Navigating

Oh, a storm is threat’ning/ My very life today/ If I don’t get some shelter/Oh yeah, I’m gonna fade away/

–“Gimme Shelter” by Mick Jagger and Keith Richards

The site has two central parts:

I. The theme

II. Digressions (anything not related directly to the theme; for the purpose of the site my daughters Joanna and Amelia [you may ask “You really regard your family as a digression?), my stories, essays, career achievements, poems, and other flights of fancy and whimsy are off message.

Now and then being a nerd, as I am, can get in the way or as the Tibetan Book of the Dead notes sometimes you (by which I mean I) become so intense that the intensity becomes “intense pride, and the pride turns into an ice-cold environment which reinforced by self –satisfaction begins to get into the system. It does not allow us to dance or smile or hear the music.” At the risk of not hearing the music, I will leave you, dear reader, to find order in Diversions as you will. Right now, the task at hand is the order the theme.

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Navigating the theme: No shelter from the storm

  1. Where do I want to go?

To a neighborhood which must be developed to serve as a global model for providing independent living so elderly and disabled individuals can age in place.

  1. What would the neighborhood consist of?

a)      It would consist of an experimental residence for an individual or an individual family. The example of the Blueroof Experimental Cottage in McKeesport, PA is a good example. The cottage consists of a one story residence built on inexpensive land in a downtown burned out section of town where rotting buildings could be razed and a community developed.

b)      The individual residence could be built out of factory housing (the fashionable term for mobile home) where sensors and other off-the-shelf technology can be embedded in the walls to monitor and protect the resident. Including building the foundation, each residence can be constructed in three days.

c)      Technology in the residence would include:

  • Security system to protect elderly and disabled residents in high-crime areas such as exist throughout the Rust Belt of Pennsylvania—where the neighborhood would gradually change to a family friendly area attracting economic growth.
  • Motion detectors to monitor falls throughout the residence, especially high risk areas such as the shower.
  • Computer voice simulation which combined with a wireless communication system can have, in effect, the walls of the building calling family or other emergency services for help.
  • Monitoring devices to detect, for example, whether the refrigerator has been opened and to call for help after an adjusted period of time. Example of a computer generated call, “Hello, your grandmother has not opened her refrigerator in over 24 hours. You might want to look in on her.”
  • Remote medical monitoring, including taking blood pressure and other health measurements and transmitting the results automatically to a physician’s office.
Blueroof”s trial pill dispenser which monitors whether the resident has taken each required pill and after computer simulated warnings, reports failure to do so.
  • Computer terminals and other equipment to provide the resident with job training (one is never too old to learn) and work opportunities from home.

d)      A research facility at a major university, such as Penn State, where the Immersive Construction (ICon) lab develops a 3-D model of the experimental model so stakeholders can suggest design changes.

 

Stakeholders would include:

  • Prospective residents of future neighborhood (or elsewhere) housing
  • Members of the architectural, engineering, and construction (AEC) community
  • Caregivers

The research facility would also be able to process data collected at the experimental facility, such as remote medical monitoring and activities of daily living (ADL) so future construction can benefit.

e)      Creation of an inter-generational accessible community with shopping, recreation, and other services which make a community a community.

Stay tuned for further navigational aids which link posts on this site to the issues raised here and which answers the question: Why is creation of a new kind of neighborhood (with a variety of other options to be presented) so critical to dealing with the housing shortage throughout the world as the largest generation in history begins to retire in an environment where a previous generation of elderly and disabled individuals (including, of course, veterans) are so poorly served at a great expense to society and at a loss of dignity among people whose talents are not being developed adequately.]

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I tell you love, sister, it’s just a kiss away/ It’s just a kiss away….

–“Gimme Shelter” by Mick Jagger and Keith Richards

http://www.youtube.com/watch?v=7nU4aiqvyt4&feature=watch_response

Celebration of the Use of Virtual Reality to Improve Housing for the Elderly and Disabled

University Park, PA.  On Tuesday, May 3, 2011 at 10a.m. Penn State’s Department of Architectural Engineering and its Smart Spaces Center for Adaptive Aging in Community celebrated progress made in a coordinated effort to reduce the cost of housing for Pennsylvania’s elderly and disabled residents today and in the future.

The celebration took place at the virtual reality Immersive Construction (ICon) Laboratory. The celebration:

  1. Demonstrated the use of full-scale 3-D virtual models on large display screens for evaluating cost-effective designs to allow for aging in place. The animated model, based on the Blueroof  Technologies housing initiative in McKeesport, PA, is the work of graduate student Sonali Kumar. The virtual reality approach allows for an avatar to enter the wheel-chair accessible cottage and evaluate tasks such as making coffee in a kitchen to appropriately design for residents who desire housing where they can grow old without having to move to a costly institution.
  2. Allowed participants to meet the leaders of Blueroof Technologies in McKeesport, PA using a live video connection.  Blueroof is using prefabricated housing with embedded sensors for improving user interaction with their residence.  The environment can inform a resident when to take medication, monitor for falls (then, call 911 if the resident slips in the shower and does not get up), and provide televised links to medical facilities reducing routine medical care cost.
  3. Show the work of the Computer Integrated Construction Research Program, directed by John Messner, associate professor of architectural engineering,  focusing on the application of advanced computer modeling to improve the design, construction, and operation processes for buildings.
  4. Present the work of architectural engineering students  trained in using 3-D experienced-based design.  Virtual modeling is rapidly becoming an important tool for the construction industry, providing the ability to make changes in health care and other facilities before construction actually takes place.
  5. Provide an opportunity for residents of Addison Court, a State College independent living facility for elderly and disabled individuals, to see what the future will bring and serve as critics who can use their life experiences to aid in the design process.
  6. Highlight the work of  Penn State’s Smart Spaces Center, directed by Richard Behr, who leads an interdisciplinary effort to address the needs of the rapidly increasing number of baby boomer Americans who wish to age successfully in their own homes.
  7. Recognize contributions made by the Raymond A. Bowers Program for Excellence in Design and Construction of the Built Environment, the Smart Spaces Center, the Partnership for Achieving Construction Excellence, and other private and public organizations working with Penn State to improve life for Pennsylvania’s elderly and disabled.
  8. Using a scooter from Amigo Mobility, Blueroof will begin to experiment on how to help residents with mobility disabilities make better use of the technology around them. The Amigo scooter will have an iPad 2 and other remote devices so residents can turn the lights on and off and perform other functions without leaving the chair.
After Florida, Pennsylvania has the highest per capita of elderly of any state in the union. Not all news about health care costs is bad news. Come learn about some of the good news.
Computer Integrated Construction Research Program:
Immersive Construction Lab (ICon Lab):
Smart Spaces Center:
Immersive Construction Lab
306 Engineering Unit C
University Park, PA 16802

Saving Medicare billions: Trying too hard can get in the way

Memorial Note: November 13, 2011, Jack Seidner aged 93, my neighbor and friend at Addison Court, State College. PA, died while talking to his son who had called from Israel. He died at Centre Crest, an assistive care facility in Bellefonte, PA, 11 miles from Addison Court.
Jack was a veteran of World War II and was a monthly calendar boy on the Jewish War Veterans calendar last year  He will be buried beside his wife in Harrisburg at a private funeral.

 

Jack was a wonderful man. He was basically an intellectual although he hid it as much as possible. When I wrote a story about home medical oxygen, oxygen which he received to stay alive, he refused to be photographed saying, “I have been studied enough.”
His sense of humor was ever-present, sometimes to the point of reciting bawdy limericks to the residents of Addison Court. I will miss him. He died at Centre Crest. The article below, originally published in HME News on September 27, 2011, is dedicated to his memory. In these days of turmoil at Penn State University, the need to care for the real needs of this community should be apparent.+++
Saving Medicare billions: 
Trying too hard can get in the way 
The money saved as a consequence of concentrating on what is right will astonish the body politic
“I have saved up enough pills to kill myself,” a neighbor told me, “if I ever have to go to Centre Crest.”

I live in an independent housing apartment building in downtown State College, Pa. The nearly 100 residents of Addison Court are disabled or elderly. Most of us are poor–the more affluent are on Social Security or Social Security Disability and Medicare.

At least once a week, the ambulance stops by my window and a resident goes off to the hospital. The lucky return. The not-so-lucky move on to Centre Crest, the default public nursing home about 11 miles away, where assisted living means expensive round-the-clock care, diaper changes, attachment to machines that keep the biological aspects of life going, medical personnel who make sure medications are taken correctly, and a world view that echoes Dante’s inscription over Hell: “Abandon hope, ye who enter here.”

Last year, Pennsylvania’s Department of Aging estimated it costs Medicare $40,000 extra each year for a resident to move from an independent living to an assistive living facility. The loss of dignity to the individual is incalculable.

The French philosopher Jean Paul Sartre observed that when one tries especially hard to listen, often the trying gets in the way of hearing. Medicare is trying too hard to do the wrong thing. Medicare‘s purpose is not to save money, but to provide health care in a way that concentrates on improving the quality of life. Recent evidence on the brain’s adaptive capacity provides hope that not only can individuals resume physical capacity from the devastation of a variety of afflictions that affect us at Addison Court, but also we can regain our talents to improve this society, not simply take from it.

“The Brain that Changes Itself, Stories of Personal Triumph from the Frontiers of Brain Science,” by Columbia University’s Norman Doidge, M.D., points to the brain’s ability to recover from strokes and other disorders with rehabilitation and concern.

“Traditional rehabilitation,” Doidge writes, “typically ended after a few weeks when a patient stopped improving, or ‘plateaued.’ And doctors lost the motivation to continue.  But…these learning plateaus were temporary…Though there was no apparent progress in the consolidation stage, biological changes were happening internally, as new skills became more automatic and refined.”

The Obama administration’s penny-wise-and-pound-foolish cutbacks on availability to durable medical equipment, rehabilitation services, and home health care are forcing residents of independent living facilities into the Centre Crests of this country. For example, the narrow focus is apparent in Medicare‘s frequent citations of the Congressional Budget Office’s competitive bidding estimates of relatively insignificant savings for Medicare Part B ignoring the astronomical costs that will result to Part A when disabled individuals like me can no longer pick up the phone and call my local medical equipment provider. Instead, I must wait for a competitive bidding winner (several have unsavory reputations and some are based out-of-state) to provide a battery. Delays could easily force me into Centre Crest as a result of falls, problems getting to the bathroom, etc. Delays would rob me of the ability to work as an adviser on virtual reality models for construction of future aging in place housing–construction which will result in significant Medicare savings.

Medicare is discouraging the necessary alliance between rehabilitation therapists and medical suppliers. This alliance will help restore the ability of my fellow residents to function and contribute to society.

“Individuals with disabilities remain one of our nation’s greatest untapped resources,” said Rep Jim Langevin, D-R.I., the only quadriplegic in Congress. To release the untapped resources of the elderly and disabled, Medicare must stop thinking about saving money and start thinking about improving health. The money saved as a consequence of concentrating on what is right will astonish the body politic. Providers of durable medical equipment require the support of consumers like me. Providers and rehabilitation therapists have been slow to recognize that in unity there is strength. Together they must spread the word that when an individual becomes old or disabled, science is rapidly increasing the ability to regain talent and good health.
Joel Solkoff is the author of “Learning to Live Again, My Triumph over Cancer” and is adjunct research assistant at Penn State’s Department of Architectural Engineering.

http://www.hmenews.com/?p=article&id=hm201109OayJh3 

Firefighter Love: From Addison Court Report February, 2009

[Note: Addison Court is an independent living facility in Downtown State College for citizens aged 55 and older and individuals with disabilities. Many of its residents are aged 70, 80, and 90. Last year we had problems with faulty fire alarms which demonstrted residents did not know what to do when the alarm went off at 1:30 in the morning. The residents formed a fire safety committee with wardens to provide assistance on each of the building’s 8 floors. We were trained by Steve Bair, Council of Governments Director of the Office of Fire Administration. A major part of the training consisted of what to do when the excellent Alpha Company, four blocks away, comes to help us in the event of fire. Alpha’s Chief is Keith Yocum]

Hug a Firefighter Two Days After Valentine’s
at Noon or 6:30; Get a Bowl of Chili

This invitation has 6 parts (some of which the author did not complete because he is too wordy):

  • Details of the Tuesday February 16th event at the Addison Court social hall. There will be two sittings; Noon and 6:30 PM. Feel free to go to one or the other and fill out the signup sheet. Be there or be square.
  • Why hug a firefighter (male or female) from the Alpha Fire Company’s Main Office on Beaver and Atherton. [No question mark required.]
  • What to do in the case of a fire.
  • Come spring you can bring your grandchildren to the fire house and see the pretty trucks. When 83 year-old Lillian Hutchison swings down the fire pole I want to take a photograph.
  • Participation as a fire warden—the Arnold Addison Court Fire Safety Committee, Carol Ames co-chair, needs you to volunteer as a part time FIRE WARDEN so we can have back up wardens in case your floor’s regular fire warden decides to spend two days gambling in Harrisburg. Please give Sherry your name and I will get back to you.
  • As my maternal grandmother once told me (and she was a wild one) when it comes to hugging, be moderate.

Details:

  • One hundred bowls of Webster’s Bookstore and Café’s famous vegetarian chili will be served at the noon and 6:30 sittings.
  • That chili will be served to our frontline firefighters, you, Steve Bair, Council of Governments Director of the Office of Fire Administration, Alpha Chief Keith Yocum, Alpha’s Jackie Richardson, and government officials.
  • Residents are asked to provide additional food and cash donations.

In the event of a fire:

  1. Call 911 and report (even if you are not sure if someone else has reported). Addison Court is a safe building. It has an excellent sprinkler system. The biggest danger to residents is if we panic and do not rely on our fire wardens and most importantly the men and women of Alpha Fire Company to come and tell us what to do. Even on the 8th floor, Alpha firefighters will know how to get you and your power chair safely out of the building.
  2. Relax. Stay in your apartment and wait for your floor’s fire warden. It takes fewer than 10 minutes for Alpha firefighters to get in their trucks and come here.

During that time:

Do NOT take the elevator. Do NOT go downstairs. Do NOT evacuate the building. Listen to your fire warden who may decide to have you move to the stair well to wait for Alpha. If you move, be
sure to close your door. One reason it might be a good idea to move is because there might be smoke
and staying on your floor but moving to a stair well where there is no smoke will make your
breathing easier.

**Note well; Your February 16th hug will not save your life. It will make you feel better to know
you expressed appreciation before you needed help.

–Joel Solkoff, co-chair, Arnold Addison Court Fire Safety Committee.