THURSDAY 28 OCTOBER - Eskaton to the City of Giants

Today the intrepid group of IAHSA explorers discovered the best of services for older people in California. Eskaton provides residences, community services and healthcare to support the independence and quality of living for more than 14,000 older adults annually throughout northern California. The nonprofit organisation's full spectrum of ageing services includes residential living with services, assisted living, memory care, hospice, skilled nursing, home care and multiple other special programs. Affordability, innovation, collaboration, education and compassion are Eskaton standards as it endeavors to transform the ageing experience. Founded in 1968, Eskaton is headquartered in Carmichael, California.

"ESKATON" comes from the Greek language and means the "dawning of a new day" or "beginning of a new age."

Visit 1. Our first visit was to the Eskaton Village Roseville, a service rich retirement community that offers home ownership, as well as the Lodge with assisted living and memory care in a picturesque, gated community. Located in Northwest Roseville, the community is just a short distance to the region’s newest medical centres, the area’s largest shopping mall, plus numerous restaurants and specialty shops. Residents enjoy the combination of peaceful community living and accessibility to everyday conveniences.





Our visit to the Lodge at Roseville was hosted by the CEO of Eskaton and members of the staff team. Seen above are Dot Bennett, Marketing Director,
Lois Roland, Exec Director of The Lodge, Todd Murch, Eskaton President and CEO and Hannah Fry, Liveable Design Representative.

The most eagerly anticipated aspect of this visit was the chance to see the nationally recognised Eskaton Demonstration Home. This is a purpose built home within the community where prospective residents and other visitors can see a full range of home technology and design ideas incorporated within a domestic setting. Combining innovative universal liveable design, breakthrough health, wellness and social technologies and green living features with beauty, simplicity and comfort, the home has won numerous awards — including the NAHB and AARP 2009 Liveable Communities Award in the builder category for homes up to 2,500 square feet and a gold award in the 2009 Best of 50+ Housing Awards.


There was keen interest in all the technology on display and the group was given an excellent tour of the home conducted by Erin Clay, Director of Research and Planning. This is the type of facility needed more widely to enable people considering the design, layout and technological innovation of their own living environments. The facility attracts visitors from many countries.

Visit 2. A half hour drive from Roseville brought us to the Eskaton Village Carmichael. The village is a Continuing Care Retirement Community (CCRC) and offers independent living, assisted living, skilled nursing and memory care on 37 beautifully landscaped acres. Located in Carmichael, the Village is close to shopping, medical offices and parks and is nestled in a quiet neighborhood community. Residents enjoy the conveniences of retirement along with the benefits of living in an active community where one can do as much or as little as desired both in the area of physical fitness and socialisation.








We were once again made most welcome by the staff and residents. In particular we much appreciated being shown her beautifully appointed apartment by resident Mrs Flo Santucci.


We were shown round the campus by Jane Ipsen, Executive Director (left) and by Tristin Benjamin, Director of Resident Services,



...and round the Assisted Living, Skilled Nursing and Memory Units by Mary Lou Frandsen RN, Director of Nursing Services.

After a comprehensive tour of these outstanding facilities we set off for the two hour drive to the great city of San Francisco. We approached the city over the majestic Golden Gate Bridge and past the world famous tourist area of Fisherman's Wharf.


We arrived in a city gripped by baseball fever and some of us managed to get to the bar in the Westin Market Street Hotel, where we are staying, in time to witness the 9-0 victory by the San Francisco Giants over the Texas Rangers in the second game of the final of the World Series. Way 2 go SFO!!

Location:San Francisco, California, USA

NEWS FROM THE HOME FRONT

While studying ageing services and models of health and social care integration in the California sunshine news comes from over the pond via the 21st Century version of the Wells Fargo Pony Express - the broadband super highway.

In the US in this interesting election season the issue of healthcare reform is a major political debating issue. So too at the local level back in the county of Somerset in my corner of the UK.

In Somerset as in many other parts of the country a debate has been underway about the future direction of health and social care integration. This boiled down to two options for the local front line NHS primary health delivery organisation, Somerset Community Health (SCH). The first was to remain within the NHS public sector environment by merging with the Somerset Partnership NHS (Mental Health) Foundation Trust. The second was to move SCH out from the NHS umbrella and to create a new independent social enterprise organisation along the lines of the successful social care social enterprise that is the Somerset Care Group.

The decision of the Somerset Primary Care Trust Board this week is that SCH will take the first option. I.e. Stay within the NHS.

While this decision is not the one many of us in the social enterprise camp were hoping for it is the one we expected. It is less risky and less culturally challenging for local NHS managers and staff. We understand it will save money. It is good at least that we have a decision and we can now put this debate behind us.

It is very important now that we move on to the more important agenda of how we improve the front line integration of health and social care in Somerset for the benefit of all residents of the county. Somerset Care looks forward to contributing it's energy to taking this work forward with our NHS colleagues.

Now - on with the tour!

Location:Sacramento, California, USA

WEDNESDAY 27 OCTOBER - California Dreaming!

After starting our tour in Washington, The Evergreen State, and our three day stay in Oregon, The Beaver State, today we entered California, the Golden State. After an hour and a half flight from Portland we arrived at the city of Sacramento, the state capital and location of the Great California Gold Rush in 1848. We arrived to find bright sunshine and a welcome warmer temperature than we have experienced in recent days of about 68 degrees fahrenheit. We met up with our bus and driver Jim and headed off to the town of Davis for our first visit of the day.

Visit 1. University Retirement Community, Davis, California.
The University Retirement Community is Yolo County’s only fully accredited CCRC. The community offers a variety of programmes, services, and amenities that have been designed to help people stay as happy and actively engaged in life as possible in retirement.




The campus offers spacious residential-living accommodations in several styles: main building apartments, garden apartments, and spacious cottages. In addition, the campus offers a full range of on-site health care options to ensure residents can be supported as needs change over time: assisted living, skilled nursing care, and special care.




We were welcomed by Executive Administrator Michael Morris and members of the administration team. After a delicious lunch and a briefing on the community from Michael we set off to tour the community. As part of the tour we were invited into the outstandingly designed apartment of John and Polly Marion. The Marions have lived in their apartment for all ten years since the community opened and were able to have their apartment architect designed to exactly their requirements. It is an impeccable example of interior design for active retirement living and we were privileged to be given a detailed presentation of all the details by Polly herself.




The author together with Polly Marion and Michael Morris standing in the way of some of John's delightful art work. Sorry John!

We were also very interested to be taken to see the neighbouring part of the campus to the CCRC which is the Affordable Housing Assisted Living complex built as part of the licensing conditions required by the City authorities. Planning permission in UK terms. It was very encouraging to see the high quality of this accommodation provided for seniors with limited means.




Three members of the very enthusiastic management team who assisted in showing us round are (l to r) Patty Clark, Director of Marketing, Rachel Betzler, Executive Assistant and Alika Castillo, Healthcare Administrator. Our thanks to them all.

This was a special visit for our tour leader Ginger Nuessle, IAHSA's Executive Director as her aunt is a resident at the University Retirement Community.




Mary Louise Greenberg (right) and her niece Ginger enjoyed the opportunity of a reunion and it was our pleasure to meet her.
See: http://www.retirement.org/davis

Visit 2. The Asian Community Center of Sacramento Valley (ACC).
The ACC is a not-for-profit tax exempt organisation whose purpose is to promote the general welfare and to enhance the quality of life for its community by identifying, developing, and providing culturally sensitive health and social services for older adults. The ACC operates three sites: ACC Park City, ACC Greenhaven Terrace and the ACC Nursing Home. Our visit today was to the latter.




Mission. The mission of the ACC Nursing Home (ACCNH) is to provide compassionate and quality care that recognises the ethnic diversity of its community and assures proactive clinical and social services.

Vision. ACC Nursing Home is a premier facility for the community that provides a quality environment and high level of service to all its residents. It is the first choice for families who need a “home away from home” and for their family members who need long-term care. ACCNH is also the employer of choice in the area for nurses, nursing aides, and others who provide a high level of service to its residents.




We were given a presentation on the philosophy and operations of the Nursing Home by Donna Yee, CEO and Darren Trisel, COO/Administrator.
See: www.accsv.org

Visit 3. Aging Services of California, Saramento.
Our final visit of the day was to the offices of the California state provider association and AAHSA affiliate organisation. We were treated to a generous buffet and some delicious Californian wine as we met with the association President/CEO Joanne Handy and members of the Association Board.

At the end of another long but highly interesting day we made for our accommodation at the Citizen Hotel in downtown Sacramento. As I write my blog entry for the day and collect my thoughts on the tour so far I have the TV on in my room as I was hoping to catch something of the great event of the day in these parts - the baseball World Series game between the San Francisco Giants and the Texas Rangers. All I have been getting however have been short snippets of the game interspersed in amongst the less attractive face of the US democratic process which is all the negative election advertising that seems to dominate the TV channels in the run up to next week's national and state elections.

Location:Sacramento, California, USA

TUESDAY 26 OCTOBER 2010 - Further Visits around Portland

The happy band of IAHSA Tourers set off early this morning in overcast weather for another fascinating day of visits. The air was cool and the skies cloudy but the landscape looks wonderful in its autumn colours. This is a very attractive hilly and forested area with beautiful views across majestic rivers. The opportunity as we travel to get a good feel for the countryside and the communities of this part of Oregon is an interesting and enjoyable aspect of the tour.

Visit 1. Cedar Sinai Park Retirement Community. Set in an attractive, leafy suburban area about an hour and a half's drive South West of Portland city centre, this 27 acre site is set on the edge of the built area backing on to woods and forest.


The community has been in being for 90 years and has grown significantly over recent years with a main campus and an additional affordable housing site closer to the city centre. It offers a full range of services for seniors of the Jewish faith. We were welcomed by the senior staff team led by CEO David Fuks and Administrator/Director of Clinical Programs Kimberly Fuson.


We were given a comprehensive briefing on the community, its cultural tradition, and its strategic business model. Services and accommodation offered on and from the campus cover the ageing services continuum and include independent living, assisted living, long term care, memory care, adult day care, special needs housing, hospice and home care. The community places great emphasis on its training and learning approach which is designed to embrace both residents and staff in a holistic way that is respectful of all faiths. While the basis of the community is strongly Jewish in character there are 27 other cultures represented amongst the staff team. See: http://cedarsinaipark.org


Visit 2. Elite Care at Fanno Creek, Tingard, Oregon. The contrast in building styles and operating methods at our second visit location was striking.


Elite Care is a family owned business with two communities, each comprising a number of 12 person households. Here we were briefed by the Founder and joint owner of the business, Lydia Lundberg, who explained the strong supportive and enabling approach of the organisation and its distinctive model that weaves together environment, culture and technology. This is a great example of person and relationship centred care where sustainable building design, technology and service culture create powerful synergy and high quality outcomes that not only benefit residents, but is also demonstrably more cost effective in terms of demand on the Medicaid system and the taxpayer.


Lydia was joined by Community Manager Steven Esser and after an excellent lunch prepared and served by two delightful chefs Whitney and Kate we were taken on a tour of this unusual and most attractive site.


Thanks for a great lunch ladies!
See: http://www.elitecare.com/fanno_creek


Visit 3. Willamette View, Portland, Oregon


Rather overcast when we visited so I cheated and borrowed this image from the website.

We were welcomed like royalty to our last visit of the day by the senior management team and by representatives of the Resident Council at Willamette View. This is a magnificent large 27 acre campus perched on a bluff overlooking the Willamette River. It is a nationally accredited, not-for-profit continuous care retirement community that has been developed on the site since it opened its doors in 1955. There are a full range of accommodation options for older people ranging from duplex-style homes to high standard long term and memory care. The campus includes everything that the retired person could reasonably ask for in terms of activities and facilities contained in a series of well designed complimentary buildings, all linked together by underground walkways and sky bridges. The connection to the surrounding landscape is achieved by stunning views of the river and gardens from all parts of the complex. It was a real pleasure to have the company of residents as we toured the campus and they spoke glowingly about the quality of the lives they are able to lead at Willamete View. We much appreciated the hospitality of our hosts at a cheese and wine reception at the end of the campus tour.


Our hosts were led by President/CEO Craig Van Valkenburg (left) and Chair of the Resident Council Frances Shaw.
See: www.willametteview.org

To conclude another great day on the IAHSA Tour we enjoyed an excellent dinner and wine tasting at the Vino Paradiso Restaurant in Portland's lively Pearl District.

Location:Portland, Oregon, USA

MONDAY 25 OCTOBER - Technology and Highrise in Portland

Visit 1. Our first visit today was to the Headquarters of the Healthcare Division of the giant of the computer processing world INTEL. Situated in a suburb of Portland this is where some of the most creative brains of this huge corporation are based in fairly modestly appointed office and laboratory facilities.

We were briefed initially by INTEL's Head of Healthcare, Eric Dishman. An inspiring speaker and acknowledged world thought leader in Ageing Services Technologies, Eric was a founding member of CAST and has been leading the technology for ageing agenda in the USA for the past decade. A key discussion point with Eric was the key role that providers of ageing services have to play in negotiating some of the barriers that still exist in bringing these technologies into mainstream services and into the hands of consumers. INTEL is a major player in this market and is actively engaged in the US healthcare reform and policy agenda, aimed at increasing the penetration of affordable technologies into the hands of consumers at the earlier stages of support need. In so doing people are able to retain independence and quality of life while keeping the costs of support down.

We were the given a further detailed product briefing by Steve Agritelley, Director of Product Research and Innovation, followed by a tour of the INTEL technology lab where we saw demonstrations of new technology such as the INTEL READER, a mobile device that reads aloud from the printed page


and the INTEL HEALTHGUIDE, a personalised home health monitoring system.



Visit 2. In the afternoon we went first to the Oregon Health and Science University (OHSU) and the Oregon Center for Aging and Technology (www.orcatech.org). There we received a presentation by Research Associate Tracy Zitzelberger on the applied research being undertaken into Ageing in Place, and the discrete monitoring of cognition and mobility amongst older people, which can assist in the early detection and prediction of changes in health and wellbeing, thereby allowing early intervention to mitigate the effects of ageing and deterioration of cognitive ability.
Much further information at www.orcatech.org.

Visit 3. Our final visit for the day was to the stunning brand new "Mirabella" CCRC development adjacent to the OHSU, built on the banks of the Willamette River by Pacific Retirement Services Inc. This impressive 30 storey high-rise tower has recently been completed and is in the process of commissioning and filling.


The building includes 280 appts which when filled will provide homes for 380 people and employment for 150 FTE staff. Present and future residents are welcoming the opportunity to participate as volunteer research subjects in ORCATECH's further work on monitoring of Ageing in Place. Our thanks to Marketing Director Adam Payn for conducting the tour of this amazing development.
Further details at: http://www.mirabellaretirement.org/portland/


Our busy and fairly exhausting day of visits concluded with short sit down for yours truly, and a reception with members of the Board of The Oregon Alliance of Senior & Health Services, introduced by Executive Director Ruth Gulyas. Further details at: http://www.oashs.org.

Location:Portland, Oregon, USA

SUNDAY 24 OCTOBER - Seattle to Portland

Departed Seattle at 8.00 this morning for Portland via Mount Rainier National Park. Slight delay while we switched buses due to a fault. We were all relieved that the bus company had provided a coach today for a long journey after the local bus we have been travelling in for the first three days of the tour. Highly appropriate for an Ageing Services tour the aptly named Gray Line had provided a bus with continence problems, i.e. it leaked all over the passengers in the Seattle rain!

Mount Rainier, also aptly named as it certainly was rainier today than previous days, is a beautiful active volcanic mountain that is currently sleeping but is expected one day to blow like its neighbour Mount St Helens did back in 1980.


This is how the mountain looks on a clear day, majestically dominating the landscape of northern Washington State. However our visit coincided with that of the first snow of the winter so the view we had was as below.


We had to turn back some miles from the visitors centre because of the blizzard. However we did have the opportunity to allow the Chairman of IAHSA, Glenn Bunney from Queensland, Australia, to enjoy his first ever personal encounter with the white stuff.


On the journey up the mountain we stopped in the rain to admire the spectacular views and I was able to capture a short video interview with Ginger Nuessle, IAHSA's Executive Director.

This afternoon we crossed the state line into Oregon and are now established in the luxurious Heathman Hotel in Portland, which is to be home for the next three days.

Location:Portland, Oregon, USA

SATURDAY 24 OCTOBER - A relaxed day sightseeing in Seattle

At the TLRC we were all given gifts by the President/CEO of "Its Never 2 Late", Jack York, who had flown in from Las Vegas to be with us. His gifts mostly had a gambling theme. The TLRC team had thoughtfully not gambled on the weather and gave each visitor a tote bag containing, amongst other things, a compact umbrella. These proved most useful in the rain today as we explored the city, first by bus and then on foot.


A wonderful place to live


Remember "Sleepless"


City skyline with Mount Rainier in the background


Flying fish at Pike Street Market

Our all too short stay in this wonderful city culminated with dinner at the famous Ivar's Salmon House Restaurant, a beautiful cedar replica of a Northwest Indian Longhouse located on the shore of Lake Union.

22 0CTOBER Study Tour Day 2. Visit 2. Tacoma Lutheran Retirement Community

After lunch at Lea Hill we travelled another half hour to the city of Tacoma. Our destination was the Tacoma Lutheran Retirement Community (TLRC). En route we crossed (twice) the highway bridge over the Tacoma Narrows. This is the site of one of the most famous bridge collapses in history when the earlier bridge, built in 1940, failed in strong winds soon after construction. Check out this video clip of the collapse:
http://www.youtube.com/watch?v=xox9BVSu7Ok&feature=youtube_gdata_player

Our visit was scheduled as a seminar on ageing services technologies and we received presentations on some of the technology innovation in use at the site. We were welcomed by President/CEO Paul Opgrande who introduced the visit with a wonderful video featuring residents and staff telling us what TLRC means to them.

He was followed by COO Lynette Ladenburg who introduced the impressive line up of guest speakers who had travelled to Tacoma, in some cases from different states of the US, to present their products to us.

The presenters were:
1. Gary Molton, Head of the Senior Products division of Microsoft, who spoke about "Senior PC". Check it out on any search engine.
2. David Munoz spoke about the TLRC Patient Self-Health Awareness and Intervention Project.
3. Lisa Moore spoke about "Accelerated Care Plus" (ACP). The OmniVR Virtual Rehabilitation System, aimed at supporting and accelerating rehabilitation for older people. See: www.acplus.com.
4. Lori Snow, Director of Sales and Marketing for "Its Never 2 Late". This is an advanced touch screen therapy system that has some similarities with, but is far more advanced than, the Somerset Care home produced "Easy PC" system. See:www.iN2L.com.

These products are all in use at TLRC. After the presentations and demonstrations we were able to visit the community's brand new Wellness Centre where the focus is on fitness, rehabilitation and exercise for seniors. A truly impressive facility built to the highest sustainability standards.



The TLRC Wellness Center.

We were then treated to a magnificent dinner presented by the TLRC Catering Team, operated by SODEXO.

This was a most informative visit and the wonderful hospitality of everyone in the TLRC team, and the presentations by the guest speakers, were greatly appreciated by their international guests.

Location:Tacoma, Washington, USA

FRIDAY 22 0CTOBER Study Tour Day 2. Visit 1. Wesley Homes Lea Hill, Des Moines, WA

Our first visit today was to Wesley Homes Lea Hill, set in the leafy and very attractive community of Auburn about half an hour's drive south of Seattle. This is a beautiful, new state of the art care community occupying a large campus of 19 Acres. We were all highly impressed by the quality of the design and the warm welcoming environment, complimented so well by the wonderful atmosphere of care and support generated by the staff team we met. We were briefed on arrival by President/CEO Kevin Anderson, who explained the concept of wide accessibility and the business culture of Wesley Homes, and by Executive Director Tom Brown who outlined the technology agenda of the organisation. Following this we were taken on a tour of Lea Hill by the staff team led by Campus Administrator Scott Hulet.


For a virtual tour of Lea Hill follow the link below:
http://www.youtube.com/watch?v=pBa-FT7os04&feature=youtube_gdata_player

Further details at: http://www.wesleyhomes.org/lea_hill.html

Location:Des Moines, Auburn, Washington, USA

SEATTLE AT NIGHT An evening to remember!

Together with a wonderful bunch of Australian friends on the tour we hit the town for dinner in the revolving restaurant in the Spaceneedle Tower. This is a must do for any visitor to Seattle. The views and the food (and the company)were amazing.


After dinner we set out to hit the bars and my chums set their sights on the Unicorn bar in Pike Street. However entry to this august establishment was to prove beyond my reach as I was required to show photo ID to get in and my Somerset Care ID card doesn't state my date of birth! I was sadly unable to convince the doorman that I was over 21 years of age and there was no way he was going to allow me to enter.



Here's my new found buddy the doorman. Thanks my ferrous faced friend - you made an old guy very happy! Luckily we found a more accommodating pub across the street!

Location:Seattle, Washington, USA

THURSDAY 21 0CTOBER Study Tour Day 1 - Seattle. Visit 3. KIN ON HEALTH CARE CENTER

A community owned, non-profit facility established to respond to the healthcare needs of Chinese and Asian elderly. This is a 100 bed skilled nursing facility that also provides outreach services to 400 Chinese and Asian clients living in the community. The Center has the distinction of being the only Chinese community owned and operated skilled nursing care facility in the USA. It offers Long Term, Transitional, Dementia, Respite and Hospice care. Residents are generally funded by Medicare but the Center is also strongly supported by donations and volunteer effort by the Chinese community.


Our hosts at Kin On were President/CEO Sam Wan and Director of Fund Development Heidi Wong. Thanks for the tour Heidi - you are a star!

THURSDAY 21 0CTOBER Study Tour Day 1 - Seattle. Visit 2. SKYLINE AT FIRST HILL

Our second visit was to a newly built high rise retirement community, and one of three built and operated by Presbyterian Retirement Communities Northwest (www.prcn.net). The Skyline building was started in 2007 and opened in 2009. It consists of 199 high quality Independent Living apartments and a comprehensive range of luxury communal facilities. The neighbouring South Tower comprises 60 Assisted Living apartments, a 34 bed skilled Nursing facility and a 16 bed Memory Support Unit (dementia care). The service is aimed unashamedly at the affluent upper tier of the retirement market and one cannot fail to be impressed by this magnificent 25 storey building. The views across the city from the top floor Sky Lounge, where we were entertained to tea, are quite spectacular.


We were made most welcome by President/CEO Alan Fletcher and his staff.
(http://www.skylineatfirsthill.org)

Location:Seattle, Washington, USA

THURSDAY 21 0CTOBER Study Tour Day 1 - Seattle. Visit 1. HORIZON HOUSE, 900 University Street, Seattle.

Horizon House - a major city retirement community facility opened in 1991 and sponsored by the United Church of Christ. 525 residents in 392 independent and 90 supported living apartments. Our welcome briefing was given by CEO - Bob Anderson. See: http://www.horizonhouse.org

We also received presentations from Deb Murphy, CEO of Aging Services of Washington, the state provider association with 106 member organisations (http://agingwa.org), and from Scott Peifer, Associate Director for State Policy at CAST (http://www.aahsa.org/cast.aspx).

Location:Seattle, Washington, USA

WEDNESDAY 20 OCTOBER A whistle stop in Vancouver

4.30 am start for 7.00 am flight from Toronto to Vancouver. Arrived at 9.20 am Vancouver time. Taxi to the University of British Columbia to visit the Centre for Research on Personhood in Dementia (CRPD) in the Department for Social Work. There I was hosted and made welcome by Alison Phinney and Elizabeth Kelson together with their PhD student Sing Mei (please forgive the spelling if I have this wrong). We spent a fascinating two hours discussing matters of mutual interest relating to storytelling and dementia. Further information on the CRPD at: http://www.crpd.ubc.ca/


The CRPD Team at UBC with Alison Phinney in the foreground in red.

4.00 pm flight from Vancouver to Seattle. Transfer to the Edgewater Hotel on the waterfront which is to be home for the next 4 nights. This was where the Beatles stayed on their visit to the city in the '60s. There I met up with fellow participants from many countries at the start of a 10 day study tour of ageing services facilities and technology developers in the US West Coast states organised by the International Association of Homes and Services for the Ageing (IAHSA), of which I am Vice Chairman, and the US Center for Aging Services Technologies (CAST).



The famous Edgewater Hotel on the Seattle waterfront on the edge of the Puget Sound.

TUESDAY 19 OCTOBER Visit to the Schlegel Research Institute for Aging and Winston Park Village.

Setting off early from Toronto I drove for an hour and a half west along Highway 401 to the region of Waterloo, the city of Kitchener and the township of Williamsburg. My visit was to the Schlegel Research Institute for Aging. The link to the Institute came about through Somerset Care's connection with the Department of Psychology at the University of Exeter and Professor Alex Haslam. I was welcomed to the Institute by it's President/CEO Dr Mike Sharatt and Vice President Josie d'Avernas. After a discussion about research projects and how we can build the collaboration for the future Josie took me on a tour of the Winston Park Retirement Community. An appropriate place to start my visits in view of it's connection with Winston Churchill, thanks to whose Memorial Trust I am able to undertake this trip. A wonderful community and one of 10 similar in the Kitchener area by Oakwood Retirement Communities.





AL with Josie d'Avernas in front of a picture of my generous sponsor! Thanks Josie, for a great visit.

Location:Kitchener, Ontario, Canada

VISITS MONDAY 18 OCTOBER

Today my study tour got underway with three important visits:

TOUR OF CHRISTIE GARDENS. This morning I met up with Diana Sweatman who gave me a tour of the Christie Gardens complex. This is a large building of 10 floors with 194 apartments mainly for open market condominium retirement living and with a significant number of life lease apartments. The Long Term Care facility offers nursing and residential care for those with higher levels of need. This includes two specialist 12 bed Memory Units (dementia care).

The centre also has a comprehensive Wellness Unit with consulting rooms for on site healthcare. The centre employs its own medical staff including doctors, nursing staff, physiotherapists and other specialists offering a full range of services paid for by residents privately or through healthcare insurance.

The building has a large basement space with garage, auditorium, cinema, hairdresser, activity room, residents resource room, shop, cafe and service areas.

Many aspects of the long term care centre are similar to those found in Somerset Care homes - memory boxes, wide corridors, nursing stations, key pads, art work, patio doors, access to gardens. I particularly liked the personalised place mats on the dining tables in the Memory Unit. These were hand made cards, made by the residents and including their name and photo on a A4 sized card and then put through a laminator. A lovely simple and inexpensive touch.

DODEM KANONSHA - First Nation Elders Lodge.
I spent several hours at the Toronto Native Elders Center in downtown Toronto, participating in a Hand Drum Circle. My host at the Center was its manager Amy Desjarlais. The Hand Drum Circle was a moving and spiritual experience through which ancient stories and themes are conveyed through music, evoking the power of the earth and nature. I joined the circle with seven other regular attendees and we sang songs following the rhythm of the hand drums - the heartbeat. Before doing so we cleansed ourselves by smudging - washing the face and body with smoke from the burning of dried save leaves mixed with tobacco. The singing was rhythmic chanting of sounds to the beat of the drums. The first song was about the Four Directions - North (white), South (red), East (yellow) and West (black). Following this each member of the circle was invited to propose a song or a subject. My choice was to sing about my family who are left behind in England while I am travelling. Others chose a healing song, a butterfly song and a very powerful "game song". Amy's spirit song about how she was created and how, in the spirit world, she chose her earth parents and selected the life she would lead before entering her human form was particularly moving.

I was amazed to learn that hand drum singing was illegal in Canada for many decades until the 1990s and women only became allowed to participate in 1992. The power of the singing is significant and it gives rise to strong emotions. The singing has few recognisable words and is regarded as a form of prayer shaped by vocal intonation. It is used in spiritual ceremonies and also as a social musical art form. The ceremonial versions are considered private and recording of them Is forbidden. The drums themselves are made with animal skin tightened over a circular wooden frame. They are imbued with a religious significance and are prized and precious possessions, loved, worshipped and cherished by their owners

Further information at: www.dodemkanonsha.ca
See also: www.fourdirectionsteachings.com

NB I was offered a strong film recommendation: "Away From Her" (2006) Director - Sarah Polley, starring Gordon Pinsent and Julie Christie. Canadian film about the destructive effect dementia can have on loving relationships.

NATIVE CANADIAN CENTER OF TORONTO
In the evening I visited the First Nation cultural centre where I was able to join in a larger Hand Drum Singing Circle. Again a fascinating experience like a prayer meeting set to rhythmic drum beats. Each participant was invited to speak about themselves and what they were looking for from the session. Some were looking for spiritual healing following troubled times. Others were looking for meaning in their lives and were joining as novices a group of longer term attendees for whom regular drumming meetings and practicing the art has become an important element in their lives. In each song the main refrain, or lead chant, has to be sung independently by each participant in turn as a solo introduction to the main chant. The lead passes round the group until each member has taken the lead at least once. This takes a bit of getting used to for the novice but the group were very kind and forgiving of the vocal inadequacy of their British guest.

Hand Drum Circles have a deep sacred meaning for the First Nation Communities. It is now a growing art form with groups and lead singers starting all the time throughout Canada. Women and men tend in the main to practice the art in separated groups but in mixed social and ceremonial gatherings it is common for the men to undertake the drumming and singing while the women dance. The potential of the use of this sacred art form as therapeutic activity for older people is as yet underdeveloped but there was warm recognition that this could be an appropriate application for use in care settings with people with memory loss challenges. The rhythmic drum beating and the ritualistic chanting has a definite therapeutic healing effect and is something that could have particularly beneficial application in dementia care. As my hosts agreed this is something worthy of further research. I am most grateful to them for making me so welcome and for allowing me to participate in their ceremony. Michael Palin would have been proud of me!

Location:Toronto