August 12, 2013
Host: Ted Simons
Beatitudes Dementia Care
- A long-term care community in Arizona is receiving national recognition for its best practices in dementia care. Beatitudes Campus has created replicable ways to decrease drugs prescribed, eliminate physical restraints, stop adult diaper usage and increase the comfort of patients. Arizona Horizon visited the Beatitudes Campus to see the ground-breaking principles in use.
| Keywords: medical
, dementia care
Ted Simons: Beatitudes Campus has created replicable ways to decrease prescribed drugs, eliminate physical restraints and generally keep patients more comfortable. Reporter Lorri Allen and photographer Scot Olson visited to see the principles in use.
Joann: These have been there, we see those every once in a while.
Lori: Joann and Phillip Young married soon after they met.
Phillip: On our first date she laughed at my jokes and she was a good dancer. I figured that's about all I really needed. We've been laughing together and having a great time.
Lori: 60 years later, Phil visits his wife several times a day at a place unlike typical dementia communities.
Joann: Here you are, sweetie. You're going to get your picture, too, aren't you?
Lori: Comfort first is the philosophy, with an emphasis on creating a sense of home.
Tena Alonzo: The home they are asking for may not be reality any longer. But we're looking for those elements that stress the importance of home, those things that connect us to a broader sense of community, and those things that ultimately at the end of the day are the things that give us peace.
Tena Alonzo: All things really boil down to what makes you comfortable. So the individual who has napped in their living room, the person who likes their recliner better than their bed, should still have the opportunity to have those same kinds of patterns that have always made sense to them. It's not my reality that's important, it's not what I say that matters, but it's rather what this person says that really counts.
Yes, that's for you.
Lori: Alonzo calls the fourth floor the neighborhood. And taking away the dietary rules here helped.
One, it's not too fattening.
No, ma'am, it's not.
Tena Alonzo: When people have dementia, it's important to know folks may not have the same kind of clock everyone else has. Being able to eat whenever you're hungry is really important. Being able to sleep whenever you want to is really important. If the person happens to be hungry or thirsty, there's something always available to help them provide a sense of comfort and security.
Tena Alonzo: You want to sit down for a little bit?
Lori: Alonzo is credited with many of the common sense ideas behind comfort first. She'll tell you it's a team effort; like almost everyone she works with Alonzo got into this career because a loved one suffered.
Tena Alonzo: My grandmother was my mentor, and someone that I looked up to more than anyone else in lifetime and when she succumbed to dementia and started to show all the symptoms that we normally see, it was really heartbreaking for my family. But what I learned out of the experience that is there had to be something more, there had to be quality of life. There had to be an opportunity to embrace who she truly was. And so I've been in pursuit of that.
Lori: That pursuit has meant the elimination of restraint, diapers and many drugs.
All right, good.
Lori: Instead of scheduled activities, play is spontaneous.
Dr. Maribeth Gallagher: What we're trying to do is get people to realize that indeed, there's this person inside this, beautiful, beautiful person. And there are so many other ways to make meaningful connection beyond the language of the brain, blah, blah, blah, blah, blah, blah. The language of the heart and soul through touch, through taste, through song, through a kiss, a smile, all of these things. From a change perspective, isn't this feasible? Isn't this easy to replicate? Does it cost a lot of money? No. Where is it taking place, the change? Between our ears and in our hearts.
¶ let me call you sweetheart ¶ ¶ I'm in love with you ¶¶
Dr. Maribeth Gallagher: That was beautiful!
Lori: Gallagher, a professional singer for year,s, has found a new audience. It happened when she started working for Hospice of the Valley and collaborating with the Comfort First program at Beatitudes.
Dr. Maribeth Gallagher: It's the most fulfilling thing that I've ever done in my life, every single day. It's difficult but it's very fulfilling, you know. Think about it, people with dementia lose their ability to think and interpret. So Alzheimer's disease and other forms of dementia are diseases of the brain. But they are not diseases of the heart, the soul, whatever elements of a human being you want to label it.
Karen Mitchell: Everyone can do this. It is changing the way you think about giving the care.
Lori: And the comfort first philosophy saves money.
Karen Mitchell: When you anticipate someone's needs, you don't have to spend the money on products to keep someone dry. You don't have to buy expensive supplements or nourishments because they are eating good food. When you have someone who is comfortable, the staff that you have doesn't have to spend time trying to fix because they are uncomfortable. So the same staffing that we had back 10-15 years ago, is exactly what we have now. We always make sure that we have staff who know how to take care of the person. And so it is very economical. Being able to know that you helped somebody to smile or feel that there was a special moment is priceless. It is the kind of thing that nurtures your own soul.
You know, yeah, I would want to go.
Phillip: This is an intricate type of hanging and tapestry, but we comment every time we go by because it's so pretty. She can forget sometimes day to day but it's so nice again to be able to see something familiar like that, something we appreciate. Joann's had her memory problems, it goes back Eight or ten years really, but it was to the point where we knew we were going to have to have some additional help along the way. And Beatitudes has an outstanding program for that kind of memory support.
Christine Parish: It's kind of funny sometimes, she'll go, okay, she'll say, I know he's messing around with other women. He laughs and gets a chuckle out of it and brings daisy his little dog over, when she tells you I've been with other women, this is the only other woman I've been with. He has his little dog in his arms. They are so loving, you can see it when they are together.
Joann: O you're so cute. Honey I love you.
Phillip: We get by, we know we have to take it one day at a time. There's comfort in that.
Ted Simons: Comfort First considers what some call innovation as simple common sense. It allows residents the flexibility to live in a relatively unstructured manner within a long-term care environment. For more information, check out the Beatitudes website at Beatitudescampus.org
Climate Change Negotiations
- A group of Arizona State University professors and students traveled to the United Nations Framework Convention on Climate Change in Bonn, Germany recently, where the students presented white papers on international climate change negotiations. Daniel Bodansky, an ASU professor of Law, Ethics and Sustainability, and law student Ashley Votruba, will talk about the trip, climate change negotiations and the paper presented by Votruba. She focused on the impact of bottom-up approaches to protecting wetlands internationally and preventing the rapid depletion of plant life and loss of top soil in desert and arid regions.
- Daniel Bodansky - Professor of Law, Ethics and Sustainability, Arizona State University
- Ashley Votruba - Law Student
| Keywords: environment
Ted Simons: A group of professors and students traveled to a U.N. convention on climate change in Bonn, Germany. Here to discuss the trip and the conference is Daniel Bodansky, USA professor of law, ethics and sustainability, and also joining us is Ashley Votruba, one of the ASU law students who presented research at the conference. Good to have you joining us.
Daniel Bodansky: Thank you.
Ted Simons: This is an international U.N. conference. Give us a better idea of what was going on here.
Daniel Bodansky: There was a convention adopted in 1992, a meeting under the U.N. convention. It's a meeting of countries from all around the world to try to develop a new agreement to try to develop --
Ted Simons: That is a framework, that is what that means?
Daniel Bodansky: Now there are various things going on under that to try to push the process forward.
Ted Simons: Is it similar to the Kyoto protocol and those things?
Daniel Bodansky: That was developed under the framework.
Ted Simons: And you guys are over there presenting white papers on a variety of research?
Daniel Bodansky: That's right. The idea of the project is to try to inject some fresh thinking into the climate change process. The process tends to get bogged down and gets very task dependent. It's hard to move from one track to another track. The idea of academia is bringing fresh ideas.
Ted Simons: And your idea is about lands, and arid and semi-arid areas. What did you bring to the conference?
Ashley Votruba: My project is, is there something we can gain from a bottom-up approach. It's one where we can let our states and countries choose their own commitment levels. I choose the convention as examples of conventions that have developed a bottom-up approach, and whether or not those things can be useful and effective.
Ted Simons: What were those approaches and how universal were they?
Ashley Votruba: It's difficult to say how useful they are. Some of the advantages are increased state participation, states are more willing to get involved if they are able to set their own commitment levels. There are funding opportunities that come with adopting those approaches and there are of course downfalls, as well. Difficult to maintain a high level of stringency from a bottom-up approach.
Ted Simons: How did you research that, what did you do?
Ashley Votruba: You do a lot of reading into academic literature published on those institutions. The ransar convention started in the 1970s, so it's older. There are papers written on its effectiveness. There are papers written on the research out of different conventions.
Ted Simons: You're looking at depletion of plant life and preventing depletion?
Ashley Votruba: Desertification convention, yes. That's one of the measures, seeing if there are ways to mitigate desertification from happening and looking to see if it's been successful in certain areas or not.
Ted Simons: Do you look at Arizona or places trying not to become like Arizona?
Ashley Votruba: The goal is to look at places trying not to become like Arizona. There are countries in Africa that have taken measures to move forward in preventing desertification from happening.
Ted Simons: How did ASU become involved in this?
Daniel Bodansky: I worked at the State Department and I have been involved in the process for about years now. We were trying to find something where ASU could make a contribution and give students real-life experience. Papers on the process, rather than just academic purposes. I developed in conjunction with the U.N. climate change secretariat and tried to find something they would think is useful to the negotiations going on right now.
Ted Simons: Sounds like an independent research project.
Daniel Bodansky: That's right, it was. Funded by Lincoln center for applied ethics. The idea was not just to do an academic exercise, but something that's applied and really practical and makes it actually useful to the people involved in the negotiations.
Ted Simons: We heard what Ashley focused on. What were some of the other areas of interest that ASU students participated in?
Daniel Bodansky: Four students all together. One was the human rights treaty system, how that evolved. It hasn't been that successful. Our idea was to look at other systems where it's been more evolutionary, step by step, incremental. That was one of the other ones we looked at. We looked at the intellectual property regime, and we looked at private international law dealing with commercial law aspects.
Ted Simons: I was going to say, trade law, intellectual property law, all of this and climate change, that's some pretty deep weeds there, isn't it?
Daniel Bodansky: We're trying to identify what are some of the key things facing the negotiations. Do they try to develop a single agreement or a series of different agreements. The intellectual property regime is an example of a lot of different treaties. It's been successful, so we're trying to see why that is the case, why it's worked as well as it has, and if there are some lessons we can learn.
Ted Simons: What kind of response did you get from the white papers?
Ashley Votruba: We had people interested in the work and talking to us afterwards. Hopefully some of these ideas will move forward and turn into something.
Ted Simons: How do you know if the ideas have moved forward?
Ashley Votruba: It's difficult to see. We'll look to see if pieces of what we presented will turn up in an agreement in the future.
Ted Simons: Is there a way to track what ASU students presented?
Daniel Bodansky: I think it's difficult to see where the exact influence goes, but you can watch and see whether somebody's ideas can be traced through.
Ted Simons: And as far as the students, what did you want them to take from all this?
Daniel Bodansky: We wanted to try to give them some sense as to how the international process really works, so they would have a better understanding as to really when countries are negotiating, what are they concerned about, how do they interact, so they are not just studying it from afar but they can actually see it in practice.
Ted Simons: And Ashley, what did you take from all this?
Ashley Votruba: Much similar to what he said. The opportunity to see the delegations in action, how it works. See the complexities. It really provided a different perspective.
Ted Simons: Going to change your career plans?
Ashley Votruba: Maybe a little bit, we'll see. It's still a ways away. I certainly have an interest in international law and climate change. If there was a way to weave that into my future I'd be up for it.
Ted Simons: It's kind of a life-changing situation here?
Daniel Bodansky: I think it's really eye-opening to go to one of these meetings and see what it's like in practice.
Ted Simons: Thanks for joining us, we appreciate it.
Drug Sentencing Changes
- U.S. Attorney Eric Holder is proposing changes to lower-level drug charges, aimed at reducing the federal prison population. Former Arizona U.S. Attorney Paul Charlton will discuss the proposed change
- Paul Charlton - Former U.S. Attorney, Arizona
| Keywords: law
Ted Simons: Good evening, and welcome to "Arizona Horizon," I'm Ted Simons. U.S. attorney general Eric Holder today suggests changes to sentences laws for low-level drug cases with the goal of reducing federal prison populations. We will discuss with it former Arizona Attorney General Paul Charlton. Nice to see you.
Paul Charlton: Thank you.
Ted Simons: The idea for lesser sentences for non-violent drug related crimes, your thoughts?
Paul Charlton: What Eric Holder wants to do is reduce the number of people currently incarcerated for the low-level offenses. We have approximately 220,000, people currently in federal prisons, 40% percentage of them for drug related reasons. If you have, for example, five grams of methamphetamine and you're brought into the federal system, you must serve if convicted a minimum of five years in prison. Eric Holder wants to begin to change some of those rules.
Ted Simons: When did that particular mandatory minimum sentencing start, and what has been the impact?
Paul Charlton: From the 80s to the 90s there was a pendulum shift in the way we looked at criminal justice. We wanted to take away the discretion that judges and prosecutors had, and we wanted to force prosecutors and judges to give certain and severe sentences. As a result, we did see a decrease in crime. Now Eric Holder says that cost is about $80 billion too much for the current budget to handle and we need to find a way to be smarter about the federal justice system.
Ted Simons: Too much because of federal crowding?
Paul Charlton: We are at about 40% over our current capacity. It's costing too much and he believes this is one way to reduce the costs and reduce the number of people currently in prison.
Ted Simons: Over half of these people are in federal prison. Is it low-level drug offenses or drug offenses in general?
Paul Charlton: 47% of any kind. Eric Holder wants to find those low-level, nonviolent, not associated with larger criminal gangs and give those individuals the opportunity to receive a sentence less than a mandatory minimum might be.
Ted Simons: How do you figure out these people are supposed to be worth taking the risk? How do you keep them from becoming high-risk second and third offenders?
Paul Charlton: 40% of all offenders released from the federal system reoffend. How do you determine those 40% will not reoffend? If we're picking nonviolent offenders, low-level individuals that they are less likely to reoffend.
Ted Simons: Okay. Is there indication that that is the case? Have we seen studies? Seems like I've heard about studies that showed a lot of times these lower level drug cases, these folks do wind up leading to other problems.
Paul Charlton: A number of people will tell you there is a direct correlation between the number of people in prison and the reduction in the rate of crime. If we let more people out of prison or give them a lower sentence, there is a risk we might see again an increase in the crime rate. The trick is to find a way to release people who won't reoffend, and that is going to be the difficult challenge here.
Ted Simons: Has criminal justice research and studies, have they changed over the decades to where it might be a little easier to say, A, and B, if they are released and put into a treatment program, how much of a factor that is?
Paul Charlton: There are different states that have acted as the laboratory for our democracy. They have had some success in that regard. Texas is one of those states that Eric Holder pointed to today, a state that we, the federal government, should be looking at to determine whether or not releasing individuals into society, keeping them out of prison for longer periods of time, might reduce costs and still keep the communities safe.
Ted Simons: U.S. Attorneys, are they ready for this?
Paul Charlton: I think U.S. Attorneys will largely embrace the opportunity to exercise greater discretion on their own. Any federal or local prosecutors, or any U.S. Attorney, they will say I would like to make the decision myself about whom to charge and what charges to bring. The risk there, Ted, you may see discrepancies between the kinds of charges brought for example on a marijuana case in Tucson and the kinds of charges brought on a marijuana case in Buffalo, New York. Different communities will require different sentences and they will see different charges. That discrepancy is sometimes difficult for people to accept.
Ted Simons: And we're emphasizing, this is the federal prison population, these are federal drug laws as opposed to state laws, correct?
Paul Charlton: Federal prison population is only about 13% of the overall population of prisoners in the United States. So this is a small impact on a small percentage of prisoners. But the Department of Justice has oftentimes taken a leadership role in making these decisions.
Ted Simons: Is the country ready for this? We've discussed, had debates on this program before, and there was a movement in the state legislature to lessen drug sentencing laws, and it didn't get too far. Is the country ready for this, the idea that we can look at different ways to treat people who are only incarcerated for low-level drug crimes?
Paul Charlton: Soft on crime has never been a winning motto for politicians. But there is this. In the Senate right now senator Paul from Kentucky, and Senator Leahy, the senator from Vermont, and others are working on giving judges greater discretion on charges. So there does seem to be an increased appetite among our political leaders on both sides of the aisle for reduced sentences.
Ted Simons: How much will that appetite be impacted by the private prison industry? I would imagine they are looking at this and saying, hey, let's get active here, let's start moving.
Paul Charlton: I don't think there's a bill passed in Congress that doesn't see its share of lobbyists. You're identifying one very much involved in the criminal justice system.
Ted Simons: Incarceration should punish, deter and rehabilitate, not merely convict, warehouse and forget.
Paul Charlton: There are many people, as an old prosecutor, I would say that applies to. There are those it ought not to apply to. There are certain individuals I would be happy to put into prison and forget about, and I'm sure the surviving family members agree, as well. We do need to find a way to reduce costs but keep the community safe. Whether or not Eric Holder has found that correct balance, only time will tell.
Ted Simons: The other thing is we can't incarcerate and prosecute our way to a safer nation. Some would say we already have.
Paul Charlton: It is a safer nation than it was in the 70s. Crime rates are down. Whether it's because we have been prosecuting our way or not, the sociologists will have to tell you.
Ted Simons: Good to see you.
Paul Charlton: Good to see you, Ted.