Now We’re Talkin’: Age Successfully by Building Your MicroBoard

This week I have been thinking a lot about ‘successful aging’, as in what exactly does that mean? Perhaps I read too much industry-related information, or it may be since aging is the focus of my practice, but it seems like that term is everywhere. So much so that I feel I must combat eye rolls or episodes of them glazing over. I must redouble my efforts to pursue the topic of successful aging as it may be a great use to me or someone I may encounter. Press on!

What are we going to need as we age in order to do this thing called successful aging? As a patient advocate, I am often involved in conversations like this, since aging is my specialty as is solo aging. At my age of 67 I have begun thinking about this question. Personally. A lot.

There are plenty of people who do not wish to think about their aging, and there are lots of reasons for that, including fear or at least discomfort. Sometimes outright denial and lack of action, or it there is action it looks like (picture fingers in both ears here) “La La La...” I had a brother-in-law who was never going to die. Until he did.

To minimize any uneasiness, my own or that of others. I as a patient advocate can always put on my clinical hat and proceed to “triage” myself. I can look at it all in third person and assess what may be needed. (I have to say that working in this profession, remaining on top of the What’s What of aging, helps me as much personally as it does professionally).

Introducing The Microboard

I am known to often talk about building a Microboard, building a team. The Microboard is a group of folks who are going to help me (or my client, patient) get to or obtain what I need to age successfully. Our job is to figure out what that means for us, and put the people or providers or agencies in place.

Whenever I refer to ‘Microboard’ I see in my mind a conference room-style table with seats around it. My client or patient is at the head of the table as Chairperson. There may be some seats in the periphery, around the walls. When the Chair is making important decisions they can tap into the advice or experience from their board. The Chair may call upon their  designated members to offer expertise, assistance, or perspective. When armed with the most and best information the Chair then makes solid decisions.

It’s kinda like designing my own constellation, a constellation of enabling parties and ones who will be my support, personally and professionally. Folks in my constellation could offer advice or experience from their own perspectives for me to try on for size.

What is key here is that I get to build my Microboard. I select and fill the seats. And while doing so I celebrate the fact that I am Chairperson of my board because I have the power to select the persons for the seats on my board. Pretty heady stuff, huh? I can also unseat if I want or if I need to as times change.

Change: Allow For it

Change: times change: I'm going to change. The people on my Microboard are going to change. Circumstances are going to change. Laws might change! Innovation may arrive. So we will plan loosely and expect that change, shall we?

So that I don’t get in the weeds with all of this I think only within the headings or topics with which I am familiar, one I use a lot in patient advocacy. I can create any seat I want or need on my Microboard or I can dissolve a seat if the need is no longer there. To keep it simple I work within the framework of Medical, Legal, Financial, Insurance, Housing and Support.

Let’s use Medical for starters

For example, there are many conversations under the heading ‘Medical’. It’s your situations, your life, your board so your concerns could be

GP or PCP (Primary care physician) – Got one? Need to find one? How’s your communication, and trust level? Are the accessible, do the steer care and coordinate or is that a back door open?

Specialists – Got any? Need to find one? For this one the communication question can mean their demeanor and time with you as a patient. How is the responsiveness to you and back to the GP, is that strong? How accessible is the provider or their office?

         Accessible, by the way, can mean responsiveness but it can also mean what are the challenges of getting there and getting into the appointment?

Physical, cognitive, emotional, and even financial – all are differing kinds of “health, and aging”. Split them up. Think about how you are, physically, now. How might that change in five years, or in10? Do the same for cognitive. How do we maintain emotional health through time? This provides for multi-faceted ponders and conversations (“with an s,” I like to say).

Sites of care – Most may think of “going” to the doctor, traveling to an office or clinic, but what if you need care brought in, like home care, or post-op care? PT/OT/SLP (physical therapy, occupational, or speech and language)? Do you know yet how all this works, how to find and select, or how it is paid for? What if you need to be admitted to a rehab, post-op, short term or longer term, do you know that industry, where they are and how to select them? If at point of discharge, do you know that you can (or your MicroBoard can help) steer that direction (do be wary these days of slipping into that “first bed available,” or to this patient advocate: why is a bed available-what -is-undesirable-and-why-do-they-have-an-opening? Call me jaded, but I have seen things).

Also, Urgent Care, Emergency Room, or hospital care – Do you know, right now, where you closest Urgent Care centers are located? Could be this nugget of information is for you or when traveling, or when someone with special needs may be visiting. Take 15 minutes to learn that, and when to go to Urgent Care versus an ER, and what circumstances are appropriate for each one. it's a good thing to be aware of and taking a few seconds to gain a grasp of what is available to you can save your bacon. 

Designation of agent or proxy with HCPOA can be key. It is a rightful subheading of Medical, and you will want to give a lot of thought into designations and alternates. Verbiage in the documents you will have created, and revisiting them over time (remember the section about all the things that can change? This designation can also).

Other factors play into the thinking within the Medical heading, such as insurance, accessibility, transportation, financial concerns (copays), weather, and holidays. Also likely present is the matter of support, such as accompaniment, to act as scribe or help ensure your questions are answered and understood. Then there is communication with any Very Important Persons to keep everyone in the loop.

Those six main headings along with our MicroBoard members must cohere (I know, I first thought ‘cohese,’ but I looked it up) because the situations will often involve more than heading, and thus requiring input from more than one seat. Lives don’t jump cleanly from one heading to another, rather our lives require and incorporate multiple headings and thus input from  more than one seat.  With that you can be assured that you will hear me expound upon the professions of patient advocacy and care managers, and other care coordination specialties.

We can discuss the variables for each of those six headings in the upcoming weeks and months. If you have any questions that you would like me to incorporate relative to those headings and aging (that’s Medical, Legal, Financial, Insurance, Housing and Support) then I encourage you to email me or hit Reply and ask away!

Now We’re Talkin’!

And talk we do, when you contact me toward consultations in any of these topics which are part of the path to successful aging. I have altered my service offering to single consultations, designed to problemsolve (yep, we’re makin’ it a verb, y’all). You and I will Q&A so that I can best assess your concerns and situation, and I will offer recommendations for further action. Building a MicroBoard is  great first step.

I hope something that I have brought to the table today gets you thinking: about successful aging – for you specifically, and the opportunity (and power!) of building your Microboard.

Nancy Ruffner is a patient advocate whose focuses include aging strategy, healthcare navigation, and solo aging. Nancy consults with clients in a triage fashion, offering one-hour consultations to find a path, gain a deeper understanding of “how stuff works” in eldercare, or specifically problem-solve. Schedule your 1-Hour session now, without obligation of commitment or continuing costs. nancyruffner.com