Small Talk, BIG IDEAS

Several years ago, I visited Pilgrim Place, an AAHSA member in Southern California. The organization has a great history of serving people who have had distinguished careers in religious work. I was invited to a resident gathering. I expected to hear the usual complaints about the food, or the cable service, or the rent increase, or pet policy—all part of the quality of life in older adult communities. Retirement communities are like small towns in that way. We all like "small talk." In fact, we had an expression back in Georgia when topics became too serious. Someone would interject, "So, how 'bout them Braves?"

At this resident gathering, I expected to hear the usual small talk. Instead, a resident stood up to give an impassioned plea about a project that residents were sponsoring to address hunger in a depressed corner of the world. BIG IDEAS—not small talk.

Recently, I was privileged to speak to several dozen CCRC residents attending the National Continuing Care Residents Association (NaCCRA) conference held at Ingleside at Rock Creek in Washington, D.C. NaCCRA's chair is Charles Paulk, who is a resident of The Estates at Carpenter in Florida. These residents are interested in the financing of long-term care, the ethical tension between autonomy and community, fair housing, quality, tax exemption, workforce issues—and how to have their voice heard in state and national policy arenas where laws are made. Not small talk, but BIG IDEAS.

Residents and other consumers we serve are known as the "silent generation." The irony is that this same silent sector voted Hoover's party out of office when America faced huge economic woes and voted FDR into office. The Silent Generation marshaled resources with unprecedented speed and commitment to win World War II. They supported the creation of the great social programs like Social Security and Medicare. They were willing to fund a presidential vision that put a man on the moon. They are a most generous and philanthropic generation in personal giving and volunteering for important causes. And they vote faithfully. They enjoy small talk, but they have traditionally supported BIG IDEAS.

Our recent Future of Aging Services Conference included visits to Capitol Hill to talk about issues with members of Congress. Based on early comments from our members, we had the most substantive meetings ever. Our agenda is about BIG IDEAS—achieving quality people can trust, financing aging services on a sound basis, creating a stable and healthy work force, technology and the importance of the advancement of the entire continuum so the elders in all of our communities can have affordable choice. BIG IDEAS that resonate with many of the millions of people our members' missions touch every year.

Yet, there is a disconnect in Washington and in many state capitals. One highly populated state is fighting over $10 million to help with adequate staffing—for an entire state. Another had a fight at a state professional board meeting over whether health care workers should be forced to display their last names on their name tags. Another state with an inadequate Medicaid program is fighting other need groups and their state legislature over 28 cents per day.

Here in Washington, politicians grudgingly allocated funds for new low-income housing units which now only meet 10 percent of the need. We have to fight for a market adjustment of a modest three percent to cover normal cost increases for nursing homes. A national Medicaid Commission concluded that asset transfers are a major problem with Medicaid, when facts show that closing transfer loopholes is a drop in the bucket of a deep well of Medicaid problems. We had to get Congress to force federal agencies that have senior programs to meet together just once a year to help coordinate service delivery—and they haven't done it yet. That legislation passed in 2006. And Congressional "fixes" to some of these problems are now done for only a few months at a time. Yet, Congress holds hearings on steroids and baseball players. (So, how 'bout them Braves?)

You see the paradox: big needs to address a generation that has supported big ideas all their lives now saddled with small thinking and petty politics. How does that happen?

Because we serve the silent generation, a generation with such a high sense of responsibility that they endure without complaint—just as we often do. We cope and adjust instead of demanding essential changes around BIG IDEAS. It is no secret that Social Security and health care, including long-term care, need to be overhauled. It is obvious that new housing policy is critical. Note the collapse of the mortgage industry and the ineffectiveness of the U.S. Department of Housing and Urban Development. We must fulfill our responsibility as advocates, not just people who cope.

Another great example is caregiving, a hidden national crisis that will affect most American families. Nationally, caregivers will spend out-of-pocket over twice what is spent on Medicaid for long-term care. When caregivers are asked why they don't complain, they tell us they are just fulfilling their responsibilities as family members or friends. Caregiving is a BIG job silently done within the context of emerging BIG needs that cannot be addressed by small thinking or small talk.

Why don't we ask the people we serve, their families, our boards and employees to support politicians in demanding BIG IDEAS for change? It's not like most Americans are averse to big thinking. Too often, politicians like to talk big and act small.

It's time to think BIG and act BIG. Small solutions don't work anymore in our work and they disserve the people we serve. We have a responsibility as their advocates to do better.

So, how 'bout them Braves?


William L. Minnix, Jr.
AAHSA President & CEO


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