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.

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