Memory Care

ConnecToMe – a Call to Mind

by dmccarron | Feb 7, 2019 | Events

The UMBC Erickson School’s 7th Annual Memory Care Summit in Orlando delivered on i`ts promise “to transform thinking about memory care.” This year’s program theme of “connections,” was inspired by Dr. Judah Ronch’s presentation surrounding brain science and neural network mapping. His message was clear. Each of us are entirely unique by virtue of both the memory formation and retrieval processes. In fact, even a singular memory becomes layered with individuality as it is compounded by recollection. We left the conference focused less on the hard science of 3D brain scan imagery and more on the natural rhythms of engagement – and how active awareness and recognition of this process can lead to higher states of order. Whether we are talking about people, projects or memes themselves – multiple associations will always create resiliency. This continuously programmable framework helps to either sustain or redefine our elusive and ever-changing concepts of “self” and “other.”

Connectomics

While recapping the conference in prior years, we have always emphasized the intentional bookends crafted by The Erickson School. Dr. Ronch launched the first day by reflecting upon the concept of the “connectome” and how its lessons can help us to improve and expand upon the culture change movement that is still underway. In essence, person-centered or person-directed care is not just a good idea – it is an elevated approach that honors the power and persuasiveness of partnership.

If you are not familiar, the Human Connectome Project represents the scientific moonshot of mapping the neural pathways in the brain of healthy adults. Sebastian Seung’s popular 2010 Ted Talk, “I am my connectome” introduced this concept to a mainstream audience:

Did you know that our connectome is presumed to be as individual as our genome? If you want to learn about the staggering complexity of this mapping project and where we are collectively in the research process, please find time to view the “Cartographers of the Brain” panel from 2017’s World Science Festival:

Our biology is so incredibly (and infinitely) complex, as each of the panelists attest, that any expert worth their salt is humbled by its study. Nothing we have created to date can compete with the technology of nature. In a time where man-made technology is revered, it is important to acknowledge how little we know about everything.

Designing with Intention

The Disney Institute’s Program Facilitator, Mark Matheis conducted a behind the scenes tour of the Magic Kingdom for us after an introductory presentation. When you learn about the Disney Culture, it is always emphasized that they have “learned to be intentional where others are not.” While walking down Main Street, we were educated on how this philosophy manifests in practice. All design elements work together to reinforce a positive experience for guests of all ages and backgrounds.

At the surface level of Main Street, every architectural and operational detail influences our behavior and engagement with the environment. Literally, just beneath the surface, a vast network of infrastructure sustains the quality and nature of that street-level experience. Disney understands what people of all ages hold in common, but they also strive to capture and account for our uniqueness. This is accomplished by combining cultural and psychological influences and establishing something that appears to be uniform but has been aggregated from the broadest spectrum. For example, the building facades borrow something from architectural styles around the world. Wherever you’re from, it is possible for you to feel at home on Main Street.

Yes, And

In a standout session led by Erickson graduate Donna Poole and her daughter Jessie, we were introduced to their personal experience connecting caregivers with the lessons of improvisational theater. If you are already familiar with this coupling, please share it broadly. We would also recommend reading Yes, And, and viewing the 2018 NIC Talk by Kelly Leonard:

There was a palpable change in the audience during this particular session because of how impactful it was. We were all intensely moved by their story and its delivery. The quality of observations from attendees during the Q&A seemed to affirm that we had all literally been uplifted – especially in our collective thinking. When we first started talking about the “connectome”, we were looking at images of the brain alone. Someone suddenly made a loose (almost transcendent) comment about the presence of memory outside of the brain for the first time since the Summit began. As Deepak Chopra consistently relays,

“Instead of conceiving reality from the bottom up, moving from tiny building blocks to larger and larger structures, one could do the reverse and create a top-down model. In other words, the starting point would be the whole, not the parts. So what do we know about reality as a whole? [1] ”

It is legitimate to focus on the brain and its immediate connectome, because we must start somewhere. Let’s just not forget that we have mountains to climb! There is a larger question about consciousness and the nature of “mind” that needs to be addressed.

A Call to Mind

We view the founding Erickson mission of combining aging, management and policy as being more timely now than ever before. Recalling that enduring progress does take time, there is finally a clear opportunity emerging from the groundswell of interest and legislative traction related to the Age-Friendly Movement. Whenever keywords surrounding the World Health Organization’s Network, Livability or up and coming building/occupant performance standards like, WELL or Fitwel surface, we are both excited and disheartened. Excitement exists because we believe in the power of shared and comprehensive frameworks to transform culture. We are disheartened because we also recognize the power of babel. There are so many competing standards and movements in our industry alone – let alone in and across other sectors and geographic boundaries. If we really want to “connect,” a unifying banner is imperative.

For the first half of the Summit, the Age-Friendly movement surfaced a few times as a talking-point. After Donna’s session, we started to make open reference to its all-inclusive nature. Just as the mind, memories and our personal identity transcend the physical brain, Age-friendly is not about “Older Americans” alone. It is (at least we hope) about being “mindful” of how to integrate everyone within an intentionally supportive community infrastructure. As the lead for WHO’s network in the United States, we commend AARP for positioning this standard as “livability” – with relevance to all ages. We should not have to visit Disney World to experience the magic of Placemaking or Building Healthy Places!

The State of Emergency

On day two, newly appointed Secretary of Elder Affairs, Richard Prudom, enlightened us about the scope of planning and coordination undertaken by the State of Florida for disaster planning. Together with Kathryn Hyer, Ph.D., representing the Florida Exchange Center on Aging, we witnessed a compelling case study surrounding the state and local collaboration responsive to recent hurricane disasters.

Emergencies are local and so too are the resource needs responsive to them. While considering the relevance of this program to the Memory Care Summit, the analogy emerges. Our industry is replete with diverse and disparate resource outlets represented by a myriad of constituents. Leadership influences are required to “connect the dots” and marshal alignment responsive to our own State of Emergency – the Future of Aging. If we want to support and augment critical public services, we should strive to become more familiar with their delivery frameworks and actively seek opportunities to leverage common language and structure.

A Quixotic Quest

A Hallmark of the Memory Care Summit is the final book-end of a human interest story – typically a first-person account from someone living with a Memory disorder. These stories are often heart wrenching and reinforce why we are in the business we are in. More importantly, the heart strings pulled remind us that this is not really a business alone – but more of a societal journey where we are all on a heroes’ quest of sorts together.

Brian LeBlanc is an International Dementia Advocate. In his own words, his personal mission is to act as a voice for those who are no longer able to speak. Brian allowed us to look inside his own experience with early-onset of dementia. He juxtaposed the active eloquence of his delivery and poise in speaking to us with a recent and personal video recording that captured an airport episode of what he characterizes as a fog – when the symptoms of his dis-ease are being expressed. The contrast between the energy of the gentleman presenting to us and the man we could observe being lost on screen was stark beyond words. In his closing, Brian read the Impossible Dream to us and asked that we listen through a particular lens – What if a Cure for Alzheimer’s was the Impossible Dream?

The Impossible Dream lyrics by Man of La Mancha from Best of Broadway – American Musical soundtrack.

The Impossible Dream lyrics: Lyrics by Joe Darion In this song, Quixote explains his quest and the reasons behind it … in doing so, he captures the essence of the play and its philosophical underpinnings. (For me, it

Catalyst for Convergence

In reflecting upon the theme of the Memory Care Summit, we consider the broad implications this has on our industry at large. The Summit, with its diversity of program content and participants, proves a stellar example of research, education and practitioners coming together and making connections. This seemingly proves the formulary for moving forward – where we recognize and embrace the individuality of all stakeholders in this journey and the value proposition represented by all knowledge and experiences – taken together and appropriately combined. While connecting the dots seems daunting, coming together and collaborating on the opportunities and obstacles ahead is undoubtedly the prudent path of achievement. This is the essence of integrative thinking that is championed by the Erickson School and its programming. The Memory Care Summit is perhaps the microcosm illustration of this universal solution. As before, the Summit fuels our own thinking and continues to inform our own direction.

Systems and processes that we design with creative intention are the true enablers of engagement and progress – but they don’t create impact overnight. The Disney Organization and its Institute have been fine-tuning and memorializing their own leadership best practices and operational expertise for decades. Any attempt to model the end-result of all their learning would be quixotic absent a commitment to do the work!

What would the world look like if we could live, work, play, stay and age well in States of America that were truly United? The first step is to embrace a “Yes, And” mentality. The gears of policy, management and aging will not turn on their own – and certainly not in isolation. The Memory Care Summit induces our thinking about the value not just of creating relationships but also on cultivating them with purpose and humility. Connections – like the teeth in a cogwheel – make forward motion possible one increment at a time. Programs like The Memory Care Summit help to pave the way!

[1] Chopra, D. (2019). Can There Be a Science of Consciousness?. [online] Deepakchopra.com. Available at: https://www.deepakchopra.com/blog/article/5791 [Accessed 4 Feb. 2019].

Forget Memory – it’s about relationships

by dmccarron | Feb 8, 2018 | Knowledge Notes

Like most of you, we have attended a lot of conferences, workshops and seminars since entering the “Senior Living” sector. As repeat attendees of The Annual Memory Care Summit and representing a graduate of The Erickson School, we have one single expectation from the UMBC Aging brand and team – delivery of academic and person-centered content that can “excite and delight” business as usual. We use that phrase intentionally because our own team has just finished a group read (on Audible – our go to “employee training” app) of Joseph Coughlin’s “Longevity Economy.” Coughlin, introduces – among several other things – the concept of “transcendent” design where we focus on developing consumer products that will excite and delight all ages and not seniors alone. He encourages all of us to embrace what we would consider a “strengths-based” approach – where we design products for ability and inclusive opportunity rather than trying to solve problems that only highlight deficits in the targeted end-user. This kind of thinking should apply equally to our planned communities and programming.

“Our heritage and ideals, our code and standards – the things we live by and teach our children – are preserved or diminished by how freely we exchange ideas and feelings”

–

Walt Disney

American entrepreneur, The Walt Disney Company

We are entering (or perhaps returning to) a new chapter in our Industry and culture where the curse of knowledge (in business and clinically) is being replaced by an emphasis on the fundamentals of imagination and relationship-building. What kind of future would we imagine, and then build, if we focused more exclusively on engaging across generations and sharing stories, experience and knowledge to that universal end?

Imagination vs Experience

If last year was about creating magical moments , and fine tuning company culture for sustained results, this year offered the charge to advance our Iconoclast Quotient (IQ) in recognition that while “Logic will take you from A to B, Imagination will take you anywhere.” Ideas and Interests are converging at an accelerated pace. If we want to offer health and wellness services to family, staff and residents, we will be required to meet our customers (all of them) wherever they are – and it will take the whole village to support their wants and needs effectively. In the past we have relied upon experience to light our path. In the immediate future we all need to be trailblazers of some degree.

Heroism and Incrementalism

In typical Erickson School fashion (this is the academic influence) a series of “pre-reading” materials were circulated via Dropbox to attendees – among these was a link from Bob Kramer of NIC to a recent New Yorker piece entitled “ The Heroism of Incremental Care” In the article, Atul Gawande shares an interesting metaphor surrounding the collapse of the Silver Bridge in 1967:

“The collapse signaled the need for a new strategy. Although much of the United States’ highway system was still relatively new, hundreds of bridges were more than forty years old and had been designed, like the Silver Bridge, for Model T traffic. Our system was entering middle age, and we didn’t have a plan for it.”

In this essay, emphasis was tied largely to the dichotomy of surgeons (heroes) and primary care physicians (incrementalists). For our purposes here, the relationship between outdated transportation infrastructure and our own bricks and mortar in Senior Living is key. We all know that we are developing products that are designed around realities/constraints and beliefs that are no longer relevant – like the Model T – and yet we still charge on without reconsidering the viability of our footings. It is worth emphasizing that EVERY time a guest speaker has joined the stage (we have been to four of the six events) they are emphatic about not wanting our “products or services.” We clearly need visionaries and iconoclasts to chart new courses for our Industry where we focus on engagement instead of behavior management alone.

5 Leadership Lessons from The Disney Institute

As leaders in the “Imagination” department, Mark Matheis offered the Disney Company’s’ perspective on how best to execute your plans once imagined:

Leaders establish, operationalize, and sustain the values and vision by which their organizations thrive.
Great leaders proactively establish values.
The more a vision can be expressed in a vivid, imaginative way, the more it will motivate people to action in the present.
Storytelling is an essential strategy for the communication of new ideas; people are more engaged and inspired by information presented through compelling narratives
The best legacy is not one that is fondly remembered, but one that is actively emulated

Value is created when Silos Break down

In “What the Smart Money Wants from You,” Robert Kramer, Founder & Strategic Advisor to The National Investment Center for Seniors Housing & Care, shared Industry Data and offered his own insight toward three drivers that are influencing our vision and narrative for the future:

The Longevity Revolution (Silver Tsunami)
Data, Robotics and Mass Customization
Healthcare Payment & Delivery Reform

“We always overestimate the change that will occur in the next two years…and underestimate the change that will occur in the next ten”

–

Bill Gates

American business magnate, Microsoft Corporation

In his engaging presentation, Bob Kramer offered his invaluable insight (replete with data metrics of course!) into the future of aging, how it is being redefined by emerging trends and the anticipated impact of “new retirees”. The later will be represented by “transitions” to encore professions as opposed to traditional retirement. Bob’s own circumstances are illustrative of this occurrence. Having been recognized as the CEO leader breeding the remarkable success of NIC as the premier research, educational and data source for the Seniors Housing & Care Industry, Bob now transitions to Chief Strategist for NIC. Undoubtedly he, like numerous other industry veterans, including the likes of John Erickson and Dr, Judah Ronch representing the Summit, will continue to influence and shape the future of aging. These are not declinists but rather industry treasures to engage and leverage.

The Declinist view of Retirement where seniors unplugged to enjoy their golden years is clearly outdated (like the Silver Bridge) and being replaced by a new emphasis on engagement where residents will want to be become integrated with the communities they choose in an intentional and productive way. As the “diaspora” of healthcare continues and senior services become “uberized,” it will become increasingly difficult to compete with the demand for full service and retail “life management” solutions. Lifestyle coupled with the presence of supportive care proving more intergenerational and “connected” will give rise to the trends of desire trumping needs. Where will we plug in to the new value equation as developers, operators, caregivers? Imagine a future of aging where business constituents are more “collaborative” than “competitive”. These trends are the leading indicators of integrative thinking (points from Dr. Ronch) and more integrated business models that emulate the real world.

Imagine a Cure for Alzheimer’s, Then What?

Scott Townsley’s session was centered around the assumption of a cure for Alzheimer’s. Whether or not a cure is on a horizon, this kind of open-ended / creative thinking enables us to focus on the survivable (or missing) attributes of our business and its offerings. Ironically, these attributes or amenities might actually define our core because they are likely “transcendent.”

“People don’t want to buy a quarter-inch drill, they want a quarter-inch hole”

–

Theodore Levitt

American economist and professor , Harvard Business School

The traps of quality and superiority were addressed where the former represents the sentiment that well established organizations don’t need to change (until it is too late) and the latter assumes that a premium offering will also maintain its hegemony – except that customers ultimately crave simpler, cheaper incumbents. The final ¼” drill trap presented echoed the detriments of Marketing Myopia where we forget that we are selling solutions not widgets. If we are struggling to identify our own value proposition as an organization, this exercise creates an opportunity to highlight (and work to close) the gap between what we think we are selling (i.e. memory care) and what the market wants to purchase for themselves or loved ones (valued relationships and engagement).

Awe – using art to create relationships

If you are not aware, The Erickson School strategically front-ends the program with business and academic content and reserves the final book-end for local guest speakers that can help to ground and synthesize our thinking (by tempering it) with the raw emotional reality of people and their own first-person caregiving stories. Just before these guests arrived, we were primed for the transition through Anne Basting and a re-telling of her incredible work. She relayed how her experience of introducing the transformational power of theatre to people with memory care issues enabled them to engage instead of being alone together.

“The arts are a way of being in relationship, of seeing and shaping the world. My work brings the tools of imagination and creative expression to care relationships and systems in order to foster healing through community building. We cannot heal without story”

–

Anne Bastings

Artist, Scholar, Teacher, UWM Center on Age & Community; Founder, TimeSlips

It should not be surprising that an entertainment giant like Disney would proffer the same insights garnered from improvisational arts. Storytelling creates a safe space for everyone through abstraction – when you create an open environment, expression naturally fills the vacuum. What does this look like in the built environment? Or is architecture just a shell if it is filled with genuinely human activities? In any case, the challenge is not just how do we create a better physical space for Memory Care but rather, how can we establish a broader network of engaging human activities? We need life centers where everyone can thrive.

Short Circuits

To echo Atul Gawande’s essay once more, “Our ability to use information to understand and reshape the future is accelerating in multiple ways.” He continues to describe that “we have at least four major data inputs that reflect our health and wellness over time, (1) information about the state of your internal systems (from your imaging and lab-test results, your genome sequencing); (2) the state of your living conditions (your housing, community, economic, and environmental circumstances); (3) the state of the care you receive (what your practitioners have done and how well they did it, what medications and other treatments they have provided); and (4) the state of your behaviors (your patterns of sleep, exercise, stress, eating, sexual activity, adherence to treatments).”

When you consider the scope of these inputs, it becomes clear that we will need more bandwidth to capture all of this data and make use of it in a meaningful way. It is unlikely that a sole “hero” provider will venture off into the forest and return with a miracle solution for Alzheimer’s or any other dis-ease. Of course, if you have eyes to see and ears to hear, we might already be the miracle we are searching for.

“Remember, creative power will not operate itself. Knowing what to do is not enough. You, imagination’s operant power, must be willing to assume that things are as you desire them to be before they can ever come to pass.”

–

Neville Goddard

Author and Teacher

In this sixth year of the summit, we were all called to cultivate our iconoclastic quotient (IQ) so that the future we imagine is built on solid ground instead of crumbling foundations. We were also reminded that if engagement is the ultimate prescription, then we cannot succeed in isolation. Let’s take inventory of our respective strengths so that we can catalog and distribute the dimensional inputs of health and wellness together as due-diligence only. The shared moon-shot is to leverage the data and best practices to craft a new story about how we can age more actively and remain engaged together.