Category: Optum – Team B

Today’s Gallery Day FaceTime call with Pat Keran from Optum went well. It was helpful for us all to come together and synthesize all of the research we have individually done up to this point and also see what each of the other group members have done. It was also good to get Pat Keran up to speed with what we have been considering for this project. Between this synthesis of information and Pat’s excellent input, we were able to brainstorm some ideas at the end of Gallery Day to figure out what other research we should do and to also get a more focused and narrowed idea of what problem we want to attack. One of the big things that Pat mentioned to us is that we should begin to consider a more diverse population of retirees, as the concerns and issues will be vastly different for people in retirement depending upon their socioeconomic background or cultural roots.

What I considered to be Pat’s best piece of advice for us moving forward, is to be conscious that whatever innovative idea we choose to move forward with is personalized, accessible, and engaging. These seem to be the three most important factors when considering a population who, on average, can be considered a bit more stubborn or stuck in their ways and resistant to technology in many cases.

Moving forward, I think that some important secondary research should involve taking Pat’s advice on learning about the needs of a more diverse population of retirees and analyzing patterns that exist across people of multiple backgrounds. We will also need to continue to narrow down our focus on what end of the retirement spectrum we will want to consider. We made good progress today in agreeing that we think want to focus on the earlier end of the spectrum and that the spectrum we are considering should not include age discrimination. Throughout all of our research and during Gallery Day, we have learned and affirmed that age does not necessarily have any relation or importance for where you appear on the spectrum of retirement.

Ethnography Summary

Mark interviewed his father to gain insight into the life of a firefighter of 26 years who is nearing retirement. His father is on the far low end of the spectrum that we are considering and we hope that we can analyze his lifestyle to get an idea of what people are doing as they near retirement.

Date: 3/4/17

Type: Interview

Location: Facetime Interview

Team participants: Mark Egan

User Characteristics:  “Motivated Do’er“

Male, Aged 49

Position: Battalion Chief FDNY

From: Staten Island, NY

What is this person about – what drives him/her?

Mark’s dad is very family driven and technically savvy, he finds himself being the person who is called by all family members whenever any sort of home improvements are needed. Keeping these skills sharp is something that he takes pride in.

Memorable quote from interview: “I’ve got the curse, but it’s important to know these things.” (When asked about his home improvement and carpentry skills, he responds that he has the curse of knowledge and is hence called upon by everyone imaginable to fix things around the house.)

Top 3 Learnings:

1. Turning skills into hobbies is therapeutic and works the mind, keeping it sharp.
2. Keeping up physical fitness into retirement is important for longevity of the body.
3. Retiring at a young age can lead to many advantages, allowing extra time for many of the healthy practices that we have been seeing are important for retirees.    

Key Insight – There are many ways to keep the mind sharp as we age. Some people obsessively read,

some play games, others practice skills.

ACTIVITIES:

• Running with dog
• Working at firehouse
• Reading newspaper
• Traveling with wife

ENVIRONMENT:

• Home
• Gym
• Firehouse

INTERACTIONS:

• Interacts with family
• Walks dog
• Work relationships

OBJECTS:

• Car
• Firetruck
• Running shoes
• Dog leash

USERS:

• Immediate and extended family
• Friends
• Fellow Firefighters
• Dog
• Neighbors

Conducted Card Sort with Bob Freund to learn about how he likes to spend his free time.

Date: 3/6/17

Location: Morningside Memory Care Center

User: Bob Freund

User Characteristics:

Male, Age 67

Previous Occupation: Heavy Machinery Worker (25 years)

From: South Bend, IN

Topic: Things You Like to Do

1. Television
2. Work
3. Go Outside
4. See Friends
5. Cook
6. See Family
7. Other

Responses:

• “We just watch TV. We Don’t do much of the others”
• “I like to cook (spaghetti, scallions) a lot, but do not do that anymore.”
• “I also enjoy seeing friends”
• “I enjoy getting fresh air, but like fishing outdoors”

• Started when he was much younger
• Had boat up in lake Michigan
• Caught Salmon
  • Can’t remember top for breeds of Salmon
  • Biggest catch, can’t remember exact size

Notes

• User was not very talkative, it was hard for him to point to the cards.
• User also had trouble telling stories as the most important pieces were generally forgotten.
  • Fragments of the story were there, but it was hard to recall details

Did analogous immersion in Pre-K Classroom to see how 4 year olds routine’s/needs fit in with those of retired population.

Date: 3/3/17

Type: Analogous Immersion

Location: Early Childhood Development Center @ Notre Dame

Team Participants: Conducted alone

User Characteristics: “Pre-Kindergarten Students”

Boys & Girls

Ages 4-5

Students

What is this person’s biggest point of pain? There is a balance that the student’s must deal with: learning to be independent, but conforming to societal norms.

“Teachers are trained in Rudolf Dreikurs’ non-authoritarian approach to child guidance based on the work of Alfred Adler, which is a positive approach focusing on choices, encouragement, and natural and logical consequences. Class meetings and the democratic problem solving process are also key to the approach. Teachers teach and model the 4 R’s (respect, responsibility, resourcefulness, and responsiveness). Teachers problem-solve with children during the child guidance process supporting the children’s involvement in making helpful and friendly choices with their behavior. Sessions are provided to interested families about the ECDC approach embracing topics such as sibling rivalry, bedtime routines, mealtime routines, and supporting very active children.”

 Top 3 Learnings:

1. Attention span of 4 year olds is about that of a person with Dementia.
   1. Students need to have nap time or crash otherwise they will be fussy & even yell.
2. Children at this age do not have full command over their bodies yet
   1. Children at this age still need assistance in the bathroom
3. Children are learning what norms are at this point & do not yet know how to interact

Key Insight – (1) Using practices that work to keep the attention of 4 Year Olds could prove potent for later stage retirees. (2) Utilizing child monitoring practices could help retirees have more attention when they need it. For example the teacher individually assisted each student as they went to the bathroom.

Activities:

• Lunch time
  • Seconds
  • Dessert
• Clean Up
• Bathroom
• Playtime
  • Built with blocks
  • Bean Bag Toss
  • Scooters
  • Climbing
• Put stuff away in lockers
• Story Time
• Class Trivia
• Nap Time

Environment:

• Notre Dame
• Early in the day: 12 Noon
• 20 Students
• Class Room Setting
  • Small Tables
  • Mini-Chairs
  • Sitting area
  • Bookshelf
  • Class Pet
• School Environment
  • Admin Desk
  • Many classrooms
  • Lockers
  • Teacher’s Lounge

Interactions:  

• Interacted during meal time with student’s
  • Watched them eat
• Observed use of language
• Watched clean up
• Facilitated play time
• Helped layout cots for sleeping

Objects:

• Wearing Velcro shows
• Play Materials
• Cots with their names on them

Users:

• Teacher
• 4 Year Old Students
• In-Class Helper (Student Volunteer)
• Front-Desk Admin Staff

Interviewed Robin Cooley, Vice President of Affordability, Medicare, Retirement, & Behavioral Solutions @ Optum Health.

Date: 3/3/17

Type: Interview

Location: Phone Call

Team Participants: Conducted interview alone

User Characteristics:  “Mental Health Expert”

Robin Cooley

Female: Middle 60’s

https://www.linkedin.com/in/robin-cooley-99973621/

robin.cooley@optum.com

Memorable Quote from Interview: “Of retired population 10% is over 85. By 2030 30% of population over 65 will be over 85”

Top 3 Learnings:

1. 16% of retired populations is affected by mental illness
2. People will be living with Neurocognitive disorders for much longer than ever before as life expectancies increase.
3. Life coaching for mental illness (Peer one on one)
   1. When retired people feel like they lose their sense of purpose because they cannot work

Key Insight – (1) There are not adequate care facilities in place to combat the “Silver Tsunami” as more of the retired age population will be dealing with mental illness than ever before. (2) Peer to peer coaches helps retiree’s get back into activities they used to do before being retired. This helps renew their sense of meaning.

Users:

• Robin Cooley

Chas Pulido Immersed in a nursing home to see what the day to day of residents in an assisted living home was like.

Date: 3/6/17

Type: Immersion

Location: Morningside Nursing Home

Team Participants: Mark Egan

User Characteristics:  “Residents of Nursing Home”

• Average Age of Residents: around 77 years (60-94)
• All have been diagnosed with Alzheimer’s or Dementia, possibly another co-morbid disease.
• “Resident’s typically come midway way through the disease & leave if need to go to another facility or the disease ends (death).”
• “Attention span of resident’s is about 30 min.”

Assisted Living Duration: Varies largely for Residents

Arrival: Referred by another facility, doctor, or family home (Where primary caregivers have been family)

Memorable Quotes from Interview: “One universal activity for Dementia patients is Music. It tends to trigger memories that are very near & dear to you, makes you think of better times.”

Daily Routine

• Day starts at 8
• Daily Activities
  • No activity is the same from one day to the next
  • Each day is the same every week however. Dementia population thrives on routine, this gives them something to look forward to.
• Dinner is served at 5:30pm
  • Few structured activities after dinner.

***Day is customized to each resident

 Top 3 Learnings:

1. Security of knowing what’s coming next, is important for Dementia Patients
2. Having a group of peers in the home helps make it easier for residents to get along & gives them motivation
3. There are a few key factors regarding to keep in mind when picking out a nursing home: Cleanliness (There will be bool movement accidents, but there is a difference versus urine that has set in), clean faces, clean clothes, look at the nails of the people living there, unkept looks means trends, look at staff working there (everyone is entitled to have a bad day), but people should take joy in what they are doing there.

Key Insight – (1) A reason to live is the most important thing. Residents need motivation & tangible things to hold onto. (2) Family members/stakeholders need to keep in mind key factors when selecting a nursing home, this has a lot to do with the person’s longevity.

Activities:

• Examples offered in Nursing Home
  • Gardening
  • Family Visits & Children
  • Entertainment: Guests come in & perform
  • Animals as pets
• Daily Routine
  • Wake Up: 8am
  • Breakfast Served: 8am
  • Daily Activities Time
    • See above
  • Dinner Served: 5:30pm
  • Un-structured Activities
  • Bed Time: Varies from resident to resident 7-9pm

Environment

• Morningside Nursing Home
• Toured facility
  • Bedrooms
  • Admin Office
  • Front Desk
  • Welcome Area
• Mid-Afternoon: 2-3:30pm
• Located in small forest in Suburbs of South Bend
• Houses around ~50 residents

Interactions:  

• Our Activities
  • Parked in Parking Lot
  • Entered through double passcode protected doors
  • Sat in Welcome Area
  • Interviewed Executive Director
  • Saw bedrooms of residents
  • Conducted Card Sort in Welcome Area with Bob & Ronald
  • Interviewed Bob & Ronald
  • Left Facility

 Objects:

• Board Games
• Television Set
• Tables, Chairs, & Couches
• Jugs of water & other drinks

Users:

• Patients
• Nursing Staff
• Administrators
• Loved Ones
• Guest Visitors

Interviewed, Veteran, Ronald Lee Cannon who is in the higher extreme of the retired age population.

Date: 3/6/17

Type: Interview

Location: Morningside Nursing Facility

Team participants: Conducted interview alone

User Characteristics: “Member of Assisted Living Facility”

• Male: Age 77
• Korean War Veteran: Served in the Army for 4 years
• Retired Electrician, repaired TV’s
• Been retired 12 years
• Married 20 years, divorced 2003
• 3 Kids (2 Daughters, 1 Son) & 7 Grand Kids

What is this person about – what drives him? Ronald is driven by stating active, he likes tinkering with things and even though he is retired he is the TV maintenance guy at the nursing home (the same thing he used to do before he retired).

What is this person’s biggest point of pain? Ronald’s biggest pain point is memory, he has an early form of dementia. It is tough for him to remember specific timeframes & do mental math. When ask how long he has been retired he said “I am 77 & retired at 65 so what is that about 20 years?”

Memorable Quote from Interview: “I like being active & having a routine. I look forward to the little things.”

 Top 3 Learnings:

1. Routines & daily activities are customized to each resident, dementia effects everyone differently so all events are tailored.
2. While daily activities may vary, weekly routines are generally the same
3. Cleanliness & staff were big reasons why Ronald likes Morningside

Key Insight – (1) Having weekly routines be the same gives residents things to look forward to, no matter how small, this gives them a reason to carry on. (2) Ronald was still fairly-capable even after being in assisted living for 7 years, this is perhaps because many of the activities he used before retirement are replicated in his day to day routine at the nursing home.

Activities:

• Used to play Baseball & Garden
• Favorite Activities: Hanging out with Friend’s, Watching TV, & Jigsaw Puzzles
• Routine
  • Wake up 6am
  • Breakfast
  • Watch TV till dinner time (Watch NCIS: Mark Harmon, NCIS LA)
  • Goes to bed shortly after dinner at ends (7pm-8pm)
• Likes writing jokes & poems

Environment:

• Morningside Nursing Home Facility (Been there 3 months)
  • Had prior been at Signature Healthcare assisted living for 7 years
• Daughter also works in the home (Head of Nursing)
• Mid-afternoon
• In welcome area of nursing home

Interactions: 

• Had shaking hands, but a firm hand shake
• Noted that he liked Morningside, while he has been there

Objects:

• Sitting in Wheel Chair
• Wearing his favorite team, The Chicago Cub’s, World Series Championship T-Shirt
• Snicker’s Bar
  • During the interview one of the nurses brought Ronald his daily treat
  • This is something that he looks forward to

Users:

• Ronald Lee Cannon

Interviewed, Father, Mark Pulido who is in the lower extreme of the retired age population.

Date: 3/5/17

Type: Interview

Location: Phone Call

Team Participants: Conducted interview alone

User Characteristics: “Active Member of Retired Age Populations”

• Male: Age 65
• Full-Time CEO
• Married 30+ Years
• 1 Child: Father of Chas Pulido

What is this person about – what drives him? Mark is driven by doing. He gets a strong sense of being from helping his close family & others accomplish their goals. At 65 he enjoys mental stimulation that work brings him. Having day to day challenges gives him optimism & keeps him young as he says.

What is this person’s biggest point of pain?  Mark needs to be stimulated by work or something interesting. He does not like feeling idle.

Memorable Quote from Interview: “You need your mind to be sharp in-order to keep your body sharp”

Top 3 Learnings:

1. Mark has a of sources of responsibility & avenues in which he derives meaning.
2. Mark has made very few changes in routine & diet between ages 40 & 65. He has not had any changes in health.
   1. Only thing Mark has done differently is be more grounded. He has focuses on sticking to decisions/discipline
3. Mark visits the doctor only once every 3 years or so and despite this is in a great health condition

Key Insight – (1) When asked how he would change his routine over the next ten years he said “I don’t think I would, I really enjoy it!” “It’s pushing me forward everyday” (2) Having a lot of reasons to live, in other words, responsibilities & close family help keep person in check & accountable.

Activities:

• Daily Habits
  • Self awareness: Pacing
  • Good sleep routine
  • Healthier eating
  • Walking
    • 1 hour of walking (4miles) 5 days of week
  • Stretching
    • Stiff joints sitting for too long
  • Get up every morning at 5:45 or 6am
    • 1 hour after getting up solitude & reflection

Environment

• Minneapolis, MN

Users:

• Mark Pulido

Extra Notes

• Family Life
  • Being with people that you love & enjoy, gives you inner strength
  • Gives you perspective, lets you think of what’s possible
  • Having close family/loved ones makes me want to carry on
• Work Life
  • Constant stimulation is needed for your mind to learn & grow
  • You need your mind to be sharp in order to keep your body sharp
  • Pursing activities helps this
  • Optimism of having challenges

• Goals
  • Be healthy & active
  • Answer lies within
    • Money, success, etc. is not a metric
  • Wants to travel internationally
  • Enjoys working as a CEO
  • Wants family to achieve their goals
  • Being apart of others dreams

Date: March 4, 2017

Type: In person expert interview

Location: Wood Ridge Assisted Living

Team Participant: Nicholas and Connor

Interview Audio File: https://drive.google.com/open?id=0B5skxyf9hGZBVEVRRU94WDF4UUk

Interview Transcript: https://drive.google.com/open?id=0B-SBU6BZXoGmc1BnVGUzV1ZyMU0

 Nicholas and Connor interviewed Matthew, one of Wood Ridge Assisted Living’s Certified Nursing Assistants (CNA). The marketing director handpicked this employee who works only on Mondays and Wednesdays. He has been in the caregiving business for over 20 years, pointing to his expertise.

Characteristics:

• Age: 46
• Gender: Male
• Marital Status: Unknown
• Occupation: Certified Nursing Assistant
• Lived in Chicago, IL
• Has been a CNA for over 20 years

Memorable Quotes:

“Making somebody’s day believe it or not. Sitting down with the resident and letting them share a story, make their bed, little simple stuff. Makes me happy when they say they really appreciate it.”

“Not just here, but every place I’ve worked the residents have had issues with the way things were managed. Administrative issues. They want to see stuff changed and who is in authority.”

“Stay active. That’s the number one. My mother just turned 84 and she is still a full time employee. What happens when you retire you are just sitting around the house not using your mind a lot and eating without proper exercise. Whatever condition you have does not get better with just sitting around. Even if you retire you should volunteer and do activities.”

Key Insights:

• Individuals want to stay in the home as long as possible
• Knowing the individual well is paramount
• Staying active, including the little things in life, will extend the length of time in your home
• Older people do not want to be told to do things, even if it is for their health’s sake.
• Retirees need to keep being social in order to not feel lonely, which contributes to mental health disorders and the deterioration of health.

Emerging Patterns:

Retirees need to stay active both mentally and physically in order to maintain their overall wellbeing. Seniors do not want to be told what to do and would rather live in their homes for as long as possible. Critical events such as diagnoses of serious mental health issues usually force people out of their homes. However, the caregivers seemed to want to continue working even after typical retirement ages in order to keep themselves sharp.