LTC Bullet: Eldertopia

Thursday, January 23, 2003


LTC Comment: Remember the moving special ". . . And Thou Shalt Honor" which aired last October on PBS? Find out what's coming next, after the ***news***.

*** This Bullet is sponsored by the National LTC Network, "Partners in Long-Term Care Insurance Coverage, Design, Education and Distribution." Visit the Network online at . Contact Allen Mansfield, Executive Director, at 800-996-6789 or for more information. Thanks so much to Network members for their generous support of the Center. Won't you help too? Go to to sponsor an LTC Bullet. Find out how you can sponsor other Center activities (e.g., articles, speeches, conference exhibits) by contacting Amy Marohn at 425-377-9500 or .***

*** Latest donor-only zone content:

The LTC Reader #3-002--How Adult Children Can Help Parents Avoid Nursing Homes

If you already qualify for The Zone, you can click the following link, enter your user name and password, and go directly to the latest donor zone content and the archives: . To Zone In, mail your tax-deductible contribution of $150 or more to the Center for Long-Term Care Financing, 2212 Queen Anne Avenue North, #110, Seattle, WA 98109. Then email your preferred user name and password (up to 10 characters each). You can also contribute online by credit card or direct withdrawal at . ***

*** The Center for Long-Term Care Financing receives frequent information requests regarding Medicaid financing of long-term care, especially questions about eligibility criteria. Therefore, we want to alert readers to the following new, and very comprehensive resource. If you really want to understand why jurists have called Medicaid eligibility a "Serbonian bog," "a morass of bureaucratic complexity," and "a Byzantine construction making it almost unintelligible to the uninitiated," then read this Kaiser Foundation book.

"Medicaid is the primary source of health and long-term care assistance for one in seven Americans, accounting for 16 percent of our nation's spending on health care. The 44 million Americans served by Medicaid include many children and families, individuals with disabilities, and the elderly. The program is the primary source of federal financial assistance to the states, and represents a major shared state and federal commitment to improving the lives and the health of America's low-income populations. To assist the public and policymakers in understanding the structure and operation of the Medicaid program, the Kaiser Commission on Medicaid and the Uninsured (Commission) is releasing, The Medicaid Resource Book (Pub#2236) prepared by Andy Schneider and staff members of the Commission."

The following quote from the Kaiser book makes the same point we often emphasize, i.e. that eligibility for Medicaid nursing home benefits does not require poverty-level income, but rather only a "cash flow" problem: "Under the 'medically needy' pathway, there is no upper limit on the amount of monthly income an individual can receive and still qualify for Medicaid coverage. So long as the individual's incurred medical expenses are sufficiently high to reduce the individual's income to the state 'medically needy' income standard during the budget period, the individual will qualify for Medicaid. In states with 'medically needy' coverage, many individuals in nursing homes qualify this way." (Chapter 1: Medicaid Eligibility, page 28, .) In states with "income cap" eligibility systems, "Miller income trusts" permit people with income far above the "cap" to qualify for Medicaid nursing home benefits. Therefore, income is rarely an obstacle to qualifying for Medicaid nursing home benefits. Assets of course are unlimited as long as they are held in exempt form, such as a home, business, car, etc. ***


LTC Comment: We previewed and reviewed the PBS special ". . . And Thou Shalt Honor" (ATSH) in an LTC Bullet last September: . The show received excellent reviews after it aired October 9, 2002. You can view clips online at . Now, the same production company that did ATSH is developing a new 4-hour PBS series to be titled "Eldertopia: The Ascent of the Elder or Old Age: Humankind's Most Powerful Invention." The producers asked us to help spread the word about this project. What follows are excerpts from their description of the program and their request for corporate financial support for the project. We think this is a fascinating inside peek at how major public television specials come to be. For more information, contact Dale Bell, Executive Producer, Wiland-Bell Productions, 310-202-3370 (tel),, . To learn more about Dr. Bill Thomas and the "Eden Alternative," go to (This is not an ad. We provide this information as a service to readers without remuneration to the Center.)


Presented by Bill Thomas, MD, Founder, The EDEN Alternative

A Four-Hour PBS Series, that provides a fresh, personal and incisive view of the way old age has shaped cultures and societies, past and present, and can shape our future.

With Web site, Outreach, Promotion, PBS Companion Book & DVD, and many other Educational Components.

Executive Summary:

Mission: As we become a society with more parents to care for than children, we seek to present a personal vision, based in part on our collective pasts, of how our global family might and can adapt to face our future as elders begin their domination of our population. This is a surprising, revealing and ennobling journey across civilizations and time as we revisit and discover the stories of humankind, past, present and future. Join this exploration.

Length: Four hours

Locations: Six Continents

Host/Guide: Bill Thomas, MD, Founder of the Eden Alternative

Broadcast Venues: PBS and other international broadcasters

Completion Date: 2005

Research and Development Phase: 6 months from first phase funding

Funds Needed for Development: $383,224.

Management Team: Wiland-Bell Productions and other Contractors responsible for And Thou Shalt Honor...

Fiscal Agent: Thou Shalt Honor Foundation, a 501c3, a not-for-profit corporation

Presenting Station: Oregon Public Broadcasting


Today, though global cultures lionize youth, we still grow old. In the next twenty years, the number of people over 65 will double. In the U.S. and in other industrialized societies around the world, the fastest growing population is the over-85 group. Will this age boom lead to a financial and social catastrophe? Can industrial societies find the virtues hidden in the necessity of growing old? Why, many ask, do we have to age at all?

Aging is complex, fascinating, and inevitable. The aged are revered while old age is reviled. The aged have much to teach us but the culture of youth is often blind to that wisdom. Old age is in the midst of an unprecedented triumph of numbers and influence but we call this a crisis and worry that they will bankrupt us.

Can we create a new elderhood that fits life in a new century? As Secretary General of the United Nations Kofi Annan observes, "Global aging is a potential pool of untapped resources that societies must learn to use in a productive manner."

The Baby Boom generation has re-shaped society for more than five decades--how will they transform old age? We think there is something new and exciting to be said about old age--no longer a stagnant backwater, it is going to become society's most innovative arena. The population group that grows most rapidly has the greatest influence on the social fabric. We are entering a period in which age and aging can experience a vibrant period of growth.

Dr. Bill Thomas--founder of the fiercely-innovative Eden Alternative concept that seeks to transform how elders are regarded--will escort a global television audience through an exploration and discovery of the role age--and the wisdom of elders--have played in societies past, present and future. He will go to places where the home is central to life; he will reveal how people grow, learn, and teach each other; his mirror of life will reflect even into the darkest places. This series will revisit the seemingly familiar with a strikingly fresh perspective and exciting insights that can come only from a rethinking old age.

In a four-hour PBS series (to be co-produced and/or distributed internationally), supported by nationwide-and global-community-based outreach and publicity/promotion campaign, interactive website, educational curricula for K through college, companion book, DVD and other ancillary publishing components, coordinated and marketed like our PBS "Program of Note," And Thou Shalt Honor..., Bill will guide this historic journey. Across all continents, peoples, cultures, and time, from the industrialized western world into our collective future, Dr. Thomas asks the very contemporary and urgent question: What Is Old Age For? . . .

Our locations--some the most "sacred sites" on the planet--will begin at the Great Barrier Reef where aging can be viewed in an evolutionary context. We will unearth some of the early civilizations of Sumer, Egypt, China, Tiahuanaco, Easter Island, Machu Pichu, Greece and Rome to discover what they have to teach us about old age. We will look down the cliffs where Vikings routinely disposed of their elders, or ride on an ice floe in the Alaskan tundra, or hike to the foot of the mountains where the Japanese left their elders. We will travel to Middle East and to Europe, chronicling the role of the elder as sage. We will visit the ancient Chuckee of Siberia who horrendously mistreated their elders as well as with the !Kung society that reveres its elders. . . .



While broadcast and print media outlets have lavished attention on the numerical outline of the coming age boom, old age itself remains mired in prejudice and misunderstanding. Indeed, little has changed in the popular mind since Shakespeare lamented an old age "sans hair, sans teeth, sans everything." The failure to strip away such bias and explore the roots of old age, where it comes from, what it has done for us and what it can accomplish in the future has resulted in misguided public policy and tremendous personal suffering. There are few social issues more in need of careful reconsideration.

Program One: The Origin of Old Age

This section begins with the origin of life on earth. The familiar story of early life and its evolution into more complex forms will be reinterpreted in terms of the creation and development of old age. We will visit places on earth where there is a profusion of life forms that reveal a wide range of approaches to aging. It will then go on to examine how the human species has made particularly clever use of old age. . . .

Program Two: The History of Old Age

This program looks at human culture throughout the history of people and how old age has manifested itself. The blurred social idea is that "back then" the aged were treated with respect. That is only partly true and the whole truth is much more interesting. Old age has always existed in tension with the power of vigorous adults. The existence of commandments that the aged must be respected should be seen as evidence of the difficulty of maintaining elderhood over the span of many generations. . . .

Program Three: Old Age Triumph and Tragedy

This section is a statement of the state of old age in contemporary society. We will use the ideas and insights from the previous programs to re-look at old age with new eyes. The duality of old age is seen to be present in full measure today. Bill will argue that social progress and improvement is contingent on reevaluating our approach to old age. Bill will explore contemporary ageism in part by talking to movie and costume experts in the movie industry. They can make someone look old (an on camera make over) and explain the assumptions that underlie their techniques. This is a way of revealing the unspoken assumptions about what old age is and how it appears to us.

Program Four: The Future of Old Age

The good news here is that an innovation as powerful and influential as old age will be very hard to extinguish. In fact, we may well be entering into a golden age of elderhood (something very different from the Golden Years). Contemporary society needs to recalibrate its relationship between young and old not because it would be more just for our elders (although that is true) but because such a recalibration can lead to a better and more just life for people of all ages. I have coined the word "Eldertopia" to describe a society based on a new understanding of old age and its place in the human life cycle and in society.

Eldertopia / el-der-to-pe-?/ (n) A community that improves the quality of life for people of all ages by: (1) acknowledging that elders represent a vast and underused natural resource (2) balancing and strengthening the means by which elders give to and receive from their community. . . .



Once funding has been secured for the initial R&D, we will require six months to set up the team, conduct the first research, travel to the proposed locations, interview the principal participants, and write the shooting outlines for the four hours. As we go, we will video Bill Thomas at some of the sites and take a number of stills, all of which will later become part of the proposal.

From this effort, we will produce a marketable and comprehensive proposal that will be used to obtain all further monies for the television and other components of the project. A preliminary web site will be constructed; outreach campaign, educational curricula, assessment and evaluation study, international co-production arrangements will all be designed and implemented.

Once complete funding has been obtained for these activities, we will require an additional 20 months to complete production and post production of the four hours.

We will then allow six months from the proposed post-production completion date until the broadcast date for the publicity, promotion, and outreach campaigns to roll out.

The companion book will be published and be in stores at least one month before broadcast date.

If we receive an uninterrupted "Go" on all funding, the entire project will require about 28-32 months from beginning to broadcast date.


Our six month budget for R&D will be $383,224. It is available for review.

Our budget for each hour, including web site production, outreach and promotion/publicity, assessment and evaluation, and the creation of the various ancillary products (VHS, DVD, educational curricula) will be about $1.6 million each. . . .