Aging in Place… Louisville

Louisville has been in the news many times over the years, as the origin of the Louisville slugger, well known bourbon, and the Kentucky Derby. However, it was most recently brought up again in an article by Forbes in regards to the growth of it’s aging population, and the symbiotic growth of the healthcare industry to compensate.

In fact, according to numerous sources, Louisville is now the city with the largest cluster of healthcare companies, from hospitals to nursing homes, focused on the aging population as a prerogative. They have designed an innovative plan where the driving force will be care employed outside of doctor offices and nursing homes… A place that Propel Health coincidentally seeks to fill a niche within as well. This is no surprise considering the statement made by the city’s mayor in 2012.

“Every city has unique strengths, and Louisville is a leader in developing targeted economic development strategies around our strengths. Aging care and lifelong wellness is an industry poised for exceptional growth, and Louisville, and its workforce, stands to benefit.”

  • Mayor Fischer

Thus, when considering this change that Louisville has sought over the last few years, will other cities seek to embrace a similar endeavor to create a long-term plan with the goal of providing healthcare and wellness to aging individuals in their cities, and potentially the country, and how will they accomplish it?


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When I was in my mid 20s, I developed a very close friendship with my aunt-in-law, Eleanor. The first time I met Eleanor and her husband Lou, I learned the art of conversation. They were in their mid-70s, had traveled the world, were teachers and musicians and were living a wonderful life together in their home.

I received the greatest gift that day.  They taught me, through their engagement with me that afternoon, that the connection and intimacy experienced during a conversation happens by asking questions and completely focusing on the other person. As we sat in the sunroom having afternoon tea, I felt so special as they spent time focused on learning about me and my life, my hopes and dreams and building the foundation for a loving relationship that would extend for almost 25 more years until Eleanor passed away when she was 99.  When I realized that I was doing most of the talking because they were so curious about me, I felt special and I fell in love with them.

Over the years, we would volley back and forth asking curiosity questions about what was happening in our daily lives as if we were enjoying a box of Godiva Chocolates!  While the dynamics of the conversation would change over the years as our life journeys continued, I would look forward to spending time with Eleanor and our wonderful conversations enriched my life, her wisdom taught me so much about being a better person and allowed me to share her stories with my children to keep their legacy alive.

So on this Valentine’s Day — and every day — call the elderly individuals in your life and be open to receive the best gift ever.

Here are five easy steps and insights to connect from love and levity with those you love as they age.

  1. Ask Questions that Start with “What”

“What” questions invite them to share stories about the past, present or future. It focuses on them.  It creates a space for them to share, reminisce and dream.  Do your best not interrupt them.  Listen patiently and closely even if you’ve heard this story 100 times.  You can ask them more questions based on the story they share to discover even more.  Listening and engaging is a wonderful gift to give them so please don’t remind them that you heard it already or cut them short!  It may be a very special memory or it may be a part of their aging process where they begin to have limited memories.

  • What was your favorite food when you were a child?
  • What was your favorite movie?
  • What was your favorite place to travel to or visit?
  • What did you want to be when you grew up when you were a child?
  • What would you do differently?
  • What advice would you give to the youth of today?
  • If you could go back and give advice to yourself as a 20-year-old….What would you want him/her to know about life?
  1. Don’t Start your Conversations with “How are you Feeling?”

Asking “how are you feeling” can make people feel that we are relating to them as their health condition or problem.  This can feel like a natural question to ask when someone has a chronic illness or serious condition.   While our intentions are good, it makes them feel that we are relating to them as “their condition” and not as “who they are.”  They are not the disease, situation or stage in their life.  They are a beautiful individual who is aging and craves love and connection from their family and friends.   What it can also represent for them is that they grow weary of talking about a health problem and if it is a significant health problem, they often may want to avoid discussing it because your emotional reaction may be far too much for them to manage.  If it doesn’t come up in the conversation, don’t ask.  Let them offer it.

  1. Acknowledge Them.

One of the best gifts we can give someone is to give them a deeply felt acknowledgement — not only for what they do in their role as parent, spouse, child or employee.

An appropriate acknowledgment will come from who they are in the world to themselves and for others.  Here’s an example of a heart-felt acknowledgement:

“Mom, thank you so much for the birthday card and cake.  It really made my birthday so special.  What I love about you Mom is that you are smart, loving, strong, kind and you have a wonderful sense of humor.”

  1. Amplify Their Dignity and Independence.

No one wants to be told what to do.  No one wants their rights, dignity or freedom taken away. It gets harder for the “sandwich” generation who need to take care of aging parents who are living longer, ourselves, careers, finances and our children.  It is inevitable that we are all aging and it cannot be avoided.  (You are on that same journey as your read this article!)  Certainly, as we age and our bodies and minds begin to change and may even fail us, we may all need additional love and support to protect us from harm.  There may be things our aging loved one has to let go of and we may have to make really tough life changing choices together.  Please keep in mind that the elderly fear being placed in a nursing home more than death itself, so how can we have a conversation that honors them while meeting the family member’s needs also?

  • Communication must come from a place of love and not from fear, stress or exasperation around where your aging loved one is on their journey.
  • Let’s keep in mind how we would want to be treated as we embark on the difficult conversations and together we can change our relationship to aging from diminishing our humanity to thriving at every age for as long as possible!
  • Would they like to remain in their home for as long as possible?
  • Would they be open to using technology that enables them to stay at home having peace and independence and dignity while allowing family members to have peace of mind? How can technology create a wonderful life and not feel like it is “big brother” but become a partnership for them to live life on their terms while giving you peace of mind?
  • If we can put ourselves in their shoes and understand that they want to express:
    • I am the CEO of Me!
    • I have ultimate authority over what happens in my life.
    • I need you to honor my wishes and respect my choices.

We can have connected and empowered conversations to create a structure that serves everyone.

Here’s a flow for a loving, empowered conversation, even when it’s really hard:

(You Begin and Let Your Aging Loved One Share First)

  • Honor them by asking:  “What do you need? What would be ideal?”
  • Summarize back to them what you heard:  “Thank you for sharing that. What I heard you say is ________________.  Did I understand you correctly?”  (Let them fine tune or clarify if needed.  Make sure you stay in this place until you can recite it back as they said it.  Don’t skip this important step.  This is where true connection and understanding are created.)
  • Ask them:   “Is there anything else?”
  • Repeat #2 and #3 until they have shared everything.

(Now it’s Your Turn to Share)

  • Share with them from love and kindness what you need while factoring in everything they just shared
  • Seek to find a balance to meet both of your needs.
  1. Call, Send Cards and Gifts for No Reason

This may not be today’s modern way things are done with instant messaging Facebook, Twitter, Instagram, and Snapchat; but let’s keep in mind that it’s our responsibility to communicate in the preferred style of the receiver.  In business, we would not assume that everyone likes to text and we would ask them what they prefer and be respectful of their communication preference.  Our aging loved ones deserve to be engaged in a manner that keeps them connected and reduces the feeling of isolation.

Sadly, for the elderly the phone isn’t ringing anymore as younger generations have an expectation that if you want an update about what is happening in their life, you can find the update and photos on Facebook.  Weddings, births, illnesses – all are being shared digitally and not though the connection of a personal visit, voice or video conversation.  It makes the elderly sad and often brings them to tears.

Facebook is exhausting for anyone to try to find important family moments through the barrage of advertisements, negativity, political points of view and kitten videos!

What becomes possible if we ask our loved one what they prefer and rally family members and friends to stay connected that way?  For all they have done for their families, I believe their children, grandchildren and great grandchildren will make them happy once they are aware.

Here are a few places to look for increasing your connection with your loved one:

  • Ask them what makes them happy?
  • What are their hobbies?
  • What do they like to do to pass time each day?
  • What is their favorite music?
  • How can we help them keep track of birthdays and events?
  • How can we share pictures of the family members?
  • Would they like phone calls or video calls from family and friends if it is really easy?
  • What is their favorite TV show so you can talk about it when you talk next week?

Don’t wing it when it comes to conversations with an aging loved one, especially when you haven’t spoken with them for a while.

Make a list of questions to ask them.  If you know they have a hobby or past interest in sports art or literature, maybe there are some interesting things happening in the world that you could share with them or maybe they can share past experiences with the things that they love.

In the end, it’s not about you. It’s about giving love away to make a difference in their life.  Make them feel special and leave them feeling great!

You can give them the gift of an extraordinary life filled with peace, love and happiness at every age and especially during the final part of the journey.

By: Diane Cashin


If I only Knew….

If I only knew….

How many times have you thought that when it comes to someone you love?  An aging parent?  A child, family member, friend or veteran who experienced a health event that might have been avoided, “if you only knew.”  If only you could have been notified, maybe you could have done something… anything.

While nothing is certain in life and we can’t prevent the inevitable from happening, wouldn’t we all feel better if we knew – If we could do everything possible – call, show up, rally troops or engage with a care provider?

Today, so much focus is on the healthcare system… A reactive experience often finding someone we love in an ambulance, emergency room or as an inpatient.  We spend almost 100% of our time outside of the healthcare system with those who love us, so why isn’t there more focus on empowering us so we know and we can do something proactively?

What if…

  • information about us or a loved one (which is currently trapped within the body or inside your medical records) could be captured for us to see?
  • we could use that data and build a personal policy unique to us?
  • we knew on a daily basis when our health was normal, moving out-of-range or more serious putting us at-risk — based on our unique health parameters
  • someone could be notified and take action when help is needed as proactively as possible? The people who love us most, know us best and care about us – spouse, children, church member, neighbor, extended family or another veteran.

While our care providers are exceptional, everyone would agree, the less time we spend with our primary care doctors, specialist and hospitalists the better – especially when we have information and a “home team” supporting us to achieve our health goals.

With the advent of the consumerization of health, we could then show up at our next visit with all the “in-between visit data,” to show our progress and have empowered conversations to adjust medications and refine our care plan!

This is the independence and peace of mind we all deserve, because we know.

I Wasn’t Supposed to be a Sandwich. I Thought It Was Time for Dessert.

There’s a vast cohort of middle-aged baby boomers who thought that once their kids were through high school/college, they’d be able to coast into retirement, carefree at last.

Funny thing happened.

With advances in medical science, the baby boomer’s parents are living longer and living more independently.

Well, almost.

The time and energy needed to take care of aging parents, no matter their health status, has “sandwiched” baby boomers, with pressure from “below” from kids who still need attention and financial support, and from the baby boomer parents, who increasingly need attention and (often) financial support.  (Hence the term sandwich generation).

With today’s connectivity (GP tracking, text, shared access to bank accounts), the kids’ life metrics are easy to track. Their health is likely perfect, so there’s not health metrics to track.

But how can sandwich boomers track the health metrics of their parents, so as to lessen the pressure of care and alleviate work-a-day worries, to keep them from darting to and from their parents’ home, before, after, and during work, to say nothing of middle of the night visits?

Well, now there is a way to non-intrusively monitor a parent’s health metrics (or anyone’s for that matter).

Health metric monitoring, powered by phone apps, has turned smartphones into one of the most-sophisticated health monitoring and reporting tools the world has ever known. Critical body functions and health status can be easily monitored with low-cost, easy-to-use sensors, and – with action thresholds established on a personal basis – alerts can be activated automatically, and sent to… well, anyone: you, doctors, other family, even first responders.  The technology has finally arrived, and it’s getting better by the day. Adopting it is low cost, but best of all, it offers sandwich generations peace of mind unachievable before. Until today.