by Wayne Sheridan
Coastal Journal contributor
This is the second in a series of articles on the current state of eldercare in the nation, the State and the midcoast region.
In the first ("Does midcoast Maine harbor a potential solution to the nation's mounting eldercare crisis?" Coastal Journal, Feb. 2, 2012), we looked at the changing demographics of the nation, region and Maine. If current trends continue, Maine will be the oldest (that is a population with the oldest average age) state in the nation by the next national census; we ranked third as of the last census in 2010, just behind West Virginia and Florida. Today, midcoast Maine is the oldest region of what soon may be the oldest state in the country.
We also looked at the growing financial crisis this aging population represents. (You can access the first article in the series by going to www.coastaljournal.com, then entering "Wayne Sheridan" in the internal search engine on top, then clicking on the article.) In fact this eldercare crisis may soon be a global one:
About 11 percent of the world's people are over 60 at the moment. In the next 25 years, that figure will double, to almost 20 percent, and one in six of those people will be over 80, according to a forthcoming book, "Global Aging in the 21st Century," by sociologists Susan McDaniel of the University of Lethbridge and Zachary Zimmer of the University of California.
Could an approach to eldercare being developed by a doctor here in the midcoast and his colleagues provide some of the answers to the problems societies face due to this growing worldwide elderly population? In this second in our series, we will introduce our readers to Dr. Allen S. Teel, and begin to reveal the profound insights he discovered, primarily from the elderly under his care in his practice in Damariscotta, which led him to develop what has been called "The Maine Approach."
I had the opportunity recently to meet Dr. Teel and interview him in the office of Full Circle America, an organization he founded to develop, implement and expand The Maine Approach, in their new offices in Damariscotta. He is an affable, but intense man, who has made improving how we understand and respect our elder citizens, and the care options offered to them, his life's work. I also had the opportunity to reread Dr. Teel's pioneering work, "Alone and Invisible No More" (Chelsea Green Publishing).
Dr. Teel's life's work literally fell into his lap, as on his first day taking over a general practice here in Maine, he was having lunch in a Damariscotta restaurant, when an older patron fell right in front of him. He treated her, and had her admitted to the hospital with a dislocation. She was his first of many hundreds of elder patients, and the first of many friends he made among the older citizens of the midcoast. He later became certified in geriatric care, and was the chief medical officer for the Lincoln Home, now primarily an assisted living facility, as well as serving in a similar capacity at Cove's Edge Nursing Home, for many years. He was also one of the founders of a series of small residences for seniors needing assistance, but who also retained the strong desire and capacity for a greater degree of independence, called the Eldercare Network. His experience with the Lincoln Home, Cove's Edge and ElderCare Network are covered in four chapters of his book.
Dr. Teel met and admired the tireless work of scores of nurses, staff and volunteers in all these eldercare organizations. The stories of the interaction of elder clients with many of these professionals and volunteers, including the caregivers' dedication, often beyond the call of duty, are inspiring. However, the obstacles they must overcome to provide both sound care, including some basic medical care, and an environment in which the individual elder is able to maintain a high degree of dignity, independence and joy in life, are enormous. In Dr. Teel's opinion, many of these obstacles are the result of regulations, primarily state and local, which are inflexible, burdensome and not truly beneficial to the elders under care. The chapters on his personal experiences, and the experience of the organizations for which he has worked with regulatory bureaucracy, are both revealing and a bit frightening.
With the insights gained from caregivers, professional, volunteer and familial and, most important, through hundreds of conversations and interactions with elder citizens, Dr. Teel sought a new way to provide elders with dignified, effective and to the extent possible, self-directed care. He rightly notes, there is no time to waste. In the introduction to his book, he quotes from an article by Shoshana Zuboff in Business Week:
"If health care is a train headed for a brick wall, then elder care is a high-speed train stuffed with our parents and grandparents racing towards a steel-reinforced concrete fortress. Today, it's them. Tomorrow, it's us ... elder care as generally practiced is a euphemism for human warehousing on the cheap."
Dr. Teel's inspiration and initial model for The Maine Approach was his grandmother, Gram Teel. He devotes the whole first chapter of "Alone and Invisible No More" to her, which concludes with these words:
"So much of my thinking in the movement to revolutionize eldercare as we know it is shaped by Gram and her simple principles. This graceful, matter-of-fact woman, and many others like her, understood their own needs and fulfilled them in part by embracing and serving others in true community. Revisiting her story is not a wistful exercise in nostalgia; rather it is a blueprint for a better way."
The chapter on Gram Teel is well worth reading in and of itself.
Dr. Teel gathered a few colleagues, and most important, a 40-member senior pilot group, to begin to shape the program that would become The Maine Approach. The key to the success of this program it seems, if it fulfills its potential, will be because it was designed, in large part, by seniors themselves. The guiding principles they came up with are:
• Emphasize elders living in their own homes as long as possible
• Engage elders as fully as possible in living every day fully
• Empower elders to take back control of their lives
• Promote elder independence and interdependence
• Encourage intergenerational contact and relationships
• Offer diverse volunteer opportunities to everyone regardless of age
• Find volunteering opportunities for even the most infirm elder
• Offer a variety of support choices, but insist on as few as possible
• Showcase and celebrate whenever possible elder wisdom and experience
• Provide a reasonable level of safety and reassurance
• Elicit and refine elder goals and new or old interests
• Make connections to family friends and community
• Harness elder talents and abilities as an untapped resource
In our next article in this series, scheduled for the first Thursday in April, we will get into the specifics of how The Maine Approach seeks to fulfill these goals. In the meantime, if you'd like more information on Dr. Teel and his work, we recommend you access the Internet site, www.fullcircleamerica.com, or pick up a copy of his book, "Alone and Invisible No More."