AgeSong Launches “The Guru Project”

AgeSong announces an initiative aimed at learning from elders called
“The Guru Project” The Guru Project logo

San Francisco, CA – February 11, 2015 – AgeSong, the San Francisco Bay Area’s leading lifestyle communities for elderly care, announced today a partnership with three of the industry’s leading experts in the care for elders to launch a new initiative called “The Guru Project”. This partnership is focused on minimizing the use of medication in geriatric mental health care.

“I am honored to have the opportunity to partner with three of the industry’s leading experts in the area of mental health to thoroughly explore the approach of care for those who are in various stages of forgetfulness, what is commonly diagnosed as Alzheimers and/or Dementia, with reduced use of medications,” AgeSong CEO and founder, Dr. Nader Shabahangi said.  “The AgeSong Guru Project will focus on learning directly from elders who are living with the changes brought on by forgetfulness (Alzheimers/Dementia).  Much of the industry resources focus on “instant gratification” medications that often restrict the life of the person, whose lifestyle is shifting due to mental and physical changes.  This project is solely based on what elders verbal and non-verbal communication is trying to tell us. We will look at any behavior as an expression of need we, the observers and care partners, must explore and understand more deeply.”

The AgeSong Guru Project is a one-year initiative that will focus on comprehensive care partnerships with elders to understand need-driven behaviors and minimize risky use of psychotropic medication.  To complete this project AgeSong has engaged in a partnership with Psychiatrist and Pacific Institute board member Dr. Richard Patel; Geriatrician, Dr. Allen Power; and Psychologist, Dr. Richard Taylor.

“As people progress with Alzheimer’s/Dementia, their humanity increases. As care takers, we must be prepared for that humanity as it is ‘unleashed’,” said Dr. Richard Taylor.  “Having been diagnosed with Dementia over ten years ago, I am delighted to support one of AgeSong’s key core value’s with this project, enabling elders to live a balanced and uninhibited life.  I am looking forward to witnessing our results being implemented within an organization that is changing the way eldercare is approached.”

Lectures and workshops are open to the public. To register for an upcoming event associated with the Guru Project, click here. If you would like to be informed about future educational resources and events, please click here to join our mailing list.

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AgeSong’s Guru Project Turns Tables on Long Term Care

Reprinted form California Health Report:

Not Crazy, Not Bad: The Aging Gurus of Mental Health

By Matt Perry

A visit to most long-term care facilities – a nursing home or assisted living facility – quickly reveals who wields the sword of control. Managers dispense orders to staff. Then able-bodied caregivers roam floors full of seniors compromised in either mind or body.

And frail residents dutifully follow the house rules.

Yet AgeSong assisted living – which has long considered older adults its revered elders – is taking another step in the fight for culture change inside the worlds of aging and mental health by introducing its Guru Project.

And it turns the tables on long-term care.

“Those residents who are the most difficult and challenging are our gurus,” says founder and CEO Nader Shabahangi, who oversees AgeSong’s four San Francisco facilities.

As a psychotherapist steeped in humanistic studies, Shabahangi has long insisted on the need for drastic new approaches within behavioral health and senior living.

Long-term care facilities, especially those populated by adults with dementia, often house residents who are strident, fearful, even combative; they may hit, yell, and throw either objects or tantrums.

The Guru Project deepens AgeSong’s core philosophy by helping staff uncover the root cause of so-called “bad behavior” – whether it’s physical, psychological or environmental.

Behavioral health staff focus on a humanistic approach rather than repair –which often means simply being present and listening.

“There’s no ‘fixing’ anyone here,” says Stephanie Rothman, AgeSong’s Guru Project liaison.

“Instead of doing ‘to’ you, we’re doing ‘with’ you,” adds executive director Janna O’Sullivan.

Suffering from Alzheimer’s disease, Carol Finkelstein’s father Ted was considered a troublesome and combative resident at his east Bay facility. He stole floor keys, wandered throughout the facility, pulled fire alarms, and barricaded himself in an elevator. He even admittedly touched a female resident’s breast.

“He was acting out because more and more restraints were being put on him,” sighs Finkelstein. “They didn’t have the ability to work with him.”

Supervisors called Finkelstein endlessly with this demand: “You need to do something about your father’s behavior.”

After moving him to AgeSong, Finkelstein was shocked by the facility’s silence, so she placed a phone call.

“Isn’t my father causing problems?” she asked.

“Of course he’s causing problems,” replied an AgeSong manager. “But they’re not his problem. Or your problem. They’re our problems to figure out.”

Shabahangi says AgeSong staff – not residents – shoulder this basic responsibility: “Constantly pay attention to the meaning behind a behavioral expression.”

“They never tell me there are issues because they don’t see them as issues,” explains Finkelstein. “It’s an attitude that’s just fantastic.”

There are several reasons for such behavior.

Residents may be frustrated at a loss of freedom. Perhaps the facility activities are boring. Maybe staff members aren’t paying attention to a resident. Or there’s not enough time spent in nature. It could be that a diaper needs to be changed, or hair combed. The root cause may be a deeper emotional issue – loneliness, or the loss of a loved one.

Guiding The Guru Project is a large multidisciplinary team that meets weekly to produce an Active Care Plan for each resident: executives, clinical directors, nurses, and both pre- and post-doctoral psychology interns. Also attending are Engagement and Education team members, along with staff who guide spiritual development. Finally – and perhaps most importantly – front line caregivers are involved, what AgeSong calls its “care partners.”

In fact, it’s these very care partners – who groom, toilet, and transport residents — who are frequently the centerpiece of The Guru Project.

“They don’t spend a lot of time learning about psychology and the dynamics of behavioral health,” says Rothman. But by interacting with the team of clinicians and staff – and attending the Guru Academy for an hour each week – they receive a crash course in psychology and mental health that will ease difficult interactions.

Consultants are also made available for more individualized training. And those residents on antipsychotic drugs will be enrolled in the Guru Registry to help prevent overuse.

Critical to AgeSong’s success is the education of psychology interns drawn from surrounding Bay Area schools trained in an existential-humanistic therapeutic approach and form the backbone of AgeSong’s behavioral health team.

Residents are typically visited weekly by a behavioral health professional.

Rothman says The Guru Project standardizes what already exists at AgeSong: “Having a plan written down that is implemented, checked off and assessed.”

Shabahangi has long infused his therapeutic work with a humanistic spin. In 1992, he founded the Pacific Institute to train psychotherapists inside a more humane, less prescriptive model. Two years later, after seeing the dismissive treatment of the elderly, he launched a Gerontological Wellness Program.

He eventually fused his compassionate counseling model with residential care, and today oversees AgeSong’s 200-plus residents.

Last fall’s keynote speaker at a California Elder Mental Health and Aging Coalition meeting, Shabahangi has noticed a shocking failure in behavioral health treatment: mental health professionals are now being infected by the same cookie-cutter approach common to physical health.

“It’s mindless, unsophisticated, almost a mathematical model,” says Shabahangi. “Therapists are becoming more like car mechanics.”

Rothman says the ability for residents to communicate extends far beyond verbal skills, and that the most potent connection comes through the eyes. Often, she says, residents don’t know her name or her occupation but know her as a friend.

“Everyone’s aware on a different level,” says Rothman.

At AgeSong, Shabahangi does weekly group supervision with his interns and asks them this simple question.

“Who is the client who irritates you most?”

Then he offers them an assignment in role reversals.

“Be that client, be that elder,” he tells them. “Think what’s it’s like to be in their shoes.”

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Read more stories about the AgeSong Guru Project


Dr. Al Power Presents New Way To Think About Dementia

by Howard Glickman, Contributor,

Just about everything you think you know about Alzheimer’s disease and other dementias is wrong. And because the conventional wisdom is so off-track, so are the ways we—both family members and professionals—respond to those with dementia.

That’s Dr. G. Allen Power’s provocative message. He wants us to stop thinking that people with dementia are victims of a terrible debilitating disease that destroys their memory and perception. Instead, Power argues, dementia is “a shift in the way a person experiences the world.”

View entire article:

Happiness – A Report from the Slow Lane

Screen Shot 2014-09-24 at 4.54.24 PMI learned about something recently that has given me so much delight, and so much challenge, that I just had to share the prospect of it with you. As you may recall I’ve been blessed this year to be part of an elder’s group, awareness of the viability of real happiness first came to me there. I feel such gratitude toward those who I am traveling with right now, because they (the elders) helped me to see something I had long ago forgotten could exist for me.  Here is how it happened, and what it has constellated for me.

One evening, during a meeting of the elder’s circle, as we were going around saying our names, and describing something we liked about becoming older, I was struck by the impression that I was surrounded by a lot of people who had become themselves. This impression intrigued me. Later, we broke into small groups, where the impression grew into a full-blown, mind-altering, realization. Growing older had meant, for some of us, that we had arrived, despite still having further to go, at a time and place in our lives, where there were no roles, rules, or expectations, other than our own. We were free, and many of us had become idiosyncratically and uniquely our selves.

A rush of happiness came cascading in. I was surrounded by people who had become them selves. I was one of them; free to be authentic, different, uncertain, sensitive, foolish, erotic, crazy, and just plain me. At that moment I liked what getting old had done for me. Of course, I learned later that much of what distinguishes an elder from a merely old person had to do with how one responded to the hardships and losses of a long life. Freedom, and true elderhood, seemed to rest on choices that people made at the most difficult times in their lives. And miraculously, it seemed as if the best choices, the most effective decisions, had all been toward becoming truer to one’s self. In the midst of this group of self-possessed elders I discovered that happiness, my happiness, lay with cleaving to my own being.

That wasn’t all the joy I was to discover that night. I was delighted and surprised by what came next. I hadn’t even gotten used to the idea that my life-long struggle, to be me, had actually resulted in my becoming someone, myself, when it became clear that just being myself made a difference. One of the remarkable things that distinguished this group of people is that they want to give something back. There has been much talk in this group, perhaps spurred on by radicalism, of an elder insurgency.  The urge to provide some kind of alternative, met with the realization that becoming our selves was a radical, even subversive, thing, and an unbelievable joyous surprise was born. Merely being true to one’s self changed the world!

During that meeting, without ever intending it, I was brought to the realization that happiness existed, and could be a regular feature of my life. All I had to do, to be generally happy, was be my self. If I merely held onto my self in my relationships, if I stayed true to what emerged in me, as me, then I would be free. Happiness and freedom became synonymous.

In the weeks that have followed that realization, I have been reflecting upon happiness, and the limited role I have let it play in my life. I have discovered that I keep myself from being as happy as I could be, by letting my anxiety take me out of the moment. I have always been good at anticipating things, I liked to think I had the skill of a chess champion, looking ahead several moves. Instead, what I have realized, is best captured in the words of a friend of mine, who once wrote in a letter, that “anticipatory anxiety” was “the constipation” that “kept all the good shit from happening;” how true, and how unfortunate, for me.

With the experience in the elder’s circle, and with this writing, I realize that I have made happiness highly conditional. My happiness has always been a product of my circumstances, instead of myself. By holding on to my anxious response to each and every coming moment, I have trapped myself in a non-existent and totally fabricated future, which would determine my well-being. I kept looking forward because happiness existed out there, instead of in here, where I am.

I realize that circumstances don’t have to determine my happiness. I don’t have to attend to the future. That is a choice; it is a reflection of where I want to place my attention. I could be happy as a day-to-day attitude. I could choose to focus my attention on my marvelous ability to respond creatively to each moment. I have been granted the gift of not being a machine, with a pre-determined range of choices, I get to meet each moment naked. This freedom scares me. It seems like too much. I could easily fall or fail. I do all the time! But, I know that this is the way to learn to fly. And, I am happy discovering that this too is part of the potential that has been granted to me by Life.

It turns out that I can be happy. I am alive, and I have been prepared for just this much choicefulness. I may be disabled, brain-damaged and egotistical, but I still get to have enough choice about how I relate to things that I can be happy. And, you know the strangest, and best, part of it all, is that I just have to be me, to be happy.

Knowing I can fly isn’t the same as flying, but it is enough to render me happier. Knowing that flying, that being my self, is a service to the world, that makes me feel something else………. a grateful awe.


About the Author


David “Lucky” Goff, Ph.D., M.F.T., had a brain aneurism in 2003. As a result of his stroke, and the onset of a rare brain syndrome, he nearly died and ended up permanently disabled. This experience had a transformational effect on David, which made him “Lucky,” and cued him into how radically connected all things are. This broader awareness now informs his approach toward what it means to be human. He writes extensively about a psychology of interdependence, community, elders and the conditions that lead to a social and ecological sense of connection. To contact the author please proceed to the linked websites.


The book, Embracing Life,


A 97 year old doctor gives advice for a long and healthy life





Advice From a 101 Old Doctor
Dr. Shigeaki Hinohara, Japan, turned 101 last year.

As a 97 year old Doctor, he was interviewed, and gave his advice for a long and healthy life.

Shigeaki Hinohara is one of the world’s longest-serving physicians and educators. Hinohara’s magic touch is legendary: Since 1941 he has been healing patients at St. Luke’s International Hospital in Tokyo and teaching at St. Luke’s College of Nursing.

He has published around 15 books since his 75th birthday, including one “Living Long, Living Good” that has sold more than 1.2 million copies. As the founder of the New Elderly Movement, Hinohara encourages others to live a long and happy life, a quest in which no role model is better than the doctor himself.

Doctor Shigeaki Hinohara’s main points for a long and happy life:

* Energy comes from feeling good, not from eating well or sleeping a lot. We all remember how as children, when we were having fun, we often forgot to eat or sleep. I believe that we can keep that attitude as adults, too. It’s best not to tire the body with too many rules such as lunchtime and bedtime.

* All people who live long regardless of nationality, race or gender share one thing in common: None are overweight. For breakfast I drink coffee, a glass of milk and some orange juice with a tablespoon of olive oil in it. Olive oil is great for the arteries and keeps my skin healthy. Lunch is milk and a few cookies, or nothing when I am too busy to eat. I never get hungry because I focus on my work. Dinner is veggies, a bit of fish and rice, and, twice a week, 100 grams of lean meat.

* Always plan ahead. My schedule book is already full until 2014, with lectures and my usual hospital work. In 2016 I’ll have some fun, though: I plan to attend the Tokyo Olympics!

* There is no need to ever retire, but if one must, it should be a lot later than 65. The current retirement age was set at 65 half a century ago, when the average life-expectancy in Japan was 68 years and only 125 Japanese were over 100 years old. Today, Japanese women live to be around 86 and men 80, and we have 36,000 centenarians in our country. In 20 years we will have about 50,000 people over the age of 100…

* Share what you know. I give 150 lectures a year, some for 100 elementary-school children, others for 4,500 business people. I usually speak for 60 to 90 minutes, standing, to stay strong.

* When a doctor recommends you take a test or have some surgery, ask whether the doctor would suggest that his or her spouse or children go through such a procedure. Contrary to popular belief, doctors can’t cure everyone. So why cause unnecessary pain with surgery I think music and animal therapy can help more than most doctors imagine.

* To stay healthy, always take the stairs and carry your own stuff. I take two stairs at a time, to get my muscles moving.

* My inspiration is Robert Browning’s poem “Abt Vogler.” My father used to read it to me. It encourages us to make big art, not small scribbles. It says to try to draw a circle so huge that there is no way we can finish it while we are alive. All we see is an arch; the rest is beyond our vision but it is there in the distance.

* Pain is mysterious, and having fun is the best way to forget it. If a child has a toothache, and you start playing a game together, he or she immediately forgets the pain. Hospitals must cater to the basic need of patients: We all want to have fun. At St. Luke’s we have music and animal therapies, and art classes.

* Don’t be crazy about amassing material things. Remember: You don’t know when your number is up, and you can’t take it with you to the next place.

* Hospitals must be designed and prepared for major disasters, and they must accept every patient who appears at their doors. We designed St. Luke’s so we can operate anywhere: in the basement, in the corridors, in the chapel. Most people thought I was crazy to prepare for a catastrophe, but on March 20, 1995, I was unfortunately proven right when members of the Aum Shinrikyu religious cult launched a terrorist attack in the Tokyo subway. We accepted 740 victims and in two hours figured out that it was sarin gas that had hit them. Sadly we lost one person, but we saved 739 lives.

* Science alone can’t cure or help people. Science lumps us all together, but illness is individual. Each person is unique, and diseases are connected to their hearts. To know the illness and help people, we need liberal and visual arts, not just medical ones.

* Life is filled with incidents. On March 31, 1970, when I was 59 years old, I boarded the Yodogo, a flight from Tokyo to Fukuoka. It was a beautiful sunny morning, and as Mount Fuji came into sight, the plane was hijacked by the Japanese Communist League-Red Army Faction. I spent the next four days handcuffed to my seat in 40-degree heat. As a doctor, I looked at it all as an experiment and was amazed at how the body slowed down in a crisis.

* Find a role model and aim to achieve even more than they could ever do. My father went to the United States in 1900 to study at Duke University in North Carolina. He was a pioneer and one of my heroes. Later I found a few more life guides, and when I am stuck, I ask myself how they would deal with the problem.

* It’s wonderful to live long. Until one is 60 years old, it is easy to work for one’s family and to achieve one’s goals. But in our later years, we should strive to contribute to society. Since the age of 65, I have worked as a volunteer. I still put in 18 hours seven days a week and love every minute of it.

Submitted by: venkatachalam p

EDUCARE – The Root Word of Education

Screen Shot 2014-09-03 at 8.06.00 AMRachel Naomi Remen, MD, explains the meaning of education and work:


So many of you responded to last week’s blog by sharing stories about your professional education that I have been thinking about education and medical education all week long and wanted to share some of my thoughts with you.For me, the process of education is intimately related to the process of healing.  The root word of education–“EDUCARE”–means to lead forth a hidden wholeness in another person.  A genuine education fosters self-knowledge, self-trust, creativity and the full expression of one’s unique identity. It gives people the courage to be more. Yet over the years so many health professionals have told me that they feel personally wounded by their experience of professional school and profoundly diminished by it.  Many of you responded to my last blog with stories like this, experiences from your professional education that were disrespectful, even abusive. Some of you shared that these memories were still painful even after many years or that it has taken you years to recover from them. This was my experience as well.

It has made me wonder. Perhaps what we have all experienced is not an education at all but a training, which is something quite different. Certainly in medicine the training dimension of schooling has become more and more central and assumed a greater importance as the many techniques of the scientific approach have been developed. The goal of a training is competence and replicability. Uniqueness is often discouraged and may even be viewed as dangerous.

A training is all about the right way and the wrong way to do everything. In a training your own way of doing something can often become irrelevant. In such a milieu students often experience their learning is a constant struggle to be good enough. Training creates a culture of relentless evaluation and judgement. In response students try to become someone different than who they are.

At the end of the Healer’s Art in all the 90 schools that presently teach it, the students stand in a large circle, silently review their memories of the course and identify the most important thing that they learned or remembered during the course. They then turn this insight into an affirmation: a little phrase which begins in one of three ways:  I AM…. I CAN…. or I WILL. One at a time, the students go around the circle each saying their phrase out loud. This year will be the 24th year that I have taught the course at my medical school. The most common thing that students say in this sharing is a simple three-word phase: I AM ENOUGH.  Year after year it is the same phrase I myself say as well. It is the beginning of everything.

In Medicine, training is essential to technical competence. The real question is, is training good enough?  Have we reduced the practice of medicine from a calling and a wish to live by values shared by generations before us to a very large collection of competencies? In our drive to train students to competence, have we neglected their education? Neglected it to the point that superbly trained young people are considering leaving medicine for other careers because they have lost their dream of medicine and their dream of themselves?

As I was reading some of your comments over again tonight, I remembered something that happened years ago. I had just given a talk on the messages, both positive and negative, that we convey to our patients without our awareness; sometimes with words but often with just our tone of voice, our touch, our facial expression or the way in which we listen. At the end of the talk I was standing with those who wanted to share their thoughts and discuss things a little more when a student came up to me, slipped a little piece of paper into the pocket of my white coat and walked off. I carried it around forgotten for almost a week. When I finally found it I was looking for something else (a lifelong pattern of mine). He had put together some lines from two other poems:

I had a dream
That honeybees were making honey in my heart
Out of my old failures.
There is no right or wrong
Beyond the right and the wrong
There is a field.
I’ll meet you there.

I have never had the chance to thank him for the healing and the gift of new eyes. As a patient myself I knew how strengthening and life transforming such genuine meetings can be. How they open new possibilities. Perhaps this poem is  the message that medical education needs to deliver to every student. It is a message for all of us as well.

My dream of medicine was not to become competent. My dream was to become a friend to life. It was that dream that enabled me to endure the relentless pursuit of competency required of me. But competence did not fulfill me then and could not have fulfilled me for my medical lifetime. Only a dream can do that.

I would love to hear your stories about friends or family or teachers or even perfect strangers who strengthened your dream of yourself and led forth the hidden wholeness in you. They are all the architects of the future of the world!

If you have some thoughts or stories to share, please share them with me on my blog page here.  Or, if you are on Facebook, you can share on Facebook here.


Rachel Naomi Remen, MD


In Celebration of Labor Day


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Retirement is Bad for Your Health

Can retirement kill you?

In 2003, Dr Harry Prosen stepped down as head of psychiatry at the Medical College of Wisconsin, but the then 71-year-old had no plans to retire. Rather, the doctor intended to focus on other “jobs” that would keep him busy.

Now 83, Prosen still sees several patients, consults for a number of organisations, recently reviewed a 600-page manuscript for a friend and regularly pores over a handful of medical journals because he “just wants to keep up,” he said.

Once you take the work away most people have no idea what to do. — Mary Peterson

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