Last fall, David Susser, right, received an American College of Osteopathic Internists citation from outgoing ACOI President Jack Bragg, D.O.

Back in the 1970s, when opportunities for advanced, high-quality training were still limited for osteopathic physicians, David Susser, D.O.’57, MACOI, helped create a haven for graduate medical students: As chairman of the internal medicine department at Zieger Osteopathic and Botsford Hospital for more than 20 years, he gave “each of his residents as much responsibility, guidance and leeway as one could possibly wish for.”

So stated the nomination that resulted in Susser’s receiving the American College of Osteopathic Internists’ Presidential Citation at ACOI’s annual convention in October.

“It was David Susser’s name and reputation that permitted consideration by our allopathic brethren for advanced subspecialty training of his graduates when it was simply not available within our own profession,” noted Gerald Blackburn and Pedro Espat, the osteopathic physicians who nominated Susser for the honor.

Board-certified in internal medicine and cardiology,
Susser was clinical professor in internal medicine at Michigan State University College of Osteopathic Medicine, a member of the Botsford Hospital Board of Directors and past director of its internal medicine residency program. He is an ACOI fellow, past president and past member of the ACOI board of directors as well as past president of the Michigan Society of Osteopathic Internists.

The Presidential Citation is not Susser’s first ACOI honor. An active member of the organization for more than 48 years, he’s also been honored as an ACOI Master Fellow and recipient of its Distinguished Service Award. He is a cardiologist with Cardiovascular Clinical Associates in Farmington Hills, MI.

He gave much to his profession, serving on the Iowa Society of Osteopathic Physicians and Surgeons and chairing the Iowa Board of Osteopathic Examiners. He played a key role in ensuring equal medical reimbursement for osteopathic and allopathic physicians. His leadership moved Iowa to create a composite state licensing board, which continues today as the Iowa Board of Medicine.

Anderson also has contributed, some would say, to controversy, with his proposal to do away with the separate D.O. and M.D. degrees. Frustrated by the lack of understanding of osteopathic medicine and concerned about limited osteopathic training programs in the specialties, he says combining the two would raise the stature of both.

An exemplar of America’s greatest generation, Dr. Anderson has quietly and sometimes not so quietly propelled positive change.

Despite one’s reaction to his view, no one can doubt Anderson’s positive and lasting impact on physicians, patients and the medical profession. His impact is similarly significant and enduring at DMU. He served as a member and president of the National Alumni Association of the College of Osteopathic Medicine and Surgery, now DMU. Anderson also has established, via his will, a trust that will direct revenue from family-owned farms in Minnesota to the University. Because that revenue will come to DMU in perpetuity, he will benefit physicians, their patients and his profession for decades to come.

Planned gift options allow you to make a major impact on DMU. Contact us at 515-271-1387 or via www.dmu.edu/donations.

You may not know, however, that a doctor of osteopathic medicine is why the red poppy symbolizes this ultimate sacrifice.

John McCrae, holder of both D.O. and M.D. degrees, was a Canadian Army surgeon during World War I. Although he had been a doctor for years, he was horrified by the suffering, screams and bloodshed during 17 days of fierce fighting in spring 1915 in Belgium.

“I wish I could embody on paper some of the varied sensations of that 17 days…Seventeen days of Hades!” he later wrote.

Among the casualties was McCrae’s young friend and former student, Lieutenant Alexis Helmer. The day after McCrae performed the funeral ceremony, in absence of a chaplain, he perched on the back of an ambulance and expressed his anguish in a poem, in view of his friend’s grave and the wild poppies that cloaked the cemetery.

That poem, “In Flanders Fields,” was first published by the English newspaper Punch on Dec. 8, 1915. Instantly popular, it made the red poppy a moving symbol of service and sacrifice.

Sources: DMU Library Archives and the Arlington National Cemetery website

Nick Bechtold, right, and Nick Bennett, both D.O.’11, immersed themselves in South African culture as well as clinical practice: They went on safari, visited shanty towns and local establishments with South African friends and took in some World Cup soccer games. They enjoyed the local cuisine, including “braai,” or grilled meats; “pap,” a porridge made from ground maize; and fried mopane worms. “After a while, they were like eating pork rinds,” Bechtold says. “We still talk about our adventure as if it were two weeks ago, not two years ago,” he adds. “It ignited my passion for medicine.” Bechtold and Bennett are completing family medicine residencies in Sioux City, IA, and North Carolina, respectively.

In June 2010, my friend and classmate Nick Bennett and I found ourselves cruising by miles of crop fields and rolling hills. Sounds like a typical scene in the summertime countryside in Iowa. However, with the mountains in view, riding “shotgun” on the left side, our friend Themba in the driver seat with the course set to Kruger National Park, we were half a world away in the South African province of Limpopo.

This global health elective rotation – a partnership among DMU, the University of Limpopo and the nonprofit outreach organization Blessman Ministries – was the rotation that I had been waiting for. It was that “ah ha” moment when you know what you want to be when you grow up. Prior to embarking to South Africa, my sights were set on applying for otolaryngology, or ENT, residency. Before we left, I had researched where I would be applying, contacted residencies to schedule audition rotations, and was mentally preparing for my future.

Those four weeks were packed with clinical experience. Within moments of my arrival in the emergency department, called Casualty, I was assessing a man who had been stabbed by his girlfriend and needed prompt bowel resection. The surgeon invited me to assist with the operation. While working at the Rethabile clinic, I was called to deliver a baby as no doctors were available. One night in the ER, I used my penlight to entertain a young orphaned boy who had been ejected from a pickup after an accident. And when the radiology department went on strike, we had to rely on our physical exam training to triage patients out of the hospital. On our last day, after two buses collided on the highway, Nick and I were called in to help. As the helicopters were flying in, it was almost like a scene from the TV show “M.A.S.H.”

These clinical experiences gave me a feeling of utility, that I can make a difference. At the Limpopo hospital, I was able to care for patients in a way that I had never experienced. My work in the emergency room was exciting, hands-on, and valuable. The cases I saw in the local primary care clinic and HIV clinic were provocative. We were able to spend time educating patients on their diabetes and high blood pressure. Nick and I often picked up extra hours in Casualty at night to see more patients.

The thing that hooked me the most, however, was the gratitude of the patients and the staff. I was not expecting the people to be as friendly as they were. In the primary care clinic, the nurses gave us African names. They named Nick “Dr. Tshepo,” which means “hope.” They called me “Dr. Kagiso,” which means “one who brings others together.” I still wear the nametag they had made for me. It reminds me of why I chose a career in medicine.

Meanwhile, the paperwork I’d brought along for ENT residency sat untouched. When I returned to Iowa, I made the decision to change my application to family medicine. I knew that this would be the avenue to touch a person’s life like I was able to thousands of miles away. I am so thankful to DMU and Blessman Ministries for providing me with an experience that altered my path into primary care.

Editor’s note:  In the fall 2012 issue of DMU Magazine, we invited readers to respond to our “Great Escapes” cover story with their own such adventures. Paul Rein, D.O.’72, did just that, sharing his “escape” that took him from coast to coast and raised nearly $35,000 for the Leukemia and Lymphoma Society.

Paul Rein, D.O.’72, knows many things, wisdom gained from the seat of a bicycle. The best roads and best drivers are in Kansas and Colorado; Missouri is home to the worst roads and most flies. He drank the best milkshake at the Dairy Café in Bluff, UT, and relished his most rewarding moment at the 11,312-foot summit of Monarch Pass, on the continental divide in Colorado.

More important, Rein knows the importance of family and friends; of finding a balance in one’s life; and in “finding something that you can do that provides personal satisfaction while doing good for others.” He lived all these lessons during the summer of 2011 when, as a fundraiser for the Leukemia and Lymphoma Society (LLS), he dipped his back bicycle tire in the Pacific Ocean in San Diego and, 67 days later, his front tire in the Atlantic in Virginia Beach, VA.

“It was the best experience of my life, short of the birth of my two children,” says Rein, an anesthesiologist in Newport News, VA.

A golf injury led Paul Rein to trade running for bicycling, which led to an epic and charitable adventure. “When you’re 64 years old and you tell people you’re riding across the country for leukemia, they listen,” he says.

Rein’s relationship with LLS began in 1967 when, as an undergraduate at Wayne State, he chaired a fundraiser for his fraternity to benefit the Children’s Leukemia Foundation, which netted $5,000. “That was a lot of money then,” he says. That was also when leukemia was a death sentence. Now, advances in detection and treatment enable the vast majority of leukemia patients to survive, albeit not without hardship.

“This ride may take me close to three months, but that’s nothing compared to what cancer patients go through during treatment,” he told The Health Journal prior to his trip. “Compared to being a parent of a child diagnosed with these diseases, my ride across our country will be a ‘chip shot.’”

Rein, who has two family members who have survived leukemia and lymphoma, has participated in many LLS fund-raisers. He kicked off his 2011 cross-country trek that June with the Lake Tahoe Century Ride, a 100-mile ride around the lake. “After finishing, I realized I can do this cross-country stuff,” he wrote on the blog he kept during his ride, coast2coastpaul.wordpress.com.

Rein, 64, plotted his cross-country path by stitching together routes offered by the Adventure Cycling Association. His son, Earon, worried about the heat of the California desert; his daughter, Kate, bought him a SPOT, a satellite messenger with GPS tracking he affixed to his bike so others could follow him online.

From a physical training point, however, Rein notes, “the only thing you can train is to get your butt in condition.” From a safety standpoint, he adds, “it helped to be naïve.” He’d changed a bike tire tube only once in all his riding. He had the first of his three flats on the trip on Interstate 10 crossing from California to Arizona; after managing to get the tire off, he discovered the CO2 cartridge he’d brought for such emergencies wasn’t working. Just then, a man bicycled up with a hand pump to fix the tire. “I was really fortunate, and what a great guy,” Rein says.

The man was one of many kind people Rein met on the trip, from the hotel managers who discounted his bill to the food vendors who fed him for free to “Marathon Martha,” a gas station staffer who inspired him with her tattoo signifying her son as a Hodgkin’s disease survivor. “I met 80 kazillion nice people,” Rein says.

Loved ones were hugely supportive, too. His significant other, Linda Bourdon, was his self-described “sag hag” for the first 17 days of his ride. Other family members and friends met up with him at points along his route. Pedaling alone, he says he was “never bored,” pondering topics ranging from business ideas to favorite songs to the national debt. He became philosophical about the importance of shoulders on roads, blogging, “If we didn’t have the support of shoulders either literally or figuratively, going through life would be so much more difficult.”

Rein also admits to some low moments in Kansas. “It’s a state that never ends, and I rode every day but one into the wind,” he says. “I yelled the ‘F’ word a few times.”

By great contrast, his arrival in Virginia Beach was “surreal.”

“A bunch of people with Team in Training were there,” he says, referencing the LLS organization for athletes who participate in its fundraising events. “It was a late afternoon but I wasn’t even tired. Seeing the people and the happiness on their faces was just so cool.”

With a final count on his bicycle odometer of 3,699.3 miles, Rein expressed gratitude on his blog to all who supported him and LLS and for “the good passion gene” given to him by his parents.

“Whether at work in wanting to be the best anesthesiologist and treat every patient as a VIP, or on the golf course wanting to shoot 68 and take money from my opponents, or riding 3,700 miles on a bicycle, I can honestly say I want to be the best,” he stated. “I know I will never accomplish that, but even now at my age that is my goal.”

Silver and gold are the gifts of choice for 25th and 50th wedding  anniversaries, respectively, because of their beauty, value and  strength. That’s a great model for DMU’s new reunion tradition: In May, reunion and commencement activities will be united in a special weekend celebration, with milestone 25- and 50-year alumni and members of earlier classes receiving silver and gold medallions.

Members of the classes of 1963 and 1988, in honor of their 50-year and 25-year reunions, and graduates of 1962 and earlier years will be invited to lead the Class of 2013 in the commencement procession on Saturday, May 25. They will receive gold and silver medallions and be recognized during the ceremony. “This will be a powerful symbol of the connection of all alumni to each other and to the University,” says Marcia Grassman Hammers, B.H.A.’88, president of the DMU Alumni Association Board of Directors. “It also will be a wonderful opportunity for graduates across the years, including the Class of 2013, to interact and share in the celebration.”

Other reunion activities tentatively planned on Friday, May 24, include a campus panel discussion featuring current students; a campus picnic for alumni, graduates and their families, current students and DMU faculty and staff; campus tours; a medallion ceremony for milestone alumni; and an all-DMU commencement reception for alumni, new graduates, their families and DMU faculty.

Ronnette Vondrak, DMU’s director of alumni relations, notes that while special activities are planned for members of the classes of 1963 and 1988, other alumni are encouraged to contact the alumni office if they want to arrange reunion events for their class.

“What we’ve found over the years is that members of the 25- and 50-year classes are especially interested in marking those milestone years by reconnecting with each other and with the University. The new medallion ceremony is intended to enhance their celebration,” she says. “That said, our alumni office will work with graduates who want to reach out to classmates and plan their own special reunion activities at a time that works best for their class.”

Inviting alumni to campus during a momentous occasion for new graduates, Hammers says, will add to the festivities.

“We hope hosting these significant milestone reunions during commencement weekend will let alumni rekindle special memories of their own graduation as they share their bond with the graduating class and reconnect with each other and the DMU community,” she adds.

You can get more information on reunions and other events by visiting the DMU alumni website, www.dmu.edu/alumni/ visiting the reunion website, www.dmu.edu/reunion/; calling 515-271-1463; or emailing alumni@dmu.edu. You can also use these contacts to plan additional class reunion activities.

Last May, 114 DMU alumni, friends, employees and students swung into action at the College of Osteopathic Medicine Golf Benefit, generating $50,192 that will be awarded to COM students. In September, it was the College of Health Sciences’ turn, when 92 golfers had a ball and raised $13,620 for student scholarships.

In October, individuals and organizations from across the greater Des Moines community came together to celebrate the legacy of the late Luther T. Glanton Jr. and Willie Stevenson Glanton, both attorneys, DMU trustees and the inspiration for a scholarship fund that benefits minority students. The event, held at the Meadows Events and Conference Center in Altoona, was attended by 430 individuals and generated $231,440 for the endowed fund.

Since it was established in 2004, donors have given nearly $1.9 million to the Glanton Scholarship Fund, of which $785,000 has been awarded in scholarships.

“I am confident that each student who is blessed to be here tonight can be a testimony to the fact that the contributions they received, great or small, have not only enhanced their medical education, but has touched our hearts and enhanced our spirit of giving,” said Glanton Scholarship recipient Ebonie Vincent, D.P.M.’15, who spoke at the dinner. “Know that each life we touch is in part because of you, through your giving and support in any and every way.”

Honored at the Glanton event was Connie Wimer, founder and chair of Business Publications Corp. and a central Iowa business and civic leader. “If Ebonie is an example of people who’ve received scholarships and choose to help the world be a better place, I hope all of you feel as good as I do tonight about contributing dollars to this cause,” Wimer said.

Event photos

October 16, 2012 (123 photos)
Glanton Dinner 2012

September 18, 2012 (27 photos)
CHS Golf 2012

May 30, 2012 (21 photos)
COM Golf 2012

“I started making calls and asking friends for favors, but finding a preceptor is difficult enough without the complication of one month over my head,” she recalls.

Enter Robert Birk, PA-C’02, a physician assistant with Community Memorial Hospital Oconto Medical Center in Oconto, WI. He took Morris on rotation and also demonstrated to her true patient care.

“I cannot say enough how much he cares about his patients…his patients know he cares,” Morris says. “It was not uncommon to see whole families during visits and then, in an afternoon visit, see extended family because word has spread that they found a trusted practitioner in the community.”

Morris’ comments were part of her nomination of Birk for the Wisconsin Academy of Physician Assistants (WAPA) 2012 Physician Assistant of the Year, an honor he accepted in October. He was selected for his excellence in patient care through relationships with his patients and colleagues, as well as for his service both in and outside of the medical community.

“Rob was just one of those guys that I knew would do great things in our profession.”
–Pam Chambers, M.P.H.’01, PA-C’92

“He really goes the extra mile,” says Morris, M.S.N., FNP-C.

Birk understands what it’s like being in a jam. He and his sister were raised by their older brother after cancer took their parents’ lives, before Birk was a teenager. As a medic with the U.S. Air Force, he worked his first duty assignment at Offutt Air Force Base in Omaha, NE, under James Tracy, D.O., who, Birk says, “more than once told me that I was more than just a medic.” Later sent to Eielson Air Force Base in Fairbanks, AK, he was mentored by Captain Jesse Ewing, PA-C, who involved him in clinical cases.

“I told PA Ewing that eventually I wanted to return to my hometown community and provide the much-needed medical care there,” Birk recalls. “I spoke about going to medical school. He said, ‘Why not be a PA? You can still be that small-town guy…most of your patients will still call you their doctor.’”

That put Birk on a PA path. He soldiered through his academic prerequisites between active duty and deployments to Saudi Arabia and Cuba. Once he was accepted into DMU’s PA program, his hospital commander agreed to release him from active military duty requirements 18 months early. Another jam: The base commander denied his release.

“I was devastated, to say the least,” Birk recalls. “My career goal hung right in front of me, just out of reach.”

Enter Pam Chambers, M.P.H.’01, PA-C’92, associate professor in DMU’s PA program, and Jodi Cahalan, Ph.D., M.P.H.’01, M.S.’93, PA-C’89, then program director and now dean of the College of Health Sciences. They gave Birk a deferral so he could begin the program the following year.

“I was beyond relieved and more thankful than ever,” he says. The next year, he was honorably discharged from the Air Force and began the PA program six days later.

“Rob was just one of those guys that I knew would do great things in our profession, as soon as I met him,” Chambers says.

Birk says he’s doing exactly what he wants – being that “small-town guy” in the county where he grew up, taking care of people he knew as a youngster, friends and now their children.

“I couldn’t be happier,” he says. “I thank DMU’s PA program for giving me the knowledge and tools I need to be a great primary care provider.”

Alumni can get involved in DMU’s PA program by serving as preceptors, signing up on the online alumni mentor map or lecturing on campus. To learn more, contact Jolene Kelly at 515-271-1685 or visit www.dmu.edu/alumni/volunteer/.

Gio Villanueva celebrates on the summit of Mount Edgecumbe, with Mount Fairweather in the distance.

Gio Villanueva’s energy almost literally sparks out of the phone, even though it’s 7:30 a.m. in Alaska and the sun won’t rise for at least another hour. His obvious drive is an asset in an area where the environment presents as many challenges as do his patients’ conditions. “From a patient point of view, I need to do the best possible job I can do given the resources we have,” says Villanueva, D.P.T.’07, ATC, a staff physical therapist at Mount Edgecumbe Hospital in Sitka, AK, a facility of the SouthEast Alaska Regional Health Consortium (SEARHC). “You can’t just send someone down the road for additional or specialized care.”

That’s due in part because Sitka’s main road system entails “seven miles of road going north and south and seven miles going east-west,” he says. “In many places, the main transportation is not a car; it’s a boat or plane.”

Alaska’s fifth largest city (population: approximately 9,000), Sitka sits on Baranof Island on the outer coast of the state’s Inside Passage. In addition to the inpatient acute care he provides at the hospital, Villanueva offers outpatient care in the 18 Native American communities that form SEARHC, a nonprofit tribal health consortium.

“We don’t have an orthopedic doctor on staff. The specialists rotate, some every four months,” he says.

“Patient education is crucial.”

So is understanding the demands and realities of patients’ lives. “A lot of people can’t afford to get off work. If they’re injured at the height of salmon fishing season, they have to be able to keep going,” he says. “You have to look at what you can do when you know the patient can’t come to therapy as often as you’d like.”

That gives preventive care an important role. In 2011, Villanueva and his colleagues established a sports clinic at Mount Edgecumbe High School, where he meets with student athletes every Monday after work. “If I find something wrong, I refer them to their primary care provider,” he says. “We catch shoulder, knee and hip injuries, and we’ve even caught some infectious states.

“The school is really happy the clinic exists,” he adds. “There’s a bonus in making sure students are healthy.”

Gio Villanueva’s attire as a physical therapist can include a fur hat.

Expanding his horizons physically, professionally and personally was what Villanueva was seeking when he moved to Alaska more than two years ago. The Los Angeles native had been working in San Antonio, TX, when a colleague planted the idea of relocating in the nation’s largest state geographically but least densely populated. He intentionally timed his interview when the Sitka season was “dark, windy and rainy.” Now he loves living in what he calls “one of the hidden jewels of Alaska.”

“The beauty, the outdoor recreation, trekking up the mountains – it’s been a wonderful ride so far,” he says. “Eighty-five percent of Alaska are public lands for us to explore, pop a tent and experience.”

The experience, he notes, includes understanding the region’s culture and history. Its Native American tribes include the Tlingit Indians, who have lived continuously in Sitka for more than 50 centuries. The city also was the cultural and political hub of Russian America in the early 1800s; Sitka is where Russia officially transferred the Territory of Alaska to the United States on Oct. 18, 1867.

“No Native Americans were involved in that transition. You have to be sensitive toward that history,” he says. “To enjoy yourself and be successful here, you have to assimilate, integrate and respect and understand others, which has always been my mantra as a physical therapist. It’s all about the patient.”

That assimilation and respect go beyond his practice. “I was looking for the spirituality aspects, the family aspects, respect for the elderly and their lessons,” Villanueva says. “I’m Filipino-American, and I see that in my culture and in others I’ve traveled to. It makes you self-reflect on what makes you truly happy in life. Your value system changes.

“Growing up in LA, I was exposed to Beverly Hills. There’s nothing wrong with that, but this has opened up new ways of living for me,” he adds. “I’m just glad to be here.”

Building an
Age-Friendly
World

Finding new answers to an ‘old’ problem

Of the many triumphs of modern society, our ever-increasing life expectancy may be the greatest achievement. Improved medical knowledge and an enhanced quality of life have allowed people to live to ages once thought impossible. Yet old age is still a relatively recent phenomenon. Only in the last 70 years has it become common to live to see 65, let alone enjoy life beyond that. But as we continue to tack years onto our lives, we face a new and unknown challenge: the aging of America.

The United States faces an unprecedented demographic shift over the next 20 years. Our population is aging rapidly. The oldest members of the baby boom generation have reached retirement age, and 10,000 more hit that mark every day. By 2030, nearly 20 percent of the U.S. will be 65 and older.

Of the many triumphs of modern society, our ever-increasing life expectancy may be the greatest achievement. Improved medical knowledge and an enhanced quality of life have allowed people to live to ages once thought impossible. Yet old age is still a relatively recent phenomenon. Only in the last 70 years has it become common to live to see 65, let alone enjoy life beyond that. But as we continue to tack years onto our lives, we face a new and unknown challenge: the aging of America. The issue is not unique to America. Worldwide, life spans are increasing while birth rates are dropping. Taken with the graying of the baby boomers, these trends create an extraordinary change in the world’s population, where two billion people will be 65 or older by 2050.

“The whole world is aging, especially in urban areas,” says Yogesh Shah, M.D., associate dean of global health at Des Moines University. “If we don’t make changes to our cities, it will be hard for our elderly to live independently.”

Recognizing this “silver tsunami,” the World Health Organization (WHO) in 2006 brought together 33 cities in 22 countries to determine key elements in the urban environment that support active and healthy aging. These cities formed the Global Network of Age-Friendly Cities.

In order to build a framework to assess and improve age-friendliness, the network went straight to the source – seniors. WHO worked with each city to set up focus groups to ask older people, as well as caregivers and service providers, to describe the advantages and challenges of city life. The findings from the focus groups helped establish a set of guidelines to make communities friendlier to older adults. They centered on issues in eight areas of urban living, from health services to social inclusion (see sidebar at left).

Through his work with WHO on global health initiatives, Shah heard about the Age-Friendly Cities program early on and thought it was a perfect fit for Des Moines. His experience as a family physician and geriatrician in small-town Iowa helped him understand the importance of making communities more livable for seniors.

“When I worked in Mount Ayr in 1996, I had a patient who was losing her abilities and had no one to help her, but she didn’t want to give up her independence,” says Shah. “The goal of Age-Friendly Cities is to keep seniors in their own environment and allow them to stay active.”

Shah moved quickly to garner support from DMU President Angela Walker Franklin, Ph.D., Des Moines Mayor Frank Cownie and other key community leaders. He formed a small committee and secured the approval of the city council in July 2011. With the support of the city’s leadership, Des Moines became just the third Age-Friendly City in the United States in September 2011.

“Age-friendly is friendly for all”

As the silver tsunami swells off in the distance, several other cities are taking action to deal with the impending flood of older people. Portland, OR, one of the original cities to join WHO’s global network, played a critical role in the research phase of the project and used that data in crafting a 25-year strategic plan for city development. Atlanta, GA, is working to adapt zoning codes for housing and retail to create walkable, lifelong communities.

Cities are quickly realizing that making changes to support an older population creates advantages for people of all ages. Common-sense solutions to improve the physical environment, access to services and public transportation are smart growth strategies that make a community more livable overall.

“An Age-Friendly City benefits everybody. It will be good for young people, the disabled and others,” Shah says. “For example, wider sidewalks and longer walk lights benefit all pedestrians, not just the elderly. Age-friendly is friendly for all.”

New York, perceived as a bustling metropolis most suited for the young, has become the model for age-friendly. No city has worked faster to incorporate the concept of active aging in all aspects of urban life. Since launching Age-Friendly NYC in 2007, the city has already responded with 59 initiatives, from adding benches at bus stops to expanding pool hours to accommodate senior swimmers.

But New York is not just plucking low-hanging fruit; the city has developed some innovative approaches to age-friendly. Local artists provide cultural activities and art classes at senior centers in exchange for studio space. City school buses, typically idle during the school day, shuttle older adults from senior centers to supermarkets. A volunteer time banking network allows people of different ages and skills to help one another by trading services.

Even businesses are getting involved. Seeing it as an opportunity to attract new customers with spending power, local establishments are catering to the needs of seniors. More than 1,000 businesses citywide have received an age-friendly designation for offering services geared toward older consumers, such as public restrooms, home delivery and senior discounts.

“It made perfect sense”

At the same time Des Moines was launching its age-friendly program, AARP was exploring a national initiative to expand the concept across the United States. With three Age-Friendly Cities already established in the U.S., the organization decided against reinventing the wheel and instead partnered with WHO to identify communities for membership in the global network.

“The country is being confronted by this aging demographic and we know that many communities are not prepared,” explains Jeanne Anthony, senior project manager for AARP Livable Communities. “AARP has promoted livable communities for some time. Age-Friendly Cities was an opportunity to help communities prepare and plan. It made perfect sense to us.”

AARP formally launched its Network of Age-Friendly Communities in April 2012 with pilot programs in eight cities. The program provides a system for AARP state offices to collaborate with local officials to recognize and implement improvements that make communities friendlier to older residents.

“We try to create resources for the state offices, local officials and communities that align with the eight domains established by WHO,” Anthony says. “We have a new website [www.aarp.org/livable] where we can share what other communities have done – their stories and best practices.”

Since joining Des Moines’ age-friendly movement, Kent Sovern, state director of AARP Iowa, has taken a leadership position on the committee. He immediately realized the importance of AARP’s role in connecting city leaders with the community’s seniors.

“AARP’s role locally is to convene, endorse, encourage and invest,” Sovern says. “We are able to take the lead in bringing people together in the community and encouraging AARP members to be a part of the process.”

To get the ball rolling, AARP Iowa organized a series of neighborhood meetings to introduce people to the Age-Friendly City template and get a general idea of the needs and priorities of Des Moines’ seniors. The organization also developed and distributed a survey to 6,000 seniors, asking, “What affects your ability to live your best life in your community?” Results of the survey still need to be analyzed but will lay the groundwork for the effort moving forward.

“With this survey, we’ll have a pretty good idea of what criteria demand our attention,” says Sovern. “We’ll have a general sense of the level of satisfaction that folks have with different aspects of Age-Friendly and be able to make recommendations on the essential features needed in our community.”

Recommendations will be citywide as well as customized down to the neighborhood level. AARP Iowa plans to survey surrounding communities next, with the state’s other metropolitan areas planned in the future. Meanwhile, work continues to weave the Age-Friendly City concept into other community initiatives. Sovern and other committee members have worked with leaders of the region’s major planning efforts, DART 2025, Capital Crossroads and the Tomorrow Plan, to incorporate age-friendly features into Des Moines’ future development.

“Age-Friendly Cities isn’t a stand-alone plan,” he says. “It’s been worked into a greater community vision. It’s exciting to think about these broader public policy issues to meet the needs of all ages with the general goal of people living their best life in the community.”

“Des Moines already has a lot in place and is further along than most cities,” adds Joel Olah, Ph.D., co-chair of Des Moines’ Age-Friendly City committee and executive director of Aging Resources of Central Iowa. “If Des Moines is ranked as a top city for young professionals, why can’t it be the same for seniors?”

Care to change

Comments from AARP Iowa’s preliminary neighborhood meetings showed that Des Moines has the necessary health care services in place. However, that access is lacking in most cities. Considering the transportation challenges of many seniors, health care providers face a major hurdle in treating the older population.

“People outlive their driving abilities by years,” Anthony says. “In suburban-style communities, which are predominant throughout the country, people don’t have access to services if they can’t drive. They can’t readily access services by walking, either.”

Hospital systems have responded by extending their services to the neighborhood level. “We’re already seeing a shift to more urgent care and outpatient services away from the hospitals,” says Sovern. “The question, I think, is how will we organize ourselves to deliver services effectively?”

Of greater concern is the increasing burden an older demographic will place on a health care industry already encountering major workforce shortages. Advanced age brings a host of chronic health issues, resulting from decades of unhealthy habits and largely sedentary lifestyles. Providers, especially those in primary care, will be taxed to meet the health care demands of an aging population.

“The health system is not structured to allow adequate time to spend with older patients,” claims Anthony. “Many doctors are in a difficult space. They need to treat patients holistically, but how do you treat the whole patient in just 15 minutes?”

The Affordable Care Act, although controversial, aims to remedy the situation by changing the focus to quality of care instead of quantity. It also emphasizes disease prevention through the promotion of health and wellness to people young and old. “As clinicians, promoting active aging for ourselves, our patients and others is critical,” says Shah.

No easy fix

The greatest threat to cities in the quest for age-friendliness is not in logistics, planning or even finances; it is the negative attitude toward the older population. In our society, there exists a false perception that seniors want to be left alone to live out their remaining years. Older adults are often forgotten soon after retirement and become isolated from the rest of the community.

“The biggest obstacle we face in making the world more age-friendly is actually cultural,” says Shah. “We can make sidewalks wider, improve transportation and make health care more accessible. That’s all easy. But the cultural aspect isn’t a fast fix. It will take time to change that mindset.”

Sovern agrees. “Social capital is crucial. Seniors want to continue to be engaged in their community, and more specifically, their neighborhood,” he says. “We need to keep them involved in events, employment and civic life.”

Des Moines University is doing its part to change these long-held attitudes and beliefs. The Senior Health Fair, held annually in November, offers health education and medical screenings for adults 50 and older in the community, and at the same time provides DMU students with direct interactions with seniors. This year, nearly 450 seniors came to campus to visit more than 50 booths manned by community service vendors and student groups, including one that focused on social inclusion.

The University also regularly partners with Wesley Acres, a neighboring retirement community. The physical therapy department recently teamed with Wesley and the Iowa Department of Public Health to host an event on Fall Prevention Awareness Day. Students from the Geriatrics Club (motto: “putting twinkles in your wrinkles”) frequently visit the center to better understand seniors and get hands-on experience working with them.

Geriatrics Club Co-Presidents Michael Eastman and Lindsey Miller, both members of the College of Osteopathic Medicine Class of 2015, are among the DMU students who frequent Wesley Acres for a weekly informal lunch with residents of its dementia unit.

“It’s good for the seniors but also good training for us,” Eastman says. “As doctors, we’re pressed for time, but the lunch is time to have fun. Diseases like dementia don’t kill your sense of humor or ability to laugh.”

Miller agrees such interactions break down stigmas about older people. She “spent a lot of time” in the nursing home with her grandfather, who had Alzheimer’s disease; she also experienced her grandmother’s end of life from cancer. “Now aspects of health care are working to improve bedside manner,” she says. “Geriatric care is not to find a cure for every condition, but to improve functionality and quality of life.”

Shah echoes that partnerships like the one DMU enjoys with Wesley Acres are mutually beneficial. DMU faculty, staff and students can learn from the residents while making them feel like part of society. It is part of the University’s commitment to promoting lifelong learning and wellness in the community.

Including seniors socially benefits everyone, the Geriatrics Club members emphasize. Eastman, who helped his mother – in her 70s – relocate to Des Moines when he enrolled at DMU, is ardent about that.

“We seclude our seniors. With the modern family structure, there are people who get left behind,” he says. “But there are important roles for grandparents in families and society.”

A block north of DMU on Ingersoll Avenue, efforts are under way to revitalize the streetscape to help breathe new life into an aging neighborhood and further benefit aging citizens. The enhancements give pedestrians easy access to the diverse mix of restaurants, retail, services and entertainment. Wide sidewalks, curb cuts, new bike lanes and longer crosswalk times not only benefit seniors but also the disabled, bicyclists and mothers pushing strollers.

Infrastructure improvements like this were meant to boost economic development, but they just so happen to be the kind of changes that earned Des Moines its Age-Friendly City status. As other communities across the country look to join the network, another demographic shift could occur: baby boomers spurning the traditional migration south in favor of vibrant cities known for their age-friendly amenities. Places like Portland, New York, Atlanta – and Des Moines.

Jordan Bahnsen is a communications associate in DMU’s marketing and communications office.

“Better to wear out than rust out”

When you ask Michael Eastman and Lindsey Miller why they’re interested in geriatrics, the two DMU osteopathic students describe the older family members who have inspired them. They then point out the wisdom senior citizens have to offer.

“It’s almost selfish,” says Eastman, who with Miller co-presides over the DMU Geriatrics Club. “I want to learn from them so I know how I can stay healthy and enjoy life.”

There are lots of such lessons to be learned from Lee and Clancy Dickson and Mary Anne and Dean Green. The residents of Wesley Acres, the WesleyLife retirement and health care community next door to DMU, embraced aging long before the World Health Organization made “age-friendly” cool. Both couples moved into the facility’s independent living residence when most of their peers wouldn’t dare utter “retirement home.”

“All our friends couldn’t believe we wanted to move into a nursing home,” says Mary Anne. “We loved our house, but we didn’t need all that room anymore.”

The two couples view aging as just another of life’s transitions to be planned yet enjoyed. For them, moving to Wesley Acres isn’t at all about being sedentary shut-ins; rather, it’s being members of a vibrant, active and engaging community.

On Wednesdays, Mary Anne participates in a water aerobics class and then plays the piano in Wesley Acres’ Alzheimer’s unit. She also plays the organ during Sunday chapel and does all the buying for the facility’s gift and coffee shop, the Gather and Gab. Dean often staffs the shop and enjoys fishing with Clancy, who is floor representative on a residents’ forum. Lee chairs the Wesley Acres Council and is in her 15th year of volunteering in hospice. Both couples exercise.

“At some point in your life, you’re not going to be able to do some things,” says Clancy, 90. He and Lee, 86, recently gave their golf clubs to grandchildren. “So you just let it go and do something else.”

Both couples credit good genes for their health. Clancy, for example, played ice hockey in his 70s and softball in his 80s. They have had their physical challenges, however. Last year, Mary Anne had a hip replaced; in 2010, Clancy suffered a stroke on his and Lee’s 55th wedding anniversary. As with so many hardships in life, their positive attitudes helped them cope.

“Clancy has always had a sense of humor,” Lee says. “Even when he was recovering in the health care center, everyone loved him. He’d joke with people and never complain.”

“We have our creaks and groans,” notes Dean, to which Mary Anne adds, “but my mother always said it’s better to wear out than rust out.”

The Greens and Dicksons are great examples of people who understand that “wellness is truly all-encompassing,” says Mary McCarthy, M.P.H., CHES, ACSM. She became Wesley Acres’ first wellness director in 2004; currently, 80 percent of the facility’s residents participate in the program, far above the initially hoped-for 35 percent.

“Wellness is not just about fitness. It’s also your social, emotional, intellectual dimensions,” she says. “It’s mind, body and spirit.”

Participating last fall in a one-mile walk with several DMU and Wesley Acres staff, Lee Dickson noted that having friends of all ages is a plus to healthy aging. Chatting later in her and Clancy’s apartment, she cites another.

“We have a small glass of wine every day at four o’clock,” she says.

Age-friendly shouldn’t be anti-aging

In discussions about healthy aging and effective health care for senior citizens, Christopher Unrein, D.O.’88, FACP, CMD, doesn’t want some critical concepts to get lost: that having a good, long life should include the chance to plan a good death; that age-friendly should include letting people get old; and that, given one’s health circumstances, it can be okay to let go.

“We’re a death-denying, youth-oriented society. In AARP’s magazine, you don’t see anyone who’s elderly,” he says. “We need a social attitude change.”

Unrein’s views are shaped by his diverse practice background, from general internal medicine to geriatrics and now focused on long-term care. Board-certified in internal medicine and in hospice care and palliative medicine, he is executive medical director of Hospice of St. John in Englewood, CO, and director of its hospice and palliative medicine fellowship. President-elect of the Colorado Society of Osteopathic Medicine, he serves on the faculty at Rocky Vista University’s College of Osteopathic Medicine and the University of Colorado-Denver School of Medicine.

“I find caring for the elderly the most rewarding medical practice,” he says. “I emphasize their quality of life. It suits me, as does osteopathic medicine; I call it high-touch, low-tech care. It’s more about managing patients’ symptoms than diagnosing and curing them.”

That approach doesn’t always jive with physicians, Unrein acknowledges – and understands. Practicing in internal medicine in his 30s, he “came from the viewpoint of wanting to fix things and be the shining knight on the white horse.”

“I know people who think going into nursing homes means the physician failed,” he adds.

Palliative care also is “undervalued” by the federal government, Unrein notes. Medicare reimbursement for consultation on advanced care and end-of-life planning came into question during the health care reform debate, when vice presidential candidate Sarah Palin conjured images of government “death panels” that would ration and restrict health care services for Grandma.

“The death panel nonsense torpedoed having these high-quality and frank discussions,” Unrein says. “But palliative and hospice care is more cost-effective than having people do the revolving-door thing in and out of the hospital. Plus it enhances their quality of life.”

Unrein believes the growing numbers of elderly people and attitudes of baby boomers – who believe there are “worse things than dying” – will tip a shift to more end-of-life planning.

“Educating people on having these conversations early is hugely important,” he says. “Knowing a person’s wishes can ease uncertainties of their loved ones, ensure the person is comfortable, help avoid thousands of dollars in medical costs and allow a celebration of the person’s life.”