THIS TIME ON CODE WACK!
America is facing a looming crisis in caregiving with an aging population and a scarcity of in-home care resources. Could neighborhood-based care networks offer answers? What becomes possible when they’re in place?
To find out, we spoke with Dr. Mary-Elizabeth Harmon, a scientist-turned-storyteller, caregiver, and founder of a business helping neighbors build caring communities and local economies through community villages.
She spent more than two years caring for her father, who lived with dementia, and is currently the unreimbursed caregiver for her elderly mother in Virginia. This is the second episode in a two-part series featuring Dr. Harmon.
Check out the Transcript and Show Notes for more!
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SHOW NOTES
WE DISCUSS
Most seniors overwhelmingly prefer to remain in their homes as they age. But most home healthcare is paid for by Medicaid, which requires that patients get a waiver to access those services. Is that a problem?
Dr. Harmon: “650,000 people right now are waiting … for a Medicaid waiver, right, for home and community-based services. And so this is something that people who are living with disabilities need so that they don’t have to live in an institution or a nursing home, right? And so these things cost the system money.
“It’s more expensive for somebody to live in a nursing home or an institution than to stay in the community, right? So it makes sense to support people in [their homes].
“[But] even if everybody who wanted Medicaid had it and everybody who wanted a waiver had it, we still don’t have the neighborhood-based systems and networks to support people thriving in the community.”
Can you share an example of how people end up having to leave their homes?
Dr. Harmon: “So I’ll tell some stories with my mother’s permission. So at one point my mother … got pneumonia and … she was in the hospital and she came home. …
“… my mom was looking at going to a rehab center … because during the time that she was in the hospital, she lost some leg strength. And so she wasn’t able to stand up as easily as she was when she went in, right?
“And because of that, it meant that going to the toilet is an issue. And so toileting something is not medical … toileting [issues] risked my mother going to a medical rehab center.
“… the only reason why she did not end up having to do that was that I said to the discharge team, I had a sister who was in town with me, so that she could help me. ‘So I said, what we’re gonna do is we’re gonna see how far we get [keeping our mom at home] … for as long as she’s in town. And then we’ll make a determination.’ And just by sheer luck, my mother regained enough strength in her legs that she was able to stand up, so that I alone could help her get to the toilet.
“… had I not had either a sister or somebody close by just to help my mother go to the toilet, she would’ve had to go into a facility.”
Today, you’re focused on inspiring neighbors to create care networks. For listeners who might be unfamiliar, what exactly are care networks, and how do they work?
Dr. Harmon: “There has been a village movement in the United States for about 20 years. And the way that it started was there were some neighbors in Beacon Hill in Boston, and they were having conversations about how they wanted their aging experience to go. And so in that process, they connected with each other and started connecting them to services, supports, and things like that. And the word spread.
“And so again, when I was caring for my father, I started thinking like, ‘Oh, well, we need the villages.’ And that’s when I discovered the village-to-village network.
“But basically what a village is … it’s neighbors helping neighbors, and generally that can look like helping with household chores, transportation to medical appointments. Actually, transportation is one of the most requested services that villages get. So it can be a variety of things. And I like to say that it’s, it’s limited only by our imagination.”
Helpful Links
Dr. Mary-Elizabeth Harmon
The Village Movement: Aging in Place with Community Support, Eastside Friends of Seniors
The Village Model: Current Trends, Challenges, and Opportunities, AARP
The Grassroots Future of Aging, National Continuing Care Residents Association
Neighbors Helping Neighbors: The Village Movement, Aging Wisdom
Episode Transcript
Read the full episode transcript.
Guest Biographies: Dr. Mary-Elizabeth Harmon
Dr. Mary-Elizabeth Harmon is a scientist turned storyteller, caregiver & founder of Village Company 360, which exists to inspire wonderful places to grow up & grow old by fostering caring communities & caring economies for & by neighbors.
A graduate of MIT and The Johns Hopkins School of Medicine, Mary-Elizabeth left the laboratory as a virus researcher and worked as a science advisor at Greenpeace. From there, she joined the U.S. Dept. of Health and Human Services, first at the Centers for Disease Control and Prevention and later in the Office of Inspector General (OIG).
In OIG, Mary-Elizabeth evaluated programs and wrote data-driven stories (i.e., reports) for their improvement for Congress, including a compelling account of Medicare home health fraud that prompted regulatory changes and several indictments. For this and other work, she is a two-time winner of the IG’s Exceptional Achievement Award.
Through Village Company 360, Mary-Elizabeth is mixing her love for storytelling with the wisdom she gained as an analyst, environmentalist, caregiver, and community builder to work with partners to grow the ranks of village growers and supporters, and to create ways to connect neighbors of all ages to each other and to convenient medical care.
A Michigander who grew up in Kenya, Mary-Elizabeth has been making informal villages since returning to the U.S. for college. Her mother dubbed her The Caregivers’ Caregiver for providing emotional, administrative, and home remedy support to aides who helped her take care of her father, who had dementia.
Visit her personal website or get The Prosperity Papers Recap for a monthly email to stay up on all her work with ONE subscription.
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