Are We Morally Failing Our Seniors?



Posted on

Jan 26, 2023


Minnesota - Twin Cities Metro Area

Share This

Joel Theisen, Lifespark CEO  and guest, Anne Tumlinson suggest that we have not embraced the opportunity within value-based care to produce meaningful outcomes – the payment model is not the core problem, value-based is not the enemy. We need accountability, leadership, creativity, and commitment to transform health care – and Anne and Joel cover a lot of that ground in this podcast.

Putting all of that discussion aside, they take a step back and look at who we are really trying to serve. For Lifespark and Anne’s work with ATI and Daughterhood, that’s seniors and their families. Are we morally failing them? There’s good intent by many in health care to try to serve seniors better and lower long-term costs but both and Anne and Joel question if we are doing it the right way and they discuss this in the podcast. Anne looks at this through the lens of both a daughter and a policy maker and believes there’s an unbelievable amount of suffering that’s happening as a result of the disconnected experience people face. Families are creating their own completely unique and separate system of care delivery on its own, without any help, and managing it. “It’s ridiculously inefficient,” says Anne. “And it makes me uncomfortable morally.”

Joel and Anne get serious in this podcast about what we need to accomplish, specifically, to create better systems of care. Having full actual risk, not just parts of the ‘value-based’ craze of caring for populations but going at-risk to serve them fully and produce measurable results is the only way to move the needle. It’s more than a monthly allocation per plan per member but total global risk for the individual. When you do that, you look at who you serve a little differently – you see them as a person beyond their diagnosis or episode to what will help them long-term and use their health plan to give them wellness, not sickness, to keep them thriving.

PACE and Medicare Advantage plans have pieces of what people need but they aren’t accessible by all seniors. Anne and Joel get candid about how there are a lot of pathways today that exist to put together all of these models and funding streams to make it available for every senior – not just the rich, poor, healthiest or sickest, but all.  The good news that should perk the ears of health care execs listening – there are financial rewards for being human in health care.

This podcast was full of interesting nuggets and takeaways. Regardless of what you believe or how you think health care delivery should be solved, the message by Anne and Joel was loud and clear: we have only a few years to figure this out and make the investments we need right now to serve the senior population. And if we don’t, we will continue to fail our seniors. Even the biggest organizations like Amazon and CVS will soon find, there’s no value in that.

Listen to our latest podcast and subscribe to get the latest episode delivered right to your inbox and explore our other podcasts with Steve Gillon and Richard Leider. And if you’re ready to get serious on serving seniors, let’s partner. Aging Magnificently will take all of us.

Other Articles You May Like

Managing Anger & Sundowners Syndrome in Loved Ones With Memory Loss

Caring for a loved one with Alzheimers or dementia can be physically and emotionally draining, especially when they have behavioral changes caused by their anxiety and confusion. Many advanced dementia patients lash out at their caregivers with unexpected aggression later in the day or at night. The phenomenon is referred to as Sundowners Syndrome or sundowning because the disruptive behavior usually occurs after the sun has gone down and feelings of paranoia, sadness, fear, or anger seep into the mind, sometimes accompanied by delusions or hallucinations. Sundowning is stressful for both persons living with dementia and their caregivers. However, our healthcare professionals are here to offer helpful tips for managing anger and Sundowners Syndrome in loved ones with memory loss.One out of five dementia patients suffer from sundowningElder care presents many unique challenges to caregivers. If youre feeling overwhelmed about your loved ones late afternoon or nighttime mood swings, the most important thing to remember is that you arent alone. According to scientific studies, as many as one out of five people living with Alzheimers or dementia suffer from Sundowners Syndrome. Much mystery shrouds this condition, but experts believe the neurological changes caused by dementia affect the individuals inner body clock. This confusion about the time of day often manifests itself in the person shouting, pacing, and acting in aggressive manners. Sadly, these anger issues tend to worsen as the persons memory loss progresses. Understand their anger isnt directed at you or your actionsThe first step to handling your loved ones anger issues is to understand where this anger is coming from and recognize that it isnt aimed at you or something you have necessarily done. Anger is usually caused by physical, emotional, or mental triggers. Your loved one may be angry because they cannot do the simplest tasks, such as tying their shoes or going to the grocery store. They could be experiencing physical fatigue, discomfort, or soreness you arent aware of, and they are unable to articulate how they are feeling.Be aware that certain medications can cause behavioral side effects. Feelings of boredom or loneliness caused by their condition could also be the culprit for sudden outbursts. Memory loss and disorientation are often mental causes for aggression. Once you understand these underlying causes for your loved ones anger, it may make it easier for you to cope and even avoid sources causing such behavior.Observe what seems to trigger their aggressive behaviorObserving your loved one can provide valuable clues as to whats prompting their aggressive behavior. Do they seem to lash out more when theyre hungry or havent had a restful nights sleep? Sometimes, anger could be caused by overstimulation. Physical clutter, loud noises, bright lights, or lots of activity around them could cause this overstimulation. Consider light-blocking curtains to create a cozy atmosphere during the day, or on the flip side, surround your loved one with plenty of lights at night to alleviate fears when its time to go to sleep. Someone living with dementia may also become upset by anything that disrupts their day, such as diverting from their typical routine or switching caregivers. First-to-second shift rotations typically occur in the late afternoon or early evening hours at most group homes and could be the cause of disruptive patient behaviors.Evaluate how you communicate with your loved oneMuch of caring for a loved one with Alzheimers or dementia is learning how to communicate with them. Always speak softly and slowly with easy-to-understand instructions. Try not to say too much or ask too many questions at once, as this could lead to overstimulation. People often pick up on feelings of uncertainty or irritability, so its crucial to remain calm and reassuring at all times. Even if your loved one lashes out at you verbally or physically, try not to get upset. Never react with force or violence. If theyre in a safe place or someone else can keep an eye on them, walk away from the situation and give yourself time to think and calm down.Consider defusing the tension with music or activitiesOften, you can defuse anger and tension with a relaxing activity, such as massage or music. Try to redirect your loved ones attention to something other than what triggered the behavior. Try putting on your loved ones favorite TV show, suggest taking a walk, or doing something else you know they enjoy.Remember to be kind and empathetic at all timesAbove all, remember to be kind and empathetic at all times when caring for someone with Alzheimers or dementia. You care about this person and their well-being. They are suffering from a disease and often have little to no control over their thoughts, feelings, or actions. Never punish or reprimand them for bad behavior. It is not their fault, and they will likely not remember the scenario afterward. Seek help from their primary care physician or a support group to learn how to detect, defuse, and prevent angry outbursts.Identify what caused the aggression so you can fix itTry to figure out what happened right before the aggressive behavior, so you can take steps to correct it. Keeping a consistent log of your loved ones behaviors and reactions can help you spot patterns and determine potential solutions. If you believe its the persons diet, sleep pattern, surroundings, or medications, consult their physician to make adjustments as necessary to avoid anger triggered by these factors. Be on the lookout for any signs of discomfort or pain and seek immediate medical attention if you believe this is the cause of your loved ones anger. Any time you are concerned about changes in your loved ones behavior, habits, or moods, consult their primary care physician. They are there to provide professional support and information. Ask about the possibility of prescribing anti-anxiety or anti-depressant medications to modify behavior.Consider professional elder care from BrightStar CareIts important to recognize when you need help with caring for your loved one living with Alzheimers or dementia. BrightStar Care has nurses, CNAs, and caregivers available around the clock to provide compassionate care in the comfort and familiar surroundings of home. Caring is more than a job to our nurses and caregivers its their passion. Your family is our family!   Contact us for help at 651-770-8427 or visit us at

Paranoia in the Elderly

One of the most alarming conditions a senior can develop is paranoia, a mental state characterized by persistent fears, worries, and accusations that often strike loved ones as irrational or even ridiculous. As a caregiver, you may feel at a loss about how you can help. The first step is to understand the causes of paranoia in the elderly and what symptoms to watch for. Then, youll be better equipped to navigate the situation and provide the best treatment for your loved one.What Causes Paranoia in the Elderly?Paranoia and extreme anxiety in seniors can often be traced to an underlying medical problem. Its important to uncover this cause so you can find the proper treatment. Here are some potential health issues that could be to blame for your loved ones developing paranoia:Alzheimers disease and dementiaBrain tumorsStroke, head injuries, or reduced oxygen to the brain causing vascular damagePsychiatric conditions, such as schizophrenia, bipolar disorder, or depressionDehydration- or drug-induced delirium and cognitive impairmentUntreated urinary tract infectionsSide effects from certain medicationsSymptoms of Paranoia in the ElderlyDont let slight behavioral changes go unnoticed, as they could become more frequent and severe if left unaddressed. Here are the signs of paranoia to watch for in your elderly loved one:Showing extreme agitation, hypervigilance, or stress without explanationExpressing feelings of unfair persecutionBeing easily offended or not handling criticism wellAssigning harmful meanings to others words or actionsHaving difficulty trusting othersIts important to note that if a seniors living situation makes them feel socially isolated, uncomfortable, or depressed, it may intensify the symptoms listed above.Tips for CaregiversCaring for a loved one with paranoia can be challenging, to say the least. Distressing behaviors and accusations from an elderly loved one may alienate or frighten family members and friends. As a result, the increased demands of caring for a paranoid older person may become exhausting if not approached the right away. Here are some tips to help caregivers navigate this difficult situation:Assess the seniors living environment: If your loved one starts showing symptoms of paranoia shortly after moving to an assisted living facility or nursing home, this could be a sign that theyre not comfortable in this new environment. It may be best to make different arrangements to improve your loved ones mental health and quality of life.Patiently explain the situation: A senior may accuse their neighbor of stealing the mail. Instead of being dismissive, investigate these concerns and provide a reasonable explanation: Mr. Jones isnt stealing your mail, Dad. Remember, letters arent delivered on Sundays.Let the senior feel heard and loved: Sometimes, the answer for a stressful situation isnt to explain the paranoia away. Try to respond with love and understanding to a difficult situation of paranoia.Keep a record: Daily journaling can help you objectively look for signs of improvement or regression in your elderly loved one. Consider any potential causes that could be triggering the behavior, and show doctors your notes when they perform medical exams.Reach out for help: Ask your family members for support, connect with other caregivers for advice, or hire a professional caregiving service to provide respite care when you need a break.How to Treat Paranoia in the ElderlyYoull find it encouraging to learn that many seniors respond well to treatment. Here are some examples of how isolating the cause of elderly paranoia can help you find an effective treatment:Problem: A senior thinks her family members are talking about her behind her back.Solution: A physician can check the seniors hearing aid and may find that auditory feedback is to blame for her hearing things.Problem: A senior is paranoid about her finances. She accuses her caregiver of stealing her wallet when in reality, she simply misplaced it.Solution: The family can hire a financial advisor to work with the senior and lay out the facts.Problem: A senior is convinced his family doesnt love him anymore because they dont visit as often as he thinks they should.Solution: Family members can make an effort to call and visit more, calmly explaining the reality of the situation if accusations arise.Problem: A senior begins showing signs of confusion and paranoia shortly after a hospital stay involving a catheter.Solution: A doctor can perform blood work and may discover a urinary tract infection, which causes confusion and delirium in some seniors.If your loved ones paranoia is causing distress and exhaustion among your family members, hiring an in-home caregiver could provide the support you need. The qualified, compassionate professionals at BrightStar Care offer peace of mind during this challenging time of changing behaviors in your loved one. We understand the difficulties you face and are committed to going above and beyond to provide the highest-quality care available.Call us today for help at 952-300-3698 or visit us at

What is Short Term Transitional Care?

When you or a loved one are recovering from a hospitalization or are being discharged from a rehabilitation center such as a skilled nursing facility (SNF), you may need short-term transitional home care. Our nurse-led care and team-focused approach are designed to optimize your health and well-being.Even if your loved one is receiving skilled nursing care from another agency (such as a Medicare-approved group), the companion care and personal care services we offer through BrightStar Home Care South Minneapolis Metro provide a wonderful supplement. These services can help meet basic needs such as light housekeeping, companionship, family respite, dressing, personal hygiene and ambulation (walking and moving around).  Professionally delivered care can help reduce undesirable outcomes such as re-hospitalization, medication errors and falls; it may even reduce long-term healthcare costs by helping to prevent the health conditions from getting worse.Short-Term Transitional Home Care ServicesA Registered Nurse (RN) from BrightStar Home Care South Minneapolis Metro oversees the plan of care to help provide a safe transition back home. Our team provides a wide range of services to support a variety of health needs such as:COPD (Chronic Obstructive Pulmonary Disease): Well coach proper inhaler use, provide medication reminders and support habits to improve wellness.Diabetes: We will conduct foot inspections and perform blood glucose level checks, as well as provide family education.Heart Attack/AMI (Acute Myocardial Infarction): Well provide education and support to develop new lifestyle habits that promote heart health.Heart Failure: Well help manage medication adherence, diet and exercise.Pneumonia: Well provide RN-led medication management, help manage oxygen therapy and offer personal care.Post-Operative: We will assist with surgical recovery in the comfort of home.Stroke: We will help with activities of daily living (ADLs) like eating, dressing and mobility, as well as promote fall safety, offer medication reminders and provide transportation to physician appointments or therapy (physical, occupational and/or speech).Therapy for Post-Op or Stroke: We also have physical, occupational and speech therapists who can provide rehabilitation in your home.Care Paths Deliver Superior OutcomesOne of the unique services we offer is Care Paths for Falls and Change of Condition. Although care paths are fairly common, weve taken this approach farther by building person-centered and condition-specific Care Paths based on your loved ones unique needs, current conditions and past medical history.Using our proprietary technology, our caregivers are able to help predict and prevent a fall or worsening of your family member's current condition. When a change of condition is identified, we will communicate that information immediately to the supervising nurse at BrightStar Home Care South Minneapolis Metro and/or your loved ones physician so any needed action can be taken. If you or your loved one would prefer to receive transitional care at home instead of receiving short-term, facility-based care, please call us at 952.300.3698 or contact us online. We look forward to sharing how we can help.  Or visit us at -

Local Services By This Author


Personal Care Assistance 5320 W 23rd St, Ste 130, Saint Louis Park, Minnesota, 55416

With Lifespark COMPLETE, you get complete senior health services designed to keep you healthy at home, living a happy, sparked life all on your terms. This proactive approach is proven to keep you off the health care rollercoaster, helping you live a fuller, more independent life as you age.Get Started TodayWith Lifespark COMPLETE, you get complete senior health services designed to keep you healthy at home, living a happy, sparked life all on your terms. This proactive approach is proven to keep you off the health care rollercoaster, helping you live a fuller, more independent life as you age.Get Started TodayIt's ok to ask for help at any age. With Lifespark's Everyday Support, one call can get you connected to the services and resources you want. We are like your personal concierge - always ready to make your day easier with no obligation. Call now to connect with a Navigation Specialist: 952-345-0919 . Also visit us at It's ok to ask for help at any age.  With Lifespark's Everyday Support, one call can get you connected to the services and resources you want.  We are like your personal concierge - always ready to make your day easier with no obligation.  Call now to connect with a Navigation Specialist:  952-345-0919 .  Also visit us at


Care Management 5320 W 23rd St, Ste 130, Saint Louis Park, Minnesota, 55416

What Can We Do For You?We want you to live a sparked and independent life.  For that to happen, our passionate team works to understand your needs, wishes, and goals.  We are your life-long advocates, ready to connect you to the right team at the right time.  That is why we start with a free, no obligation consultation along with a start of care discovery by an RN Case Manager.  From there we offer:Ongoing Free Access to Lifespark's 24/7 Everyday Support ServicesCompanionship and Meaningful ActivitiesHomemakingTransportationSafety and SupervisionFall PreventionLive-In CaregivingMobilityMedication Assistance and RemindersSupport for clients with memory loss or dementiaSpecialty CarePersonal CareCall us today at 952-345-8770 or visit us at


Non-Medical 5320 W 23rd Street Suite #130, St. Louis Park, Minnesota, 55416

Living with purpose and passion is what drives all of us and gives our lives meaning. Our Community Home Care team provides in-home caregiving services to help manage health needs and assist with daily activities so clients can keep living life on their terms. A key difference with Lifespark is a client has an RN Case Manager providing professional oversight, who can also help manage medications or provide wellness checks. Services are covered by most long-term care insurance policies and private-pay. Call for our simple pricing options - no surprise invoices.