by Joe Hearn | May 24, 2016 | Lifestyle Design, Pursuits
Last year I read a book called The Power of Habit that gave me some insight into what happens in our brain when we develop habits or get into a routine. I’ve thought about this topic before and had the sense that, while some routine is often necessary, too much routine can make life feel dull and short. It turns out that research backs this up.
In the book, the author talked about an experiment that the Brain and Cognitive Sciences Department at MIT did on rats. They hooked their brains up to a bunch monitoring devices and then put them, one at a time, into a simple T shaped maze. At one end of the maze, behind a partition, was a rat. Down the hall and around the corner was some chocolate. With the flip of a switch, the researcher would drop the partition (which made a loud click) and the rat would be standing there staring down the hall.
Slowly, it would start to sniff. It could smell the chocolate, but didn’t know where it was, so it would wander down the hall, stopping, sniffing, scratching and looking around. When it got to the end, it would usually look to the right, sniff, look to the left, sniff and then follow its nose to the left where the rat would discover the chocolate.
The more they did this experiment, the more the rats would hear the loud click, the partition would disappear and they would go straight to the chocolate. Once the rats had figured out the maze and developed a routine for getting the chocolate, the researchers compared the before and after brain scans. When the rat was new to the situation, his brain exploded with activity when he heard the click and the partition disappeared. Each time it scratched, sniffed and looked around the brain was buzzing with activity as it analyzed the sights, sounds and smells.
After repeating that experiment hundreds of times, however, the way their brains reacted started to change. Once they had the routine down—walk down hall, turn left, get chocolate—their mental activity started to decrease. The more automatic it became, the less the rats had to think. Almost every area of their brains quieted down. Even the part of the brain responsible for memory went quiet.
The only part of the brain that was still active was the basal ganglia, which is this ancient part of the brain that, up until then, scientist didn’t understand very well. What they learned from their experiments is that the basal ganglia is responsible for identifying the habits and routines that we have. Once it recognizes those patterns, it takes over and allows the rest of the brain to pretty much shut down.
The basal ganglia is your best friend when you’re trying to form new habits like going to the gym or eating healthy, but it’s bad news if life becomes so routine that your brain basically switches to autopilot. In that case, you’re not really creating new memories or being an active participant in big chunks of your day because major parts of your brain are switched off. If you do the same thing every day for a year, you don’t remember a bunch of unique days. You basically remember 1 day that you lived 365 times. The entire year kind of feels like it took 24 hours.
So if we want time to feel as if it’s passing more slowly and we want our memory banks full of unique experiences, we need to find a good balance between routine and novelty. Yes, we want a good exercise routine, but we also want to steer off the well-worn path of life once in a while. Especially in retirement. We need to find ways to break up the routine. We need to try new things and seek out new experiences. How can you do that in your life? What can you do this week to break routine? Experiment and see what happens.
Here’s a short video for inspiration. It’s by Jed Jenkins where he talks about coming to the realization that routine is the enemy of time so he quit his job and took a thousand-mile bike trip from Oregon to Patagonia. Some of you may remember the video from our Facebook page a while back. If you haven’t seen it yet, it will likely be the best 4 minutes of your day. Enjoy.
Joe
by Joe Hearn | May 3, 2016 | Health, Housing, Insurance, Medicare
Have you ever wondered what it would be like to live in one of those newfangled senior living facilities that are popping up all over the place? I was curious too. So I moved into one. I have a friend whose company owns a number of these retirement centers and they had just finished building a new one called Aksarben Village in Omaha. Since it was new and not yet full, I asked him if they had room for a temporary resident. He pulled a few strings and before I knew it my name was on the door of room 217, I was getting my hair cut at the in-house salon and I was sitting down to meals with my fellow residents. How did it go, what are these facilities like, what are the pros and cons of assisted living and what can you learn from the experience if you ever need this type of care for yourself or a loved one?
Who’s the new guy?
“Hi, I’m Pat,” she said as I sat down beside her for lunch. She was friendly and had that gleam in her eye that immediately puts you at ease. She quickly introduced me to the others at the table, including Dick, Kris, Martha, Dee Dee and Alice. We spent that first meal talking and laughing and I got to know a little bit about each one. I heard about kids, pets, spouses and stories from back in the day. They knew I was writing an article about assisted living facilities, so I asked them what prompted them to move. Most gave two or three reasons, but a common thread throughout revolved around health.
There aren’t many certainties in life, but this is one: Your health is going to change. Your mental and physical abilities will look different at 70 or 80 than they did at 50 or 60. Sometimes the changes are minor and sometimes major, but about two thirds of us will need help coping with those changes. In the past, as abilities diminished, your choice was either a curtailed lifestyle (e.g. no driving, less cooking, etc.) supplemented by whatever assistance friends and family could provide or a move into a nursing home facility that was very expensive and provided way more care than you needed.
The basic idea of the new retirement living options is that they broaden the spectrum of help available. They provide a base level of services that cover issues most of us deal with as we age and then provide a laundry list of à la carte services so that people get help where needed while still maintaining their lifestyle and independence.
Care levels
I learned all about these different levels of care during the check in process. At one end of the spectrum are independent living facilities. As the name implies, residents basically live independently (similar to renting an apartment), but the facility provides services like housekeeping, home maintenance, some meals, security and a number of other amenities.
Assisted Living, where I stayed, is next on the spectrum and provides much more involved care. You have your own apartment (equipped with things like zero entry showers and an emergency response system), weekly housekeeping, laundry services, access to onsite medical personnel, transportation to outings or appointments and three restaurant style meals per day in the dining room. In addition you have a personalized care plan based on an assessment completed at admission and then updated every 30 days. This personalized care includes things like medication management, breathing treatments, bathing, grooming, using the restroom, mobility, dressing, safety checks and help with things like the phone or email.
People who need more intensive or specialized care—such as those suffering from dementia or Alzheimer’s disease—can move into either a memory care facility or a nursing home. These facilities have specially trained staff and caregivers who are there to provide care 24 hours per day.
Many facilities (including where I stayed) recognize that people may need all three of these levels of care at some point, so they build them together into a sort of senior living campus. This allows a person or his/her spouse to move up to the next level of care when needed.
Amenities and Activities
These new facilities are definitely not like nursing homes of old. For example, where I stayed there was a large movie theater complete with popcorn machine and iPad controls that are connected to cable, Netflix and just about every other streaming service you could imagine. There was a banquet room, private dining rooms for when family comes to visit and a full service kitchen with chefs who were more than happy to take any special requests. There is also a workout room, a physical therapy room, billiard room, beauty/barber shop, chapel, library and an activity/craft room.
Residents put these facilities to good use. Each month the lifestyle coordinator releases a new activity calendar containing church services, workout classes, movie nights, political discussion groups, cooking classes and trips to places like museums, stores and local restaurants. Partnerships with community organizations provide additional benefits. For example, the Omaha Public Library rotates new books each month through the library based on resident requests and Hy-Vee does free delivery of groceries each week to any resident that orders them.
Cost
As you can probably imagine, these services are not cheap. The more care a person needs, the more expensive it gets. Independent living averages about $2,500 per month nationwide. Memory care and nursing home care are higher, averaging $6,000-$7000 per month. Assisted living falls somewhere in the middle with the median cost of care nationwide around $3,600 per month. Studio apartments where I stayed start at $3,500, but you could spend much more if you wanted a 2 bedroom, 2 bath unit. The monthly care plan can add additional costs to assisted living. Where I stayed, services are given a point value and any additional costs are based on the point total. For example, someone who needs 2 medication reminders per day as well as assistance with shaving and getting dressed would have a point total of 14, which would cost about $285 extra each month.
How to pay
Except in very limited circumstances Medicare does not cover any long-term care costs. Medicaid does, but to qualify, you basically need to be both sick and poor. Even then, the amount Medicaid provides is limited, so most private facilities have a minimal number of beds set aside for Medicaid residents. Because of that, those who want to live in these facilities will need the means to pay for it, which can be a major obstacle. Most of the people I talked to were covering the costs from a combination of personal savings and payments from long-term care insurance. Those policies can be expensive, but one month of care will usually cost more than one year of insurance premiums, so having a policy can make financial sense if you end up needing it. In some cases, adult children were also helping to cover some of the costs so they could have peace of mind that mom and dad were well cared for.
Pros and Cons
One of the first people I met when I arrived at Aksarben Village was Colleen. She is suffering from mild dementia which affects her short term memory, but was otherwise healthy, sharply dressed and a kick to talk with. She has six kids and we spent the better part of an afternoon talking about each of them. On the last day of my stay, I actually got to spend some time visiting with one of her daughters, Sara Wachter. Her perspective gave me some great insights into the pros and cons of assisted living facilities.
Prior to moving into assisted living, she told me that her mom’s dementia was causing problems like social isolation, missed medications and missed meals. Even with a big, supportive family the memory loss was creating issues that were impacting Colleen’s health, safety and lifestyle. Their gerontologist said it was time to make a move so they started exploring options. “Mom grew up in this part of town, so it was a good fit,” Sara said. It wasn’t without challenges, however. Finding out she had to leave her home was initially a shock, but hearing the news from the gerontologist gave it more weight and took the pressure for that decision off Colleen and her family. Giving up her car was also tough, but since the facility had transportation the kids thought it was for the best. Expenses were also a concern, but Colleen’s mother lived to be 104 and was in a nursing home, so Colleen purchased a long-term care policy years ago which has helped with the costs.
As Sara and I talked, we saw her mom come down to the front lobby and start chatting with other residents. Dick Loneman, the driver at the facility, was getting ready to take them for an afternoon at the Joslyn Art Museum.
“Mom has thrived since moving in here,” said Sara. “The things she couldn’t take care of were all of a sudden being taken care of by someone else. Now she’s free to enjoy life and doesn’t have the responsibility for all those day to day things that had become so challenging for her. It’s less stressful for us too, because we know she’s in good hands.”
