Peninsula Daily News column 2-24-11 "A way to help"

I suppose it’s bad form, and probably even poorer grammar, to begin a column with, “…uh…well…”

                Or I could begin by confessing that I probably am what a colleague characterized me to be: “An analog man in a digital world,” but I’m not entirely certain that I know what that means. I suspect it alludes to the fact that I am somewhat anachronistic, but that sounds a bit like saying that something is a “little prehistoric,” which makes no sense at all; thus, I’m reduced to beginning this column with..

                …uh…well…

                It appears that I’m being dragged, kicking and screaming, into a few years ago; specifically, into the world of “social media.” I think you all have pretty much gotten the drift by now that we at “Information & Assistance” are in the business of providing “help;” interestingly, “help” is of remarkably little help if you’ve never heard of it or don’t know where to find it – That isn’t news.

                Now it seems that a number of people who might reasonably partake of “help,” if they’d ever heard of it or knew where to find it, are “finding” their information on social media; specifically, in this instance, “Facebook.” To that end (or means), “Information & Assistance” has decided to join 500+ million of our closest friends and are developing (if that’s what one does when one…”Facebooks”) a Facebook page (I think).

                Good for us.

                Then I was informed that, in order to see said “page” and interact with the folks who might be looking at it and asking questions, etc (which is, after all, the whole point), I had to have a Facebook “profile.”

                Oh-oh.

                …uh…well…OK.

                So, now I have one, and to date, I’m containing my enthusiasm. There is next-to-no information on there, because I spend way too much time on the road to “update my status” or put things on walls or whatever, or even to respond to “friend requests,” so please don’t be offended if I don’t “friend” you; alas, I appear to have achieved the zenith of my technological capacity with the advent of e-mail, so that will remain the best way to get to me directly: harvemb@dshs.wa.gov . I will check said Facebook page from time to occasional time for messages or whatnot, but don’t hold your breath waiting for me to tell you what I did on my summer vacation; besides, major portions of it are generally classified.

                And I do not “tweet” (at least, he said, sighing, not yet).

                So, the point of all of this is that we have a Facebook page! – “Olympic Area Agency on Aging-Information & Assistance!”  Just search for it when you are in Facebook. There are links to things that genuinely help, and there will be more; in fact, if you have ideas for links (or other stuff) that would actually help real human beings, let’s hear them. Please feel free to leave comments, start discussions and “like” it, which will keep you updated with our latest posts.

                You’ll also find a link to my “blog,” which, I’m told, is a place in cyberspace to archive these PENINSULA DAILY NEWS columns from the first of this year. You can get to this blog-thing by going to http://markharveyshelpline.blogspot.com/ and, I’m told, you can also leave comments and questions and Lord-only-knows whatever else there, too, so I’ll check that on a regular basis, too.

                I remember when one could “compute” on an abacus, and I confess that I found rotary phones seductive in their simplicity, but here we are and here I am, being a little prehistoric.

                Look, the medium isn’t the message; the message is that there’s a lot of help and information out there for people who need it and want it, and many of us are quite capable of using that information to conduct our lives, and aid-and-abet the lives of those we care about, IF we can find it. It should not be our job to hide information, or make it seem so “secret” or “sophisticated” or abstract that, somehow, regular human beings cannot – or should not – have access to it. It should be our job to make all of it as public and accessible as we possibly can, in order to rationalize calling ourselves “Information & Assistance.”

                So, into the Facebook and blog frays we go.

                You will still have questions, because you’re smart. You will still need to tell the story of what’s happening to you or yours to a living person, so we can help you understand what you need to care about – And what you don’t. That won’t change, and there will remain decent human beings at any of the numbers at the end of this column who will listen to you, and not make you feel like an idiot.

                But if “Facebooks” and “Blogs” and whatever-else are ways to give people what we all have a right to have – Information! – Then, bring it on; so: “Olympic Area Agency on Aging-Information & Assistance.”

                And, Yes, I do remember helping my grandmother put ice INto the “icebox,” but that’s only a little prehistoric.

Peninsula Daily News column 2-17-11 "Medicare can help one be and stay well"

OK, it’s three days after Valentine’s Day and it’s pretty clear to me that I should attempt to redeem myself after last week’s column.

                For those of you who completely lost your minds last Thursday, or spent it in another time zone or experienced any other aberration that prevented you from catching last week’s effort, I essentially implied (well, OK, I said it “out loud”) that chocolate and other nutritional sins might actually have their place, particularly if you happen to be in the situation of caring for someone with dementia.

                While that seems pretty specific to me, some of you undoubtedly took that as a recommendation (if not a prescription) to go forth and consume vast quantities of BAD FOOD; so, since our February excuse for indulgence has passed, I’ll gloss-over the “excuse” that I may have provided by directing your attention to “wellness” and “prevention.”

                Look: You know as well as I do that the only way to avoid the astronomical costs of healthcare and the coma-inducing experience of health insurance that usually comes with it is to utilize either (or both!) as little as possible; thus, for those of us who have yet to achieve immortality, we’re forced to confront the daunting realities of wellness and prevention – In other words, don’t get seriously sick.

                Even Medicare has begun to figure this out.

                Now, it makes absolutely no difference to most of us whether this stuff has been available for a while or it’s a product of “health care reform;” the fact is, here we are and here it is and we might as well use Medicare (which is “health insurance”) to avoid having to use health insurance! (…or something like that) – Anyway, here we go.

                …and if you’d like to research all of this yourself, by all means, do so – Just go to: http://bit.ly/9hc89L and have a real nice day.

                The “Welcome to Medicare” physical exam has been available for a while, but a lot of us don’t seem to be real sharp about getting it done. Beginning January 1 of this very year, there is no longer a coinsurance or deductible payment required for it, so now we have even less of an excuse to avoid it: Not knowing what might be wrong will not make “what’s wrong” go away, in the same sense that “denial” is not a river in Egypt.

                Also beginning last January 1^st, we Medicare-types have access to an “annual wellness visit.” You do not need to get the “Welcome to Medicare” physical before getting the “annual wellness exam,” but if you do get it first, then you have to wait 12 months to get your first “wellness” exam – Your call, because doing SOMETHING beats-the-heck out of doing NOTHING.

                The initial Annual Wellness visit includes:

• Routine measurements (height, weight, bloodpressure, etc.).
• Medical and family history.
• Establishing a list of current medical providers, suppliers and medicines.
• Personal risk assessment.
• Review of functional ability and level of safety.
• Detection of any cognitive impairment.
• Screening for depression (very common for a lot of us!).
• Establishing a schedule for Medicare's screening and preventive services for the next five to ten years.
• Any other advice or referrals that come up.

So, besides getting on the front-end of anything that might be wrong (which often includes, NOTHING), you’re establishing a “baseline.” Subsequent Wellness visits will pretty much retrace the same steps, the idea being to see whether anything that might have changed is a “problem.”

I realize that this isn’t exciting stuff. If you’re looking for “exciting,” try spending your spare time in a hospital bed, trying to figure out whether you’re there under “inpatient” or “observation” – No? Then, this is looking a little better all the time.

Now, also beginning January 1^st (Yes, January 1^st was a busy day!), cost-sharing was eliminated for these Medicare-covered services, assuming that your doc “accepts assignment,” which means she/he agrees to accept what Medicare pays as payment-in-full:

• Abdominal aortic aneurysm screening;
• Bone mass measurement;
• Breast cancer screening/mammograms;
• Certain types of colorectal cancer screenings;
• Flu shots;
• Hepatitis B shots;
• Pap tests and pelvic exams;
• Pneumococcal shots;
• Prostate cancer screening;
• Smoking cessation;
• Medical nutrition therapy services (for those with diabetes or kidney disease, or who had a kidney transplant in the last 36 months.

You’ll probably pay 20% of the Medicare-approved amount for the doctor visit for these services:

• Cardiovascular screening tests;
• Diabetes screening tests;
• HIV screening tests.

Now, wasn’t that simple? Of course not! This is Medicare! But the fact remains that the game has changed and, for once, it’s swinging our way, meaning that prevention and wellness makes more sense than the high drama (and higher cost!) of heroic medical intervention.

No, you probably won’t live forever, and the fact is, most of us don’t want to – We just want to “live” until it’s time to do something else.

This is a way to help us do that.

Peninsula Daily News column 2-10-11 "Home has heart and chocolate; it works"

Today is the 10^th day of February. Four days from now it will be the 14^th day of February, which we culturally, socially and commercially refer to as “Valentine’s Day.” If that is startling information to you, put this newspaper down and go take care of whatever it is (or WHOever it is) that will allow your life to proceed without emotional distress – The newspaper will still be here when you get back.

                If that is not startling information to you, read on.

                Valentine’s Day is an interesting grab-bag of images and icons: A fat little cherub-like critter flits hither-and-yon, smilingly firing arrows into humans, who are then struck by love and romance, and/or the bill from the ER room. I particularly like the “love and romance” part, presume you do, too, and further presume that you have that part under control, because that is not the kind of “help” we purport to offer under “Help Line.”

                My second favorite part of the Valentine’s Day hoop-tee-doo is the almost unanimous, if fleeting, acceptance of chocolate as a “good” thing, which to my mind merely overstates the obvious, but do you know who else might have a lasting affinity for chocolate? Folks with Alzheimer’s disease.

                No, I’m not kidding, and NO! – I’m not prescribing chocolate as a universal panacea for dementia, but listen to this:

                A December 31, 2010, article in The New York Times relates the story of a 96-year-old with Alzheimer’s (or some other dementia that “looks” like Alzheimer’s, so I’m just going to call that – Caregivers don’t really care) who was summarily evicted from several nursing homes for being “difficult,” refusing to eat and rather routinely whacking on staff members and other residents. Her family, after considerable angst and pleading, moved her into a home in Phoenix called “Beatitudes” – Care to guess what “Beatitudes” did?

                Well, they let her sleep, be bathed and dine whenever she wanted – Even at 2 a.m. – And she could eat anything she wanted anytime she wanted, including unlimited chocolate; and Yes, I have reserved a corner room with a view.

                Further, after plumbing her past with the family, they gave her a baby doll, which seems to calm and soothe her; apparently, folks with dementia at “Beatitudes” fare pretty well, as they can even be provided an alcoholic “nip at night,” if that’s their custom and preference.

                I realize that I’ve already “lost” a lot of folks, either because chocolate is considered “unhealthy” or because baby dolls are undignified or because liquor is generally objectionable, but I’m largely talking to caregivers (somebody who is taking care of somebody who needs to be taken care of, whether they like it or not) who are all about what “works.”

                Listen: Some of the latest science on the subject of Alzheimer’s suggests that creating “…positive emotional experiences” for patients diminishes distress and behavior problems. Some facilities have stopped anti-anxiety and/or antipsychotic drugs, which can have some pretty harmful side effects, and focused more on prescriptions for pain or depression; in other words, trying to get to what’s really wrong.

                A study published in “The Journal of the American Medical Association” found that brightening lights decreased depression, cognitive deterioration and loss of functional abilities. At Beatitudes, they’ve installed rectangles of black carpet in front of elevators, which seem to be perceived as cliffs or holes, so residents shy away; in fact, when it’s necessary to escort a resident via the elevator, the place a white towel over the black carpet, to make it be OK….hmm…

                And they greet folks with “over-the-top” HELLOS! Like Cheshire cats! It works.

                More new research suggests that emotion persists after cognition deteriorates; in other words, the feeling lasts a lot longer than the thought, so…Focus on creating positive feelings? Makes sense to me.

                The general drift here won’t come as big news to serious pro’s who work with Alzheimer’s patients – They’ve learned a lot of it because it’s taught to them by the folks they work with, but listen to this, since we’re all about the “latest science:” All kinds of professionals and studies have found that when people who cared for folks with Alzheimer’s were given six counseling sessions as well as counselors whom they could call in a crisis, they did a lot better for a lot longer – The “patient” didn’t change, but the “caregiver” did….hmm…

                No, caregivers aren’t crazy -  At least, not “officially” – But they are doing high-stress work 24/7, and usually with someone they loved in another way, before it was “this way” – Counseling kinda makes sense, huh?

                But let’s go back to Beatitudes, for a minute: They figured out that nutritious, low-salt, low-fat, doctor-recommended foods might actually be discouraging folks from eating, so they serve whatever folks seem to want – Including bacon, and/or whatever; in fact, some staff members carry a stash of chocolate in their pockets. They think that comforting food improves behavior and mood because it sends a message that can still be understood: “It feels good, therefore I must be in a place where I am loved.”

                Happy Valentine’s Day.

Peninsula Daily News Column 2-3-11 "Attack Alzheimer's, fight the scammers"

Way back last year, when we were worrying about Medicare Part D, Advantage Plans, the end of the economic world as we know it and, of course, a minor distraction called “THE Holidays,” I decided to distract us all by suggesting that we (America) ought to just do away with Alzheimer’s Disease – And I wasn’t kidding.

                Given our national track record for beating horrible diseases when we put our collective minds to it, I thought then (and still do) that this is doable: To finally eliminate one of the most terrifying and devastating afflictions knocking around the planet – One that takes a devastating toll from the patient, certainly, but from caregivers, families and the entire health care and long-term care systems, as well – One that twists what ought to be a lovely journey into Elderhood into a frightening, day-by-day roll of the dice.

                Sure, we’re all going to “go” someday and someway – But not THAT way.

                Well, within days of my pronouncement, Congress passed, and the President signed, the “National Alzheimer’s Project Act,” which creates a coordinated national strategy to do away with something that has a nasty habit of doing away with us. Are we “there” yet? No. It still has to be funded (feel free to advocate) and the work – The miracle! – Still has to be accomplished, but now there’s hope, where there was no hope before.

                Thank you. I’ll be issuing a call for a national chocolate chip cookie stimulus shortly.

                Now, or rather, Again – Here we go again, because the “Bad Guys” are back; well, actually, they never left.

                Yup, SCAM: This time you might be contacted, via phone, e-mail or letter, by some low-life posing as some manner of governmental agency rep (like, Department of Health & Human Services, or whatever). They’ll spit-out a name and a fake employee ID, and then tell you that you’ll receive “government grant money” as an incentive for paying your taxes on time. All you’ll have to do is provide them with personal and/or financial information, like your Social Security number or bank account number, or maybe even send them a check or wire transfer to cover a “processing fee.”

                Sure, the message varies, but that’s the basic drift; now, think about it: Are the Feds really going to send you money for sending them money? Probably not, so hang up, hit DELETE or shred it! If you’re not sure, take five minutes to call a friend and a run it by them, to help you get out of the “…heat of the moment.” Could that be embarrassing? Maybe, but not as embarrassing as being played for an idiot by the Bad Guys, then having to call the same friend for a loan to pay for the dog food.

                And speaking of receiving crap from folks that you never asked to receive crap from, you can cut down on the number of pre-screened offers for credit and insurance, by “opting out.” You can do this by calling 1-888-567-8688 or going to www.optoutprescreen.com and saying so. These are operated by the major consumer reporting companies, and you’ll be asked for your name, home phone, date of birth and Social Security number, so be ready for that.

                And, of course, there’s always the good old “Do Not Call Registry,” which is designed to reduce the number of telemarketing calls you get at home at dinner time. You can do that by going to www.donotcall.gov or calling 1-888-382-1222. You should see a decrease within a month or so, and both of these (Do Not Call and Opt Out) should last about five years.

                Yes, I have done them. Are they perfect? No. Did they eliminate all the garbage? No. Has my evening mealtime magically become sacrosanct, leaving me awash in peace and quiet? No, but there’s a heck-of-a-lot less than there used to be; in my world, less crap is good.

                Thinking that you’re on a roll? OK, you can go to www.the-dma.org/consumers/offmailinglist.html or write to the Direct Marketing Association, Mail Preference Service, PO Box 643, Carmel, NY, 10512, to reduce the amount of direct mail marketing you get from national companies.

                Really trying to get off the radar? OK, if you go to www.dmaconsumers.org/offemaillist.html you have a fighting chance of reducing the number of unsolicited commercial e-mails you get.

                Again, are these perfect? No. Will they help, if “help” means less stuff assaulting your senses and invading your life? Yes.

                One more, on the third day of February, 2011? OK, try this:

                Beginning on March 1, 2013, all federal benefits will go “electronic,” which means either direct deposit into a bank account or (Ready?) a “Direct Express® Debit MasterCard® card and, Yes: Paper checks will go away – Forever.

                “Federal benefits” includes Social Security, VA, Supplemental Security Income (SSI), Railroad Retirement Board, and more; so, if you’re currently getting a paper check from the Feds, you’re going to have to switch to one of the above by March 1, 2013. And why am I giving you a two-year warning? Because I have an incipient “mean streak,” that’s why!

                Not really; the fact is that anyone (which means EVERYone) applying for “federal benefits” on or after May 1, 2011 (that’s this year, if you’re feeling disoriented) is going to have to choose direct deposit or the magic card, so if you’re going to become “one of us” on May Day, the check will NOT be in the mail.

Finally, Valentine’s Day is exactly 11 days from today, and that’s why we call this “Help Line.”