So many people when asked what it was that drew them to this field would tell me, “I go home every night feeling good about the work I do.” Though this is a genuine and relevant answer to the question, it is not mine. I have always said that it is the people that make this work so special. What makes the population of people that we work with so incredible is that they are not caught up with the everyday way of life that you and I are. It is that freedom from conventions which sets them apart. They are not as worried about the latest fads, trends or fashions. They are people shaped through the years of their lives, filled with experience and wonder that is hard to imagine, let alone understand. They are individual’s not so much worried about “What do you think about me?” as much as, “Do you love me?”
Their character and convictions are steadfast, and though they may be hardened to change, their hearts remain soft and tenable. The following essay has been written for these people, with hopes that it would inspire even a single person to take an earnest look at Oregon’s current service models for Seniors and People with Disabilities, and to keep Oregon as a premier model in which other states can continue to look to. What legacy will we leave? What hope will we inspire? My objective is to utilize this essay to answer these questions. In our state’s history, Oregon has been blessed with so many great advocates and has been a National leader with the Self-Directed Support model of services across the division of Seniors and People with Disabilities.
So how will the new generation of college graduates continue this legacy? After an in depth inquiry into this subject and much self reflection, I submit the following. As we begin to take those choice words like “Independence, integration, productivity, choice and dignity”, and not just make sure our companies or non-profits mission statements included a few of them, not just check off the box on the service plan that says these are being implemented or accomplished, but actually look at the root meaning of the words. Are we really where we want to be? Or can we do better? We have a choice, we can take a rational and intellectual inquiry into our current and proposed service models to see if the services we are providing and more importantly plan to provide fall in line with these words.
Or, we can set our sights on mediocrity, from which no legacy will be made. The choice lies with us. Do we remain stagnant and content with the progress made? Do we measure Oregon against the backdrop of other states and take solace in the fact that we may still be slightly ahead of the pack? I think the answer among fellow Oregonian’s would be a resounding “No”. The preservation of Oregon’s existing legacy as being a National leader in the legislative, economic and social advocacy for seniors and people with disabilities is important. It is something that I conclude can only be done by my previous statement of rational and intellectual inquiry into Oregon’s current and proposed service models. My personal response to this inquiry is based around the philosophy of person centered planning and person directed supports. With the heart and focus of this model remaining on individual choice.
At the age of 25 years old, having spent 5 years in human services I have worked within all different areas of Oregon Seniors and People with Disabilities. Through this time, one theme that I have heard loud and clear from the people I have supported is the need for choice, more specifically is choice as it pertains to the location in which people live while receiving services. Which leads me to the following; If Oregon is going to continue to be a leader and innovator in providing the Self-Directed Support model of services, the legacy of hope that we need to focus on leaving would stem from successful implementation of what is known as the “Community Based Care” models of services. The emphasis of this model being on serving seniors and people with disabilities in ways to help them live and age comfortably in the place of their choice.
Rather than emphasizing their diagnoses, medical condition or inabilities, we focus on the things in life that give them happiness, peace and strength. All things that can be accomplished through something many of us now take for granted, and that’s having the freedom and choice of where we live. As the medical field progresses people are living longer and healthier lives than ever before. The number of those over the age of 65 is growing dramatically. There are 10,000 new Medicare recipients added each day. In 2000 the number of seniors over the age of 85 was 4.2 million. By 2010 the number is estimated to be 6.1 million. Beginning in the years 2011 & 2012, the baby boomers will begin to turn 65 years old. More astonishing then that, by 2030, Americans 55 and older will account for 31% of the population and those 65 and older will account for 20%.
From the fiscal standpoint, Community Based Care has been projected to cost as little as a few hundred dollars a month, comparatively to someone who has been displaced from their home and is living in a facility where the monthly cost to the tax payers now shoots as high as $5,000- $6,000 monthly. The SPD population overwhelmingly wants to age in place, to be able to remain living in their own homes. But they very concerned about their choice to do so. In the book, “Water for Elephants” Sara Gruen, writes from the perspective of a man named Jacob Janokowski a retired veterinarian who is 90 years old, (or 93 he can’t remember which). Below is an excerpt from the book I believe helps illustrate the discussion.
“But Dad, they said, you broke your hip, as though maybe I hadn’t noticed. I dug my heels in. I threatened to cut them off without a cent, until I remembered they already had controlled my money. They didn’t remind me- they just let me rail on like an old fool until I remembered of my own accord, and that made me even angrier because if they had any respect for me at all they would have at least made sure I had the facts straight. I felt like a toddler whose tantrum was being allowed to run its course.
As the enormity of my helplessness dawned on me, my position began to slip. You’re right, I conceded. I guess I could use some help. I suppose having someone come in during the day wouldn’t be so bad, just to help out with the cooking and cleaning. No? Well how about a live in? I know I’ve let things slip a little since your mother died… But I thought you said… Okay, then one of you can move in with me… But I don’t understand… Well, Simon, your house is large. Surely I could…? It was not to be.
I remember leaving my house for the last time, bundled up like a cat on the way to the vet. As the car pulled away, my eyes were so clouded by tears I couldn’t look back. It’s not a nursing home, they said. Its assisted living- progressive, you see. You’ll only have help with the things you need, and then when you get older… They always trailed off there, as though that would prevent me from following the thought to its logical conclusion.”
I truthfully believe it is a realistic belief that Oregon can pioneer the cause of helping seniors and people with disabilities live confidently with independence, and the freedom to age with a positive sense of self-worth in their own homes. This is my vision of Community Based Care, and this is the legacy that I hope to leave behind.