Nan Johnson Continues to Blaze New Trails at Villa Gardens

There are some moments that change everything. For Nan Johnson that moment was in 1955, when the dean of a prestigious law school, to where she was considering applying, told her, “You do understand you won’t be arguing any cases. You will do the briefs and the men will argue the cases.”

Since that time, Nan has been an advocate for social change. She was the first woman to serve as Majority Leader of Monroe County, New York legislature and went on to become an associate professor of political science at the University of Rochester where she co-founded the Susan B. Anthony Center and introduced courses on “Women and Law” and “Women and Politics.”

So when this life-long East Coaster and her husband Bill, also a retired professor, landed at Villa Gardens, Nan did what she’s done all her adult life; she got to work, assembling a team of diverse women to help her spear-head her next project.

“Not long after I got to Villa Gardens, I began to think about the fact that the year 2020 would be the 100th anniversary of the 19th amendment.” The amendment, which was ratified in 1920, guaranteed American women the right to vote.

“I didn’t know many people here at the time, but invited a few Villa Gardens residents and staff as well as volunteers from the Pasadena community who might be interested in planning a celebration. One of these savvy California women said ‘what if we put a float in the Rose Parade?’ I thought it was a great idea.”

Pasadena Celebrates 2020, has expanded to a larger community project. They celebrated their float’s acceptance into the Rose Parade earlier this June. As Senior Advisor to Pasadena Celebrates 2020, Nan credits the Villa Gardens staff for helping with essential logistics every step of the way: including hosting meetings large and small.

“When I bring guests here to discuss the float, we meet at the Bistro,” Nan said. “The recent improvements are wonderful. Very tasteful. When we’ve had larger events, Villa sets up the room and provides refreshments.”

Nowadays, when she’s not lending her expertise to the float project, Nan takes advantage of outings to the opera, and the wide array of social and cultural activities that Villa hosts. Nan also enjoys her daily afternoon swim in the pool.

Naturally, she loves the fact that Villa Gardens is home to so many retired educators. “When they walked into Villa and saw the newly renovated library just off to the side of the lobby, they knew they’d found “the one.”

Their children, who live 10 minutes away from Villa Gardens, have been encouraging Nan and Bill to move out west for years. It was a big cultural change, but Nan feels like they’ve finally found their tribe in sunny SoCal.

Looking out from their roomy fourth floor apartment with its breathtaking views of the San Gabriel Mountains, Nan says, “I’m proud to be in California. I think it’s ahead of things in many ways. I’m proud to be part of that.”

For more about Pasadena Celebrates 2020 and the float, please visit www.PasadenaCelebrates2020.org. 

For more information about Villa Gardens, visit www.villagardens.org.

Pass the Popcorn! New Resident Theater Debuts at Sunny View

The scent of hot buttered popcorn fills the air as residents relax in their large, overstuffed reclining bright red leather seats anxiously waiting for the lights to dim and the heavy leather wrapped studded door to close. It’s not only movie time at Sunny View but a theater experience like no other.

With its surround multi-speaker audio system, 145-inch HD screen and reflective acoustical panels, Sunny View’s new movie theater provides a state-of-the-art experience, yet harkens back to a time when ushers with red flashlights wore tuxedos and double features were the norm.

“I never dreamed Sunny View could build something like this,” said resident Gloria Burns. “This is a true theater experience in so many ways.”

The 21-seat theater was made possible due to the generosity of former resident Bruce Watts and current resident Mitch Wendell who financed the project through the Sunny View Foundation. Movie lovers, sports fans and music enthusiasts, Bruce and Mitch wanted to create an immersive experience where residents could enjoy the latest releases as well as classic films, sporting events and concerts.

“I’m most interested in classical music,” Mitch said, who hosts a regular classical concert series in the theater. “But this theater is perfect for all sorts of events including lectures and even guided meditation.”

The theater is able to stream the latest movies through Apple TV and Netflix and is

equipped with a DVD and Blue-Ray players to give residents choices ranging from classics like Casablanca and My Fair Lady to contemporary films like La La Land and The Shape of Water.

Future plans for the theater are to integrate voice first technology so residents can easily operate controls and make viewing choices. A theater lounge with a snack bar is scheduled to open in the fall.

“Enhancing resident life is one of the Sunny View Foundation’s goals,” said Sunny View Foundation Development Director Bill Penrod. “I’m pleased that our generous residents could make a project like this come to life.”

 

Longevity of Kingsley Staff Reflects Culture of Community

 

Jeannie Weber

The year was 1984 and Los Angeles was in the middle of hosting the summer Olympics, when Jeannie Weber, who had just moved to town, took a part-time job as the Kingsley Manor Retirement Community receptionist on the night shift.

Thirty-five years later, Jeannie, who long ago migrated from the front desk, is the director of sales and marketing. “Kingsley has become my second home,” she smiles, looking over at the rose bushes outside her office. “Who could ask for a nicer place to work? And I just fell in love with the residents – they’re my extended family.”

But Jeannie is far from an anomaly among the Kingsley staff. As of this year, the community has 14 team members celebrating 25 years of employment or more.

“I don’t even think of it as work anymore,” said Emyrose Lacuesta, director of health 

Emyrose Lacuesta

services. 

“It’s where I live. It’s where I enjoy being.” Starting her career at Kingsley 31 years ago, Emyrose worked her way up from a part-time charge nurse to director.

“You really get to know the residents, and their families,” she said. “I love that part of it. I miss them when I go on vacation.”

Both Jeannie and Emyrose had a background in their chosen field when they arrived at Kingsley, but for 30-year veteran Angela Pineda, who was still in high school when she started, Kingsley was where she discovered her calling. “I started off working in the dining room part-time,” she said. Later, Angela received her CNA training and was hired in the Care Center. Now, as the life enrichment director for the Care Center she’s found her passion.

“I had no idea when I started here how much I would love coming up with fun, engaging experiences for residents,” Angela said. “I love that I’m contributing to a sense of community. I love the creativity involved.”

“I’m not surprised about the longevity of our employees,” said Executive Director Shaun Rushforth.

“Word gets out that Kingsley Manor is a great place to work and live. We’re a family here.”

How Can You Pass On Your Passion?

 by Arlene Harder, resident at  Villa Gardens Retirement Community

If you have ever needed to leave an organization you started, did you do so with joy, or was there grief and regret? Let me tell you my experience.

Fifteen years ago, about one-hundred of us stood on a patio under sturdy canvas covering food stations contributed by several restaurants for the occasion. (It was the end of our first winter storm—one week after our record high of 113 degrees.) We were celebrating the 20th anniversary of The Wellness Community-Foothills, a non-profit cancer support program in Pasadena, California. As a cofounder, I was one of the honorees at the $75-a-person event.

Although I was no longer on the board or gave workshops, twenty years earlier I did whatever I could to support an organization that has served tens of thousands of cancer patients and their families.

What I said several years after I had left an organization of which I was proud

When I was given a lovely bouquet and a certificate of appreciation from the mayor and our county supervisor, I needed to say a few words. I repeat them here (approximately, since I didn’t write them down) because I think you may find them helpful if you are in the beginning, middle, or end of organizing some new venture.

Thank you for this honor. When I was asked to say a few words, I wasn’t sure what to say and decided to get my inspiration after I came here and saw all of you. That’s when I realized I knew hardly anyone! When I was involved in the first fund-raising events, I knew the names and faces of most of the participants. Tonight I recognize only a small handful.
When we began this organization, I wasn’t thinking about what it would look like in twenty years. All I knew was that the community needed a place where cancer patients and their families could get comprehensive social and psychological support.

I had a passion to make that happen. Looking around at all of you, I can see that an organization only continues through the effort of new people who catch the same passion that began it—and then expand it in their own way.

So I am glad to see all of you here, even though I don’t know who you are.

Later in the evening, a woman said that my comments reminded her of a speech she had heard on the stages of creating an organization. There was first the recognition of a need, a passion to make a change, a vision for how that could be achieved, the work involved in accomplishment, the need to do something else, and the grief of letting go.

She said, “I think you are in the stage of grief, seeing all these people you don’t know taking part in something that used to belong to you.”

“Good heavens, no,” I replied. “Far from it. I am absolutely thrilled that others also have a passion to make this organization successful.”

Then I told her that, “I believe one of the things that has prevented my grief in moving on is that I have other passions. For example, about thirteen years ago, I cofounded CancerOnline, a non-profit Internet program where I served as pro-bono executive director for five years. With that experience on the web, I later created LearningPlaceOnline, and then Support4Change and ChildhoodAffirmations. Along the way I wrote three books, am actively writing a fourth, and have ideas for two others.”

I continued, “So you see, if one stops an activity, for one reason or another, and there is nothing to fill the void, then I suppose grief is natural. But if you always have something to catch your interest and your passion, you don’t have to grieve. You can let go joyfully, celebrate the involvement of new people, and move on.”

Our ego gets in the way of letting go

I believe that one cause of grief in leaving an organization or activity is our ego’s attachment to what we’ve accomplished. The ego says, “If whatever you did was successful, you are successful. That organization or activity is you.”

Operating from the “true self,” however, you can create an identity that says something quite different. This central part of who you are says, “You are a person who has accomplished something that makes the world a better place. You are a person who saw a need and met it. You are a person who can see another need and, using the skills you have, can meet those needs with the same passion you gave to other projects.”

How to be successful in creating an organization, activity, or program and then letting go when you need to


Based on my experience, if I were to suggest the steps to creating a successful organization and then moving on, I think it would be this.

• Notice a need that has not been met by anyone else.

• Notice whether you have a passion to meet that need.

• Find others who can help you accomplish it

• Use the passion and skills of all of you to create the best possible solution to the need you are trying to meet.

• When you have given all you can give, or when there is something else in your life that needs your focused attention, notice all the people who are still involved in the project you’ve created.

• Give the new people attracted to your project your best wishes, celebrate their efforts, offer whatever advice you can, and let go, knowing they will each bring their best to this venture you helped create.

• Embrace your new passion or responsibility with enthusiasm, as you did for the one you have left.

You won’t always know what will happen to your old projectOver the years, The Wellness Community formed more than 25 separate facilities across the country and in several other countries. Another organization, Gilda’s Club, was also created to meet the needs of cancer patients. Then the two groups combined to create the international Cancer Support Community, the largest organization of its kind. This is an example of how you don’t know what will happen when you begin something new.
So my advice for you who see a need is just to go for it. Don’t try to imagine accolades you’ll receive for your success, for you may not be successful for any of a hundred different reasons. However, your intention to create something of value for the world will become like a snowball rolling down the hill, gathering more momentum as it rolls. The shape it takes will not be entirely in your hands.





Arlene Harder, MA, MFT is a resident at Villa Gardens Retirement Community in Pasadena, CA. As a licensed psychotherapist for thirty years, Arlene developed an interest in the use of guided imagery techniques to reinforce the physical, emotional, mental and spiritual qualities that arise from deep within each one of us. She co-founded The Wellness Community in Pasadena, CA, (now the Cancer Support Community), the largest professionally-led nonprofit network of cancer support worldwide. And she has written four books, Letting Go of Our Adult Children: When What We Do Is Never Enough, Healing Relationships in an Inside Job and How to Love a Perfectionist Without Going Crazy.


© Copyright 2010, Revised 2017, by Arlene F. Harder, MA, MFT

World-Class Athletes Live Well at Casa de Mañana

Swimmer Betsy Jordan and Weightlifter Len Sandberg thrive at community that promotes wellbeing

Friendly and diverse, there’s an easy air of camaraderie among the residents. You’ll find them in the dining room, by the fountain, tending to the roses, on the hiking trail, in the pool and in the gym. Casa de Mañana is no stranger to interesting folks, some with extraordinary accomplishments, including world-class athletes Betsy Jordan and Len Sandberg.Betsy is a record-breaking, award-winning, master-level swimmer, who, in her 40-plus years of masters swimming competition, has set more than 40 world records. Many are national and local records, including All-Star and All-American awards. In 2005 she was inducted into the International Masters Swimming Hall of Fame.

Len is an amateur weightlifter who recently set a powerlifting record in the 148-pound-and-under Powerlifting Bench Press World Championship sanctioned by the Amateur Athletic Union (AAU).

Len took home the championship by lifting 110 pounds in the 90 and older age bracket.

 “I saw the current record and thought that I could beat it,” Len said with a smile. “It was that simple. It’s not that I’m so great. I just have lived a long time.”
Despite his recent accomplishment, Len describes himself not as an athlete but as a “gym rat” who began regular workouts in his early 40s.

 “I got involved in a fitness program designed for business professionals who did not have a lot of time to exercise,” said Len, who worked in the steel manufacturing business at the time.
 
“I needed to do something to keep in shape.”

While preparing for his record-setting performance, Len worked out at the Casa fitness center three days a week.

“There is no question that weightlifting has improved my life,” Len said, while enjoying the ocean view from his fourth-floor balcony. “I like to stay active and coming to Casa eight years ago gives me a marvelous atmosphere for healthy living.” 

 Betsy’s path to greatness began as a child growing up in the Midwest.

“When I was nine and little and scrawny, I wanted desperately to be like my big sister and join the Riviera Club swim team in Indianapolis, my home town,” Betsy remembers. “The coach, however, said no, and suggested I go home and grow a while. Incensed, I joined the rival and then fledgling Indianapolis Athletic Club team, where I trained and competed regularly in local, state, and national meets until I left for college. It was a golden era for swimming; no butterfly invention, no pace clocks, no time standards for entries to nationals, but great team spirit.”

In the 1950s, women didn’t compete much past high school, so while talented, instead, Betsy attended college on the East Coast and graduate school at UC San Diego. She received a master’s degree in art history and a Ph.D. in literature. She also taught humanities at UCSD in the 1980s.

“Raising four children became my major focus in the 1960s, but by 1971 I was back in the pool and the ocean, living in California,” Betsy said.

These days, the Casa resident enjoys swimming in La Jolla Cove. Her most recent accomplishments were winning two first place and one second place medals in the San Diego Senior Games this summer and being inducted into the Wellesley College Hall of Fame in October.

“Swimming is my passion,” Betsy said. “I like the feeling of being one with the water. That’s easy here at Casa with the ocean outside my door.”

A Christmas Letter from Ellin Ostler, resident at Vista del Monte

Merry Christmas. I have decided to send you a Christmas letter about "Service" this year instead of a card. Service has brought a lot of joy into my life and I hope it will for you. Below are words I wrote in the 1980s as I was pondering on the meaning of service. They still represent my beliefs today.

"Service given freely with no expectation of something in return is one of the greatest sources of true joy and happiness. However, service which is not given freely and unconditionally will bring resentment and unhappiness."

I have hired, trained, and supervised hundreds of employees during my life. During their training, I told them a story about how I learned to make a seemingly boring job fun. The story goes like this:

I had a part-time job as an usher at the BYU Marriot Center where the BYU basketball team play their games. I was assigned, the VIP entrance each year. Most of the people had season tickets and sat in the same seat each year. It was a boring job because everyone knew where his or her seats were and I did not have anything to do.

One year, I decided I was going to do something different. As people came to my entrance, I stood right in front of them as they came in, looked into their eyes, gave them a big smile, and said, "Hi, how are you tonight?" They were shocked and surprised. I am sure they thought I was a little weird. I continued to do it each game during the basketball season;

To my surprise, after a few games, many of the people tried to beat me to the punch by saying "Hi," and wishing me well first. After a few games, they began to treat me as if I was one of their good friends. Some of them even brought me food to eat during the game.

Sometimes, I would see these people downtown away from the Center, and they would come up to me and wanted to know how I was doing. They often had to remind me where I had met them. I was shocked about how something as simple as a smile and saying hi could make such a difference in my relationship with people. I learned from this experience that I could make a boring job fun just by smiling and saying hi. I also learned that it is impossible for me to give more than I receive when I freely give of myself.

I had another experience when I was working at UCSB. I supervised a group of students who were responsible for the student union building when it was open. The only time we could all meet for a weekly staff meeting was at 7:00am. Most of the students at UCSB stay up late and are not use to going to a meeting so early in the morning. I decided to show my appreciation to them by bringing them something to eat. At first, they were very appreciative of my gesture.
These students also worked with the student union catering manager. The manager decided to show his appreciation by fixing them a breakfast for .the meeting.

Before long, the students started to complain when they didn't get what they expected. What started out to be gift of appreciation turned out to be an obligation for me and the catering manager. We decided to stop giving them food because it had become an expectation. The students were disappointed, but I think they learned an important lesson about being grateful. I experienced the joy of giving until it became an obligation.

I have decided to experience the joy of giving as often as possible by freely giving of my time and talents. I have also decided that when giving becomes an obligation or an expectation, I will find another way to give. I hope you experience the joy of giving this Christmas.

May you have a Merry Christmas and a Happy New Year.

-Ellin Ostler, Vista del Monte resident

Vista del Monte Retirement Community in Santa Barbara’s Hidden Valley serves seniors from all walks of life in Southern California.

Sunny View and Summer House Residents Make Connections Through Memory Bridge

Gennie Waters has a special moment with her friend Maxine.

Sunny View resident Gennie Waters remembers her longtime friend Maxine as a talkative, vibrant, funny person. But in the past several years, dementia has compromised Maxine’s ability to express those qualities, as she would have in the past. However, Gennie is still able to connect with her friend, a resident of Summer House, Sunny View’s memory care neighborhood, but in a different way using techniques she learned from Memory Bridge, an empathetic form of communication.

 “I am a Bridge!” Gennie exclaims, who learned how to “be with” Maxine and how vital being together is to her and Maxine’s lives, regardless of cognitive capacities.

“We may not communicate in the same way but our time together is just as special to me as always,” Gennie said. “Some days when I visit, Maxine does not recognize me and that’s OK. Other days I can see her light up as soon as she sees me. That’s the special part. At first, I thought I was helping her but then I realized she was helping me learn patience. This has changed my life.”

 Memory Bridge training at Sunny View is funded by resident Jean Eckert through Sunny View Foundation and spearheaded by Sunny View Chaplain Pastor Carol Been. About 15 staff members, residents, family members and volunteers participated in the initial training that teaches non-verbal ways of empathic communication, or ways of “being with” people with cognitive impairment. The techniques are meant to combat emotional isolation that often affects those with Alzheimer’s and other dementias.

 According to the training course, one of the biggest mistakes people can make is to stop communicating with those diagnosed with Alzheimer’s or dementia because of the erroneous belief that they are “gone.” This counter productive approach to communicating with people with Alzheimer’s and dementia not only negatively impacts the individual living with memory loss by making them feel lonely and depressed, but it also deprives those who have stopped communicating from learning valuable lessons from these individuals, like the importance of presence and patience.

 Chia-Liang Li visits his Memory Bridge “buddy” at Summer House at least once a week. “We are both Chinese and both Christian so we have that in common,” Chia-Liang said. “I just don’t want her to be lonely. I do the best I can to let her know I care about her and her son appreciates that.”

“A one-on-one approach is the focus,” said Sunny View Volunteer Coordinator Julia Earley, who participated in the training and visits her buddy Marie, regularly. “We learn to be in the moment and let our buddies guide us during our visit. Sometimes a simple touch is all that’s necessary to get a positive response.”
With additional funding from the Sunny View Foundation, Sunny View hopes to expand training to more volunteers.

Just What the Doctor Ordered

Pioneering physician, veteran, family man, detective novel enthusiast, 60-year Santa Barbara resident and amateur astronomer all describe Vista del Monte resident Dr. Dean Vogel.

“I have a full life -- a somewhat exciting life -- and I’m looking forward to experiencing new things at Vista del Monte,” Dr. Vogel said.

Dr. Vogel was born in a small town in Indiana but moved to southern California when his brother received a basketball scholarship to play at USC. After graduating from medical school, he was an associate member of the Mayo Clinic before coming to Santa Barbara. He was instrumental in bringing coronary care to southern California in 1968 when the field was in its infancy.

Although the retired internist likes to keep up to date on the latest medical news, he spends most of his time enjoying the simple pleasures of life with his wife Mary at Vista del Monte.

“The last few years I’ve been the cook in the family so I’m glad I don’t have to do that anymore,” Dr. Vogel said with a smile. “The food here is excellent. And whenever we go to dinner here we end up sitting with someone with a PhD, or someone who performed on the New York stage or someone with an interesting hobby or story. The people here are just fantastic!”

He describes his wife Mary as a crossword puzzle expert. They both appreciate the newly landscaped grounds. “I don’t think there is another retirement community in the area that has such a wonderful garden as we have here.”

When Dr. Vogel wants some quiet time, he listens to detective novels using books on tape or gazes at the stars from his balcony through his telescope – lifelong hobbies that he has plenty of time to savor.

 “Living at a continuing care community was important to us at this time of life.” Dr. Vogel added. “We looked at several communities but Vista del Monte is by far the best choice for us.”

All in the Family at Wesley Palms

Employees enjoy working with family members


Francisco Murillo remembers the day in 1977 when he applied for a housekeeping position at Wesley Palms. The then 24-year-old got a ride from his dad to the retirement community high atop Mt. Soledad in Pacific Beach.

“That was the first time my dad told me the story of how he helped build Wesley Palms in the late 1950s and early 1960s,” Francisco said. “He was a pipefitter back then and was hired to use his expertise for Wesley Palms.”



Housekeeper Francisco Murillo has worked at Wesley Palms for more than 40 years. .

Wesley Palms opened in 1962 when Francisco was about nine years old. “Obviously I knew my dad went to work every day but I didn’t know exactly where,” Francisco said. “When he told me the story I was very surprised. I thought … I have a chance to work at a place my dad help built. How about that! Thinking back, I wish I could have visited my dad here when he was building this place.”

Francisco’s sister has photos of their dad at work at Wesley Palms. The iconic façade of main building is pretty much the same on the outside but of course, the new patio homes have replaced the original cottages. “That’s a huge change from the original cottages that my dad built. Back then, Wesley Palms was probably considered a new concept with its large open spaces and cottages. Now, the new patio homes at Wesley Palms are unique.” Francisco is now Wesley’s longest standing employee at more than 40 years.

Francisco isn’t the only employee with family ties at Wesley. Husband and wife, Laura and Juan Vargas have been working together for more than 13 years. Laura is the housekeeping supervisor and Juan is in the maintenance department. Laura began at the community first and then Juan joined her two years later.

“We both started in housekeeping but then after a few years Juan encouraged me to apply for the director’s position,” Laura said. “If I got the job, he knew he would have to transfer to another department since family members can’t supervise each other. He was sad at first that we would not be working closely together anymore but he soon found new energy on the maintenance team. He’s one of that department’s top employees now.”



Husband and wife Juan and Laura Vargas love working together at Wesley Palms.

 

“We take our first break together every day and then we don’t see each other until we get home,” Juan said. “Sometimes we like to swap stories around the dinner table about how our day has gone or we tell a funny story a resident told us.”

And then there is Muhannad Sofi and his 17-year-old daughter Delan Sofi-Haji. Muhannad has been dining room manager for 21 years and last year Delan joined the team as a receptionist. “I told Delan that Wesley is great place to work and left it up to her if she wanted to apply for a job here,” Muhannad said. 

“I kind of grew up here,” Delan said. ”My dad would tell me stories about how nice the residents are and how much fun he has doing his job so I decided to apply. Now I have my own stories to tell about our incredible residents.”

Wesley Palms’ staff are not the only ones who have family connections. Many residents are second generation. Longtime resident Bob Crabb’s mother lived at Wesley Palms in the 1970s as did resident Holly Steere’s parents and Becky Graber has the privilege of currently living at Wesley Palms with her mother.

“I’m not surprised we have both second generation residents and staff here,” said Executive Director Ben Geske. “Word gets out that Wesley is a great place to work and live. We’re a family here.”

 

Can Bundled Medical Payments Save You Money?

The promising idea aims to prevent unexpected bills after a surgery 

Credit: Adobe Stock

By Richard Eisenberg, via Next Avenue

Two of the most upsetting things for patients are the high cost of health care and the surprise — sometimes indecipherable, sometimes nonstop — hospital bills. But something known as “bundled medical payments” might relieve both of those and possibly provide you with better health care.

With bundled medical payments, patients are told before the medical procedure exactly what the whole shebang will cost, and pay a flat fee up front. Think of it as prix fixe health care.

With a bundled payment, you wouldn’t get one bill from the surgeon, one from the anesthesiologist, one from the hospital, one for physical therapy and so on, the way you normally do now. Instead, you get a total fee and hospitals and doctors are incentivized to keep costs down, so they can ensure profits. 

How Bundled Payments Could Help Patients and Hospitals

Bundled payments are “a powerful tool for the health care system,” Shawn Bishop, vice president for the Controlling Health Costs Program at The Commonwealth Fund, a nonprofit health research group, said at a recent webinar on the topic. They’re being tested to “improve the cost of health care and the quality of health care,” she told me in an interview.

“It’s a significant departure from the legacy model of health care,” said P. Marshall Maran, CEO and president of Muve Health, a joint replacement company that works with health systems to bundle payments before hip or knee replacement surgery. “We have a 50-year-plus run of a business model and tech and infrastructure with large insurance companies set up for a fee-for-service model, so unwiring that will take time.” 

Hip and Knee Replacement Surgery

So far, hospitals and doctors are mostly experimenting with bundled medical payments for hip and knee replacements — because those surgeries are typically straightforward. (An average joint replacement costs $26,000, but some cases exceed $125,000, according to The New York Times.) The results for patients charged through bundled payments have been promising, especially for people over 65 who are on Medicare.

“The bundled-payment trend is very smart and very good for health-care consumers,” said Leor Catalan, CEO and co-founder of Robin, a new platform that lets consumers know the cost of health care in advance.

Medicare began testing bundled payments in 2012, on a voluntary basis. Then it began making bundled payments mandatory for hip and knee replacements in 67 markets; President Trump has since scaled back the number to 34, but added new, voluntary bundles for some inpatient and outpatient episodes of care.

So far, hundreds of hospitals and thousands of health providers have made millions of bundled payments. Here’s a U.S. map showing places where Medicare has bundled payment arrangements. 

What the Bundled Payment Studies Show

When The Commonwealth Fund, along with researchers from Harvard University and the University of Pennsylvania, studied the outcomes of some bundled payment surgeries, they found “costs generally are lower and contained, and quality is either stable or a little bit better” than similar procedures billed the traditional way, said Bishop.

In one study published in the Journal of the American Medical Association in 2017, joint-replacement surgery payment bundles for 3,942 Medicare patients saved taxpayers $5,577 or roughly 21 percent per joint replacement care episode.

Dr. Amol Navathe, assistant professor, health policy and medicine at the University of Pennsylvania, noted during the bundled-payment webinar that research he and colleagues did found a four percentage point improvement in cost (roughly $500 to $1,000 per joint replacement episode) by bundling hip and knee replacements.

“There was no effect on increasing or worsening quality,” he added. Nor was there a significant increase in the number of surgeries performed. And patient satisfaction neither worsened nor improved with bundled payments.

One caveat: the data was based largely on the experience over one year. “What we know is that change is hard and takes time,” Navathe said. 

The Future of Bundled Payments

Surgeons who’ve tried a bundled payment system are “warmly embracing it,” said Maran, “because it allows them to control the care and decide how dollars are being spent.” Many hospitals, Maran added, “understand that this is the future.”

Medicare, Bishop said, wants to test and broaden bundled payments as much as possible to help save the system as much money as possible.

“We’re still in the early innings” of bundled care in America, said Maran. But other countries, such as The Netherlands, have been using bundled payments more aggressively, said Bishop, including for maternity care. And these countries often make bundled payment estimates for health procedures and recuperation for as long as a year; bundled payments in the U.S. are generally restricted to a 30-to-90 day period of care.

Odds are, you’ll be increasingly likely to see bundled medical payments offered by hospitals for knee and hip surgeries where you live. But don’t count on them for many other types of medical maladies soon, if ever.

“The thing about medical conditions like lung and heart conditions is that it’s harder to set up a set of services for them,” said Bishop. “It’s harder to manage a condition than a surgical procedure.” In other words: their medical treatments vary too much to set a fixed price, because situations of patients can be so different.

Added Catalan: “The types of services you can create bundles around are very limited. So this trend will grow, but it has a ceiling on it.”

McKesson and ORC International forecast bundled payments to account for 17 percent of payments by 2021. Already, some large employers are negotiating bundle pricing, according to a NEJM Catalyst article. 

2 Potential Concerns

There are two potential, disconcerting, unintended consequences for bundled payments, though.

First, people who are sicker than typical patients getting these procedures (so-called “higher acuity patients”) may be turned down because the hospitals might lose money on them. As Dr. David Blumenthal and David Squires wrote in a Commonwealth Fund article: “The otherwise healthy patient needing a knee replacement may prove more profitable than a knee replacement patient with complicating problems such as heart, lung or kidney disease.”

Second, hospitals might assign less-experienced and possibly less-talented doctors to the bundled payment surgeries to keep costs down and under the bundle price.

Health researchers and the government will need to keep an eye on both of those possibilities.

As of now, there’s no easy way to find out whether you can get bundled payments for your next hospitalization. And health providers aren’t yet advertising they offer them. So, if you’d like to bundle up, the best thing to do is ask your doctor or a hospital representative whether that’s possible.

© Next Avenue - 2018. All rights reserved.

Finding Creative Opportunities After Retiring

Investing time into developing your 'second act' can pay off

By Patricia Corrigan, Next Avenue

Ann Nessa presenting one of her shawls

Tone deaf? Turned off by a blank canvas? Two left feet?The arts enhance the lives of older adults, but even if you have no desire to sing, play an instrument, paint a picture or take up the tango, many other options for expressing creativity exist.

That was evident at a recent pop-up art show at a home in my neighborhood, where colorful lithograph prints, origami-inspired leather purses and wallets, handmade kimono jackets and abstract art crafted from recycled materials were on display.

Whether you’re interested in exploring a new area of endeavor or want to reinvigorate a passion from the past, finding the right path can be part of the process.

Four people who did just that include a doctor-turned-sculptor, a former astronautics and aeronautics engineer with a sweet job in a chocolate shop, a veteran of the corporate world who reinvented herself as a photographer and a retired buyer at a manufacturing firm who knits gorgeous scarves she calls “neck art.”

Credit: Compliments of Susan Emmerson

 A longtime ear, nose and throat surgeon in Illinois, Susan Emmerson took early retirement, earned two fine art degrees and now works as an artist in Boston. Clients make appointments at her studio or view her work at the Kingston Gallery.

What do they see?

“People tell me they see vague body organs, interesting shapes and shadows — and some say they enjoy the colors,” said Emmerson, 60. “I started drawing what I was most familiar with — the inside of the body. Now I draw on Tyvek®, heat it and sculpt 3-D globular objects.”

Emmerson has long been interested in both art and science. “I knew I couldn’t do both at the same time — you have to throw yourself into both careers — but it was always in the back of my mind that I would retire early from my practice and go to art school,” she said. Emmerson left medicine in 2004 and completed her undergraduate and graduate degrees in art in 2012.

“If people want to retire to write or be an artist, I encourage them to find a way to do it,” Emmerson said. “Yes, it takes time. But you may as well be doing something you love to do, because time is going to go by anyway.”

‘Being Creative Is a Form of Relaxation for Me’

Astronautics and aeronautics engineer, ski racer, information systems technician,

Compliments of Doug Cale

consultant, house flipper, marathon runner, homebuilder, proud grandfather and owner and head chocolatier at Birmingham Chocolate in Birmingham, Mich, near Detroit. That sums up much of Doug Cale’s life to date.

“I’m a risk taker,” said Cale. “I like to take chances, and I’m not big on the word ‘retirement.’” Cale, 71, left his “first collection of careers” in 2002. One day, while working on a house he hoped to flip, he met with three friends who also had left the corporate world. One was making chocolate, which interested Cale.

“I’ve been in the chocolate world now for 10 years,” he said. “I’m not trained in the pastry arts, but I come up with ideas for new recipes. I’m always asking why we can’t try this or work on that.”

One of the dark chocolate truffles at Cale’s shop is flavored with Jamaican rum. A white chocolate truffle has hints of blood orange. A specialty bar, made for a pie company, combines a streusel crumble with berries.

Cale also finds job satisfaction developing marketing strategies, exploring new partnerships and experimenting with his business model.

“For me, life is all about engagement,“ he said, “Coming up with new ways to do things day in and day out, what I get out of this job is the creativity. And being creative is a form of relaxation for me.”

Credit: Compliments of Pete Rosos

‘Photography Is My Second Act’
“Originally, photography for me was a way of hiding, but now it’s about making connections, meeting new people and hearing their stories,” said Carol Thomas. “Photography has opened my eyes and my heart to the beauty of the world.”

Thomas, 71, lives in Berkeley, Calif. She got her first camera at age 12 and has considered herself serious about photography since the 1970s. But only recently has she started identifying herself as a photographer.

In 2012, Thomas retired as the CEO of Education Northwest in Portland, Ore., one of 10 federally funded regional education labs. Her list of retirement goals included improving her photography skills. “I looked for local resources, started reading more photography blogs and enrolled in a class,” she said.

Since then, Thomas has joined two local photography clubs and she is an affiliate of Pro Bono Photo, a group of volunteer photographers that works with nonprofits. This year, Thomas was invited to join Berkeley Fine Art Photographers and her work has been included in exhibits at galleries.

“Photography is my second act,” Thomas said. “I wasn’t very good at first, because it was a hard switch from being so analytical and literal in my old job to being more creative and abstract. Now, it’s cool to think of myself as a photographer!”
‘Making Shawls Brings Me Lots of Joy’

Ann Nessa never goes out without wearing one of her shawls — wardrobe accessories she calls “neck art.” Nessa knits them from colorful yarns, including silk, merino, linen, angora and even bison. Many of the yarns are hand-dyed, and they come from all over the world.

“I look for unique yarns, and I want no distraction from the design. I want the yarn to do the talking,” said Nessa, 75. “Some of the shawls are big and some are small, and I wear them with dresses or jeans.”

When Nessa retired in 2009, she was already a knitter. When she noticed new and different shawl patterns available, she decided to make shawls. Each one takes a couple of weeks to finish, depending on how often Nessa sits down to knit. How many has she made? She admits to “hundreds,” each one unique. “Making shawls brings me lots of joy.”

For Nessa, knitting is not a solitary art. Before she moved recently from Whitehall, Mich., to Buffalo, N.Y., Nessa was a longtime member of Pints and Purls, a knitting club that met at a craft microbrewery. In her new city, Nessa has learned about one knitting group, but hasn’t ruled out starting another.

“I’ll go to a library and see what groups they have, or maybe I’ll settle in at a coffee shop and start knitting,” she said. “Other knitters will come right over to talk. Who knows what might get started?”

Patricia Corrigan is a journalist and the author of numerous books, including a guide to San Francisco that expresses her great joy in her adopted city. Visit her blog here.

 

The Best Way to Improve Brain Health

By The Milken Institute Center for the Future of Aging from Next Avenue

Credit: Adobe Stock

(Advances in science and public health are increasing longevity and enhancing the quality of life for people around the world. In a series of interviews with the Milken Institute Center for the Future of Aging, 14 visionaries will be revealing exciting trends and insights regarding healthy longevity, sharing their vision for a better future. The Longevity Innovators interviews highlight new discoveries in biomedical and psychosocial science, as well as strategies to promote prevention and wellness for older adults. This is the first in the series.)
Renowned neurosurgeon Dr. Keith Black (chair of the department of neurosurgery and director of the Maxine Dunitz Neurosurgical Institute at Cedars-Sinai Medical Center in Los Angeles) has pioneered advances in our understanding and treatment of brain cancers and complex neurological conditions. Black is also a research scientist studying targeted drug delivery, cancer stem cells and Alzheimer’s detection through retinal imaging, among many other areas. In an interview with the Milken Institute Center for the Future of Aging, Black talks about the importance of developing a test for early onset Alzheimer’s and his goal to inspire the next generation.

Dr. Keith Black

What is the most important thing that people should know about improving brain health?

People need to know how important lifestyle is to sustain health. Lifestyle, diet, exercise, moderating stress, making sure you get a good eight hours of sleep when you can, making sure you keep your brain engaged particularly in novel activities — all of these matter. You have to remember the brain is a living organism very much like a muscle — the more you use it, the stronger it becomes.

We need to treat our brains better. For example, try to avoid excessive alcohol and make sure that you screen yourself for diseases like diabetes and hypertension that can be devastating to the brain.

What will be the benefits of having a reliable test for early onset Alzheimer’s?

I think there’s a huge misconception that if you get Alzheimer’s or if you’re going to get Alzheimer’s, there’s nothing that you can do about it. And I think the science shows that that perception is incorrect.

We know two things now that address your question. The first is that Alzheimer’s starts about two decades before a person develops symptoms. During that period of 20 years, you’re losing brain cells, and you’re losing brain connectivity. If you can detect the disease at the very start, particularly before you lose enough brain cells to become symptomatic, we may have the ability to stop the process or at least slow it down and prevent an individual from becoming symptomatic.

If people are developing Alzheimer’s in their 50s and 60s, they are going to become symptomatic in their 70s and 80s. If you can slow the overall process and have people become symptomatic in their late 90s or 100s, you have the ability to essentially prevent the disease from being symptomatic in most of our lifetimes. That’s really the major reason to move towards early detection, because preventing brain loss is a lot easier than restoring brain cells once they’ve died.

The other reason people should be interested is that even though we don’t have a pill that can stop the progression, we know that Alzheimer’s also has a lifestyle component. The scientific evidence shows that lifestyle habits such as a Mediterranean diet, exercise, sleep, meditation and other types of mindfulness modify stress levels. We’re seeing that potentially even micronutrients like the omega-3 fish oils may be very important in slowing the progression of Alzheimer’s disease.

What’s your take on Pfizer ending research to find new drugs aimed at treating Alzheimer’s and Parkinson’s diseases? How do you think it will impact ongoing research?

I think a lot of the trials that have failed for Alzheimer’s disease, including the Pfizer trial, could’ve been better designed and better developed. I think we have a lot to learn from the failure of those trials.

For example, how do we get the drugs into the brain more effectively? How can we better select the right population of patients to treat? I think addressing those potential reasons for the failures of those drugs will lead to successful therapies and hopefully successful approvals.
By The Milken Institute Center for the Future of Aging

The Milken Institute Center for the Future of Aging aims to improve lives and strengthen societies by promoting healthy, productive and purposeful aging.

7 Ways to Find Love and Friendship Later in Life

Remaining open to connecting with new people can be rewarding
By Wendy Sue Knecht for Next Avenue


Credit: Adobe Stock

There’s no question of the importance of personal interactions and connections with friends as an important source of our well-being. This is especially true as we age, and much has been written about the challenge of making friends and finding love in the later years.

Looking for love, or even just hoping to make a new friend, can seem intimidating when you’re older. But it doesn’t have to be that way.

Personally, I didn’t find Mr. Right until late in life, and it definitely took some work on my part to be ready for the right person when he came along.

Here are a few insights that may be helpful in finding love and friendship as we get older:

1. Re-frame old mindsets It’s all how we frame things in our minds that affect our vision. With the right mindset, it is easier to find love and friendship.

Although it is often said that as we get older we get more stuck in our ways, this doesn’t have to be true. We learn more about ourselves as the years go by, and our tastes become more distinct; but that doesn’t necessarily imply that we have to become more rigid. As I’ve experienced, it is possible to become more open-minded as we age.

When I got married for the first (and only) time at age 47, I can’t tell you how many comments I received from well-meaning friends and acquaintances: “Really, wasn’t that difficult?” “Weren’t you used to living alone?” and “Weren’t you set in your ways?”

“No!” I would emphatically answer. Being single for so long made me ready to welcome change. Having more self-knowledge made it easier to feel open to new experiences. I realized that being set in my ways was a choice and served no purpose. I made a conscious decision not to be “stuck” in a rigid mindset.

2. Don’t expect others to be perfect With age comes confidence, and hopefully, the acceptance of our own imperfections. Personally, in my younger days, I had strict standards that everyone had to live up to. My friends used to tell me that I was “too picky” regarding men, which was a nice way of saying “too critical.” Once you come to accept your own faults and imperfections, it is much easier to accept other people for who they are. Not only do I not expect anyone to be perfect, I would hate for anyone to expect that of me.

3. Don’t let others define you When we were younger, many of us chose friends a lot like ourselves. Hence the “cliques” in high school, where everyone was pretty much alike. Back then, we needed to be alike to be accepted.

Once we have the self-assurance of age, it is no longer necessary to find a partner or a friend to define ourselves. You can appreciate others more fully when you realize they are not a reflection of you. Differing opinions and tastes can make things more interesting if you are open to listening without judgment. For example, the famous friendship between Supreme Court Justices Ruth Bader Ginsberg and Anthony Scalia comes to mind.

4. Embrace quirkiness Perfect is boring and quirkiness can be a lot of fun if you have a sense of humor. My husband’s “Obsessive Cleaning Disorder” would have driven me crazy in my 30s, but now I can work around it and even appreciate it. As long I keep my own modicum of neatness, I can reap the benefits of his obsession. I am perfectly happy for him to clean up the dinner dishes and organize the drawers (he does a much better job than I do).

Quirkiness in ourselves and in others can make life more interesting. Don’t fight it, embrace it.

5. Celebrate differences An appreciation and tolerance of differences is a big bonus of getting older.

A recent vacation was a big eye-opener. In my newly acquired travel agent role, I booked a small French river barge and filled it to capacity with 21 people. I recruited half of the passengers, whom I knew, and one of my friends brought along the others. Although mostly everyone knew at least one or two of the others on the trip, it was a fusion of childhood, college and work friends from all walks of life, white to blue collar. Everyone took a leap of faith and I held my breath, feeling responsible for the whole lot.

Our group was smart to ignore the topic of politics — one that is way too divisive these days. But everyone took the time to learn from each other. We shared our love of travel, food and wine, and embraced each other’s differing backgrounds. By the time the seven-day trip ended, we all had made a few new friends.

6. Visualize Remember the self-fulfilling prophecy is just that. If you really can feel in your heart that you are ready to meet a new friend or love interest, you are much more likely to be open to it when the opportunity presents itself. Visualize it happening. I found there is a lot of value in putting good thoughts out to the universe.

7. Keep an Open Mind Keeping an open mind is key to finding new friends and love as you get older. Never say never; love and friendship could be just around the corner.

By Wendy Sue Knecht
Travel expert Wendy Knecht is a former flight attendant, a designer of travel bags and author of Life, Love, and a Hijacking: My Pan Am Memoir. She blogs at WendySueKnecht.

Are You a "Solo Ager"?

By Richard Eisenberg

With her recent book, Essential Retirement Planning for Solo Agers: A retirement and aging roadmap for single and childless adults, Sara Zeff Geber brought the term “solo agers” into the national vocabulary. By Geber’s definition, a solo ager (sometimes called an “elder orphan”) is a boomer without children and/or grandchildren. Geber, a 2018 Influencer in Aging based in Santa Rosa, Calif., is a retirement coach for boomers, a life planning and retirement transition expert, a professional speaker, a workshop leader and a Forbes contributor. She has a Ph.D. in organizational behavior.

Next Avenue: Your bio says: Sara has been among the first professionals in the field to recognize that the baby boom generation would re-invent the whole notion of retirement in a very exciting way. Tell me about that.

Sara Zeff Geber: In 2010, nobody was talking about this. Boomers were primarily in the workforce. I was looking at the trajectory of the boomer generation and what we’ve changed in society and the likely changes we will enact in our later years. Now, we’re starting to see them bigtime.

Why is there so much interest in solo agers now?

For one thing, there are so many of us. Almost 20 percent of boomers don’t have kids and as I keep being told in my talks, solo aging is not limited to people who don’t have kids. Lots of people are aging alone with kids who live a long way away and a lot of them don’t want to rely on their kids.

Some people refer to older adults without children as ‘elder orphans,’ but you don’t like that term and many others don’t either. Why?

I hate that term. I find it offensive; the word ‘orphans’ has always had a negative connotation. I wanted to use words that are positive or at least neutral. I think I coined the term ‘solo ager’ eight years ago and now I’m pleased others are using it.

What are the challenges and opportunities solo agers face that are different than other people?
Opportunities? You absolutely have a lot more freedom to decide where you’re going to live. You don’t have the tug of kids or grandkids to live in a particular climate you don’t want. And you can go wherever you want.

What do people ask you about solo agers when you give talks about it?

People are very interested in the topic of where they should live. I’m not the biggest fan of aging in place; I like to see people focus on aging in community. It’s so important to build and maintain a social support network. I encourage people to think through to the end of life when we need people around us.

What do solo agers need to do first for their retirement planning?

They should use professionals like financial advisers and estate attorneys and get their paperwork in order — advance directives, wills, trusts, powers of attorney. That forces solo agers to think through: ‘Who will I name on those documents?’ And they have to talk to those people; you can’t just name them and let it go. You need to tell them your values and your vision for your future.

What happens when a solo ager asks someone to be in charge of their end-of-life wishes?

I can’t say people are always very gracious and say: ‘Yes, I’d be happy to do it.’ They’re not always comfortable at first. Help them understand you need people in your corner as a solo ager. If you tell me ‘I asked one person and she declined,’ I say: ‘Move on to the next person.’

I encourage people to start with family: a niece or nephew who lives near them.

What happens is often people go into a crisis after a fall or a medical event and there they are in the hospital and somebody needs to be there as an advocate waving paperwork saying: ‘I am power of attorney.’

What do you want your legacy to be?

I want people to remember me as a person who opened the world’s eyes to the fact that many people in the coming older generation of boomers, and possibly generations to follow, don’t have the safety net of adult children as we get older. And we need to plan in many ways what want to be, who we will be around and how we will avoid isolation and loneliness.
 

Richard Eisenberg is the Senior Web Editor of the Money & Security and Work & Purpose channels of Next Avenue and Managing Editor for the site. He is the author of How to Avoid a Mid-Life Financial Crisis and has been a personal finance editor at Money, Yahoo, Good Housekeeping, and CBS MoneyWatch.@richeis315

Fighting Ageism on a Hiking Trail

At Great Basin National Park, a couple discovers possibilities are as important as goals

Credit: Compliments of Donna Trump

By Donna Trump for Next Avenue

This is a story about me, a woman of a certain age, gray-haired and a little thick through the middle who, a few summers ago, asked a much younger, positively lithe national park guide …well, I asked her a question I didn’t really want answered. At least not the way the guide answered it.

The park was Great Basin National Park in far eastern Nevada, just over the Utah line. I was nearly overwhelmed with the remarkably remote beauty of the region. It is located in a huge geographic basin — spanning from the Wasatch Mountains in Utah to the Sierra Nevada in California, which, according to the National Park Service, is a “200,000 square mile area that drains internally. All precipitation in the region evaporates, sinks underground or flows into lakes (mostly saline). Creeks, streams, or rivers find no outlet to either the Gulf of Mexico or the Pacific Ocean.”

Anyway, the question I asked was this: “Do you think I can do the Wheeler Peak hike?” And the answer I got was, without hesitation, “No.”

“Is it technical? Is that why? Is it very long?” I asked.

“No, it’s not technical or very long, but there’s the altitude. It’s 3,000 feet of elevation gained in four miles — most of the gain at the end,” she said. “No, I just don’t think you could.”

Wheeler Peak summits at something over 13,000 feet. The only reason I even considered it possible ws that my husband and I would drive up to the trailhead at 10,000 feet.

“Did you tell her you bike 50 to 60 miles a week?” my husband asked, firmly in my camp. But by now I was miffed, feeling subject to ageism and determined to prove the guide wrong.

A Scheme for Summiting Success

The next morning, after picking up lunch and driving up to the start of the hike, my husband and I imagined coming back to the ranger station later in the day with tales of summiting the great Wheeler Peak.

The trail started out in a slight descent, which when you think of it is not a good thing: a “minus” in the “elevation gained” column. Then for two miles, it climbed pretty gradually, through alpine meadows and past pristine lakes.

Because my husband is a wonderful man, we followed a scheme for summiting success: 10 minutes hike, five minutes rest, even when the hiking was easy. What couldn’t be accomplished with 10 minutes of walking and five minutes of resting? Although when we rested, flies buzzed about and their drone reminded me we forgot the EpiPen my husband uses for bee stings.

We also forgot the map.

Negotiating a Rocky Trail

As we approached the tree line, we encountered our first patch of rock trail — pretty big stones making up the whole pathway.

“Scree!” I shouted with glee. (I have a thing for certain words, and this one means loose rocks covering a trail.) By contrast, on the way down, when it seemed we’d never return to a trail that was not pure, continuous rock underfoot, we’d navigated yet another switchback corner when my husband, somewhat uncharacteristically, muttered, “More damn rocks.”

In fact, on several occasions on the way up, I considered how this was all going to go coming down. The last time I descended such a steep, rocky trail I’d made good use of some hiking sticks. Which I hadn’t brought along. But we were still going up, right?

At one point, I swore I heard a rattlesnake.

A few hikers passed us, coming down as we ascended — one before the trees disappeared, telling us we had completed just short of half of the hike, and another when the trail had turned entirely to rock and the summit was intermittently visible.

“All you’ve got left is this bunch of rocks here — oh, and the next one too, but then there’s only one more hump to the top,” said the last hiker.

A Kind of Epiphany

We went a couple more feet — in my case, literally on hands and knees, and now resting every five minutes because, good Lord, it was hard to breathe — before I came to a kind of epiphany.

“I don’t think I can do it,” I said.

It absolutely surprised me: at a certain point in time that day, I really thought I could.

“Last 15 minutes kind of rough?” my husband asked, more than kindly. In truth, he was breathing hard, too.

“Try hour,” I said. An hour in which I more or less constantly imagined precipitous falls, sprained ankles and heart attacks. Emergency rescues. Pain. It was actually a variety of pure terror, overall.

“How about lunch?” said the fine man who is my husband. “Good idea,” I said. So we sat, and stared up for a while. But then, eating peanut butter and jelly sandwiches, we looked down, and around.

Imagining the Possibilities

It’s not always necessary, is it, to reach the imagined goal? Doesn’t failure, in some respects, increase possibility?

After lunch, I patted the rocks in acquiescent defeat and my husband and I started down. It took nearly as long to descend as ascend. When we got back to the ranch and looked over the map, my husband proclaimed we’d made it to within about a half-mile of the summit — only an eighth of the distance of the whole hike — but a distance in which we’d have to have ascended perhaps a quarter of the mountain’s elevation gain.

And, no, we didn’t go back and tell the park guide she’d been correct. Instead, we had dinner and sat in the hot tub, imagining a next time. A next time we were quite certain would never happen. A next time that, even so, was forever and irrefutably possible.



Donna Trump’s work has been published in december magazine (forthcoming in November 2018), Ploughshares and Mid-American Review, among others. She has received several Pushcart Prize nominations. Honors include a Loft Mentorship, mentorship with Benjamin Percy, a MN Emerging Writer grant and the selection of her story “Portage” by judge Anne Tyler for first prize in a 2018 contest sponsored by December.