Posts Tagged ‘change’
Dream On!
I was meeting on Sunday with a visionary, a person who had a bigger idea of what would make a vibrant, living, artistic community, and he was describing the various challenges he has found with the people who spend so much time rooted in the “reality” of things as they are right now.
It’s a frustrating thing to have a great idea of what would make things truly great, only to be reminded, constantly, of all the good things that we can do right now. It feels sort of like having a bake sale to build a new school: laudable, perhaps, but a great effort that entirely misses the potential of those precious moments, and dreams small.
I think this often, as I think about tests and pilots and demonstrations that have a great vision in the beginning to solve a problem. The ones I have most encountered in my recent career world have something to do with access to services, and facility of navigating systems that can ideally fund the most basic needs, level the playing field so to speak for people who need wheels to get around, or an extra set of hands to pick things up.
There always seemed to be some prevailing notion that everyone can have adequate assistance, if only the system were simplified into one easy method–or no wrong method, at any rate.
I sometimes think back over the last few years, and wonder if the numerous individuals who benefited from that ease of access to services are now living better lives because of it.
I ask this now, as we contemplate the future of healthcare. I ask it, because I see the future efforts at developing new infrastructure, building new programs, and I think about the last several posts, in which I lamented the utter lack of essential services for various age and disability groups. All the knowledge and navigational assistance in the world is only helpful in so far as it stops an endless maze of pointlessness. And perhaps the visible hole of need brings along enough anger in its wake that more of us feel motivated to speak up.
We need a bigger vision. But it really is more than that, as I believe that the vision is clear enough and common enough to many people who have worked in or personally encountered the health and human service system. Dreaming of some world where we can respond quickly and efficiently to the obvious needs for housing, transportation, and personal care is not a waste in itself. Only, we do not need more focus groups or advisory committees; we need to start building. Action is bold, and it is unlikely. But it is absolutely essential to stop wasting time and money on securing our comfort zone. The small efforts may feel good in the moment, but really, when they keep us from focusing on the big picture, all they really do is waste our energy, and make us feel good about it.
Wishin’ and Hopin’
and thinking and praying…
Though it’s early in the year, we seem off to a tough start. The obituaries (yes, I read them) are a mile long, daily, and the hospitals have been swamped. The calls are more urgent, despite the increased awareness I have noticed about programs that used to be “the great secret” or otherwise underutilized.
The damning thing about knowing all the options is that it makes the situations with no options all the more visible. It gets harder and harder to be the bearer of bad news, but it is so often the situation we face now. I mentioned a few of these groups in my last post, but they keep returning, constantly, similar situations, different stories. It seems obvious that change is needed, but it cannot come fast enough.
It seems so obvious that we need houses we can access, neighborhoods, transportation, and help. And yet, as we see solutions so easily adaptable at times, it seems far from everyday thinking. Stairs? No problem. More highways instead of public transportation? No problem. It seems as obvious as global warming–we are burning, like Rome. Yeah, I know. It sounds like fool talk.
Perhaps it is the thought of winter, here with us for a few more month, but I do not want to wait, to watch more people in despair. I want to skip to the part where we feel productive, where the change seems to be around us, people talking. The number of people who are truly in trouble, suffering, seems to be growing. The danger is that we are not prepared. The advantage is that it will be impossible as the numbers grow for this problem to remain invisible, ignored.
The Last Taboo
Last night I had the great pleasure of seeing Alexander Freeman’s new film, The Last Taboo. I am so glad to have found out about it just a few nights before the screening, so glad to find this vehicle for change.
There are two things that we Americans just cannot discuss: death and sex.
I spend a lot of time talking about death with people who have to. But it is so easy amid the housing and transportation concerns to dismiss the basic human need for–right to!–love. And touch. And pleasure.
I will be writing more on this in the future, and will soon share some projects in the works around this topic. In the meanwhile, check out Alex’s profile (featuring this film and previous work) here.
Evidence-Based Practices and the Full Moon
5pm came none too soon today, phones ringing, and the strangest and most difficult situations making me wonder what on earth had happened over the weekend.
And then, we all remembered the full moon.
Oh, I have used the full moon as a catch-all explanation before, along with other convenient superstitions. But in truth, it is just another way of expressing that I often feel a need for making sense out of nonsensical situations, and often want some control when in fact I have very little–or absolutely none.
I include the idea of “evidence-based practices” in this conversation tonight, not in the medical sense, but because I often consider the meaning of this concept in my own work, as I try to justify it. Sure, I do keep data for my day job, despite what I talk about here, and am surprised more at the sheer quantity of people served than in any trends I see in those particular numbers. Maybe the numbers I pull are not the right ones. But then, what should I be measuring?
So, I think through the various stories I hear–my evidence, only anecdotal, as I have said–and try to look for patterns. Why so many people from one particular town? I assume a common referral source, but then realize that they are coming from everywhere, from doctor’s offices to hospitals to the neighbor from two towns over. Why so many with the same disability? or the same age? and why all at once?
I try to think of marketing efforts, or people in the community who have talked to me recently, or anything that makes sense of it all.. and rarely can I figure out any sort of reasons. Maybe it’s in the water. Or maybe there really are a lot of people who are turning eighty years old at the same time in a particular town, a town that lacks resources for transportation, perhaps, and a town where reassessed properties have caused taxes to rise dramatically on houses that these octogenarians paid off years ago…
But we have not measured these sorts of things–not effectively–and we certainly have not added transportation resources or other services that may give any sort of opportunity to test what sort of difference they might make.
And this leads me back to thoughts about the full moon, and that natural event that somehow may predict things. The moon, the stars, the transit of Venus… Do they predict anything?
In many ways, I like to deal with uncertainty, to figure out how to cope in spite of it–because in the end, life itself is uncertain. Beyond that, also, sometimes all the causal relationships we try to create may in the end make no difference if the people involved do not believe in them. And they believe in them, because they feel the difference from a qualitative perspective, not because we assign a quantitative value to that difference.
I want to figure out evidence-based practices for people’s lives–but I am not sure that any of us is ever so great at determining what will work best in a situation that is not our own. We can insist that someone will do better in a situation, but in fact, we may be better at predicting the emergency department visits spiking at the full moon.
Perhaps the thing we should measure is whether people, given enough resources, really do figure out their own best practices for themselves, and in what manner they want to use our expert advice.
But for now, it is easy to be superstitious when we have so few other choices. And maybe, just maybe, good things will happen, if I just keep my fingers crossed.
Oh, and get ready: there is another full moon later this August! Only in a blue moon…
Only Anecdotal 