Posted in N&V

Dealing with Health-Related Crises

by Connie Kent

For a medical crises, we know to dial 9-1-1. But what about medically related crises that aren’t emergencies? In January I approached Father Joel to discuss a perceived need. A couple of residents I knew, both living independently in cottages, were recently unable to get the care they thought should have been available to them from the Manor following medical procedures which left them temporarily disabled. My question to Father Joel: Who should residents turn to for help in dealing with such a crisis? These residents felt they were abandoned when they had been led to believe the Manor’s promised “Continuum of Care” would provide the services they needed. Other crises that might need such a resource are a devastating diagnosis, the need for help for a spouse whose health is failing, or the sudden death of a partner.

How can we help each other, living together as we do, at this point in our lives? One way is to offer our support when we see someone in need. Please see Need Help?

Another way is to develop systems for dealing with our concerns and to make them known. Following the Residents’ Forum Zoom meeting in February, a small Residents Council Ad Hoc committee was formed to address some of the health-related issues I had brought up with Father Joel. Failing to come up with a name for our new committee, we call it The Unnamed Committee. Members include Gary Crites, Gini Armstrong, Dan Wagner, Jan Rowe, Jim Ellis, Joni Johnson, Bob Carter and me. We’ve met several times via Zoom. Here are the topics we have addressed.

1) Issue: One of our residents spent months after he moved in, going from office to office here at the Manor, collecting information about how to help his ailing wife. 

Q: What single person or agency here at the Manor should residents turn to in a crisis?

A: In May, at the time of this writing, Debi Watt has told the committee that Resident Services is the office residents should consult when they’re in crisis.

2) Issue: medical transportation. More and more medical procedures are conducted in surgery centers rather than hospitals, and frequently they are scheduled early in the morning, before regularly scheduled Manor Medical Transportation is available at 8 o’clock.

Related is the issue of transportation back home. Following in-hospital out-patient procedures as well as surgery center procedures, patients are routinely discharged while still in need of round-the-clock care. If I am such a patient, I may well be woozie from anesthesia and need help navigating. 

Q: How can I get to early morning medical procedures? And will Medical Transportation pick me up and see me safely back to my unit?

A: This issue has been turned over to the Health Services Advisory Committee, which is currently evaluating the extent of the need. Their assessment should be available in 60 days.

3) Issue: If I am discharged to a nursing facility and there is room and sufficient staffing in the Health Center, I will be given a bed there. But then there is the issue of cost. In the past, one had to have been hospitalized for at least three consecutive nights in the hospital for Medicare to cover the expense of skilled nursing care.

Q: With more and more out-patient procedures and short or non-existent hospital stays, will Medicare cover the cost of skilled nursing care?

A: Melissa Preston, Health Services Administrator, says that this past year, due to the COVID 19 pandemic and the need to relieve the burden on hospitals, CMS (Centers for Medicare and Medicaid Services) has authorized hospitals to activate waivers that allow for the 3 midnight stay qualification to be waived. She says we have seen it happen several times with our local hospitals, where individuals have been discharged to the skilled nursing facility under this waiver and have qualified for skilled services without a 3 midnight stay. However, the ability to activate those waivers expires soon, unless it is renewed at the Federal level. Ed. note: please refer to Hill Topic‘s “Home Health, Home Care: Support for Vulnerable Times” in the May 2021 issue and “Continuing Care Levels Explained” in the April 2020 issue.

4) Issue: in-home services. Tremendous confusion has existed around what services the Manor provides, in part because of the similarity between the terms “Home Care” and “Home Health.” 

Q: If I am returned to my unit, what services are available to me?

A: Melissa Preston gave a very helpful presentation on the difference between Home Care and Home Health. Her presentation is available on the Health Services page of myRVM. Here is a brief summary.

The Manor provides Home Care, primarily to those in Residential Living on an on-going basis but to Independent residents also, for short-term needs, depending on staff availability. Home Care includes help with activities of daily living, meal preparation, companionship, and running errands. It does not include health care. The cost may or may not be covered by one’s insurance.

Home Health services are not provided by the Manor but rather by any one of several outside agencies. Home Health services are typically prescribed by a doctor and provided by licensed personnel such as RNs and therapists. They include such things as administration of medications, wound treatment, IVs, and so on. The cost may be covered by one’s insurance.

5) Issue: end of life planning. If we die without having left information about our affairs and instructions for what to do next, those we leave behind face not only grief but aggravation as well. Even though our own death is a topic we might prefer to ignore, most of us living here can expect to die here. We would do well to prepare for the inevitable while we are most able. This will save our families, friends and the Manor a whole lot of stress.

Q: What do I need to do to ensure that my family and/or my executor knows how to handle my affairs after I die?

A: The Unnamed Committee is currently compiling a document with information your family and/or executor will need. This information includes details about your medical, financial, insurance, and legal contacts and documents as well as a checklist of people and agencies that will need to be contacted at the time of your death. Of course, the information will need to be reviewed periodically and modified as necessary. But the time to take care of it is now.

A-2: Resident Services Director Cynde Maurer and Debi Watt, Resident Services Coordinator, have invited Beth Knorr, Director of Trust Services for Oregon Pacific Bank and member of the RVM Foundation Board, to address residents on “Implementing Your Estate Plan,” which will air on Channel 900 on June 23, 2021, at 10 am. A document listing appropriate information to include in such planning will be made available in advance of that presentation.

6) And now there’s a new wrinkle: Issue: what happens when you’re discharged from the hospital on a weekend, you live in a cottage, and you need at-home care? This issue has not even been brought to the committee yet. Click on the link to see Bob’s Story.

Father Joel is movin’ on!

By Joni Johnson

On May 14, 2021, after being at the Manor for 9 years, Father Joel has left us in body but not in spirit!  During his time at RVM, he has had an enormous impact on its residents. He has created an abundance of programs here that crossed all sectors of the campus from the religious to the not at all religious.  To name but a few of his coordinated efforts: the 19thHole, Speaking of Faith, monthly Shabbat services and dinners (pre-Covid), The Chanukah Party, Secular Conversations, Socrates Café, Two Beards and a Cup of Coffee, Story Corps, and a series of Education seminars both on campus and in the Valley.

                   Father Joel’s Last Day

When I asked residents what qualities they saw in Father Joel, this is what they said.  He was compassionate and open to all. He was accepting and had an ability to connect with everybody. He was ecumenical.  It didn’t matter what your religion was or whether or not you were religious.  He was there for you.  He had a wonderful sense of humor.  His friendship with other religious leaders of varying faiths in the valley brought our residents a depth of experiences both on and off campus. He appreciated having deep philosophical discussions that were not necessarily based in religion and realized that there were many residents here on campus that saw themselves as non-religious and even agnostic or atheists who wanted and needed a place to congregate and speak about important spiritual and intellectual issues.  He made everyone feel that he liked them, regardless of background.  And as someone said when they talked about his replacement, we certainly need someone who likes old people. Father Joel certainly did.

Transition

by Joel Maiorano (written Sunday, May 16)

As change enters our body,

our bones question – is it time again?

We shed, like seeds dropping from a tree

announcing out loud … “part of us is dying,

while proclaiming we are alive!”

Unwelcoming, most often yes

not unlike aging, yet inviting us

to alter ourselves

like a spring caterpillar…

unsure if this is our end

or a new beginning.

When he first came to the Manor in 2012, he came as a replacement for Don Hildebrand, who was well liked.  Father Joel said that it was the respect that Hildebrand engendered that allowed him to confidently engage in producing the programs that he did.  And of course, he gives much credit to the residents and their leadership, service and insight that created an opportunity for his leadership. He claims it was residents and their involvement that created his effectiveness.

   

He said that leaving will be very difficult for him.  He will miss engaging with the residents and having the intimate relationships afforded him through his experiences here – counseling, visiting those who have lost a loved one, or just living life together.   “Through my position here, I was both a minister of spirituality and a person who helped create belonging.

 “Leaving breaks my heart and it will take time for it to heal.  However, leaving was also my decision because I am moving into a position that I have wanted for a long time.

Father Joel with Barbara and Fred Moore and Becky Hyde

“I will be the Chief Mission Integration Officer at Providence Hospital.  It is more of a managerial role rather than working with patients.  I will be helping to shape and influence how the mission, values and vision are lived out in the daily life of the hospital. I will be the first non-Catholic or half Catholic in my position.    My plan is to listen to the heartbeat of the employees, study the rhythms of how the organism lives and laughs, so that I can best support the ethos of the sisters who started the hospital and celebrate Providence as a beacon of hope. My question will not only be what is universal “catholic” healthcare, but more importantly, how do we live it out to make it inclusive for all.”

We will miss you, Father Joel in so many, many ways.  But we wish you the very best in your new endeavor.

 

A Cautionary Tale

What’s New in June

Dear Readers: We don’t have archives by issue, but the Complement’s format has been revised so that you can view all of the past articles on any given page.  If there is a “Load More” link at the bottom of the page, clicking it will bring up the older articles — all arranged in chronologic order.

An added service feature — if you  would like to get a personal email when we put out the RVMlist notice of a new issue or new material, email us at openinforvm@gmail.com and we will put you on the mailing list

NEWS & VIEWS

Dealing with Health-Related Crises, by Connie Kent
      -The tangle of medicine and management

A Few More Health-Care Questions, by Bob Buddemeier
     -Even more tangles

Father Joel is movin’ on!, by Joni Johnson
      -Hail and Farewell — with an original goodbye poem by Fr Joel 

A Cautionary Tale — Anonymous
      -An unprepared-for death

The Experiment Continues — README Again!
–     -An invitation to sample an opinion page

 

         in Big, Borrowed, or Both

Toward a Planet-Wide Culture of Non-Violence, by Russy Sumariwalla
     -a reprint of an article published in the UN Chronicle, 10/2/2018

3550:  the Portland Mirabella quarterly magazine (most recent issue)

Mirabella Monthly, Newsletter of the Seattle Mirabella (most recent issue)

 

ARTS & INFO 

Manor Penthouse Bonsai, a photo collage by Reina Lopez

Do Cats Grieve?  by Bob Buddemeier

Timely Word Playby Connie Kent

RVM May-July Event & Entertainment Schedule

June Library Display, by Anne Newins

Power Couple — (Book Review), by Bonnie Tollefson

Digital Currency Firm Eyes Manor Retail Location, by A. Looney
       –Our Nit-Wit Newz correspondent has returned!

PREPARE

‘Tis the Season to be…ALERT!, by Bob Buddemeier
      -Don’t put that mask away yet!

 

New Features and Services

We don’t have archives by issue, but the Complement’s format has been revised so that you can view all of the past articles on any given page.  If there is a “Load More” link at the bottom of the page, clicking it will bring up the older articles — all arranged in chronologic order.

 

An added service feature — if you  would like to get a personal email when we put out the RVMlist notice of a new issue or new material, email us at openinforvm@gmail.com and we will put you on the mailing list

THE EXPERIMENT CONTINUES — READ ME AGAIN!

THE EXPERIMENT CONTINUES

For the next one or two months the editorial team of The Complement will provide trial posting of VIEWPOINTS, an online resident discussion forum .

For our second VIEWPOINT, we move away from the theme outlined in the following paragraph.  Pratibha Eastwood’s essay War!?  Not Again is extremely personal, and insightfully addresses racism, war and politics.  It is more than we want to handle in the Complement, but not more than we think deserves a forum at RVM.  Comments and contributions solicited.

The intended topics started out as RVM community issues involving residents, Residents Council, and Administration.  These are normally considered taboo – to be ignored because of the potential for divisiveness or disruption.  We believe that a community of adults with undeniable common interests should be able to identify and work toward constructive resolution of issues of community concern.  In the interests of civility and accuracy the discussion is moderated and all contributions subject to editing.

RVMlist discussions and resident input to the editors have suggested a need for this kind of forum.  However this goes well beyond the role envisioned for The Complement, so we will see if the trial can develop an independent identity.

For VIEWPOINTS to continue beyond a trial period, we will need to have:

  • Significant participation in the form of contributed articles or substantive comments;
  • Expressed approval at least comparable in magnitude to expressed disapproval; and
  • At least two individuals willing to serve on an editorial board that provides selection of topics and moderation of discussion.

Comments on either the basic idea of the discussion page or the specific contents of the articles presented may be submitted by either of two pathways:  The Reply forms at the end of each posted article, or by email to myinforvm@gmail.com.  We will periodically summarize and post results; although we prefer signed communications we will honor requests for anonymity when we publish results.

The first topic is transparency in RVM/PRS decision making.  Mark Edy has initiated RVMlist discussions on this topic more than once.  The editors considered his submitted compilation reasonable, respectful, and indicative of as much effort to find answers as could reasonably be expected of an individual resident.  We worked with him to produce a briefer summary of the issues he presented, and have added brief notes from the RVMlist discussion of the freeway off-ramp project, and a brief history of key actions with respect to that project.

Please let us and your fellow residents know your views on this online forum experiment and on the issues raised by Mark Edy’s and Pratibha Eastwood’s essays.

………………………………………………………………………………………………………………………………………………………………….

The Manor Mart is Open!

ANNOUNCEMENT

The Manor Mart is now open for business on the lower level of the Terrace building, across from the Clinic, where the Pharmacy used to be. It serves RVM residents and employees between 10 am and 3 pm Monday through Friday.  The Manor Mart comes close to being a necessity for some of our residents, and can be a convenience for all of us.  We want it, we need, it and we should support it by using it when we can.

Historical perspective, Questions and Conclusions

. . . about the I-5 offramp construction project

by Connie Kent

In his broadcast talk to residents on Friday 7 May, Stan Salmonson, RVM Executive Director, offered some background information to help clarify confusion over the freeway offramp construction project at the southbound I5 exit at Barnett. Hoping to gain some historical perspective, I consulted Faye Isaak’s Vision with a View: How Rogue Valley Manor Evolved Through Grace and Gumption, published in 2015.

In his talk, Stan explained that in 1992, RVM bought the properties on Ellendale north of the Annex. According to Isaak’s book, Tom Becker was the Administrator of RVM at that time, serving from 1978-1991 (Isaak 77).

In 1997, he said, RVM submitted a PUD* request to the City of Medford. Co-administrators of RVM at that time were Patricia Kauffman and Brian McLemore (Isaak 78), while Tom Becker had become CEO of Pacific Retirement Services the year after it was formed in 1990 (Isaak 49-50).

Finally, in 2019, Solmonson explained, RVM submitted an update to the PUD, in order to “increase the trip count.” Sarah Lynch was then the Executive Director of RVM, and Brian McLemore was CEO of PRS. Since that time, Sarah Lynch has become vice president of administration for PRS.

According to the Mail Tribune article of 23 April 2021, “. . . obviously (Rogue Valley Manor) is wanting to expand and the reason for this project — it’s part of their mitigation for some of the development that they’re planning on building on their property.” Quoting Sarah Lynch, the article goes on to say, “The Manor has a stake in the project because it owns a property at 1020 Ellendale Dr. That piece of property is up for sale, Lynch said, and is only part of a commercial village, which the Manor is planning to develop.”

Sarah Lynch adds, “The trip cap applies to the entire commercial village, not just that property.”

Communications Advisory Committee minutes of May included this: [Sarah Lynch] explained that RVM’s request to change the zoning of the property it owns on Ellendale – from “10‐unit residential per acre” to “commercial” – brought with it a requirement by Oregon Department of Transportation to increase the trip cap traffic by more than double. She noted that the property, which RVM has on the real estate market, is more valuable if zoned for “commercial.”

Apparently because development of the property on Ellendale would be enhanced by less congested access from the freeway, Oregon Department of Transportation required RVM to pay for the off ramp upgrade.

That’s the historical perspective. Here is what I wonder about. There seems to be a clear pattern in this series of events: the relationship between RVM directors and PRS leadership. Is there any significance to this pattern?

I would like to learn more about how developing property for commercial purposes jibes with RVM’s status as a not-for-profit entity. On the surface, there would seem to be a disconnect. I don’t know enough about how this works.

My tentative conclusion is that since the property value has undoubtedly increased since 1992, RVM will benefit financially from having acquired the property almost 30 years ago. And maybe that sort of transaction is part of what has allowed RVM to continue on a sound fiscal path for the last sixty years. Thus, despite potential inconvenience to RVM residents in terms of traffic congestion on E. Barnett and Ellendale, we, the residents, benefit from living in a community that is financially stable. I realize that this conclusion doesn’t address all my questions. But it’s a start. And I trust that more information will become available. 

* PUD stands for Planned Urban Development, a real estate development that integrates residential and commercial buildings with open spaces in a single project. It can be loosely considered as a planned unit development (PUD), which uses the same acronym and for all intents and purposes is interchangeable (Investopedia).

 

Sources:

Investopedia. https://www.investopedia.com/terms/p/planned_urban_development.asp

Isaak, Faye. Vision with a View: How Rogue Valley Manor Evolved Through Grade and Gumption. 2015.

 

Confusion over Freeway Offramp Construction

by Connie Kent

A Medford Tribune article, published on April 23, 2021, caused confusion among Manor residents. The article claimed a single-payer construction project was being undertaken to widen Exit 27, the South Medford I5 freeway exit for traffic coming from the north, so that, during peak hours, traffic on the off-ramp won’t build up to the point that it interferes with the fast-paced traffic on the interstate.

The single payer is reportedly RVM. One wonders, naturally, what’s in it for RVM? The article attempts to explain: the project will “mitigate” some of the development planned on the empty lots at 1020 Ellendale Drive (near the two Hilton hotels), which are owned by RVM, and which, according to Sarah Lynch, are to become part of a “commercial village”.

A number of comments were posted on the RVM listserv, expressing everything from puzzlement and concern, to alarm and distrust.

“. . . not enough has been explained.”

“The article in yesterday’s MT brings more questions than answers.”

“This change will increase the traffic onto E.  Barnett.” “ RVM population traffic that tries to make a left turn from Ellendale onto East Barnett. . . already has to wait up to five minutes to make that turn, and very few vehicles can make it through that light on one light cycle.”

“How can RVM develop a ‘Commercial Village’? [It] is a non-profit CCRC and cannot be in the business of selling or providing items for a profit. That is the reason the golf courses are leased to a sub-corporation for profit of PRS as RVM cannot offer golf play for a fee.”

“I am unsure as to the overall benefit to RVM. Possibly I do not have enough information.”

“It is amazing what the RVM Board approves without the residents being aware???”

A skeptic summed it up: “I think the fundamental question is about what it means to live in a retirement community that happens to be operated by a corporation whose primary objective is real estate development.”

Surviving Surviving

By Joni Johnson

Becoming suddenly single through the loss of a loved one is not an easy thing to navigate. There is, of course, the paperwork, which I understand is quite an adventure.  But in addition, all of a sudden you are faced with a whole new world to maneuver.  Who are my friends?  I used to be a couple.  What am I now?  How do I play?  Where do I eat and with whom? So many questions while at the same time you are grieving for your lost love and the comfort and habits of the past and worried and uncertain about your expectations for the future. . . .

And yet, there are many here on campus who arrived at RVM as a “solitaire”- either because they have always chosen to be single or because they have chosen to remain single after becoming widowed or divorced. In many ways, they have faced the same questions, but without the same pain attached, and I thought it would be interesting to learn how they have managed to enjoy their life as a single person.

In writing this article, I interviewed men and women who had lost their significant other while living at the Manor as well as men and women who had come to RVM content in their single status.  This is what I found.

One thing that made a difference for those who have come as couples is how dependent each one was when they were a twosome.  If the suddenly absent partner had specific jobs in the family like doing the finances or maintaining the household, the suddenly single partner might be required to learn all sorts of new skills. In some of the cases I interviewed,it meant learning how to cook, getting the house ready for the cleaners, how to wash the clothes, learning the computer, taking the dog out, learning how to do the taxes. For some, that meant needing extra help at the beginning. Where once they could rely on someone else, now they had to do it alone. And all these adjustments must take place at exactly the same time one is grieving. It can be overwhelming. Luckily, at the Manor, there is guidance and support if one looks for it. There are people here to help with taxes and computer skills and all sorts of other advice.  It just requires asking for it. People to Contact for Help at RVM

Oddly enough, when I talked with those who have come as “solitaires”, and I asked them what they liked the most about being single, they said it was that they felt empowered to make decisions on their own. They didn’t have to worry about what anyone else thought.  They could go where they wanted, travel where they wanted. They loved being on their own.

In a sense, the biggest issue seems to be establishing a new self-vision. That is hard to describe and is more easily explained in how one navigates the new world that used to be the terrain of “couples”.  All of a sudden, one’s partner for dinner is gone. Going to plays and concerts is now different.  One has to sort of reinvent who one is. And that usually means going way out of one’s comfort zone.  If you were lucky and were a member of a religious group or a bridge group or a dog group or the Hawaii crowd, you were fortunate because some of your work was done for you. Such people were often scooped up and taken care of by a group that they were already a part of. That might mean being invited to lunches or dinners or other events.  However, it often depended on the person him or herself to branch out and invite others to an event which might include a meal or a play or concert.  And that certainly was more difficult.

Some people used the friendship tables to get to know others.  That will be changing in the future since friendship tables may be disappearing.  In the future, when reservations are no longer required, RVM restaurant hosts will be asking guests if they would like to have others join them or if single members would like to join other tables. This might make it easier for those who are alone to dine with others without making arrangements ahead of time.

Another loss for those new to the single life was being alone at night when typically one had someone to talk with and share the day.  That is hard to replace.  It just takes time.  In my discussion with those who have made peace with their loss or who chose to live as a single, it doesn’t seem to be an issue.  Somehow, life just takes over.  It’s when one watches TV or reads or writes.  And if one has something important to discuss, they find someone to call or Skype or Facetime with.  It just doesn’t seem to be a problem any more.

For those who traveled a lot with their spouses, all of a sudden, there are travel groups.  In fact, I know of several people who have found friends they love to travel with through these groups, so that feeling of loneliness just lasted one trip.

What people tell me is that the bottom line to “surviving surviving” is really up to you. There are all sorts of ways to get help with the grieving process.  Counselors like our own Linda Bellinson who provides private sessions and groups, Father Joel (and his soon to be successor), Chaplain Anya and outside counselors and groups are wonderful resources to help newly singles move through grief to the other side.  Friends, especially those who are newly or long-time single, are wonderful resources for activities. My interviewees say,  “Don’t wait for them to invite you.  Invite them! Join activities, especially now that Covid is moving away and we are rejoining the human race again.”

Those who have chosen to be single have the same issues.  Who do I eat with?  Who do I play with?  How do I spend my time?  They solve them the same way.  They ask people out on dates!  They are the masters of their fates.  And that is what they love about being single!  And they say, so will you. Just give it time.