Seacoast  Sunday really went big on the  dream  of converting the  Great Bay  Community  College campus. That was really  a  whopper of a story . It’s time to take a closer look at Continuing Care Communities and the rush to build them.

I am not a fan, just being up front with you. The entrance fees are outrageous and frankly unsustainable in a RE market that may have reset  for some time to come. Some facilities already  have changed the “deal”. The  nursing home component  is always too small. You are surrounded by old people, getting older, not everyone is playing tennis. Fear  is a great driver to  continuing care communities and that is too bad. Some have postulated  that this population that  has experienced the Depression harbors great fear. The promise of life care, is comforting. I would prefer to hand out Halloween candy in a mask, than  play another hand  of bridge. Many feel the same  and opt for  the condo. I hope  that all this press(Riverwoods gets a ton) doesn’t’  fool us  into thinking we are addressing the issue of elder care. The idea of giving up prime commercial land to one in Portsmouth is ridiculous. I question giving up a potential  site configured for education  to this concept in Stratham.

If you were a hospital administrator with a large CCC  you would be smiling.

Carriage trade, I understand.

It might even affect your attitude concerning  your fee structure.

I asked my  parent’s who live on Cape Cod   if they ever drive over to Hyannis,  to the mall . My dad hated it , “it was full of old people” he snapped. He is 93 , Mom is 90. I got a  long way to go if genes actually do matter.

The picture painted  in the paper  of the campus proposed in Stratham  sounded like  a  Town? Village? Neighborhood? You would be better off selling the mansion and buying a small cape in a real town rather than a faux village.

You are better off in your own home practicing slow medicine. What’s slow medicine? That’s recognizing that  aggressive  intervention needs to stop. An elderly person with myriad health issues  really is not going to benefit by aggressive work on one condition. You can knock an elderly person right out of the here and now with  anesthesia. If your sciatica is killing you  and the ED can give you a shot  and you  are 84, don’t tell them the pain is at  ten level when  it’s really a three, you’ll end up in rehab wondering what happened.Everything that happens when growing old is not an emergency.  I think the use of the Frailty Index is a good thing. That is the fact facing news that  doing your hip is not  going to mean you begin playing tennis. What it does mean is that you might never make it out of rehab. So take the pain.

The lack of  nursing home beds, and legions of well trained , compensated, and caring aides/nurses is approaching an emergency.

Every nation is in the same boat, with  no course charted. These continuing care communities are not the answer for most of us,the great bulge in the middle. The over 70  group is the fastest growing segment of the population. This is another of the many things we did not do and prepare for over the last 75 years.

Geriatrics is specialized medicine where success should be measured in keeping a patient in most  cases, just stable. There is no  cure for the march of time.

Dartmouth Medical is really the leader in this concept of slow medicine. Again slow medicine is not about denying medical care , it’s about being realistic,and caring .  I mention them because the newspaper article  did bring them into the story.Kendal at Hanover, the life care community could end up a sister facility to this proposed site in Stratham. Most if not all Kendal facilities are near a major university. The alum draw is strong as well as a perceived community vibrancy, concerts, continuing ed etc.  The Kendal facilities  have  a Quaker  sensibility.

Since Dartmouth Hitchcock was mentioned , a spokesperson from Exeter Hospital was quoted , several times. This was in the context of  Exeter participating in this grand design. That the Exeter Hospital might mirror DHMC  efforts at Kendal at Hanover.  Perhaps  establish a presence  on campus. Really,  having to bundle up to go see a cardiologist for 15  minutes , 20 in the  waiting room, at a hospital  is a chore.

Despite the valet.

I was  not feeling warm and fuzzy about  EHR’s participation at this point.

Health Care comment- Wentworth Douglas also is adding private rooms, more  than Exeter. That  is  really another post.

I just found a great article from the NY Times on Slow Medicine and the facility in Hanover  dated 3/5/2008

Mike