Jaimie Lazare, Aging Well, Vol. 6 No. 2 P 20, on Today's Geriatric Medicine) Treating acutely ill older adult patients diagnosed with conditions such as congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD) at home rather than in a hospital has many benefits: "lower costs, shorter duration of hospital-equivalent treatment, fewer procedures, reduced geriatric complications, improved activities of daily living, and better patient and caregiver satisfaction."
At Home, Many Seniors Are Imprisoned by Their Independence (Paula Span, NY Times, 6-19-15) To keep older people in their homes, as Medicaid and other programs increasingly try to do, represents a laudable goal but an inadequate one. Aging in place also requires a variety of supportive services; creating or expanding them involves money, time and many moving parts. Remaining at home, however difficult or isolating that becomes, gives older people a sense of control that may prove illusory...Being homebound in rural areas can be harder and lonelier.
NORC's Aging in Place Initiative. (NORC = naturally occurring retirement communities -- without walls). One page on this site shows location of NORC demonstration communities--more than 40 of them, in 25 states. (Jewish Federations of North America)
PACE4You (a program of all-inclusive care for the elderly) The focus of every PACE organization is to help you live in the community for as long as possible. To meet this goal, PACE organizations focus on preventive care. Although all people enrolled in PACE are eligible for nursing home care, only 7 percent live in nursing homes. PACE organizations support family members and other caregivers with caregiving training, support groups, and respite care to help families keep their loved ones in the community.
Is a Naturally Occurring Retirement Community Right for You? (Philip Moeller, US News, 3-25-09) Good overview.
Shaping the City: Aging and Neighborhoods Kojo Nnandi chats with architect and urban planner Roger Lewis about the “NORC” phenomenon and how it’s shaping the face of the Washington region.

As Caregiving Shifts To The Home, Scrutiny Is Lacking (Anna Gorman, KHN, 1-5-15) Prolonged abuse and neglect by In-Home Supportive Services (IHSS) caregivers is not surprising when low-paid caregivers are largely untrained and unsupervised, even when paid by the state.
Frail Seniors Want To Live At Home. But Is it More Dangerous? Howard Gleckman (Forbes, 7-9-14) reports on a study that finds that seniors receiving care at home face both preventable and nonpreventable hospitalizations at significantly higher rates than nursing home residents, even though those in nursing facilities are often sicker than those in the community. Elders at home "were at greater risk of hospitalization for potentially preventable conditions...including congestive heart failure, pneumonia, dehydration, and urinary tract infections.... It may be that better medical care, in the form of house calls, community health centers, or other services, could reduce many of those preventable hospitalizations. Better training and more support for family caregivers could help as well."
Understanding What Home Care Really Costs (Home Instead Senior Care)
Home Health Agency Compare (Medicare.gov--find a home health care agency near you)
Physician Compare (Medicare.gov--find a (geriatric) physician near you)
Thriving 99-year-old is right at home in today's lively downtown L.A. (Steve Lopez, L.A.Times, 9-21-13). "The Markoffs lived comfortably in the lefty environs of Echo Park and Silver Lake for decades...but his driving wasn't so good, and the house was too much to manage. So they sold, bought a condo downtown in the same building as their daughter and 80-year-old son-in-law and got a surprise...."
Staying Independent in Old Age, With a Little Help (Jane E. Brody, Wellness, NY Times, 12-24-12) Many older people need outside help long before they require round-the-clock care. "Needed changes at the community level include affordable small-scale housing and cluster housing situated in walkable communities with nearby amenities, businesses, health facilities and public transportation. Borrowing from the design of assisted living facilities, individual dwelling units might be located around a common space that includes dining areas and social rooms." Concludes with How to Know When Home Alone Is No Longer a Good Idea.
Age in Place. The services you need for a life at home. National Aging in Place Council (an association of service providers)
Community Aging in Place—Advancing Better Living for Elders (CAPABLE) (Johns Hopkins School of Nursing)
Handymen, home care helps seniors trying to age in place (Lauran Neergaard, AP, 9-7-16) An innovative program that combined home fix-ups and visits from occupational therapists and nurses improved low-income seniors' ability to care for themselves in their own homes. CAPABLE — which stands for Community Aging in Place, Advancing Better Living for Elders — is a program testing modest home modifications and strategies for daily living. A double banister let people rest their weight on both sides to get up and down stairs safely. Handymen fixed trip hazards, installed grab bars and lowered shelves so seniors could reach without climbing. Occupational therapists bought assistive devices to help people with tremors feed themselves, and taught the frail how to get in and out of high-sided tubs. Still to be answered: Does better daily functioning save taxpayers dollars? In a previous article, no longer online, Neergaard wrote:
"The environment in which you live can be as disabling as a disease, and too often, older Americans wind up in a nursing home not because they’re super-sick but because they can’t get through their days safely at home. Now a major research project will bring handymen, occupational therapists and nurses into the homes of 800 low-income seniors in Baltimore to test if some inexpensive fix-ups and strategies for daily living can keep them independent longer, and save millions in taxpayer dollars spent on nursing home care."
Sensors Help Keep the Elderly Safe, and at Home (John Leland, NY Times, 2-12-09)
Seven 'Life Hacks' to Help Keep You Out of the Nursing Home (Jason Kane, PBS Newshour, 8-8-13). A low-vision keyboard, motion sensor lighting (to help you see when you get up at night), bed rails, zipper pull on your clothes, safety strips in your tub, tape for rugs--to prevent tripping).
Babyboomer demand boosting universal home design (Realty Times)
Age in Place (National Aging in Place Council)
Aging in Place blog
Aging in Place (National Association of Home Builders)
Disaster recovery resources (National Association of Home Builders)
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Cohousing


Cohousing. Cohousing communities are old-fashioned neighborhoods that bring together the value of private homes with the benefits of more sustainable living, including common facilities and good connections with neighbors.
Cohousing directory
Will Cohousing Catch on With Boomers? (Scott Lyle, 4-13-16) Basically, these are developments where residents share group kitchens, car rides, and other amenities. More than 150 such communities exist and 14 are being planned across the country exclusively for seniors, according to the Cohousing Association of the United States. These places are often committed to sustainable living as well. EcoVillage is one such example ...Quimper Village is another.
Not Home Alone (Sally Abrahms, Time) Seniors are signing up for semi-communal enclaves, with separate homes but a supportive community. "Cohousing, which debuted in Denmark in the 1970s, is a semi-communal concept in which separate living units–usually attached condo-style–are clustered around a “common house,” which, at the very least, has a kitchen, a dining room and a third area for gatherings and activities."
Elder Cohousing: A New Option for Retirement or Sooner! (Sally Abrahms, AARP) Don’t be fooled by the word “senior.” Many opting for this arrangement are in their 50s, 60s and early 70s and often still work .
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Tiny houses and the small-home movement

(minimalism and mini-houses)

Tiny House Nation (watch various episodes/​tours of tiny houses)
Backyard "granny pods" could be the alternative to nursing homes (David Wolfe, MEDCottages)
What Is the Tiny House Movement? (with infographics)
The Tiny Life store
The Crib (an enviroresponsible environment -- weekend cabin, backyard office, study, or guest house)
Straw bale cottage rises in South Berkeley (Judith Scherr, Contra Costa Times, 11-19-14). Building the 438-square straw house became a community project. And no, it's not a fire trap.
Another tiny house, for minimalist living (video, Tiny House Nation)
How the Trailer Park Could Save Us All (Lisa Margonelli, Pacific Standard) A healthy, inexpensive, environmentally friendly solution for housing millions of retiring baby boomers is staring us in the face. We just know it by a dirty name.
Could You Survive in 150 Square Feet? The Lowdown on Tiny Homes (Teresa Mears, US News, 6-18-15)
Living Large in Our Little House: Thriving in 480 Square Feet with Six Dogs, a Husband, and One Remote--Plus More Stories of How You Can Too by Kerri Fivecoat-Campbell
An RV Like You've Never Seen Before (Tumbleweed Tiny House Company)
Small House Movement (links to several Huffington Post articles on the subject, including 17 Tiny Dream Homes Under 200 Square Feet (great images!)
Storage-Smart Renovation in New York City (Sarah Rich, Dwell, 5-13-09)
From the home front: Critiquing the tiny house movement (Pat Jeffreies, The Oregonian, 7-31-13).
more Oregonian stories on the tiny house movement.
Living Large in Our Little House (Kerri Fivecoat-Campbell's blog, to be a book in June 2016)
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The Village Movement:
Aging-in-place supported communities

Some of these are geared to Montgomery County, MD, where I live, but I include them because they help convey the practical concepts involved.
Village to Village Network
Washington (DC) Area Villages Exchange (WAVE)
What is a village? What does the Village offer? Who creates the Village? (Montgomery County MD, Department of Health & Human Services) With links to further topics and some interviews.
Retirees Turn to Virtual Villages for Mutual Support (Constance Gustke, NY Times, 11-28-14) Villages are " low-cost ways to age in place and delay going to costly assisted-living facilities... At the core of these villages is conciergelike service referrals for members...[who] can find household repair services, and sometimes even personal trainers, chefs or practitioners of Reiki...Most important, the villages foster social connections through activities like potlucks, happy hours and group trips."
Through a growing number of senior villages in the D.C. area, aging in place becomes easier (Tara Bahrampour, Washington Post, 2-6-14). See also list of linked-to senior villages in the DC area.
What is the Village movement? (Montgomery County, MD) What does the village offer? Who creates the village? Village blueprint.
DC-area senior villages, other resources (Washington Post)
Villages: Helping People Age in Place (Martha Thomas, AARP, May/​June 2011) More than a neighborhood, a village gives older people a better chance to stay in their own home longer
Villages Take Root Around Virginia (Marsha Mercer, AARP, 10-1-10)
North Carolina Tries Village Concept (Sue Price Johnson, AARP Bulletin, 6-1-10)

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Continuing care retirement communities (CCRCs)


A Geriatrician's Search for Senior Living -- One Caregiver's Story: Doctor, Daughter, Caregiver (Sherri Snelling,Caring.com). Sally Brooks' solution was a continuing care retirement community (CCRC), where her mother could live in assisted living while her dad was cared for in the dementia-care facility on the same campus. See Five Things to Consider When Selecting the Right Nursing Center for Elderly Parents. Note that she checked the facility's rating (on a five-star scale) by the Centers for Medicare and Medicaid Services.
Continuing Care Questionnaire (a checklist of questions to ask when visiting and considering a continuing care retirement community (National Caregivers Library)
Today's Continuing Care Retirement Community (CCRC) (PDF-- this white paper from SeniorsHousing.org provides background you should have when you start looking at facilities)
Finding Communities That Connect and Nurture the Like-Minded (Abby Ellin, Your Money, NY Times, 12-26-14)
How to select a continuing care retirement community (PDF, CARF-CCAC, the only accrediting body for CCRCs)
"Often what we define as health problems are really support problems." ~ Judith Snow, quoted in Consequential Strangers: The Power of People Who Don't Seem to Matter. . . But Really Do by Melinda Blau and Karen L. Fingerman
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FACILITY-BASED SOLUTIONS

The Eden Alternative, The Green House Project, and alternatives to traditional nursing home models


The Eden Alternative -- a nonprofit that believes aging should be a continued stage of development and growth, rather than a period of decline. Its aim: culture change in long-term care, to eliminate the three plagues of loneliness, helplessness, and boredom.
• The Green House Project. We’re lucky if we get to be old, physician and professor believes (Tara Bahrampour, Wash Post, 1-23-16) Bill Thomas, who argues that "there is a “third” phase of life beyond adulthood that can be as rich as either of the phases that came before..." He moved beyond nursing homes to set up small, intimate residences called Green Houses. With private bedrooms and bathrooms, they offered dignity and privacy. Their size had an unexpected effect. “Within six weeks, they had to send a truck around to pick up all the wheelchairs,” Thomas said of one house. “You know why most people [in nursing homes] use wheelchairs? Because the buildings are so damn big. . . . The buildings disable elders.”
A New Model for Nursing Home Care (Susan B. Garland, Kiplinger's Retirement Report, April 2016) 'Green Houses' offer homier atmospheres and more individual attention from caregivers.
The Eden Alternative . (Dale Bell, & thou shalt honor). Dr. William Thomas, who proposed the Eden Alternative, believes that nursing homes are primarily homes, not hospitals, and suggests nursing homes commit to a human habitat model--in which the residents' lives in nursing homes revolve around a decentralized team method of care delivery, resident animals, daily children's activities, and many plants. The Harvard graduate and father of five has so far "Edenized" about 300 nursing homes in the United States and a handful in Australia and Europe.
Find a member of the Eden Alternative registry
The Eden Alternative Explained (Virgil Thomas, ChangingAging.org, 3-17-14) Read more on the Eden Alternative blog.
Mission, Vision, Values, and Ten Principles of the Eden Alternative. To eliminate loneliness, helplessness, and boredom.
Ten Principles. An Elder-centered community commits to creating a human habitat where life revolves around close and continuing contact with plants, animals, and children. It is these relationships that provide the young and old alike with a pathway to a life worth living.
Eden Alternative video (Jason Goodman). Add companionship, pets, and children, to turn a nursing home into a living home.
Personal Pets in Long-Term Care
Archives of stories about Eden Alternative
How is the Green House Project Different From the Eden Alternative? (Dana Larsen, A Place for Mom 10-8-12)
Small Residences for the Elderly Provide More Personal, Homelike Care (Constance Gustke, NY Times, 11-20-15) For greater warmth and nurturing, seniors are turning to small residences like Green House, which is part of a complex of senior housing and care options, and privately owned care homes that are often unmarked in residential neighborhoods. They are usually newer, sometimes cheaper, and generally offer more customized care than most nursing homes. Jewish Home Lifecare wants to open a building consisting of 22 stacked homes. “This is a concept where the commune meets the kibbutz.” "Another alternative to big-box nursing homes is residential care, also known as adult foster care, which typically costs about half of what a nursing home charges, according to A Place for Mom, a referral for senior care. Residential care homes are often simply single-family homes adapted for elder care."
The Green House Project
The Green House Project model (caring homes for meaningful lives, transforming the culture of long-term care)
My Mother, the Lion (Ruth Little, on her mother's life and her final days in Elders' Eden)
Action Pact "Changing communities, changing lives." "Culture change is a process and movement of transforming traditional, institutional long-term care facilities, into true homes. It involves a change of environment, systems and attitude. It’s not just a change you can see, it’s a change you feel; a change elders feel as they direct their own lives and staff feel as they are empowered to help them do so."
Pioneer Network Changing the culture of aging, with a focus on person-directed care. See, for example, Low Cost Practical Strategies to Transform Nursing Home Environments: Towards Better Quality of Life (PDF, Lois Cutler, Rosalie A. Kane).

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Assisted living

(also called residential care)

The move to assisted living: Navigating the fine line between money and emotions (Liyna Anwar, Marketplace, 7-13-12)
What You Need to Know About Assisted Living Facilities (Howard Gleckman, Caring for Your Parents blog, 5-17-13)
Assisted Living is a “Ticking Time Bomb” ( Frontline, PBS, 7-30-13--edited transcript.) Frontline interviews Catherine Hawes, director of the Program on Aging and Long-Term Care Policy at Texas A&M University. Weak regulation and inconsistent training standards could soon mean a surge in preventable deaths at the nation’s assisted living facilities, she says. Unlike nursing homes, where you have information systems and consumer rating systems that tell you something about the facilities in terms of quality indicators, in terms of staffing, in terms of deficiencies, such information does not exist for assisted living facilities. It's not clear from state to state, or from facility to facility, what assisted living is. Assisted living does not provide the same level of care as nursing homes, yet there is a lot of early memory loss, short-term memory loss, impaired decision-making. "...administrators who worked for some of the big chains, and they told me they were expected to have between a 35 and 40 percent return on revenues. I mean that’s huge. I don’t know any industry that produces a 40 percent return on revenues. Not on investment, on revenues." So they have to take all comers and the more ill patients are the more the facility can charge. You've got a population of people who need medication and bathing and dressing and walking and using the toilet, etc., and the facilities are understaffed, with personnel who are not adequately trained to handle the level of impairment and serious illness they are marketing to attract, to get 90% occupancy rates. "“If you want to be a manicurist in Texas, you have to have 300 hours of training … and yet in 40 hours you can become [an] assisted living administrator. I ask you, does that make sense?” "“That’s why I talk about it as a ticking time bomb, because we’re going to see more deaths, more injuries." Read this transcript before signing up for assisted living! Or watch the video: Life and Death in Assisted Living.
Assisted Living: Costs And Contracts (a checklist of financial questions to ask when you visit an assisted living facility, developed by The Consumer Consortium on Assisted Living (CCAL), a national nonprofit organization that represents consumers's needs in assisted living facilities).
Seven Questions To Ask When Searching for Assisted Living (Pro Publica, 7-31-13) Pro Publica did an investigative report on the assisted living chain Emeritus, together with PBS's Frontline. Check out additional Pro Publica reports from the series.
Life and Death in Assisted Living (PBS Frontline/​Pro Publica TV documentary on the Emeritus national chain of assisted living facilities). You can watch online. Main points: In the 1990s, with the baby boomer population aging, there was a boom in commercial development of assisted living (AL) facilities, which do not provide medical care and are therefore under-regulated and tend to be understaffed, with staff undertrained and underpaid. Much of AL care is for seniors with dementia (which the facilities market for), for which problem staff do not get adequate training and for whom facilities can charge more money. Most of those patients should be in nursing homes, says one director interviewed; staff members paid $10 an hour are not trained to manage medication for patients who need various sets of pills several times a day, much less handle the other problems of dementia care. So do your homework before you pick a facility. Read Emeritus's approach to thwarting federal oversight as a response to the documentary.



Assisted Living: Personal Care (a checklist of personal and health care questions to ask, also developed by CCAL)
Assisted Living: Quality of Life ( checklist of questions dealing with socializing, meals, safety, and other issues to consider when visiting and/​or considering an assisted living facility, also developed by CCAL)
Assisted Living (Medline Plus's excellent and wide-ranging links to information, resources)
The Day I Moved to Assisted Living (Kent Mulkey, Senior Housing Forum, 6-19-26) Food for thought.
Advice About Assisted Living for Aging Relatives, Part 1 (Debra Drelich, Ask an Expert, NY Times, 10-16-13) . Followed by Advice About Assisted Living for Aging Relatives, Part 2 (Debra Drelich, Ask an Expert, NY Times, 10-23-13)
Small Is Beautiful . . . Board and Care Seeks Recognition; Representation (Pam McDonald, Senior Housing Forum, 3-27-16) Board and care facilities are small, typically six-bed personal care homes. While many people think “board and care” and “assisted living” are two separate levels of care, they are actually more brother and sister than unrelated families. As in many other states, California’s assisted living (AL) communities and board and care (BC) homes are licensed and governed by the same state laws and regulations. They both serve seniors age 60+ and are non-medical facilities so they are not required to have nurses, certified nursing assistants or doctors on staff.
Taking Questions About When It’s Time for Assisted Living (Nicole Higgins DeSmet, NY Times, 10-9-13--answers to be posted 10-16-13) Ask an Expert features Debra Drelich, a specialist in geriatric care who will answer questions about assisted living and other special living arrangements for aging relatives.
All the Right Questions. What to know and what to ask when choosing an assisted-living facility. Julyssa Lopez (Washingtonian, 11-09) explains key questions to get info on: What care is provided? Is the facility well run? Can it handle emergencies? What if my health gets worse? What do I look for in a contract? Can I change the contract? Are there hidden fees? Can I get a refund? Can they kick me out?
10 Things to Know About Assisted Living (Jane Gross, New Old Age, NY Times, 10-20-08).
Ten Things You Need to Know About Assisted Living (Martin Bayne, Changing Aging, 2-25-13)
Life and Death in Assisted Living (series by Frontline and Pro Publica, as part of an ongoing investigation, A.C. Thompson and Jonathan Jones and others reporting)
---Part 1: The Emerald City (7-29-13).
---Is Assisted Living Putting Profits Above Care? (Blair Hickman, ProPublica, 7-31-13) Is the loosely regulated, multi-billion dollar assisted living industry putting seniors at risk?
---World of Hurt: Those Lost and Those Left Behind (8-1-13) When things go wrong in assisted living, people can pay with their dignity, and sometimes with their lives. A review of state regulatory records and more than 100 lawsuits turned up repeated examples of grave mistakes or misconduct at facilities operated by Emeritus Senior Living, the country’s largest assisted living company. These are the stories of five families still trying to cope with their pain.
---For Assisted Living Industry, a Media Strategy to Thwart Federal Oversight (Pro Publica, 7-30-13) In a talking points memo, Emeritus, the country’s largest assisted living company, seeks to highlight the company’s compassion and deride any need for greater regulation out of Washington.
---The Deaths and Disappearance that Haunt Assisted Living (8-1-13)
---: Elderly at Risk and Haphazardly Protected (A.C. Thompson and Jonathan Jones, Frontline and ProPublica, 10-29-13). This examination of the multibillion-dollar assisted living industry reveals a mishmash of minimal state regulation and no involvement by federal officials. Even though increasing numbers of assisted living residents are seriously ill and require complex care, regulations for assisted living lag far behind the reality in many states -- and assisted living operators face few consequences for even the most serious lapses. Pieces: Elderly at risk and haphazardly protected. In California, a major system's considerable failure. The industry is smart. In Washington, a lack of will.
Nude Modeling In Assisted Living (Steve Moran, Senior Housing Forum,2-23-15) A facility that does things beautifully.

LongTermCare.gov (U.S. Department of Health and Human Services), a helpful site that provides such information as the estimated cost of care in your state.
How to Live in Assisted Living (Judith Graham, The New Old Age, NY Times, 3-20-13). Graham interviews Martin Bayne about the emotional experiences of older adults in assisted living and what changes he would like to see made in this type of long-term care. Bayne, who lives in assisted living, writes an excellent blog: The Voice of Aging Boomers . Read some of his blog posts for frank discussions of what goes on and what should and shouldn't go on, among the elderly who need help.
Assisted Living vs. Memory Care (Senior Living Blog, A Place for Mom, 8-6-15)
Assisted living facilities may be wise to appeal more to men (Pam Gerhardt, Washington Post, 8-1-11). To begin with, change the name.
Nude Modeling In Assisted Living (Senior Housing Forum, 2-23-15) A visit to Bayside Park assisted living facility near Berkeley.
Tenure (Martin Bayne, 2-9-13). On his 10th anniversary in assisted living, Bayne writes "Purpose is the magic elixir that trumps pain, transcends any notion of limitation and opens our minds and hearts to possibility. It is also the single most accurate predictor of joy and fulfillment in an aging population." (Among other things.)
A Room With A Grim View: The ‘Ambient Despair’ That Marks Life In Assisted Living (Martin Bayne, Health Affairs, 7-26-12). After entering an assisted living facility at age fifty-three because of young-onset Parkinson’s, an observer-advocate contemplates the dire need for long-term care reform. In another, blog post, he writes that sub-standard wages are the biggest obstacle to better assisted living facilities. "The women of color that are the backbone of this country’s network of institutional aging facilities – many of them single parents – are denied a living wage. This creates a 'revolving door' phenomenon that cripples moral and destroys any sense of continuity for the residents."
How is society to look after the ever-growing number of people with dementia? (Martin Bayne, The Voice of Aging Boomers, 8-18-12). A curiously uplifting care home near Amsterdam may have the answers
Assisted Living Facilities and Standards of Care (listen to Diane Rehm discussion with guests Joanne Lynn, Larry Minnix, Becky Kurtz, or A.C. Thompson) or read the transcript.
The National Long-Term Care Ombudsman Resource Center
A Dark View of Assisted Living (Paula Span, New Old Age, NY Times, 7-30-13)
Life and Death in Assisted Living (Frontline, 7-30-13). Watch video online. Is this loosely regulated, multi-billion-dollar industry putting seniors at risk? As more and more elderly Americans choose to spend their later years in assisted living facilities, FRONTLINE and ProPublica examine whether this loosely regulated, multi-billion dollar industry is putting seniors at risk? Watch the full film here; you can also download the full series as an e-book.
“The Emerald City” Life and Death in Assisted Living, Part 1 (very readable text, A.C. Thompson and Jonathan Jones, ProPublica). On the same website page follow Part 2, “They’re Not Treating Mom Well,” Part 3, “A Sinking Ship,” Part 4, “Close the Back Door.” The reporters invite staff to report (Have You Worked In an Assisted Living Facility?) and the responses are posted online.
Seven Questions To Ask When Searching for Assisted Living (Jason M. Breslow, Frontline, 7-30-13)
The Deaths and Disappearance that Haunt Assisted Living (A.C. Thompson and Jonathan Jones, Frontline, 7-30-13)
Lessons We Can Learn From Frontline's Expose of Assisted Living (Howard Gleckman, Forbes, 7-31-13)
Managing the Assisted Living vs. Hospice Dilemma (Judith Graham, New Old Age, NY Times, 11-19-12)
Assisted Living Facilities and Standards of Care (listen to Diane Rehm discussion with guests Joanne Lynn, Larry Minnix, Becky Kurtz, or A.C. Thompson) or read the transcript.
Eldercare Locator
The National Long-Term Care Ombudsman Resource Center
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Memory Care


Assisted Living vs. Memory Care (Senior Living Blog, A Place for Mom, 8-6-15). Assisted living is defined as “a long-term care option that combines housing, support services and health care, as needed.” "Memory care is a distinct form of long-term skilled nursing that specifically caters to patients with Alzheimer’s disease, dementia and other types of memory problems." Assisted care living communities may or may not have special (memory) care units (SCUs).
What is Alzheimer's memory care? (A Place for Mom's helpful fact sheet)
New technology featured in Council Bluffs memory care facility (Camila Orti, KETV, 3-23-16) ) Automatic unlocking doors and key-controlled kitchen utilities are just a few of the high-tech safety details found in the Hansen House in Council Bluffs, Iowa.
Grind Dining: Beyond Finger Food (Angela Downs, Eating Well, CARES blog, 10-23-15) "In nursing homes and senior living facilities all over the country, meals for memory care residents – primarily those with neurological conditions like Alzheimer’s and other related dementia – are often uninspiring and child-like....Chef Stone, inspired by memories from her childhood, decided to try grinding up proteins, carbs, and vegetables to create an elevated version of “finger food.”
What is Memory Care and How Much Should it Cost? (Assisted Living Today)
What You Need to Know About Alzheimer's Care Facilities (Gilbert Guide, Caring.com)
Finding Activities for Parents with Memory Loss (Cynthia Green, The New Old Age, NY Times blog, 4-6-10)
Sensecam: A Little Black Box to Jog Failing Memory (Yudhijit Bhattacharjee, NYTimes, 3-8-10, on a gadget that may be useful for Alzheimer's patients)
The Trouble With Alzheimer's Care: One Family's Story (Kerry Hannon, U.S. News, 3-11-09, four pages) After Dad is taken away for a psychiatric evaluation, his family loses control. Then they learn that memory care facilities are reluctant to take patients who exhibit aggressive behavior.
How the Loss of Memory Works in Alzheimer’s, and How Understanding This Could Help You (Carole B. Larkin, Alzheimer's Reading Room
16 Things I Would Want, If I Get Dementia (Rachael Wonderlin, Alzheimer's Reading Room)
Horses and Dementia . . . Are They Nuts? (Steve Moran, Senior Housing Forum, 10-19-15)

How to Become a Dementia Detective (Rachael Wonderlin Alzheimer's Reading Room)
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Nursing Homes
Old-style and New

including Green Houses

How to Choose Between Home Health Care, Assisted Living, and a Nursing Home
Nursing Home Checklist ( basic questions to ask when you and your loved one visit a nursing home, developed by National Caregivers Library)
Your Guide to Choosing a Nursing Home or Other Long-Term Care (Center for Medicare and Medicaid Services) Use the checklist on pages 26–32 to compare nursing homes.
The Savvy Resident's Guide: Everything You Wanted to Know About Your Nursing Home Stay But Were Afraid to Ask by Eleanor Feldman Barbera
You’re In a Nursing Home. Now What? (Ellen Rand, Last Comforts blog, 6-7-16)
The Cost of Nursing Home Care (Guide to Nursing Homes)
Nursing Home Unthinkable? Be Prepared in Case It’s Inevitable (Jane E. Brody, NY Times, 7-28-14) "You may not want to place a loved one in a nursing home for more than a short-term recovery — but never promise an aging relative that it won’t happen."
Nursing homes turn to eviction to drop difficult patients (Matt Sedensky, New York/​AP, Seattle Times, 5-8-16) "Nursing homes are increasingly evicting their most challenging residents, testing protections for some of society’s most vulnerable. Those targeted for eviction are frequently poor and suffering from dementia, according to residents’ allies. They often put up little fight, their families unsure what to do. Removing them makes room for less labor-intensive and more profitable patients, critics of the tactic say, noting it can be shattering. Hospitalizations are a common time when facilities seek to purge residents, even though the Nursing Home Reform Act of 1987 guarantees Medicaid recipients’ beds must be held in their nursing homes during hospital stays of up to a week.
Residents' Rights: An Overview (The National Consumer Voice for Quality Long-Term Care, April 2011)

Picking a Nursing Home Shouldn’t Be Trial and Error (Jane E. Brody, Well, NY Times 8-4-14) More expensive isn't necessarily better. Six things to look for in a nursing home, especially for dementia care.
Old And Overmedicated: The Real Drug Problem In Nursing Homes (Ina Jaffe, Shots, Morning Edition, NPR, 12-8-14) Almost 300,000 nursing home residents are currently receiving antipsychotic drugs, usually to suppress the anxiety or aggression that can go with Alzheimer's disease and other dementia. Antipsychotics, however, are approved mainly to treat serious mental illnesses like schizophrenia and bipolar disorder. When it comes to dementia patients, the drugs have a black box warning, saying that they can increase the risk for heart failure, infections and death....Federal law prohibits the use of antipsychotics and other psychoactive drugs for the convenience of staff. It's called a "chemical restraint." There has to be a documented medical need for the drugs.For dementia patients, the drugs have a black box warning, saying that they can increase the risk for heart failure, infections and death....Antipsychotic drugs change behaviors, Williams says. "They blunt behaviors. They can cause sedation. It increases their risk for falls." And in the vast majority of cases, the drugs aren't necessary.'
Choosing a Nursing Home: What to Look for, What to Ask (pdf, Alzheimer's Association, West Virginia Chapter)
America's Best Nursing Homes (U.S. News & World Report -- notice step 1: Decide if a nursing home is necessary)
Where Can You Get the Best Nursing Home Value in America? (Howard Gleckman, 6-25-14). A new study by AARP, the Commonwealth Fund, and the SCAN Foundation ranks the quality and affordability of nursing homes by state....according to some indicators, you get what you pay for: The states with the most affordable facilities are plagued by many poor performers.
Nursing Homes Unmasked: How California’s largest nursing home chains perform (Part 1 of an outstanding 3-part series in the Sacramento Bee, by Marjie Lundstrom and Phillip Reese, 11-8-14) Part 2: Who owns California’s nursing homes? (11-9-14) Bottom line: Business people who are not concerned about quality of care, who see nursing facilities as a money-making operation "with no real interest in – or intuition for – the practice of providing care,” claim that chains provide efficiencies--boosting profits, but not enabling good patient care. “When you look at the facility itself, it’s losing money every month. So that’s telling you the building is underfunded. Every penny that comes in the door from the patients … gets swept up to corporate headquarters.” See Help for consumers: How to research California nursing homes (11-9-14)
Lawmakers renew effort to crack down on bad nursing homes (Brian M. Rosenthal, Houston Chronicle, 2-22-17)
What working in a nursing home taught me about life, death, and America’s cultural values (Valery Hazanov, Vox.com, 3-17-16) People in the nursing home like to watch TV. It's always on. How strange, then, that there are no old people on TV. What Hazanov learned: 1) At the end, only the important things remain; 2) Having a routine is key to happiness; 3) Old people have the same range of emotions as everyone else; 4) Old people are invisible in American culture; 5) The only distraction from pain is spiritual; 6) If you don't have kids, getting old is tough (the saddest people I see in the nursing home are childless.); 7) Think about how you want to die. "I think of death as a tour guide to my life -- "Look here; pay attention to this!"
The Nursing Home Rating System Gets A Reboot (Richard Eisenberg, Forbes, 2-24-15) 'Trouble is, Nursing Home Compare has had serious flaws that have made the facilities look like the children of Lake Wobegon (all “above average.”)' Now there's a new rating system. The problem is, nursing homes still rate themselves.
Pivotal Nursing Home Suit Raises a Simple Question: Who Signed the Contract? Nursing homes have embraced arbitration clauses, which are often buried in complex contracts that are difficult to navigate, especially for elderly people with dwindling mental acuity or their relatives, who can be emotionally vulnerable when admitting a parent to a home. The son of a woman who died because a nursing home assigned her a dangerous roommate who subsequently killed her, will now have his day in court. Appeals courts across the country have been throwing out arbitration agreements signed by family members of nursing home residents.
Nursing Home Care—The Great Challenge for the Celiac (Curtiss Ann Matlock, Celiac.com, 3-30-16, from Journal of Gluten Sensitivity Winter 2016 Issue) ""No. We just had a team meeting and it was decided we cannot accommodate your mother because of her diet....I hadn't realized that a nursing home would, or could, turn down a patient based on the need for a therapeutic diet. I thought the reason for a nursing home was to care for ill people....This is our new challenge—to make certain those elderly people with food sensitivity needs are well cared for." (Read the story and be forewarned.)
Nursing Home Compare (Medicare.gov--find a nursing home near you) . Here's a critique of that rating system (Paula Span, The Fault in Our Stars, NY Times, 7-8-14) You need to visit to check a place out!
Aggressive Neighbors in the Nursing Home (Paula Span, NY Times, 11-25-14)
For Veterans, an Alternative to the Nursing Home (Alyson Martin and Nushin Rashidian, NY Times, 7-18-12). The Department of Veterans Affairs Medical Foster Home program places veterans who need round-the-clock care in private homes.
In nursing homes, deaths are shrouded in secrecy and silence (Bob Tedeschi, Endnotes, Stat--Reporting from the frontiers of health and medicine, 1-14-16)
Five Things to Consider When Selecting the Right Nursing Center for Elderly Parents (Kindred Healthcare, 8-6-13)
Nursing Home Alternative Susan Dentzer (PBS Newshour, 2-27-02) reports on life at a different kind of nursing home. (From the Eden Alternative to the Green House.)
The Promise, Practice, and Problems of the Eden Alternative (Long-Term Living, 12-1-03)
Green Houses Offer Elders an Alternative (RWJF, Robert Wood Johnson Foundation) Many frail elders seek an alternative to the typical institutional-style nursing home. With more Green Houses taking root across the United States, that alternative is getting closer to home....Nursing home quality and affordability vary widely across states, and they only sometimes have much to do with one another."
Move Over Nursing Homes — There's Something Different: Green Houses (Ina Jaffe, All Things Considered, NPR, 7-24-13). Typically each elder will have a private room and/​or a private bathroom.
The Green House Nursing Home Alternative (video, Green House as outgrowth of the Eden Alternative)
A Nursing Home Shrinks Until It Feels Like a Home (Laurie Tarkan, NY Times, 10-31-11). Echoes days later in A Home for Those Who Hate Nursing Homes
In Nursing Homes, an Epidemic of Poor Dental Hygiene (Catherine Saint Louis, NY Times, 8-4-13)
A New Disaster Looming for Nursing Homes? (Senior Housing Forum, 3-9-15) New small, luxurious skilled nursing operations that provide complex high intensity rehabilitation therapy services to individuals fresh out of the hospital are proving a boon to hospitals and patients, but these boutique-style high-end operations are a threat to the traditional nursing home. "What makes older skilled nursing communities work is that while they mostly care for long-term Medicaid residents they have a large enough group of high paying Medicare/​HMO residents that make the bottom line profitable. These new models will ultimately reduce the number of high revenue residents in many skilled nursing communities to a level that will put their financial viability at substantial jeopardy."
Bullying Is Ageless: Conflict And Violence Widespread In Nursing Homes, Study Finds (Nell Lake, CommonHealth Reform and Reality, WBUR, 11-14-14)
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Long-term acute care hospitals


At These Hospitals, Recovery Is Rare, but Comfort Is Not (Gina Kolata, Health, NY Times, 6-23-14) The Hospital for Special Care is one of 400 long-term acute care hospitals in the United States. These are no ordinary hospitals: Critically ill patients, sometimes unresponsive or in comas, may live here for months, even years, sustained by respirators and feeding tubes....These facilities often are tucked out of sight, and even many doctors do not know they exist."
LongTermCare.gov
What are long-term care hospitals (LTCHs)? (PDF, Centers for Medicare & Medicaid Services)
FAQs about long-term acute care hospitals (American Speech-Language-Hearing Association)
House, Senate Leaders Introduce Bill to Change Post-Acute Care System (Steve teske, Bloomberg BNA, 6-27-14)
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Health problems, surgery, aches and pains


Patients Freed to Live Life Through Program Targeting Advanced Illness Management (AIM) (Betsy Gornet, American Society on Aging (ASA). AIM patients spend less time in the hospital and manage their pain and symptoms better through the innovative care provided.
Avoiding Surgery in the Elderly (Paula Span, The New Old Age, NY Times, 1-26-12). For the very old and frail, surgery can become a source of danger in itself.
Joint replacement had been a success, but pain persisted in patient’s shoulder ( Sandra G. Boodman, Washington Post, 7-22-13). Be your own advocate and make sure they ask about allergies to other metals, including nickel, in those titanium parts.
At Too Many Hospitals, a Revolving Door (Judith Graham, New Old Age, NY Times, 7-23-13). Hospitals need to learn that if a patient isn’t ready to hear what a medical provider wants to say, meaningful communication becomes impossible--some patients cannot assimilate medical advice at the time of their discharge. And they need more than a sheaf of papers to feel comfortable going home.
For the Elderly, Emergency Rooms of Their Own (Anemona Hartocollus, NY Times, 4-9-12). Geriatric emergency rooms, specifically designed for the elderly, are part of a growing trend. See also Emergency Rooms Built With the Elderly in Mind (Alyson Martin and Nushin Rashidian, The New Old Age blog, NY Times, 3-14-11). These are motivated in part by hospitals' desire to find an edge in the increasingly competitive health care marketplace.
When Is the Worst Time to Go to the Hospital? (Pauline W. Chen, MD, NY Times 3-18-10)
Overprescribing the Healthy Elderly: Why Funding Research and Drug Safety Is Paramount (Laura Newman, Scientific American guest blog, 6-30-11)
Arthritis Supplies (online catalog of aids for daily living
Living Better with Arthritis (catalog of aids for arthritis--for comfort & therapy; communication; dressing/​grooming; foot care; house, car and garden; kitchen; resting and relaxation; bath.
Remedies for Nail Fungus (Anahad O'Connor, Ask Well, NY Times, 4-8-13). Is there any cure for toenail fungus that doesn’t involve a risky drug? Yes. Don't spend $1000 for laser treatment, as I did (and it was administered by a young woman, not the doctor).
SteriShoe shoe sanitizer . It sez here that using ultraviolet light (UVC), the SteriShoe shoe sanitizer (which you insert inside shoes) kills the organisms that cause toenail fungus, athlete's foot, and smelly shoes. $130
Medical Mysteries (Sandra G. Boodman's interesting series in the Washington Post--not a bad place to start reading if you're dealing with a problem your medical caregivers aren't fixing or alleviating)
Coping with cancer and critical illness
Coping with chronic, rare, and invisible diseases and disorders
Medical mysteries, patient stories, and places to read up on illness (resources for specific diseases, conditions, syndromes, including rare diseases--not otherwise covered in two categories above)
Memoirs of illness, crisis, disability, differentness, and survival (a reading list)
Discussion groups and chat rooms about specific problems (assistivetech.net)
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Assistive devices, remodeling,
and other ways to enable independent living

(advice, reflections, equipment, services --things that make life easier
when our body falls short)
Those of us who have had encounters with serious illness or injury, or just plain aging, have come to value highly some of these wonderful devices. All those steps taken to help disabled people suddenly are enormously relevant when we are pregnant are temporarily disabled after an accident (try ­naviga­ting stairs with a broken limb), or begin to experience the surprising number of disabilities that often accrue with age. Life is different when you can’t see or hear as well or get around with the same physical ease you once had. Luckily many aids and support programs are available. Check them out. If you're not ready for them, take a look on behalf of friends and relatives. Here is information about technology and products that may enable independent living in the frail and elderly. The first item I realized would be useful even when I was in good health was the reacher grabber brought by a friend. I love the longer reacher-grabber (by Ettore).

THIS SECTION UNDER RECONSTRUCTION AND REARRANGEMENT--THERE WILL BE A SLIGHT DELAY!
Abledata (Tools and Technologies to Enhance Life -- a federally funded project to provide objective information on assistive technology and rehabilitation equipment available from domestic and international sources). AbleData doesn't sell products; it provides lots of useful information about products in various categories: Aids for Daily Living; Blind and Low Vision; Communication; Computers; Controls; Deaf and Hard of Hearing; Deaf Blind; Education; Environmental Adaptations; Housekeeping; Orthotics; Prosthetics; Recreation; Safety and Security; Seating; Therapeutic Aids; Transportation; Walking; Wheeled Mobility; Tools to Help at Workplace. Take a look at products for housekeeping, or aids for dressing such as buttoning aids.
AbleGamers (online community for disabled gamers, including gamers with muscular dystrophy, deaf gamers, etc.)
Accessible Web page design (for those serving disabled readers)
Adult diapers, incontinence supplies, bedding, safety equipment, mobility devices, etc. (Parentgiving)

Adult tricycles (article by Emily Stokes, "The Third Way: Tricycles," in T, 11-11-14)
Adult tricycles (Best Reviews guide)
These Aren’t Tykes on Little Bikes: A Mature Market Adopts the Tricycle (Rachel Bachman, Wall Street Journal, 10-9-14) You've heard of recumbent bikes? Try a recumbent trike.
Advice from a Home Health Aide (by Jane Gross, The New Old Age, New York Times blog, 1-21-09))
Aging Care
Aging Parents Authority
Agitator’s Guide to Elder Care (MediCaring.org)
American Red Cross Disaster & Emergency Kit (by First Aid Only, helpful for carrying in car; only things missing are saline solution and a flashlight, so buy those separately, advises one reviewer)
American Red Cross Emergency Smartpack for One Person (First Aid Only kit)
Best Medical Alert Companies, 2016 (BestCompany) 63 Total Companies Rated 1,006 Real Customer Reviews
Blue bands (Blue Willow Products). See Senior Housing Forum story about device for detecting seniors' falls or wandering. These devices detect falls and provide real time notification of the fall and resident location; provide a meaningful useable Geofence; and provide real time location information on residents and staff.
Home Remodeling for Disability and Special Needs: What You Need to Know (Michael Sledd, Expertise.com, 6-17-15) Covers several important topics: (1) Federal resources for veterans, seniors, and disabled citizens; (2) Planning your remodeling project; (3) Creating accessible approaches, landscapes, and doorways; (4) Disability friendly flooring; (5) Electrical, lighting, and smart-home technology; (6)Handicap-accessible bathrooms; (7) Handicap-accessible kitchens; (8) Remodeling for special needs. And concludes with links to valuable resources and pages of information.
Grants for Home Modification: 16 Resources for Homeowners with Disabilities (HomeAdvisor) Thanks for many of these links to Able Rise
Home Adaptations for Your Needs (HomeAdvisor)
Living in the State of Stuck: How Assistive Technology Impacts the Lives of People With Disabilities by Marcia J. Scherer


Accessible Environments, Inc. (call 1-800-643-5906)
Active Forever , which also provides clear explanations of many health problems and medical tests (call 1-800-377-833)
Adaptive Living Store
AssistiveTech.net (resources in many categories, for assistive technology and for disability-related information)'
AT Exchange (Ability Tools, Assistive Technology Network) Connects Californians to the assistive technology (AT) devices they need to live independently.
BillRay Home Mobility (Friendly Beds--heavy duty assistive devices to the bed-mobility-challenged--watch the video to see how they work)
Conval-Aid
Crest Healthcare Supply (call 1-800-328-8908)
Discussion Groups (CATEA Assistivetech.net, National Public Website on Assistive Technology)
Emergency Readiness for People with Disabilities (Centers for Disease Control and Prevention)
EnableMart
Fire Safety and Disabilities Guide (Andrea Davis, ImproveNet.com, 4-4-16)
Flaghouse (rehabilitation tools, aids to daily living, therapeutic aids, etc.)
Garden Kneeler and Seat (Yard Butler GKS-2). You can also buy a Garden Tool Pouch For Kneeler
Gold Violin (lighting and magnification devices, adaptive furniture, cooking and gardening items-- does catalog sales for Lighthouse International)
Guide to Securing Life-long Accommodations for Adult Children With Special Needs (Redfin blog, 4-10-16)
HDIS (products for those who experience loss of bladder control, aka incontinence)
HealthCraft sells at-home products (poles, rails, bath boards, grab bars, ceiling-mounted bars and trapezes to help you lift self in bed), commercial products (for safety in the bathroom, kitchen, bed, living room, and on stairs), and so on
Healthy Kin.com
Life with Ease (products to help you live life to the max in spite of impairments or injuries)
MaxiAids (products for people with impaired hearing, vision, or mobility)
Medical device recalls (USDA)
Mobility Store (mobility devices, scooters and wheelchairs, bathroom aids, personal care and patient care items, and other aids for daily living)
Interiors for Independence (call 610-834-7849)
Ocelco (call 1-800-328-5353)
A New Life on Wheels... How to Cope With Your Loss, and Move On (1-800-Wheelchair.ca) Links to many helpful articles about disability resources, making your home wheelchair friendly, modern wheelchair inventions, and so on.
Orthotics and Prosthetics (Infinitec.org directory of catalogs and other resources)
Pass It On Center (Georgia Tech, with information about organizations that recycle AT devices)
Patterson Medical (rehabilitation and independent living aids, including devices for eating, drinking, and cooking) Worth looking at for openers alone;
ReHabMart (tools for the job of living)
uCan Health (home healthcare products: safety and mobility aid, patient room equipment, items such as a bathtub transfer bench, to make it easier to get over edge of tub)
Vitality Medical
WestCanProducts.com (Wheelchair accessories and aids for the elderly, including wheelchair trays)
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Alzheimer's (links to many resources)
Americans with Disabilities Act home page
Answers for families (Nebraska site that may be generally helpful)
Assistivetech.net (searchable database on assistive technology (AT) and disability-related information)

Caregivers, caregiving, and preventing or minimizing caregiver burnout (links to many helpful resources and articles)
Caring for an Ill Spouse, and for Other Caregivers Alix Kates Shulman (NYTimes 9-9-11).
Caregiving 101 (Debbie Newsham's blog on trying to stay positive while caring for her father, who has dementia)
Caring for the Elderly (Jane Gross’s excellent list of resources, categorized as government sites, housing and services, caregiving, legal and financial, end of life, miscellany, advocacy, emotional support)
Caring Today’s blogs, including Debbie Newsham's My So-Called (Caregiver) Life
Center for Aging with Dignity (scroll down to find useful articles on various aspects of aging and caregiving, for practical advice on safety concerns with aging drivers, and for insights into grieving)
CAST (Center for Aging Services Technologies, some useful links for disabled or older people)
Comfort Zone and Comfort Zone Check-In. Alzheimer's Association Comfort Zone®, powered by Omnilink, provides location updates. Family members can monitor a person's location, while the individual with Alzheimer's can maintain their independence and enjoy the emotional security of familiar routines and surroundings. A Web application that includes a location-based mapping service, or LBS. See also Medic Alert.
Designing a Better Day: Guidelines for Adult and Dementia Day Services Centers by Keith Diaz Moore, Lyn Dally Geboy, and Gerald D. Weisman
A difficult drive in a suit that mimics aging (Vivian Nereim, Boston Globe, 6-18-09)
The Digital Divide of Disability.NPR's On the Media hosts people from Knowbility, an organization that advocates for technology that allows blind, deaf and otherwise disabled people to use the Internet (and things like AbleGamer video games)
Dignity Therapy. For the Dying, A Chance to Rewrite Life (Alix Spiegel, Morning Edition, NPR 9-12-11). Listen or read transcript.
Disability.gov (online resource for Americans with disabilities)
Disability resources (Syracuse Center on Human Policy, Law, and Disability Studies). Links to useful resources in many categories, including Family supports and academic programs in disability studies.
Disabled World (disability and health news)
Disaster preparedness for people with special needs (Red Cross)
Doctors say medication overused in dementia (AARP Bulletin)
Eldercare locator (download their useful booklets on transportation and housing options)
The Do’s and Don’ts of Signing a Nursing Home Admission Agreement as a Responsible Party (Henry C. Weatherby, ElderCare Matters, April 2014)
Engage with Grace and the One Slide Project. To help ensure that all of us--and the people we care for--can end our lives in the same purposeful way we lived them. • Watch the Engage with Grace Story (Video, Za's Story) • Download the One Slide (PDF)
Everyone Communicates (augmentative and alternative communication, for when a person loses the ability to speak)
Family Support 360 Initiative (providing grants to local service providers to help families with developmental disabilities)
*Family Village (a global community for disability-related resources)
Gadgets for Growing Old at Home (John Leland, reporting from the International Consumer Electronics Show in Las Vegas, NY Times)
Home Remodeling for Disability and Special Needs: What You Need to Know (Michael Sledd, Expertise.com, 6-17-15) Covers several important topics: (1) Federal resources for veterans, seniors, and disabled citizens; (2) Planning your remodeling project; (3) Creating accessible approaches, landscapes, and doorways; (4) Disability friendly flooring; (5) Electrical, lighting, and smart-home technology; (6)Handicap-accessible bathrooms; (7) Handicap-accessible kitchens; (8) Remodeling for special needs. And concludes with links to valuable resources and pages of information.
How to Choose a Nursing Home (Toby Bilanow, NY Times 3-19-10) and Stressful but Vital: Picking a Nursing Home Walecia Konrad
How to Choose Between Home Health Care, Assisted Living, and a Nursing Home (Money and Health, Health.com)
In a Charmed Life, A Road Less Traveled (Layng Martine Jr, "Modern Love" column, NY Times 3-6-09), how love and the help of others help sustain this couple when a car accident makes her paraplegic)
Increase Mobility, Brighten Your Outlook with Yoga Stephanie Golden on Yoga and Arthritis, Cleveland Clinic Arthritis Advisor, March 2004)
Independent Living Centers (a directory)
Independent Living Institute (promoting disabled people’s self-determination)
International Longevity Center (navigating the age boom)
Interpreters for the Deaf, Registry for (RID, searchable U.S. database through which to locate individual interpreters)
KnowItAlz (Alzheimer’s Caregiver Community)
Leonardo’s Laptop (Ben Shneiderman interview about human needs and computer design)
Lessons from the Lost. NY Times video story about law enforcement officers learning how to search for missing persons with Alzheimer's or dementia. For the first time, more missing persons are elderly, with dementia, and may not know they are lost. Missing children used to be the main target of searches.
Lo-Jack SafetyNet (Lo-Jack bracelet allows families to keep track of dementia-driven wanderers via radio signals, from the stolen-automobile recovery company)
Making Rounds with Oscar: The Extraordinary Gift of an Ordinary Cat by David Dosa (about a cat who senses death and stays to comfort the dying, but also about Alzheimer's and geriatric care and nursing homes and being there, at the end of life)

Meals on Wheels (a crucial service for the elderly and disabled who are living alone, unable to shop and cook for themselves. Many days the people delivering Meals On Wheels are the only people some elders see.)
Meals on Wheels May Be Your Best Meal Ticket (Robert Littke with Harry Margolis, podcast from ElderLaw Radio).
MedicAlert + Safe Return (Alzheimer's Association medical bracelet helps when a person wanders or is lost and provides access to vital medical info in time of need) See also Comfort Zone.
Medicare Compare. Sites for comparing information about physicians, hospitals, nursing homes, home health agencies, dialysis facilities--on HealthCare.gov
Medicare's Hospital Compare (search and compare hospitals)
Medicare's Nursing Home Compare (an interactive tool allows you to search and compare detailed information about every Medicare and Medicaid-certified nursing home in the country)
Medicare Guide to Choosing a Nursing Home (PDF file)
Mind Our Elders (Carol Bradley Bursack)
My Elder Advocate (the meeting place for elderly concerns)
My So-Called (Caregiver) Life
National Association of Professional Geriatric Care Managers (NAPGCM) (GCMs can help assess elders' long-term care needs, find them a place to live, and help them navigate the health-care system--for example, hiring private nurses, as needed, for fees that range from $80 to $200 an hour)
National Clearinghouse for Long-Term Care Information
*National Library Service for the Blind and Physically Handicapped (Library of Congress, free library program of braille and audio materials circulated to eligible borrowers in the United States by postage-free mail)
Network of care
Nursing home checklist (Medicare, what to look for)
Nursing Home Compare (Medicare's interactive tool allows Medicare beneficiaries and their caregivers to search and compare detailed information about every Medicare and Medicaid-certified nursing home in the country)
Ombudsmen, by state (federally funded advocates for nursing home patients, who can find latest health inspection reports for a nursing home and tell you how many complaints have been filed about it).
Ouch! It's a disability thing! (blogs, message boards, podcasts by Mat Fraser and Liz Carr, videos with subtitles, funny computer wallpaper, news reflecting the wider view of life for disabled people)
OurAlzheimer’s.com
Program of All-Inclusive Care for the Elderly (PACE), an optional benefit under Medicare and Medicaid that helps older people frail enough to meet state standards for nursing home care stay in their home.PACE offers and manages all the medical, social and rehabilitative services enrollees need to preserve or restore their independence, stay in their homes and communities, and maintain their quality of life. Listen to this interview on Kansas Public Radio about PACE. There is evidence that this new model of care is effective, but it is not yet widely available. Here is a current list of PACE-provider organizations
SafetyBunns (comfortable non-restrictive pants for people who use wheelchairs, to keep them from slipping and falling from the chair. Story here from Shadra Bruce, MomsGetReal:Safety Bunns Helps You Keep Your Seat in a Wheelchair .
SeniorHomes.com
SeniorNet provides nonprofit computer and Internet education for older adults and seniors -- a site for content and community
Small Mercies (Canada's Veterans Independence Program successfully provides assistance with home care instead of facility care)
SmartPack Sac (a carryall for people with special needs--for example, using power and manual wheelchairs, scooters and walkers, or carrying special equipment like a Diavox or medical supplies-- a way to stow all their gear – in style)

Talking Book Program (Library of Congress, answers to frequently asked questions)
10 Things to Know About Assisted Living (Jane Gross, NY Times)
3GenFamily blog (caring for parents, raising teens, and staying sane)
Tips on Caring for Aging Parents (Elizabeth Alterman, CNBC.com, 6-19-12)
Universal home design (AARP)
Vocational rehabilitation (fact sheet - pdf format)
Well Spouses Association. Support and support groups for spousal caregivers. Read Alix Kates Shulman's story about the importance of a caregivers support group.
What I Wish I'd Done Differently (Jane Gross, on the four biggest mistakes she made while caring for her mother)
What to Know If You Are The Boss of a Caregiver (Victoria E. Knight, Wall Street Journal, 3-19-09)
Who Cares? (Federal Trade Commission on sources of information about health care products and services)
Who Takes Care of Mom? by Francine Russo (Time, 2-1-2010), author of They're Your Parents, Too!: How Siblings Can Survive Their Parents' Aging Without Driving Each Other Crazy
Why Hire a Geriatric Care Manager? (by Jane Gross, The New Old Age, New York Times blog)
The Wrong Care for Dementia Patients (Tara Parker-Pope, Well blog, NY Times)
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Changing Attitudes About Disability


NDEAM 2015: My Disability is One Part of Who I Am (Jennifer Sheehy, U.S. Dept. of Labor blog, 10-5-15)
Adaptive Action Sports, nonprofit organization cofounded by Amy Purdy, to help people with physical disabilities get involved in action sports, go snowboarding, skateboarding, etc. Purdy is co-author (with Michelle Burford) of On My Own Two Feet: From Losing My Legs to Learning the Dance of Life Growing up, Amy Purdy was an artist and board sport enthusiast. Her goal was to spend a few years traveling the world and snowboarding when suddenly, at the age of 19 her life changed forever. After a day of flu like symptoms Amy was rushed to the hospital in a state of septic shock and diagnosed with Bacterial Meningitis, a deadly blood infection. Amy fought for her life for nearly 3 months, leaving the hospital a completely different person physically, mentally, and spiritually. Amy lost both of her legs below the knee, as well as all kidney function, but it didn't stop her from following her dreams. A world-class snowboarder and 2014 Paralympic bronze medalist, she also danced on Dancing on the Stars.
Disability Is Natural: Revolutionary Common Sense for Raising Successful Children with Disabilities by Kathie Snow. Check out her website for many other useful resources: Disability Is Natural.
Renting with Disabilities (Tenant Resource Center for Housing Justice in Wisconsin). Search for similar sites in other states, but this may be helpful generally, too.
ADA: Disabilities & Your Rights as an Employee (FindLaw)
Past Due: A Story of Disability, Pregnancy, and Birth by Anne Finger (a frankly detailed story about home birth by a woman with postpolio problems that make giving birth "problematic" -- also opens one's eyes to the stereotypes people have toward disability and to the complexities of reproductive rights).
Reflections from a Different Journey: What Adults with Disabilities Wish All Parents Knew , ed. Stanley D Klein and John D. Kemp (40 stories by successful adults who grew up with disabilities
No Pity : People with Disabilities Forging a New Civil Rights Movement
Why I Wrote the Americans with Disabilities Act ( Robert L. Burgdorf Jr., U.S. Dept. of Labor blog, 7-29-15) "The ADA was a response to an appalling problem: widespread, systemic, inhumane discrimination against people with disabilities. ...a good reminder of what our nation’s leaders can accomplish when they meet each other in a spirit of civility and compromise." An interesting article.
National Veterans Wheelchair Games (Dr. Govloop)
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Blogs about disability


Abled
AbledBody (where can-do is done different) This consumer website (with guest bloggers) covers disability news and assistive and emerging technologies for people with disabilities. Suzanne Robitaille, founder of AbleBody, also writes a column for the Huffington Post.
Can-Do-Ability
The DD News Blog . News, information, and commentary for families and friends of people with developmental disabilities.
DeafRead (best of deaf blogs and vlogs). Includes A deaf mom shares her world
Disability & Media Matters (Shawn Burns writes about how people with disability are represented in the Australian news media and how they feel about that.
Disability.Blog, the official blog of Disability.gov, features weekly posts by experts on topics important to people with disabilities, their families, and others.
Disability Scoop. A premier source for disability news, with daily coverage of developmental disability news, including intellectual disability, autism, cerebral palsy and Down syndrome).
Disability Studies (Temple U)
E-bility (an online resource for people with disability)
Fred's Head (a blindness blog, rich in resources)
Girl in a Party Hat (Raising Sophie). Amy Silverman blogs about her daughter Sophie, who has Down syndrome
Have wheelchair will travel (Richie, 17 and in a wheelchair, travels around the world with his family.)
Jan's Group Home Support (resources, ideas, and support for caregivers)
kathiecomments Retired clinical psychologist Katherine Schneider writes about aging, disability and assisted services, including service dogs.
Martyn Sibley
McGuire on Media. Tim McGuire blogs about news media and journalism education and occasionally writes about disability from a personal perspective.
Media dis&dat . News and information about people with disabilities and disability issues.
Melissa's Solid Ground (for children and adults who have parents with disabilities to share their experiences and just talk to each other in a secure and safe environment)
Melissa's Dad Reflecting on a 22 year journey as the father of a daughter with special needs.
Meyrick Jones Racing (The diary of an endurance sports enthusiast with big dreams to represent Canada at the 2010 Paralympic Games in Vancouver.)
Ouch blog (Brothers, sisters, and disability) (BBC's monthly dose of disability radio -- exploring the disability world in blog posts and a monthly internet radio talk show)
Rolling Rains Report (precipitating dialogue on travel, disability, and universal design)
Sense and Disability (Chelsey Blair's blog on being a young adult with a disability)
Service Dogs
Shaping Our Lives. A national UK network of service users and people with disability.
Still Outdoors Adventure is still possible!
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Traveling with limited mobility and other disabilities (books on)


Access Anything: I Can Do That! - Adventuring with Disabilities by Andrea & Craig Kennedy
Traveling With Disabilities (Kojo Nnandi show, 11-3-15). After a five-hour flight from San Francisco to D.C., D’Arcee Neal, who has cerebral palsy and could not use the airplane bathroom, simply couldn’t wait any longer and crawled off the plane when the airline failed to bring him the wheelchair made to fit the plane’s aisle. Although federal laws require equal accessibility to transportation for people with disabilities, his experience is not uncommon. Kojo talks with D’arcee and other disability rights activists about what happened to him and how similar events can be avoided in the future.
Barrier-Free Travel:A Nuts And Bolts Guide For Wheelers And Slow Walkers by Candy B. Harrington (author of 101 Accessible Vacations: Vacation Ideas for Wheelers and Slow Walkers and There Is Room at the Inn: Inns and B&Bs for Wheelers and Slow Walkers)
Rick Steves' Easy Access Europe: A Guide for Travelers with Limited Mobility
These Aren’t Tykes on Little Bikes: A Mature Market Adopts the Tricycle (Rachel Bachman, Wall Street Journal, 10-9-14). See also Adult tricycles (article by Emily Stokes, "The Third Way: Tricycles," in T, 11-11-14). And Adult tricycles (a Best Reviews guide).

Traveling with disability blogs and websites


Abiitytrip (accessible, fun travel for all)
Barrier Free Travels (Candy Harrington's blog with travel info for slow walkers and wheelchair users)
BootsnAll (one-stop indie travel guide, recommended by World on Wheels)
Chris Eliot, travel ombudsman
DisabledTravelers.com
Emerging Horizons (travel info wheelchair users and slow walkers)
Flying with Disability
Global Access News (Disabled Travel Network). See its disability links
92 and Still Driving? Seniors At The Wheel (Debbie Brodsky).
Rolling Rains Report (precipitating dialogue on travel, disability, and universal design)
Travels with Pain (helping travelers with hidden disabilities explore the world)
The World on Wheels (a blog). Tim, disabled from birth, travels with a wheelchair; Darryl, his father and caregiver, travels with him.

"An individual with a physical or intellectual disability, then, is said to be 'handicapped' by the lowered expectations of society. A person may also be 'impaired' either by a correctable condition such as myopia, or by an uncorrectable one such as cerebral palsy. For those with mild conditions, related impairments disappear with the application of corrective devices. More serious impairments call for adaptive equipment."
~ Disabled World, "The Language and Terminology of Disabiity"
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Legal and Financial Decision-Making



Advance directives, living wills, Medicare, and other practical matters

Benefits.gov. The official benefits website of the U.S. government. Informs citizens of benefits they may be eligible for. Provides information on how to apply for assistance.

Disability Planning (ElderLawAnswers)

How to apply for SSI

Japan’s elderly turn to life of crime to ease cost of living (Leo Lewis, CNBC, 3-26-16) Japan's shoplifting crime wave represents an attempt by those convicted to end up in prison — an institution that offers free food, accommodation and healthcare.

Long term care insurance (links to articles and sites that answer your questions) Should you or should you not buy long-term care insurance? How much? Can you afford it? Where to learn about options. Do premiums or benefits affect your tax picture? Separating expenses and emotions.

Nolo online law center (provides legal assistance in preparing documents for elder care)

Social Security cash benefit programs for people with disabilities and parents of children with disabilities

Supplemental needs trusts and planning for disabled children (ElderLawAnswers)

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Addressing problems of homelessness


Why Grandpa Is Homeless (Rachel Nuwer, Pacific Standard, 1-9-17) A sagging economy, a complex job market, and a lack of social programs have led to an increase in the number of elderly people living—and dying—on the streets. Radical efforts to end homelessness: Old, Sick, and On the Street One of Pacific Standard's always excellent pieces/​series.
Visions of the Rust Belt Future (Part 1, Richey Piiparinen, NewGeography 4-27-13). Also Part 2 analyzes whether or not there is a new way forward for post-industrial cities, using the lessons from Pittsburgh and Cleveland as a guide.
‘I wasn’t crazy’: A homeless woman’s long war to prove the feds owe her $100,000 (Petula Dvorak, WaPo, 8-22-16) Most folks dismissed Witter as crazy as she roamed the nation’s capital with a hand-truck loaded down with three suitcases packed full of Social Security paperwork. And most counselors believed that mental illness, rather than messed up Social Security payments, were her problem.
National Alliance to End Homelessness
Room for Improvement (Scott Carrier, Mother Jones, Feb. 2015) Clean up cities. Give the homeless a place to live. And save money too? The shockingly simple, surprisingly cost-effective solution that won over a bunch of conservatives in Utah.
Homelessness Assistance (HUD.gov)
Mental disorders keep thousands of homeless on streets (Rick Jervis, USA Today, 8-27-14) A series: Mental Illness: The Cost of Not Caring. Individual pieces: Early intervention could change nature of schizophrenia. The Fortunate Mother: Caring for a son with schizophrenia. Cost of not caring: Stigma set in stone. Cost of not caring: Nowhere to go. Substance abuse treatment often impossible to find.
Baltimore Station. The Baltimore Station is an innovative therapeutic residential treatment program supporting veterans and others who are transitioning through the cycle of poverty, addiction, and homelessness to self-sufficiency. Did you know? 40% of homeless men are veterans. 200,000 homeless veterans sleep on the streets every night. 76% of homeless veterans experience alcohol, drug, or mental health problems? “There is a turning point in every war. Ours is when a man comes in off the streets, through our door.”
Hanging Out With the Tech Have-Nots at a Silicon Valley Shantytown ( Josh Harkinson and Prashanth Kamalakanthan, Mother Jones, 12-2-14) We took a video camera to the vast homeless camp a stone's throw from Apple HQ. "In the heart of Silicon Valley, a stone's throw from Apple's headquarters, is a 68-acre homeless camp that's widely believed to be the largest in the country. The Jungle, as it's known, is more accurately described as a shantytown: a collection of shacks, adobe dugouts, and treehouses inhabited by some 300 people, many of whom have lived here for years. In a land of million-dollar bungalows, it's a last place of refuge for many locals who've missed out on the booming tech economy." "It's hard for us to find spaces for folks, especially when they are competing with young techies."
In Wealthy Silicon Valley, 300 Evicted from Homeless Camp (Bill Moyers, 1-8-15)
Tent City, America (Chris Herring, Places, Dec. 2015) Tent cities are now so common that advocates are campaigning to make them semi-permanent settlements of micro-housing. But is this a genuine solution or merely a quick fix?
Reforming the U.S. healthcare system

Rights Battles Emerge in Cities Where Homelessness Can Be a Crime (Jack Healy, NY Times, 1-9-17) Activists and homeless people are waging public campaigns and court fights against local laws that ban urban camping, as some politicians urge a "zero tolerance" policy. See links to more NY Times stories on homelessness
D.C. Homelessness Doubles National Average as Living Costs Soar (Noah Weiland, NY Tims, 1-1-17) Record housing prices are cited as one cause leaving students and working class people with nowhere to turn but an overburdened shelter system.
Builders That Got Tax Breaks Must Set Aside Some Units for Homeless, City Says Charles V. Bagli, NY Times, 11-4-16) "The de Blasio administration now wants up to half of all community-preference units to be reserved for people living in homeless shelters. In a 300-unit building, that could mean up to 15 apartments for tenants who were previously homeless."
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End of life decision-making in the critical care unit



End of life decision-making in the critical care unit. "For several months, Globe reporter Lisa Priest and photographer Moe Doiron documented the journeys of four patients, each hooked to a ventilator, each grappling with a debilitating illness or condition. Their stories, while deeply personal, underline the scope of the challenges facing our strained health-care system: challenges that are medical, ethical, and even economic. How much treatment is too much treatment? How and where do we draw the line? And how do we distinguish between what we can do, and what we should do?" Stories from, and related to, the Canadian series from the Globe & Mail:
Critical care: Spending 10 weeks with patients facing death (Lisa Priest, Globe and Mail 11-26-11)
Why are we afraid of talking about death? (Erin Anderssen 11-27-11)
Navigating life and death in 21st-century critical care (Globe & Mail). Watch video of four patients.
Government lawyer draws line between euthanasia and war (Marc Hume, Vancouver, Globe and Mail, 12-8-11). Read the comments, too.
A B.C. family's secret: How they helped their parents die
‘Good death’ in Swiss clinic held up as model (Mark Hume, 12-7-11)
Tale of death that took ‘painful eternity’ opens right-to-die case (11-14-11)
Court hears details of woman’s suffering with ALS in right-to-die case (Mark Hume 11-14-11)
Government lawyer draws line between euthanasia and war
Right-to-die laws don’t lead to rise in assisted deaths, experts say (Mark Hume 12-5-11)
The end of life: a just and reasonable accommodation (Gary Mason, 9-9-10)
By the numbers: The costs and counts in critical care (11-25-11)
When it’s time to die: Home is where the heart is

OTHER TAKES ON THE SUBJECT:
Still Life (Susan Okie, WaPo, 8-10-14) From defibrillators to suspended animation, it is getting easier for us to cheat death. But should we? Okie reviews David Casarett's interesting book Shocked: Adventures in Bringing Back the Recently Dead by David Casarett

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