Saturday, April 15, 2006

Optimism Over All

My optimism about old age and what it can do to make life better for us all is tempered by the knowledge that human beings have squandered great wealth before and may do so again. Even now, social trends are working against the potential of a new old age. We live in a society that is changing even faster than we realize. We are being led away from the truth of human experience and toward a lie that places youth and the young alone at the pinnacle of human society. We are expected to find our way from birth to death with less and less to guide us. The old maps of human life are out of date. Childhood and elderhood were once understood to have their own virtues but are now measured by how well or how poorly the young and the old emulate the lives lived by adults. Our fascination with and worshipful attitude toward all things adult go well beyond simple preoccupation. Indeed, the devotion is so complete and so widespread that we can legitimately ask whether adulthood has come to function as a society-wide cult.

Tuesday, April 04, 2006

Emily Dickinson on Aging


Crumbling is not an instant's act,
A fundamental pause,
Dilapitation's processes are
organized decays.
'Tis first a cobweb on the soul,
A cuticle of dust,
A borer in the access,
An elemental rust.
Ruin is formal,
Devil's work consecutive and slow.
Fail in an instant no man did,
Slipping is crash's law.

Other words from Emily Dickinson:

We turn not older with the years
but newer every day.

Hope is the thing with feathers
That perches in the soul
And sings the tunes without
the words
And never stops--at all.

To live is so startling it
leaves time for little else.

Saying nothing...sometimes
says the most.

Tuesday, March 28, 2006

Pennsylvania Gets Into the Act

Here is a nice article about one man's visit to the original Green Houses in Tupelo. Looks like elders in Palmyra are going to be benefitting from the Green House in the years to come...

Palmyra nursing home to offer privacy, freedom
Palmyra nursing home sees Green as the way to go
Thursday, March 23, 2006
Of Our Palmyra Bureau

PALMYRA - Jeff Shireman knew the Green House he was visiting in Mississippi was a different kind of nursing home when he saw a bag of chips sitting on the counter.

The 10 residents who live there can grab a few chips when they're hungry. They can raid the refrigerator, get up when they want, help prepare meals if they are able and smell the roast cooking in the oven.

Instead of semiprivate rooms next to long corridors leading to a nursing station, their private rooms open to a shared living and dining area.

Shireman, president of the Lebanon Valley Brethren Home, was so impressed he brought the idea back to Palmyra.

The Brethren Home plans to build the first, radically different kind of skilled nursing home in Pennsylvania, and advocates for the elderly are excited.

"I think this is a wonderful idea," said Bill Bordner, director of nursing care facilities for the state Department of Health. "I think it's going to be the wave of the future. ... If I have to go to a nursing home someday, I hope it's one of these."

About 85,000 people in Pennsylvania are in nursing homes, according to Department of Health numbers.

The first four Green Houses were built in Tupelo, Miss., in 2003. They grew out of an idea called the Eden Alternative, developed by Dr. William Thomas. It is the same impulse that has brought pets, plants, children and activities to traditional nursing homes.

"People need reasons to care about something," Shireman said.

The idea, according to Shireman, is that people want to live in a home, not a "homelike environment." Here is a nice article about one man's visit to the original Green Houses in Tupelo. Looks like elders in Palmyra are going to be benefitting from the Green House in the years to come...

Monday, March 27, 2006

Another Great Caregiving Book

The Fearless Caregiver: How to Get the Best Care for Your Loved One and Still Have a Life of Your Own

Gary Barg is the long-time publisher of Caregiving Magazine and an all-around great guy. This book offers an insightful take on caregiving and would be helpful to caregivers both family and professional. The lead review notes that...

This book by Gary Barg [is] a terrific source for all caregivers and has every aspect that needs to be addressed in it. It takes you through every part of caregiving, from how to take care of yourself to attending to legal matters promptly. There is a list of ideas to help make your patient safe in his/her surroundings. This is valuable tool for every caregiver. It is superbly written and easy to read."

I like it and think that you will too...

Monday, March 20, 2006

News Up North

This story ran in a University of Minnesota Newsletter...

Looks like a home, feels like a home

Green Houses model a new approach to long-term care

A Green House and its residents
Green House residents get to select, and even help cook or bake, their own meals. family members are welcome to join them at the table.

Photo courtesy of

By Pauline Oo

From M, spring 2006

On a recent episode of the TV series, "Grey's Anatomy," a gregarious 79-year-old patient named Sophie refuses to move into a nursing home. Her reason: "If I have to go to that place, I'm afraid I'll become old."

Nursing homes strike fear in the hearts of many because they're viewed as "bad places to live and bad places to get care," says Rosalie Kane, a University professor and long-term care expert in the School of Public Health. "Most were modeled after hospitals--in terms of long corridors, linoleum floors, rooms doubled loaded with beds, shared spaces, and meals squeezed in between 8 and 5. You wouldn't choose a hotel like that, let alone a permanent living space."

But, adds Kane, the quality of care has improved a great deal in nursing homes in the last decade. "Many of them have made enormous efforts," she says.

Green Houses have sunny private bedrooms and private bathrooms, vibrant outdoor spaces, and a community life centered around the "hearth," an open kitchen and dining area.

Cedars Health Center in Tupelo, Mississippi, is one example. Instead of upgrading its worn-out 140-bed facility, administrators decided to build four single-story houses. The 6,000-square-foot houses opened in 2003 and were the nation's first Green Houses--homes for eight to ten elders with sunny private bedrooms and private bathrooms, vibrant outdoor spaces, and a community life centered around the "hearth," an open kitchen and dining area. While adhering to all codes required by licensure, Green Houses look and feel like a home. The idea is the brainchild of William Thomas, a Harvard-educated geriatrician.

Today, that cluster of houses in Tupelo has grown to 10, and dozens of other Green Houses--from New York to Hawaii--are in the planning stages or have recently broken ground.

Participants--as residents are called--in the Green House project are more satisfied and in better physical shape than those in traditional nursing homes, says Kane, who received a grant from the Commonwealth Fund in New York City to conduct a two and a half year study comparing groups from a Cedars' Green House, the original Cedars Health Center, and a nearby nursing home.

Nursing aides who work at a Green House have also reported greater satisfaction, and were more likely to stay on the job. They manage the household, receive an extra 200 hours training, and report to an administrator called a "guide." Nurses and therapists support them with regular house visits. As does a sage--someone from the community, such as a retired minister or psychologist, who helps them solve problems.

Although Kane's findings favor the Green House over the other two locations, there's still more to learn. The Commonwealth Fund has awarded Kane and her research team another grant to examine what will happen when the Cedars Health Center closes its traditional care facility and only offers a Green House option.

"Essentially, we're interested in how the Green House model is sustained, and how it functions when no traditional nursing home is there to fall back on," says Kane

Monday, February 20, 2006

America's Hero: Elma Holder

A wonderful post from this fascinating web site
tells the story of Elma Holder better than anything I have seen. She is one of the giants on whose shoulders we stand. Jude and I received a call from her this weekend and she told us that she was facing another cancer challenge. We will be keeping her in our hearts and minds and hope you will do the same.

With Love in her Heart and a Blaze in her Soul

How do I tell you about Elma Holder? In my mind, she is a legend; a marvelous, under appreciated story and, most assuredly, a book waiting to be written. We begin then with a statement of definition:

No one, in or out of government, has done more for nursing home residents than Elma Holder who, with remarkable vision, founded the National Citizens Coalition for Nursing Home Reform (NCCNHR) 25 years ago. Congratulations, and happy birthday, my friend.

Tonight, when the lights go out in 17,000 nursing homes, from Maine to California, most of the 1.5 million residents will be reasonably well-fed, they will have been given adequate water and other liquids, and will have benefited from some nursing care. For this level of care, they can properly thank Elma Holder.

Tonight, when those same lights go out, too many residents will lack for professional nursing care, they will have been only moderately well-fed and hydrated, and when they hit the call button, because a diaper is wet or soiled, no one will soon respond. To all of those hapless, abused residents, I say: "Cry out, in complaint, to your ombudsman ... your advocate under the law ... the law Elma Holder helped to write and pass."

During the Ronald Reagan administration, there was an attempt to deregulate nursing homes. One big city newspaper reported, "Members of the nursing home lobby are almost deliriously happy" because the White House wants to "do away with unnecessary and obstructive regulations..."

The only obstacle standing in the way of this diabolic plan was Elma Holder's Washington-based organization, described as "a loosely-knit coalition of citizen groups with a tiny, under-staffed office --one flight up-- in a less than fashionable section of downtown..." Insiders said NCCNHR (pronounced Nick-ner) was going broke, and most bills went unpaid. Headlines therefore alluded to the biblical showdown between David and the giant, Goliath. The nursing home industry, incidentally, grosses $77.9 billion a year.

As in the bible, David, alias Elma Holder in sensible shoes, won the contest. Following this historic moment, NCCNHR pressed on, helping to write the landmark nursing home reform legislation, known as OBRA (Omnibus Budget Reconciliation Act). "It's a wonderful law," Elma has said. "Those opening words... as public policy, it's beautiful."

The law states each resident has "the right to attain and maintain the highest practicable physical, mental and psychosocial well-being." In other words, residents come first, and must be afforded the potential to live each day as though they were in a true home.

What is it that makes this plain-looking woman, who was "named after my daddy," so successful, such a crusader? "There's love in her heart," a friend told me, "but, at the same time, there's a blaze in her soul."

The details of her biography offer small clues: with her degree in social work, she came out of Oklahoma and was hired by a young Ralph Nader. Later, she teamed up with the indomitable Maggie Kuhn, a guiding spirit of the aging movement. Elma once told me, "We worked unbelievable hours." Thus, significant experience was gained alongside formidable mentors.

In 1975, Elma Holder founded NCCNHR, and has kept this non-profit entity viable, and growing stronger, through force of will, guile, vision, and by being stubborn. Today, thanks to Elma's generous spirit, longtime staff workers have pensions, along with the respect of those in the federal government. As for Elma, she no longer is the coalition's executive director. She's no less vigilant, however.

"I developed cancer," she said to me, as one might announce they had come down with influenza. "It's multiple myeloma... there were some rough times." In a letter to family and friends, she acknowledges: "I'm one of the fortunate survivors. Through fate, good medicine (interferon, plus) and a tremendous amount of love and support, I'm still holding on in the cancer drama..."

At this auspicious, quarter-century anniversary, co-workers, and others, have submitted messages for an Elma Holder scrap book. One longtime friend remembered dark times. "I asked her, where she found the strength to go on?" this writer recalls. Elma answered, "As long as there's breath in my body, I have hope."

Finally, this is what all nursing home residents have unknowingly inherited: they have Elma Holder in their corner, and thus, can hold onto hope.

Thursday, February 02, 2006

The Way It Is

There are planty of good reasons to be critical of the way that our society sees, thinks about and talks about age and the aged. Even the words we use are loaded with hidden and not very hopeful meanings. Consider, for example, that the United States Senate is full of old men. This should come as no surprise given that the word senate is derived from the Latin word senex, which means “old man.” Senex itself is descended from the Indo-European sen, which means “old.” Senility, another old man word, is not used as often as it used to be. Before it was replaced with the more clinically precise term dementia, it was used to refer to the relentless decline in thought, memory, and understanding that seemed to accompany old age. Senility has always been a fearful thing.

"Sen" also gives us senior with its interesting twofold meaning. A senior in college has reached an apex of achievement, a senior officer is always in command, and senior debt is the first to be paid off. Senior citizen, on the other hand, is unlikely to bring power and achievement immediately to mind. It is a euphemism for “a person declining into old age.”
The schizophrenic nature of age-related words can be seen in the sentence, “Se_or Smith may be senile, but he is our state’s senior Senator.” The clash between the affirmative “senior senator” and the negative “senile seniors” can be condensed into a single word, “senescence.” Linguistically, “senescence” is closely related to “adolescence,” that word being formed by the combination of the Latin words for up and growth, it literally means “growing up.”. Adolescents struggle to grow into adulthood. Senescence could, quite easily, be understood as the act of growing into old age. In common usage, however, it carries much more pessimistic meaning. “Senescence” generally refers to the gradual, painful undoing of the vigor of adulthood. It is a falling apart, the sum of all the unhappy changes that accrue after a brief moment in the full sun of youth.

The Caregiver's Tale

Caregiving has the strange capacity to be both emotionally difficult and personally rewarding. Its complex nature is reviewed by the writers collected in the new book THE CAREGIVER'S TALE: LOSS AND RENEWAL IN MEMORIES OF FAMILY LIFE, by Ann Burack-Weiss. The publisher says that...

"In this eloquent new work, Ann Burack-Weiss explores a rich variety of published memoirs by authors who cared for ill or disabled family members. Contrary to the common belief that caregiving is nothing more than a stressful situation to be endured, memoirs describe a life transforming experience-self-discovery, a reordering of one's priorities, and a changed view of the world. The Caregiver's Tale offers insight and comfort to individuals caring for a loved one and is a valuable resource for all health care professionals.

Identifying common themes, Burack-Weiss describes how the illness career and social meaning of cancer, dementia, HIV/AIDS, mental illness, and chemical dependence affect the caregiving experience. She applies the same method to an examination of family roles: parents caring for ailing children, couples and siblings caring for one another, and adult children caring for aging parents.

Jamaica Kincaid, Sue Miller, Paul Monette, Kenzaburo Oë, and Philip Roth are among the many authors-known and unknown-who share their caregiving stories. Burack-Weiss provides an annotated bibliography of over one hundred memoirs as well as an accompanying chart to help readers quickly locate those of greatest interest to them."

Read more about the book here

(Columbia University Press, 2006).

Aging and Creativity

People usually think of creativity decreasing with age. After all, old dogs rarely learn new tricks. The evidence on the matter tends to run in the opposite direction. There are good reasons to see old age time as an ideal venue for creating art and music. This article (an outcome of the White House Conference of Aging) brings new light to the subject.

Aging and Creativity

Life is a Journey

People have always tired to make sense of the crazy thing we call life. To understand life we must understand age. There is no way around it. Here is what the philosoper Carl Jung had to say about it...

"Wholly unprepared, [people] embark upon
the second half of life. Or are there
perhaps colleges for forty-year-olds which
prepare them for their coming life and its
demands as the ordinary colleges introduce
our young people to a knowledge of the
world and of life? No, there are none.
Thoroughly unprepared we take the step into
the afternoon of life; worse still, we take
this step with the false presupposition that
our truths and ideas will serve us as hitherto.
But we cannot live the afternoon of life
according to the programme of life's morning
--for what was great in the morning will be
little at evening, and what in the morning
was true will at evening have become a lie."

--Carl Jung, "The Stages of Life"

Tuesday, January 17, 2006

Old is Good

Old people are valuable assets, or should be. This article from the Washington Post hits the nail on the "gray" head.

It was minus 26 degrees -- the dead of winter in Mongolia -- when Jerry Friedman stepped off a plane in Ulan Bator and resumed his search for the oldest people on Earth.

Friedman was in awe the next morning when he met Damchaagiin Gendendarjaa, a 110-year-old Tibetan Buddhist lama: He had earned a doctorate in theology at age 106. He had all his teeth. He had never seen a doctor in his life, yet mild arthritis in his lower back was his only ailment.

"He was the holiest person I've ever been in the presence of," Friedman recalled of his February 2003 trip. "It's hard to describe, other than he had a certain countenance I had never experienced before."

The lama was one of more than 50 supercentenarians -- people at least 110 years old -- whom Friedman interviewed and photographed for a book, "Earth's Elders: The Wisdom of the World's Oldest People."

Friedman, 58, a commercial photographer, closed his Connecticut studio so he could travel the world to track down his elderly subjects, verify their ages as accurately as possible and document their life stories.

"This process has changed me completely, just meeting these people," he said. "I have learned to listen. I have learned that my own cultural bias needs to be addressed and changed."

His journey started in 2001, when he "embedded" himself at his mother's assisted-living facility in Westwood, Mass., and lived there for four days. He set out to get a glimpse into his future, but he saw much more than that.

"What I saw really opened my eyes. I saw so much good and bad," he said, explaining how he found people "living in a cultural shell.

"We as a culture have found a way to move them out of the mainstream and box them in."

And the good? "They are people we can learn from," he said. "They are just sitting there, waiting to give us this extraordinary information. You just have to listen."

Before he could embark on his worldwide search, Friedman needed a "compass" to find the world's oldest people. He found one in Robert Young, an Atlanta-based investigator for the Gerontology Research Group, which keeps a global database of supercentenarians.

As of Dec. 21, the group's database listed the names, ages and home towns of 63 women and 8 men who are at least 110 years old, but that's only the number the group's researchers have been able to validate. Young said there are an estimated 300 to 450 living supercentenarians worldwide, with around 60 in the United States.

To separate actual supercentenarians from those who are mistaken or lying about their age, Young and other researchers search for birth and baptismal certificates, marriage licenses and census records.

"Believe it or not, scientists have not found a way to accurately determine the age of a human body," he said. "So if there is no paperwork, there is really no way to prove a person's age."

Friedman started his project in Manchester-by-the-Sea, Mass., where he interviewed 112-year-old Ann Smith at a retirement home. Smith made him wait an hour while she finished her dessert.

"She was testing me," he writes in his book. "At 112, time was of no importance to her. . . . It was her will against mine and she dictated the terms."

From there, his search took him across the United States to New York, Florida, Georgia, Nebraska and South Dakota, and overseas to Italy, Portugal, Spain and Morocco. Ten of his subjects were from Japan, which Friedman describes as the "gold standard" for how a country treats its elders.

"There is a basic reverence for their knowledge," he said. "Once they reach a certain age, they are venerated for being cultural treasures."

One of the first people to whom Friedman showed his photographs was Lama Surya Das, a Buddhist teacher who founded the Cambridge-based Dzogchen Meditation Centers. Surya Das, who lived in the Himalayas for 20 years, agrees with Friedman that elders in the United States are largely an untapped resource.

"In general, in the old Eastern cultures, age is a mark of respect, experience. The people have a place in society," he said. "In the modern West, everything is about the new, the culture of youth. There is not that much respect for the elders."

FullArticle Here

Walk This Way

The good news for people who develop the exercise habit continues to grow.

This recent article in USA Today lays it all out...

"Older people who exercise three or more times a week are less likely to develop Alzheimer’s and other types of dementia, according to a study that adds to the evidence that staying active can help keep the mind sharp.

Researchers found that healthy people who reported exercising regularly had a 30 to 40 percent lower risk of dementia.

The study, published Tuesday in the Annals of Internal Medicine, reached no conclusions about whether certain types of exercise helped more than others, but researchers said even light activity, such as walking, seemed to help."

Read more here

A Powerful Illusion

Over the years I have learned how to work with my mind rather than against it. For reasons that I can not explain I often find that an idea, word or phrase will enter my mind and start to resonate there. If one of these thought fragments stay around for a month or so, I start paying attention. The next step in my creative process involves the obsessive scribbling of notes and diagrams in one of the many black and white speckled notebooks I use for that purpose. I like to write in ink and never correct or cross anything out. The intent is to discover whether there is anything to support sustained interest in the “thought fragment” that has been circulating in my mind.

Most ideas of mine perish at this point. I have boxes full of notebooks that are all filled with ideas that went nowhere. (In retrospect we can all be glad that they sputtered and died because some of them are really awful.) The good ones begin to take form and substance. If I find that I can bend them, ornament them and breathe some imagination into them then the hard work can begin. This is where I find myself with the latest idea that I have been working on.

The thought fragment that has been the focus of my attention is…

“Aging in Place is an Illusion”

Book Wins Award

The book What Are Old People For? was just named runner up in the book of the year awards given by the American Journal of Nursing. Hoo Rah.

You can read more about it at the Pionner Network blog kept by Joe Angelelli at this address...

They have loads of good information there and tell them I sent you...

Sunday, January 08, 2006

Diamonds not Devils

I live in a small rural county in Upstate New York. There is little industry, few tourist attractions, and no college campus. Taken together, these factors have limited the area’s economic growth and the county lost population in the 1990’s. Not surprisingly, the Chamber of Commerce is always searching for ideas that could boost the local economy. While I was writing this book the Chamber’s director called me up to talk about economic development. I listened as she described her efforts to lure manufacturers to the community and her frustration with the difficulty of this work. What, she asked me, would I suggest the county do to spur growth?
I told her that old age is the answer.
Many people believe, usually without giving it much thought, that older people represent a net drain on community resources. The idea being that the fewer older people live in any given community, the more healthy and prosperous that area is likely to be. This bias grows from our society’s careless ageism. In truth, older people represent a net social and economic gain for communities fortunate enough to recruit them. Rather than trying to lure a defense contractor to our county the Chamber of Commerce should be making itself attractive to older people.

The same "thow away" mentality can be seen in the working world of people who care for elders. The idea of the Shahbaz is valuable because it matches the vision of a valuable elderhood with the idea that the people who choose to work with elders being equally valuable.

Tuesday, January 03, 2006

The Snark Says It's Good...

This post is from the largest and best "branding blog" on the web.

They think we are doing it right...


Naming and branding a new ‘nursing home’ model

Sometimes it all just comes together. Actually it never just comes together. But the confluence of hard work, contrarianism, and vision that is the Green House Project is a thing of beauty on each and every level. The folks at Green House have remade the stagnant and stagnating nursing home model into a positive celebration of life. And followed through with great naming and branding to boot. From their website:

The Green House is designed to be a home for eight to ten elders. It blends architecturally with neighboring homes, includes vibrant outdoor space, and utilizes aesthetically appealing interior features. The first Green House were designed by Richard McCarty, the McCarty Company, in Tupelo Mississippi. Richard and Dr. Thomas collaborated to create an environment that would be a home to the elders. The result was a house where each elder has a private living space with a private bathroom. Elder’s rooms receive high levels of sunlight and are situated around the hearth, an open kitchen and dining area. While adhering to all codes required by licensure, Green Houses looks and feels like a home, and contain few medical signposts…

…The Shahbaz or elder assistant is the direct care provider who prepares the meals and maintains the household in the Green House. Shahbazim are certified nursing assistants who have advanced training. They work as a self managed work team to complete assignments, scheduling and all of the work in the household. They are coached by a guide, usually the administrator and advised by a sage, who is a community dwelling volunteer elder. There is a clinical support team available to the elders and the Shahbazim. The clinical team visits the house to provide skilled nursing and therapy.

The word Green House is nicely repurposed to reflect the idea of individual houses rather than the long-corridored, anonymous, institutional model. And of course a greenhouse is a protected, nurturing, life-affirming environment.

Let’s also note that the residents are participants in Green House Project, not residents of something called Green House. Calling it Green House Project helps reinforce the idea of mind-share ownership for the residents, and the term “Project” conveys an ongoing quest, a sense of continual experimentation. Nicely done.

The term “Shahbaz” is in place to signal that this is an entirely new model, free from the constraints of the pervasive system. “Shahbaz” demonstrates rather than explains that break and as any Shahbaz will attest, is a self-propelled conversation starter.

“Shahbaz” is a Persian term for “royal falcon”, and is the name of a helpful bird in a short story written by Green House founder Dr. Thomas. The word’s definition is random in this application, but its quality of mystery is what makes it well chosen to define a new concept and to prompt people to constantly ask, “What’s a Shahbaz?”

Getting the public interested enough to lean forward and ask questions, enabling you to engage them in a conversation, is always a big win.

One more thing they got right is the collateral surrounding the Green House identity, where, thank goodness, you won’t find the color green.

What is a Shahbaz

What exactly is a Shahbaz? Here is the definition that I use...

shahbaz (noun) A shahbaz is a person who works in a Green House with elders and is dedicated to (1) the enlargement of the skills and capacities that are latent within the elders and (2) the pursuit of the most positive elderhood possible. They are the midwives of a new elderhood. Plural: shahbazim

What is a Shahbaz

What exactly is a Shahbaz? Here is the definition that I use...

shahbaz (noun) A shahbaz is a person who works in a Green House with elders and is dedicated to (1) the enlargement of the skills and capacities that are latent within the elders and (2) the pursuit of the most positive elderhood possible. They are the midwives of a new elderhood. Plural: shahbazim

Saturday, December 31, 2005

2006: A New Year and A Good Year

I am sitting in front of a roaring fire on the afternoon of New Year's Eve Day. It is cold and snowing outside and warm and toasty inside. The year to come is going to be good for the Green House movement and for the Shahbazin who make it all happen. I am hoping that, as time goes on and more people come to visit this blog and begin to offer a few of their own comments, the Shabazim Blog will turn into an online home for all things related to the work of the Shahbaz. That is my New Years hope and dream.

By the way, the Shahbaz figured in this recent front page article in Texas, click the link to read more...

Tuesday, December 20, 2005

Welcome to the Shahbazim Blog

In an effort to share thoughts and ideas about the work of the Shahbazim, I will be making regular entries into this blog. All are welcome here and there is a feature that allows readers to offer feedback. Hopefully, the comments offered here will bring insights, ideas and new points of view to the debate over how best to think about the ways we care for and about older people.

Welcome and enjoy.

Dr. Thomas