Dr. Bill Thomas speaks at the Senior Living Innovation Forum

Dr. Bill Thomas speaks at the Senior Living Innovation Forum


so on this evening I’m really excited that we ought to get him here on one of his his tour stop sure and I caught it in New York City
were based back in March I believe and I resized you know will you be an
excellent speaker to kick off this event and he said that’s impossible I gotta be
in oklahoma City next day and I kept hounding him and going back and forth
microfiche I is from here and then get you to Dallas and you could stay near
previn I can catch up and he’s like that’s crazy but I kept on calling and
somehow I got them to agree to this crazy guy dinner so we’re really excited
to have you here with us he doesn’t need much of an introduction because most
most overused but without further ado doctor bill times lot of you know that this this the
reason I was willing to take your car to Miami tonight and fly to Dallas and stay
overnight in flight to Oklahoma City is that I had a chance to talk to you
that’s the other Michaels for a charming you the real draw I I think this really
is a pivotal moment in the history of our relationship with AJ our cultural
relationship with aging and the people who were in this room right now are
among the Americans were shaping the future right now what that’s going to
look like and for me to have the blessing to be with you for 30 45
minutes that’s worth it to me so first thing just want to say is thank you so
much for welcoming me and lending me your ears for a little while and I’ll do
my best to repair that attention by talking about what’s on my mind right
now first I’m concerned this is an elite
group and the doors are closed and I’ve been encouraged to speak freely do so
I’d like to sort of just talk to you about what’s in my notebooks right now
I’m not hardcore daily journal and journaling person and back at home I
probably have a six-feet of field notebooks and i was just actually doing
some reorganizing at the house this weekend and pulled out no books from
five or six years ago and looked at what I was thinking about working on and
basically I want to give you a look at my new books right now what’s in them
right now we’ll see how it goes drop some fair to you ok so first thing I am very much a lover
of language and I think language has credible power for the good and the bad
and I see a pair Senior Living innovation forum and of course senior
some people in the room will recall that the word senior descends to us from
latin the original route in Latin is 10 X 10 X means old man and Centex actually
comes from the indo-european sin which means all and what’s interesting about
american english is that that word that route has diverged into two pathways and
you can see them both in our language and our culture on the one hand we use
sin and senior when we want to indicate that something is vulnerable and
honorable so if you were a senior in college or if you’re a holder of senior
debt or if you just visited with your state’s senior senator then you’re
indicating something positive that word also gives us a sense and sensibility it
was thought at one time for example the dimension was just simply a matter of
age and what we now call alzheimer’s was called dementia praecox meaning wow that
was fast you’re ready to mention like everybody gets so send me liberty is
thought to represent kind of a declining related to age and senescence here’s an
interesting bit of language if I was speaking to a roomful of botanist and I used the word suggestions
you would all believe that I was referring to the right the naming of
fruit you make wine from grapes interestingly when we talk about humans
and senescence we’re using very different meaning which means a person
who has declined from or fallen away from the peak of youth and we give very
little attention to this idea right thing so we have a senior interesting
word living i’m for it fan the real innovation and something we
have to keep in mind all of us together the real innovation took place is a
little hard to tell but probably around fifty thousand years ago when
grandparenting first emerged first appeared and this was the beginning of
the humanity’s greatest invention yes you heard of the wheel yes you heard a
fire bigger than either of those things was the invention of old age if you look
at the human species comparative study of the other creatures on earth you find
out that humans we are good at it I can give you proof our closest biological relatives on the
planet with the chimpanzee we have about 98% identical DNA with chimpanzees the
other two percent that’s kind of a big deal with outfielder 2% you would not be
paying attention because you can see each other’s hair ok so who do percent
his big 98% saying let’s look at a few thanks what’s the ordinary length of a
chimpanzee pregnancy she eight months how long does it take a chimpanzee
female to reach reproductive maturity to become fertile 12 years 748 12 to 15
years how many years of fertility couldn’t chimpanzee female anticipate years of fertility 40 maximum
lifespan of a chimpanzee barely get the AARP card humans have a
maximum life span that’s twice as long and here is the thing and I’m telling
you this makes us freaks of nature all of the extra life comes after the period
of real productive capability and talk about the females well actually that’s a standard we can
map against both species so the chimpanzee female remains fragile right
up to the very end of life the human female and also gets an Arbonne yes five
and a half decades there’s nothing like that on the planet no other creatures even comes close to
it it is aging that made us human it is aging that gave us grandparents it
is aging which allowed us to develop culture and then transmit that culture
across generations form of aging is the most powerful tool and the source of the
greatest advantage of anything human beings have ever created Senior Living that’s a radical ruled
altering statement right there and it’s worth reflecting on the fact that we are
descended from a thousand generations of grandparents every one of us sapiens we probably should call
ourselves generous man the old so it’s good to
have an innovation forum about the most innovative things human beings I’ve ever
done good dive in the first thing that I’m under rampage about these days is a
word that actually first appeared in the literature in 1982 in a peer-reviewed
nursing journal for the very first time we find in the published literature the
words continuum of care and in 1982 this was like wow you’re blowing continuum of care well it’s been 30 years I’m not so
impressed and let me tell you why first off if something is going to be a
continuum has to be continuous but anyone in this
room who’s ever had an older relative become
involved in aging services know that in a continuous not even close what we really have our segments of care separated by terrifying gaps vast and there’s no continuum of care
continuum of care is an optical illusion that is seen by healthcare executives
only because they have PowerPoint slides in on their PowerPoint slides all the
box but as you walk out of the building and you talk to anyone who has any experience with this is no box is
the continuum of care probably was an interesting and useful
tool for thinking in the eighties before you know cell phones and the internet
but really it’s not useful to us now and the bad thing about it is I witness with
my own ears healthcare executives standing up in front of me and saying
things that are not true like we’ve got a continuum of care that
is not true and is never good for business to organize your efforts around
something that’s not true I the continuum of care you can understand
it fully if you understand the second thing about american hospitals are
killing our elders not not by the thousands by the tens of thousands year
after year after year that’s not me saying that that’s the Institute of
Medicine the number of probably higher last year ninety thousand elders
medicare beneficiaries lost their lives in hospitals due to errors even know how many were killed when
everything went right according to the plan anymore it turns out hospitals are uniquely ill-suited to the
well-being of older people there are in fact in fact if I entered some bizarro
world where I was turned into a person who wanted to do the worst thing I could
possibly imagine for older people who aren’t sick I would design a hospital
and I would put older people in it that’s how bad it is let me run through
the specifics in order to be well you have to be able to move if you don’t
move bad for you if you’re an older person who doesn’t move it can be
catastrophic for the past six months have looked at the literature what do
you think the literature says about how much and how well elders move in the
hospital anybody who’s had an older relative in
the hospital already knows he answer to the question you didn’t even have to
read the papers but the research shows older people and to enter a hospital and
enter into a period of enforced in mobility here’s one I bet you never
thought of this before in order to be well you have to sleep what do you think
the literature on sleeping in the hospital looks like some of you even
have the experience herself and her older people it’s much much much worse
so older people are documented to get very very little sleep in the hospital
and to build up what we call sleep yet there’s also a significant problem with
something called sleep fragmentation and by the way I think there’s going to be a
great piece of work of innovation innovators doing a lot better work was
sleep and helping people sleep better who are well it or not well I think this
is going to be a big topic going forward so hospitals don’t do a good job with
sleeping in the hospital is posted for many years in my clinical practice I
took care of people who had been in the hospital and then were sent back to me
in many cases they were worse off than when I sent them to the hospital in the
first place not only did they come back so often
with the same problem I’d something out with but now they had colonization with
resistant organisms it’s dinner time I won’t go into details but let’s say bad
things happened and instead she lying I then had to spend six months trying to
help this person back together after a five-day stay in the hospital ok move EEE he and II a mess the future of well-being measures hair
thing that’s brilliant about her field is that nobody has to go out and invent
some amazing new molecule nobody has to come up with the miracle drug you can be
you can be a hero you can be you can have your face chiseled into Mount
Rushmore if you can help people move eat sleep and he’ll that’s the miracle
that’s the amazing wonderful thing so as innovators and want you to think about
the environment you’re involved with and ask how we doing move he he’ll now
remember the old continuum of care concept measure the new concept in my
view is not a continued on its a measure it so we’ve it’s a fabric it’s an
interlaced structure and here’s what I love about the measure concept anybody
who’s ever laid on a hammock on us sunny summer afternoon knows exactly how
it works you look at the hammock it’s a better
road together it’s full of holes but you climb right on it and you laid back and
you go to hold you up it’s mostly not there yet Syria’s it’s a mash the pieces
are woven together there’s no silly continued woman imagine taking your
summertime nap on the continuum that happens to have some gaps in it good the other thing I love about a mesh is
even if you’re in little hammock has some holes in it I mean like stocks
broken it still ok a lot of things can go wrong it is still hold you up a
continuum breaks it it’s not a continuum intense gaps in it so the mesh concept
can lead the people in this room to collaborate in very exciting new ways
technology design material science architecture clinical I mean I guess
about the approach to clinical care and and physiology better understanding of
aging all of that goes into the mesh so the old idea of a continuum of care
really if you want to be as generous as you can be actually describes a down
escalator and we ask older people to step would you please step down
escalator and then the down escalators posed to take them all the way to the
bottom and that’s the continuum of care instead the mesh concept is laid back
enjoying the sunshine we gotta and the Wii isn’t a handful of institutions the
Wii is a complicated we’ve of family members religious congregations fat
friends technological innovations online partnerships physical spaces all woven
together to support people in a specific community in ways that enhance their
dignity and allow them to move and he’ll know I mentioned going to Harvard med
school a while now but I went to a school reunion and my class ring found
out that I’m going into geriatrics and they were like well man you had talent
don’t know really what happened but we thought you’re gonna be somebody and
I can kind of feel that a little when I realized that I am 56 years old and I’m
talking about things that are very simple but isn’t that true in all of
life if you really want to be good if you really want to be a master if to do
the simple things well and continuum of care has let us all in the wrong
direction time to give it up now with that thought
in mind I’d like to ship gears a little if you don’t mind like to talk just for
a few minutes about the thing that makes all of our work much more difficult than
it has to be and that is a jism jism we find all of us in our field that we
often have the experience of walking outside on a winter day and you’re going
straight into the teeth of a cold wind you can keep walking but your forehead
is frozen your eyeballs hurt but you can keep walking that’s what we experience
in our field when we confront ageism every day we confronted it work we
confronted it home everywhere we go we are never free of it
and neither are the people who work with us for the people we care about ageism
is everywhere and I’m gonna make a statement that can not seem to nice but
if you think about it per minute it’s common sense actually at all of us all
of us work in a just organizations we must we are surrounded by it you been surrounded by ageism every day
of your life television programs magazine covers
novels movies stories about older relatives that are painted in a negative
light it’s been all part of our heritage is
all part of our story all part of our past ageism is the last form of bigotry
that is permitted to be spoken in polite company and so people do make a just
jokes in hospitals they use a just words to describe older people and I’d like to
point out two of them to you so you can see what I mean by being everywhere and
I guess is sort of back to the theme about language the first horribly
terribly a just word that I no longer use in my vocabulary although you can
find this word in my earlier books there is a just ruler it goes like this
elderly become convinced that the word elderly is in a just ruler and here’s
why if you think about sexist slurs or
racist you realize very quickly that the slur is actually a calm pressed against
version of every negative stereotype you can imagine compressed into one word and then hurled
at people and we’re familiar with them and we don’t company like this does not
speak those slurs at dinner tonight racist slurs that’s because they’re
weaponized language they don’t carry any redeeming parts to their not complicated
words they don’t say you know a little of this little of that no it’s all
negative then I think about the word elderly first thing i i i realize his no
older person employees that word to describe themselves so you don’t meet
somebody got you high I’m jurors elderly mother doesn’t happen that people who
were elderly are always somebody else the people who are elderly are always
and need people who are all day earlier always we can grill and long robe or
they’re always this close to crashing the finances of the United States of
America that’s elderly and eventually stopped using the word I think it
communicates the wrong message especially in company like this you
don’t treat people like that I know you don’t but that’s what the world
communicates ready for 1211 no ok skipper skipper yeah alright the dirtiest five-letter
word in the English language till the words still is used to punish older
people and to enforce an orthodox vision of aging the says the only good old
person the only word the old person is an old person was just like a young
person so let’s see how it goes she drives to work every day and then
you know somebody’s got a great grandfather is just back from climate k2
is 98 he’s in Florida because he loves to waterski barefoot in the nude still would still is used to communicate
the idea that an old person who was worthy is an old person who’s like a
young person look at this language my my my uncles 82 he drives by and see no 87
she drives to work every day same idea what the word still is evidence of a
deep-set ageism in our society the money to talk to you a little bit
but something had been up to actually with the participation of some of the
people in the audience here the last couple of years I’ve been actually
deciding that my future was going to be as a touring performer so I’m kind of
unemployed now six weeks a year I live on a bus that sleeps 12 and I travel the
country performing in an effort to dramatize and emphasize how deeply
ageism has impacted our culture how it impacts us as individuals and what
becomes possible when we escaped from the bonds of ageism and begin to think
of aging in the way we thought about it when I started remember when I was I
started off by telling you that aging is better than the wheel better than fieger
that’s what made us human but that’s not how we wind up thinking about it and
talking about it it turns out that in american society people are encouraged
everyday to wish they were younger adults little kids still wanna turn
seven so they can get to know the new toy or whatever but adults always are
encouraged to look backward and say yeah boy you know when I was 25 when you’re
forty five now and what happens when you do that you’re cutting yourself off from
being who you are right now that’s kind of the interesting thing I i’m
advocating for and this is a told you stuff that’s in my notebooks i advocating for a culture where I can
be my age I said earlier on 56 I want to be
about the best fifty six-year-old I can be lucky someday I’m here for the 20th
anniversary of this event I B 76 you know hopefully I’d be the best 76 role
that could be I want the best age to be the age I am right now and there are a
lot of reasons why that’s hard to do everything that makes it hard for a man
ten times harder for women just ageism I talked about is is punishes women much
more severely than it punishes man in our culture I’m allowed to let my beard
in my hair go right my wife was the same age colors our hair
why cuz she’s that’s why if you live in an age of culture and signs of aging are
are are punished culturally then you can you dye your hair that’s the smart thing
to do it’s appropriate I’d rather live in a world where people could dye their
hair or not and nobody cares cause it doesn’t matter because gray hair doesn’t
reflect negatively on women as it does in american society now you might wonder
ok and coloring your hair what about innovation headwind that makes everything difficult
that’s called ageism and if you really want to be created and you really want
to develop really great new stuff you got a deal
with the ageism why do hospitals get away with doing what they do to older
people because our culture says they’re alt you kind of expect can’t do any
better than that and we know it’s not true so wrapped up with a couple of
points about another piece of language that is important to me about winning
I’d like to now talk about winning but could you favor I mean I’m very bad I’m
in terribly insanely competitive person it’s playing games with me not run we
don’t have a fun time playing games for a bad I go to the gym they have this
site where you can race other people in the bike very bad not healthy you know I
fall off the bike exhausted not not how it’s supposed to be so winning big deal
for me and I think since you came here it’s a big deal for you to we have to
stop it with this post acute language let me explain to you that if you’re
using the terminology post-acute you’re giving away the crown jewels you get
your saying the hospital’s oyez oyez down to the acute care system system
we’re posting key no way man they they have messed up on a bus staggering trillion dollar hundreds of
thousands of lives lost they the acute care system has 90 year old people who
are mildly dehydrated laying in a bed alone in a hundred million dollar bill
does that make any sense at all even anyway does that make sense no it does not make sense it is exactly
the opposite of what that mildly dehydrated nine year old person needs
and if the research is to be believed yeah that nineteen year old person makes
it out on that health care hospital acute care hospital should be weaker
less well nourished less rested and farther away from her ideal state them
when I’m really sorry anybody wants to argue argue with me i’ll be delighted to
argue with you about that now ok I just think about your own relatives ok
you been there yes sir exactly they don’t even know I wouldn’t
even given the age I do have to give him I would just love it I can’t they think
they are but they’re really doing the T treatment they think that’s no good there’s
litigation about vaginal match forget it trading still fighting spirit ok that’s the first thing the second
thing they had me on my head and say you don’t understand when the fact is I do
understand and I know I’ve been laid out for you I could put in front of you you
know a twenty-page reference to paper with all the research the point is
they’re the ones who don’t understand now so thank you for saying they believe
they have a mortal lock on so-called acute care and nobody can touch them I
disagree in the future the only older people actually I’ll start with older
people the only older people r gonna wind up a hospital or older people who
need or want intensive list interventionist care and honestly if I
need that kind of care I’m going to the hospital honestly really good at it I need a new
kidney you’re not doing it home ok you know I’m going to the transplants
honor mild dehydration they do not do well with this it’s not really even
their business but and this is another fun thing to do I’ve had the experience walk around the
hospital with healthcare executive and I will say to them instead of talking to
them about young geriatric specific unit I talked to them about perfect yes why
don’t you create a special unit for the people who are not on medicare has you
can put it off over here on the side on this one wing you’re running a geriatric
hospital and you’re not doing a very good job of it so last point and I
actually do have to catch a plane and he’s like get so last point aging is the
greatest thing we all of us have been going down the wrong road on continuum
we gotta get go to basics movie Eat Sleep he’ll create a measure that
supports people where they want to live free we live in a just society ageism is
impacting you and your innovation right now today deal with it for do not give
away acute care with this post acute lingo we
own the experience of older people when they are well and when they are on well
the hospital can only experience of people who need interventionist
intensive care fine they’re good at all the rest belongs to thank you very much
michael thank you so much Diamond Dr Bill Thomas

One thought on “Dr. Bill Thomas speaks at the Senior Living Innovation Forum

  1. I was in the room for this presentation and enjoyed it immensely. Interesting speaking style, however an obvious genius on ageism issues.

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