"Welcome to our cruise ship, without the water."

From the moment I stepped onto the Iris Place campus, just off Epps Bridge Rd., I knew I was in for a different experience. Seated atop a rolling hill overlooking lush woods and private gardens for the residents, it is a type of retirement paradise, the kind of well-kept community that 401k managers have in mind when seeking out shrewd investments.

Iris Place, and its parent company Holiday Retirement (if there were ever a more telling and transparent company name, I have yet to find it), only accept private pay, no long term-care insurance policies, no Medicare and no Medicaid. Just the type of cold-hard cash that people tend to have on hand after years of thoughtful planning and saving. (The company is actually starting to take VA benefits as well, opening the door for customers who in the past haven't had the same access. Side note: this deal was negotiated by a man with the last name Machete, and by all accounts he fought for the acceptance of veteran's benefits with all of the steely resolve that his name implies.)

Ron Smith and his wife Jackie are one set of live-in managers at the facility, and whenever they show the place to someone new, they always like to say, "Welcome to our cruise ship, without the water." Holiday Retirement owns over 370 independent living facilities across the US, and one of the unique amenities offered to Iris Place residents is the ability to travel all over the country and stay for free at any of the other Holiday Retirement facilities.

This mobility is the main sticking point in thinking about independent care. When we tend to think of independent living, we tend to think of spry seniors, engaging in retirement community hijinks, but as Ron Smith pointed out, the definition of “independent” has changed over the past thirty years. Whereas at one point we amy have viewed walkers, oxygen tanks, wheelchairs and even personal caregivers as clear signs that a person was losing their independence, the official policy at Iris Place and for Holiday Retirement nationwide is that each of these things are a tool that enables a person to maintain their own independence.

Though on the one hand this seems to be a very empowering way of talking about aging, it also represents a subtle effort on the part of the company to loosen the rules and keep people living in independent living facilities longer. Iris Place does not have any assisted living facilities, and so once a person loses their independence, they have to move somewhere else, thus causing Iris Glen to lose the minimum $2200 monthly rent the person had been paying.

There is also research that shows that when the elderly maintain their independence, they also maintain a higher quality of life and are more likely to live longer than expected. So we can’t and shouldn’t demonize affluent retirement communities for offering a desired service to people who can afford it, and who show health benefits from it. But we can call into question and make sure that they are still offering the level of care that they claim to offer, and that the residents are as happy, healthy and satisfied as they seem to be.

Reasons to Plan Well

Just over the Oconee County line, down Jennings Mill Road, past office parks and housing developments that look more like country clubs, sits the Highland Hills Retirement Community. With open door policies among all the staff, meals in an exquisite dining room, and a list of activities to make any cruise ship participant jealous, Highland Hills prides itself on the quality of life that they can offer their residents.

“Depression is the number one enemy, and we try to fight that by being involved in the lives of the people who choose to live here,” said Beth Guthrie-Johnston, the sales coordinator for Highland Hills. “About 2/3 of the residents only see there families on holidays, so we try to at least stay aware of what is going on in there lives.”

Highland Hills offers both independent living and assisted care to the elderly. As a person ages, their quality of life can fade as routine chores and tasks become more difficult.

“What I tell people is this: you don’t want to find yourself hurt or drastically ill, all of sudden needing to go to a nursing home where you are dependent on so many other people. If you come out of your normal routine into something so drastic, you’re going to be depressed. Come here, or to a place like this, where you can get used to having people take care of you while you take care of yourself and experience a still normal life. We like to help people make the transition,” Guthrie-Johnston said.

Quality of life is expensive though. Highland Hills costs around $2000 a month, buying the resident food and access to medical care, as well as a very attentive and well-trained staff. To live at Highland Hills, a person needs to maintain a certain level of independence and mobility, though staff at the facility admit that have been making certain concessions.

“It’s warm and it feels like home here, probably because they keep treating you like a person when you move in. They remember your name, they look at you when you talk to them,” said Mr. Hughes, a resident.

St. Mary’s bought Highland Hills seven years ago, but until recently had been hands off on running the facility, and this distance allowed Highland Hills to maintain its community atmosphere, Guthrie-Johnston said. Given the recent economic crunch though, St. Mary’s has been looking for ways to cut costs, turning their attention to Highland Hills, even instituting the first price increase in seven years. As the hospital takes a more active role in running the facility, Gutherie-Johnston said that she and other staff worried that the community will slip away and start to feel much more corporate.

Over twenty residents have full-time outside caretakers, or “sitters.” These sitters allow the residents to maintain a certain level of independence, keeping them out of more intensive assisted-living facilities and nursing homes. St. Mary’s though has decided to look more closely at the residents using sitters and may decide to move these residents if they are declared “not independent enough” to live at Highland Hills. Guthrie-Johnston and other staff members have expressed a displeasure with this change in policy, saying that it will leave too many beds open at the facility and disrupt the valuable sense of community they have achieved.

Community seems to be the key concept, casting Highland Hills as a neighborhood made up of late-lifers who will fight and slyly cajole their way into staying. And for good reason: those who can afford it and have planned for it are all very well taken care of.

If Only Sickness Were Always this Posh

Crossing into Oconee County from Athens, there is a billboard just over the county line. “Hey mom, watch this!,” it reads and in the bottom corner advertises the convenient 24 hour varied-services of Athens Regional Medical Center, for those cute little emergencies that you sometimes can't plan for. The billboard screen then flips to reveal an add for high-end orthodontics. It's almost like the sign marks passage into a land where health-care is both abundant and convenient, where rich parents are paying heftily to keep their children healthy.

Just past the sign, there sits the prime jewel in the St. Mary’s Health Center crown. Perched along the edge of the Epps Bridge Parkway, 10 minutes away from St. Mary’s main campus in Athens, is the new and fairly posh St. Mary’s Outpatient, Rehab and Wellness Center at the exchange. Built in 2007, the facility is capped by a state of the art fitness center on the top floor that shines like a good health beacon through the floor-to-ceiling plate glass windows.

To me, this center is representative of a type of convenience medicine that is less likely to impact your routine and lifestyle. When people have options for their health care, convenience is the key to getting their attention, (and their insurance dollars, I'm assuming) said Marc Ralston, the PR Director for St. Mary’s. At the facility, patients can receive CT scans, MRI’s, mammography, bone density scans and a slate of outpatient services for whatever illness you might have. Ralston said that the center has cut down on traffic to the main hospital by allowing people to receive many of the more time-intensive and long term treatments without having to travel the ten miles to Athens.

My favorite part (and perhaps the most noticeably ostentatious) is the sleep clinic. Ralston said that it features 8 hotel quality beds with “luxurious private bathrooms” and 24 hour monitoring and counseling to help diagnose and treat sleep disorders. If my insurance paid for high-end hotel rooms, I could see myself quickly developing the most complex form of sleep-walking insomniac night-terrors witnessed by medical science.

Assuming there is nothing wrong with you that requires expensive treatments or sleep analysis, but you still crave some professional advice on how to get healthy, you can get a personalized wellness consultation from the fitness and wellness center doctors. They test your metabolism, put you through stress tests, eventually developing a highly specialized diet and workout regiment for the patients.

“I’m really starting to understand how uniquely my body functions,” said Mary Thompson of Watkinsville. “I now know the ways I need to specially care for myself to have the most productive life.”

When I asked Ralston about Oconee’s presence in other counties, he quickly pointed out that they provide home health care and hospice in each of the counties adjacent to Athens, but was also quick to admit that the Outpatient, Rehab and Wellness Center in Oconee County was the only building like it in the hospital system. What he did not say was that the money drew the hospital there, only saying that thanks to the facility, the hospital is more accessible to patients in Oconee and other counties. It has been noted by other DeepSouthHealth bloggers that there is a lack of hospitals and hospital funding in many of Georgia’s rural counties, but here in Oconee County, there is at the very least a place that patients can go to when they do not need long term or emergency care. And when they do get sick, at least patients can see a doctor in both comfort and style.

The Most Popular Yoga Spot in Town

It's a Thursday afternoon at the Oconee County Senior Center in Watkinsville, and the most popular class of the day is just starting to begin. Yoga mats are on the floor as the most popular yoga session in Oconee County is set to begin.

Three years ago, two yoga instructors approached the center interested in offering yoga classes to the elderly of Oconee County. Since then, the beginner and advanced yoga classes have been the most popular offerings at the center, trumping cooking classes and the ballroom dancing classes.

Margaret Farr, a staff member at the Senior Center, says that she has noticed a real difference in people's health since the center added yoga classes. She says that one local resident cured her chronic hip pain after three weeks of regular yoga. Keeping seniors activity has been a challenge for the Oconee County Senior Center, but it seems that yoga has been a bit of a magic bullet. The importance of staying active as you age cannot be overstated, and the national Senior Fitness Association has a list of the benefits of yoga for seniors here, as well a series of poses that are specially tailored for aging bodies.

But aside from the direct physical benefits of regular activity, regular group yoga sessions also offer a much needed community connection. Depression and isolation can target the elderly as they age, especially if they lose connection with their family and friends, Farr said. She also said that when they make connections with those around them more freely, elderly residents take better care of them and show a higher sense of self regard.

It's easy to forget that our psyches as well as our bodies change as we get older, and that we should pay attention and take care of our mental and emotional health as well. After all, if the teachings of yoga are truly correct, then our bodies and psyches are permanently connected, and changes in one truly affect the other.