Peninsula Daily News Column 12-27-12 "Help sometimes more of a hindrance"

            In a few days it will be 2013, and that’s about as “current” as I feel like being.

            What I feel like doing is looking back to what I said last week, because that’s what a lot of you have felt like doing – Good! Let’s do it.

            Last week I went on about “help” – Dignity and respect – And negotiation.          

I went on about how we often go out and do all kinds of stuff for “Mom” (or whomever) because we love her (Really!) and we want her to be “safe” (Really!), but we neglect to negotiate that “help” with her, so “help” becomes part of the problem and she starts acting “less than” and blah blah blah – For today, the operative word is “safe.”

I’ve heard from a number of you on the subject – Thank you. And more than one of you keyed in on that word – Safe; You really do want Mom to be safe and she isn’t safe now, living where she’s living or the way she’s living or…And you’re probably right.

I’m not about to suggest that we stop caring about whether Mom is safe – That’s just stupid, and since we call this little column “Help Line,” not “Stupid Line,” I think we can safely dispense with that, but I also think there’s something worth considering – Something that might “flavor” the conversation.

Tell me the last time you, or anybody you know, was “safe.” You weren’t “safe” the day you got here! Hopefully, you were welcomed and cleaned up and fed and cuddled and kept warm and hovered-over by any number of very protective big people, but were you absolutely “safe?” No, you weren’t.

Some bad medical thing could have happened or somebody could have dropped you or there could have been an earthquake or a meteor shower…Unlikely, I agree, but possible; so, were you “safe?” No – You were just safer than you might have been.

Safer – Not “safe.”

And if most of us stop and really think about, that’s the way it’s been all of our lives, because “safe” is a relative thing.

Now, I’m not talking about reclusive billionaires with two inch-long fingernails and a battalion of underlings singularly dedicated to killing germs, nor am I talking about teenagers, who are often incapable of discerning the difference between “safe” and a pizza. And I’m certainly not talking about anyone with dementia/Alzheimer’s or any other brain-impacting condition (although, “dignity” and “respect” will go a long way toward pre-empting an unpleasant “push back”) – I’m talking about most of us, mostly “normal,” most of the time, where “safe” is a relative thing.

We’ve spent our lives making decisions, making choices, taking some chances – Calculated risks; often, we’ve done alright or gotten by – Sometimes, we’ve paid a price. But we made choices about what we were or weren’t willing to live with – Calculated risks – Because it/them were worth it to us.

Yes, I know all too well how often we’ve made mistakes that we’ll regret to the end of our days – All I have to do to know that is go look in a mirror! – But, that’s what we did and it’s still what we do: We make our choices and we take our chances. It’s just the nature of the planet.

So, why is it that when some of us turn some magic age or our hair changes color on its own or we have a limp or WHATEVER, we’re suddenly required to be “safe?” When did we forfeit the right (and the curse) to make decisions about our “safety,” regardless of how extraordinarily idiotic they may be?

We didn’t; other people just decided we did.

Here’s an example that I’ve used before, because I know it’s true because I lived it: Mom is a bit overweight and has severe arthritis, which bends her over; thus, getting up and down from chairs, sofas and beds is a bit more “exciting” than she might like it to be. Mom also has two small, very overweight dogs who adore her and sleep at her feet, so every time she gets up, two small, fat dogs think, “Party time!” And are all over the place! Running and jumping and tail-chasing and…

Might Mom trip over one of these manic little critters and bust her you-know-what? Or lie there for God-only-knows how long, hoping somebody will come to help? Yes. Absolutely.

Then get rid of the **** dogs, right? Then, she’ll be safe!

Well, OK, but those two fat little yappers are what give purpose and meaning to her days – A reason to get up in the morning. And they’re who keep her company long after you’ve gone back to your own busy life to be busy – They’re who’s there; so, now, in the name of “safety,” we’ll eliminate the risk.

And her “reason” and her purpose and her company. Gee – Thanks for making me “safe.”

Calculated risks. We make choices.

Look around, wherever you are – Are you safe? Could you be safer? Probably. Is it worth it to you? Why not?

Oh, sure, I know: We could all come up with a million examples and scenarios and debate the common sense of this vs. that; and No, I don’t think there’s any harm in advocating with Mom to have the washing machine moved upstairs in order to avoid those way-too-steep, piece-of-crap stairs to the basement, because, sometimes, she’ll say, “YES!” – Or, at least, “OK”…

But it is, after all, up to her – Isn’t it? Or is it up to you? Or me? Or us? Because, if it’s up to us, we’ll go do the “right thing,” which could, soon enough, become the “wrong thing” as we watch Mom begin to become someone else – Someone other than she used to be: Weak, frightened, listless and lifeless – But safe.

The spirit is much more fragile than that old hip bone will ever be.

So, I’ll say it again: Take the word “negotiation” and have it tattooed on your heart, then pray that the people who love you will do the same.

Peninsula Daily News 12-20-12 "Help sometimes more of a hindrance"

            In my world, this is what’s known as a “reality check:” Christmas is five days from today.

            If that realization strikes terror into your heart (or should!), I may be able to help.

            I may not – We’ll see.

            In the past, which for me is anytime that wasn’t within the last 20 minutes, I’ve been known to provide last-minute gift ideas for Elders to those of us who are less-than-focused. Given my infinite capacity for generosity, mercy and tolerance, I started out to do exactly that today and, certainly, I’m quite capable of generating an avalanche of wonderful ideas.

            But then I got to thinking about the “Elders” I know (and I know more than a few!) and what they’d want for Christmas, or whatever other gift-giving event might be occurring for you and yours, and what came up was apparent and universal: Dignity and respect.

            Don’t go look those words up in whatever passes in your life for a dictionary – I didn’t. I didn’t because most of us think we know what they mean, and if we think we already know, we’re certainly not going to allow ourselves to be distracted by facts.

            Now, forget about whatever it is that you think those words mean and think about you – Yes, You. How do you like it when somebody treats you like an idiot, or a child or someone who is generally incapable of running their own lives? Maybe it’s in a doctor’s or dentist’s office. Maybe it’s an insurance person, particularly a health insurance person! Maybe someone or something having to do with finances or taxes, or the washing machine repair guy, or almost anybody who knows more about computers and technology that you do, which seems like almost anybody! How does that feel?

            It makes me feel…angry. And embarrassed. And resentful. And incompetent. It makes me feel…less than. And I don’t like feeling “less than…” - Neither do you.

            And do you know what often happens when we’re in a situation where some jerk has made us feel “less than…?” We start acting “less than:” We don’t mean to and we don’t like to and we often kick ourselves ALL THE WAY HOME!

            But we do; we start acting the way we were treated: Less than.

            You don’t like it and I don’t like it, so why, pray tell, would we treat people that we claim to like that way? Well, we probably wouldn’t, if we thought about it, so THINK ABOUT IT!

            I don’t know if it’s Mom or Dad, or Grandma or Grandpa or the neighbor or an old friend or somebody you’ve never seen before in your life, but somewhere in your life, there’s an Elder; for some of us, we don’t have to look any farther than the nearest mirror, but let’s don’t get distracted by overly-personal distractions, so we’ll assume we’re talking about someone else.

            Let’s say it’s “Mom,” a personal favorite of mine. I sit with a lot of folks who are trying to do everything they can to “help” Mom, and they’re trying to do everything they can because they care – Genuinely, honestly! – So, often, they go out and do a lot of stuff (arrange for a lot of “help”) for Mom because they can see what she “needs,” and, often, they’re right. They love Mom and they want to keep Mom safe.

            Safe.

            But the problem, sometimes, is that nobody checked it out with Mom: Does she want this person or that gadget or this agency or these meals or or or…? Maybe not.

            “…but she NEEDS it!”

            That wasn’t the question.

            “We want her to be safe!”

            Me, too.

            “So, what-the heck are you SAYING??”

            I’m saying that when we “help” somebody, that usually suggests that they need help – Or we think they do. That they can’t do it alone.

            How would you feel if I suddenly came along and decided to “help” you? You didn’t ask me to – I just decided that you needed it, so here’s the “help” that, I see, you obviously NEED! Aren’t you glad? Aren’t you grateful? Aren’t you just thrilled that I was able to know what you needed in order for you to continue your pathetic little existence and be SAFE??

            No? Why NOT?

            Right.

            Now, go look up “dignity” and “respect” (I did), and let’s begin again.

            When we treat people like they need help, they start acting like they do, whether they do or not. So, am I saying that we should all stop helping Mom? OF COURSE NOT! (…geez…What do you think I do all day long?)

            What I’m saying is that “help” has to be wanted – Accepted – Before it qualifies as “help;” when it is, life can be better, easier, safer and, maybe, even longer! But when it’s not, it just makes us feel…less than.

            So we start acting “less than,” and pretty soon we become “less than;” less than what we were, less than what we could be, less than what we wanted to be, less than what we used to be – Less than.

            The missing piece is, usually, the conversation – The Negotiation! – That turns “help” into being part of the solution, instead of part of the problem.

            Negotiation. If you take nothing else from today’s diatribe, take that word – Negotiation – And have it tattooed on your heart. Negotiation.

            Now, does all of this let you off the hook for getting Mom a Christmas present? No, it was never intended to. It was intended to help you figure out what a “gift” is…

            ..and what it isn’t.

           

Peninsula Daily News Column 12-13-12 "Some light fare after open enrollment"

            Good morning, “open enrollment” survivors!

            You did it! We did it! We navigated our way through yet another labyrinthine safari through the nether world of Medicare Part D and Advantage Plans! Well done.

            If it makes you feel any better (and it probably won’t), more and more of us are grasping the unfortunate necessity of looking at these things every year and actually pulling it off, which means that more and more of us are (a) saving a little money, and (b) getting better coverage – Remembering that “better” is a relative term.

            So, with that rather considerable accomplishment under our collective belts, let’s just…pause…breathe…And resolve not to get into anything too heavy; after all, the latter half of December will take a toll of its own, right?

            Right; so let’s just clear the deck, huh? Like:

*In case you haven’t already heard, the 2013 Medicare Part B premium will be $104.90 per month. If you are one of the very few of us who is blessed with paying a Part A premium, that’s actually decreasing from $451 to $441 per month. The Medicare Part A deductible (like for up to 60 days of Medicare-covered INpatient services in hospitals) is increasing to $1,184 per benefit period. A “benefit period” starts the day you’re admitted and ends when you’ve been out of the hospital for 60 days in a row – So, Yes: You could conceivably have more than one benefit period “experience” in a calendar year, but I hope you don’t. The Part B deductible goes to $147 from $140. So it goes.

• Some of us (OK, a lot of us) get confused about which vaccines are covered by Medicare Part B vs. Part D, if they’re covered at all – Here’s the deal: Part B covers flu, pneumonia, Hepatitis B (if you’re at “high” or “intermediate” risk) and any others (like “tetanus toxid) if directly related to an injury or direct exposure to this-or-that. Part D generally covers vaccines that aren’t covered by Part B (assuming that they’re included on the God-Almighty formulary) and, generally, the shingles vaccine (“Herpes zoster”) and our Part D plans should also cover administration of said vaccines. Hey, for immunizations covered by your Part D, check with your Plan before you go to the Doc, huh? You might get a better break by going directly to a participating pharmacy.
• How about something that isn’t Medicare? (How about anything that isn’t Medicare??) OK, the Olympic Area Agency on Aging is looking for a representative from Clallam County to participate on the “Advisory Council,” which means advising regarding services for Elders and adults with disabilities, e.g. long-term care services and a whole lot more? Said Advisory Council meets once per month in Shelton, so mileage reimbursement and lunch is included. Maybe? Good! Contact Carol Ann Laase at laaseca@dshs.wa.gov or 1-866-720-4863. No, you probably won’t be able to redesign Medicare; Yes, you could make a difference.
• OK, this is NOT a nice way to punctuate the 2012 holiday season! – Specifically, the “grandmother” scam is still operating (or operating again or never went away, or whatever). This is the one where you get an e-mail (sometimes a phone call, but usually e-mail) from grandson (or daughter) who got busted in Brazil for brandishing bananas (or whatever!) and said prodigal offspring’s offspring needs bail money or travel money or something. People are sending money or, at the very least, getting very upset and frightened! Don’t do this; if you get such a missive, check with somebody (like the kid’s parents) or somebody (even call one of the numbers at the end of this column) before you do anything, PLEASE! Most of us can’t afford to support the bad guys in the style to which they’d like to become accustomed, so please don’t send anything anywhere until you’ve talked to somebody, OK? And if you get an e-mail from Mr. Viffleschlitz with a bunch of letters after his name needing you to help him get a considerable sum of Ghaddafi’s hidden loot back to the good ‘ole US of A, please don’t do that, either! I get about four per week.

            Enough? OK, now just think about one thing that you’re thankful for – I don’t care, anything. Or anyone. Got it? Good – Me, too. That’s what we all need to remember for the rest of today, and let Mr. Viffleschlitz solve his own problems.  

Peninsula Daily News Column 12-6-12 "On free meals, paper checks, and benefits"

            It’s the HOLIDAYS!

            I know this be true because tomorrow is the last day for Medicare’s “open enrollment” for Part D and Advantage Plans!

            So, what’s something that a lot us enjoy doing during the holidays? OK…what’s another thing that a lot of us enjoy doing during the holidays? Right! Eat!

            I know what you’re thinking: You’re thinking that I’m going to go on a binge about over-eating and obesity and all the bad health stuff that comes from all of that and blah blah blah…WRONG! I’m going to go on a binge about not eating enough.

            Look: If you can’t afford to buy food (or enough of it), it’s tough to eat. Or if you can’t, for any number of good reasons, shop or cook or whatnot (at least, very well), it’s tough to eat – At least, very well.

            And if you spend most of your time alone, it can be tough to get excited about eating…Or shopping…Or cooking; so, sometimes, we just don’t.

            In 2010, the agency that was providing “senior meals” in Sequim – Olympic Community Action Programs – Had to cut back from providing meals five nights per week to three nights per week – Now, think about that.

            Well, a number of good folks in Sequim got to thinking about that and decided that they didn’t like what they thought about it, so they decided to revive the program to five nights per week, and they did – They still are, so here’s the deal:

            If you’re a “senior” and food isn’t your strong suit, for whatever reason, consider giving this a try. Meals are served at 4:30 pm, Monday through Friday, at Suncrest Village Retirement Apartments, 251 S. Fifth, in Sequim, and the “suggested donation” is $5. Give them a call the day before at 683-8491 to let them know you’re coming, OK? Why? Because they’d like there to be enough food for you without wasting any, which (a) makes sense, and (b) is just simple human courtesy.

            If food isn’t an “issue” for you but you qualify as a decent human being who would just like to help, you could send a tax deductible donation to TUMC-Sequim Senior Meals, P.O. box 878, Sequim, 98382. If money isn’t your strong suit but you’d like to help, call that 683-8491 number and tell them that.

            Aw, COME ON! It’s the HOLIDAYS! Food matters.

            Now, just a casual little reminder about a little something that has nothing to do with food, but it does have to do with money: Are we remembering that on March 1^st of next year (2013!) paper checks for Social Security, SSI, VA, Railroad Retirement, etc are going away?

            No, the money isn’t going away, but the paper checks are, so by 3/1/2013 you’re going to have to have made arrangements for a direct deposit into a bank or credit union account OR you’re going to get your payment directed into a “Direct Express” debit card account.

            Now, the fact is that the vast majority of us have long-since arranged for direct deposit and appear to be living happily-ever-after, but if you haven’t, HEADS UP! – Because come March, you’re going to have to do something! You can go to www.godirect.org to get more info or you can call any of the numbers at the end of the column and decent people will help you, for free.

            And, as long as I’ve drifted into the realm of Social Security, I might as well answer some of the miscellaneous questions that have come along, because of one asks, ten want to know:

*”OK, since you brought it up, when are Social Security benefits actually paid?” The answer is that it depends upon when your birthday is: If you were born on the 1^st through the 10^th day of whatever month, your Social Security money shows up on the second Wednesday of the moth. If your birthday falls on the 11^th through the 20^th day, look for the money on the third Wednesday and if your birthday is on the 21^st through the 31^st day of the month, you can celebrate with money on the 4^th Wednesday – And if you’re receiving benefits as a spouse, the money appears based on the spouse’s birth date.

            Wednesdays are good days.

*”How can I get a copy of my “Social Security Statement?” You can’t (no, I’m kidding…); of course you can! Go to www.socialsecurity.gov/statement and have at it. This is a swell little tool – I’ve done it. You can get pretty good estimates for retirement, disability and/or survivors benefits as well as making sure that your earnings have been accurately recorded (NOTE: This is just smart, because if there is a mistake, you only have three years to correct it!). Social Security now only sends paper Statements to folks 60 or better and (starting last July) to folks the year they turn 25.

            I have no idea why they picked “25.”

            Well, as long as we’re talking about “swell little tools,” if you retirement and/or Social Security is something you’re even beginning to think about (or wondering if there’s any point in thinking about it at all) try Social Security’s online “Retirement Estimator” at www.socialsecurity.gov/estimator and take your time. You can learn a lot, play with some “what-if’s” and generally get smarter, so give it a shot.

*How can I get rid of last year’s fruit cake?” You can’t – They’re not bio-degradable.   

Peninsula Daily News Column 11-29-12 "Suit follows 'improvement standard'"

            Does it ever seem to you that we ought to get some manner of recognition for just “making it through?” I mean, we have, presumably, survived Thanksgiving (CONSUMER NOTE: If you can’t readily identify what that is behind the leftover cranberry sauce, you probably shouldn’t eat it) AND an election!

            Congratulations!

            Regardless of your reaction to the outcome of the election, most of us reasonably conclude that “ObamaCare” will lumber forward, and rightly so; thus, a reasonable question from Elders and/or Medicare beneficiaries is, “NOW, what do I have to do??”

            Answer: Nothing. For the foreseeable future, all you need to do is what you were already doing, which is to do your “due diligence” regarding your Part D and/or Advantage Plan, make a decision (or do nothing) and have that in a proverbial bag by midnight on December 7^th; other than that, put on your seatbelts and prepare for the December holidays.

            But while we were busy making ourselves nuts with the election, the Center for Medicare Advocacy (along with a number of other folks) sued CMS(Centers for Medicare & Medicaid Services) who runs, obviously, Medicare and won – Well, they’re winning, because a settlement has been filed in federal District Court and should be formally approved soon. And you would take off your HazMat suit and back away from the refrigerator for this little piece of news WHY?

            Here’s the deal: As way too many of us well know, for years and years Medicare has had an “improvement standard” that limited our access to Medicare-paid skilled nursing and therapy services (think, among other things, “Home Health”); in other words, when you stopped “improving,” services stopped.

            …hmm…So, if I had a condition that was stable, chronic, not improving or that required such services to just keep things from getting worse (“maintenance only”), I was out of luck. Here are two surprises:

1. A lot of us have conditions like that;
2. Said “improvement standard” isn’t in Medicare law!

It was just some rule or regulation or standard or whatever that got injected into the mix somewhere along the way and became gospel; thus, those of us who need such services to keep from getting worse (a reasonable goal, if you’re in that situation) will now have access to them.

Think about that, then say, “Wow!”

The true wonks among us may already have heard of this as the “Jimmo Settlement Agreement,” and if you want to learn a whole lot more about it, go to http://www.medicareadvocacy.org/hidden/highlight-improvment-standard/ and let it sink in. When the Court formally approves the Settlement, CMS will launch a big (I hope!) education campaign aimed at Medicare medical providers AND the rest of us, but the fact is that we could push this NOW – Take a look at the “Self-Help Packet” on that web site.

Will this only apply to certain diseases, diagnoses or conditions? No. It applies to any Medicare beneficiary who requires “skilled services” to keep from getting worse.

“Skilled services” – Does that mean “…only in a nursing home?” No, it could mean at home, outpatient OR in a skilled nursing facility.

Will this add to the number of days that Medicare will pay for in a nursing facility? Good question! No, because the famous “100 days” is specified in Medicare law, but it does change how you might qualify for same.

Won’t this just cost Medicare more and make this whole “healthcare thing” worse? Smart! Well, we shall see, but a study was done through the Veterans Administration model where people had access to services like this and it appeared that it actually cost less, because hospitalizations and nursing home costs went down! Why?

Well, because if we have access to what we need when and where we need it, we tend not to get worse and cost more – Makes sense, huh?

Well, the federal District Court certainly seems to think so.

This will all be unfolding in the next few months, so stay tuned; in the meantime, if you or yours are on Medicare and are denied skilled nursing and/or therapy services because you’re not “improving,” say “Jimmo Settlement” and argue about it, because allowing people to get worse doesn’t save anybody any money.

And remember that this is Medicare, so it’s national, so this is all just as true for Cousin Clem in Kansas City as it is for your sister in Sappho, OK?

“Improvement” can be a relative thing – This is an improvement.

Peninsula Daily News Column 11-22-12 "Thank you to weary, done-in caregivers"

            HAPPY THANKSGIVING!

            Do you s’pose that, just for today, we could lighten up a little bit? Call a time-out to the perpetual offense that we take, on a daily basis, to all those people who are wrong and rapidly leading us to the brink of global destruction? To all those liars and cheats and power-hungry, self-righteous greedy ne’er-do-wells who are leading the rest of us down the proverbial primrose path to poverty, servitude and sore-throats?

            I didn’t think so – OK, never mind.

            It is an interesting day, though, with all of the commercial images that are thrust upon us, from seemingly happy pilgrims in funny clothes gorging themselves to the Waltons (gorging themselves) to the paintings that were on the covers of Post magazines (if you have no idea what that was, never mind – If you have no idea what a magazine is, just GOOGLE it and trust me), but the theme is often the same: family and friends gathered about some manner of table, gorging themselves…

            …because if there’s anything that will make us grateful quickly, it’s FOOD! The more food, the more gratitude, so by the end of day we’re so grateful we’re comatose! – And already worrying about diets, which do not make us grateful, so…

            It’s an interesting day, but I have no intention of going on today about obesity – Gratitude is where we find it.

            And, indeed, today there are families plus friends plus neighbors plus spouses plus significant others plus kids-who-are-already-making-kids and dogs and whomever else celebrating and enjoying a lovely time with a lot of food – Good for you! Enjoy! Any Respite from the grief and worry of the “real world” is welcomed and deserved – And so has it always been.

            And I’m not going to go on about all of the tragedy and poverty and horror and hunger and loneliness in the world – Or next door; you know that as well as I do, but that doesn’t mean that you can NEVER just forget about it for a moment and enjoy yourself and the people you love, so let’s don’t worry about the bad guys or the good guys today – Tomorrow, despite our best efforts, will be here soon enough.

            So, for just a couple of more minutes, I want to talk to people who are taking care of somebody who needs to be taken care of, whether they like it or not – “Caregivers,” if we need a label – Because I know what today is.

            So do you.

            Today is a day that you get to do even MORE! Ta-Dah! Oh…goody.

            Today is a day when, on top of everything else you were already doing just to get him or her or them (and you) through the day – Any day! – You get to do even more! You get to do something that will make it feel like Thanksgiving, whatever that may be.

            Even if you’re taking care of someone who has no idea where they are, who they are or who you are, it just seems like you should.

            Even if you’re not really all that crazy about whoever it is you’re taking care of, and maybe never were, or barely even recognize them or aren’t really doing this whole “caregiving thing” out of some deep love or commitment, it just seems like you should.

            And even if you’ve already figured out that trying to do anything on top of just getting him, her and you through the day in more-or-less one piece is SO past stupid that you’ve been very carefully pretending that today is just another “…day in the neighborhood,” it just seems like you should, and you also know (just as well as I do) that before the day is over, you probably will.

            Softy.

            And it doesn’t matter what you try to do, whether it’s cook a special meal or have family over or try to take him or her somewhere else or just nuke a Cornish game hen and watch the “Wizard of Oz” (again) – Whatever it is, it’s going to mean that you have to do more.

            Like you weren’t doing enough.

            Oh…goody.

            Maybe we do this out of love – Or duty or honor or to “pay back” – Or just by default: There is no one else.

            Maybe being able to take care of him or her is the most wonderful gift we’ve ever been given! Maybe it’s not. Maybe it feels like a…sentence.

            Maybe it is.

            For many of us, though, we do this out of all of those reasons, but we only admit to some of them to certain people at certain times – “Truth,” sometimes, is a moving target.

            But we can’t think too much about it, because if we do, we might not be able to do anything! We’d paralyze ourselves with the prospect of tomorrow and tomorrow and tomorrow and “…I don’t have time for that because I have to get the meds down him RIGHT NOW!”

Or whatever.

And we know that, on some level, he or she knows what we’re doing and appreciates it – Understands the magnitude of the gift we’re giving, and loves us for it, but it would sure be nice to…hear it.

Faith, sometimes, is a moving target.

So, go ahead and do whatever you think you need to do to make today “special,” because you’re going to do it, anyway – Even if you had very carefully decided not to, you will: You’ll do something that you didn’t have time to do, and you may not even realize that you did it for a few more days – And when you do, you’ll say to yourself, “Am I NUTS?!”

Maybe sanity is a moving target, too – We seem to have a lot of those.

So tonight, when you’re very quietly stealing those few moments with a few leftovers and planning for tomorrow (because you are, and you and I both know it) and thinking that “Thanksgiving” just isn’t what it’s cracked-up to be, remember what that guy in the paper said – He said:

Thank you.

Peninsula Daily News Column 11-15-12 "Have a care to avoid hospital (again)"

            Let’s face it: When you’re sick and in the hospital, there’s nothing more annoying than a hospital full of sick people.

            Oh, sure, you probably get good care (especially locally!) by genuinely decent people who honestly do care, and you get to lay around a lot and most of the time (despite all the old jokes) the food is even pretty decent, but the fact is, you’re IN THE HOSPITAL!

            …and that’s usually not good.

            It’s not good because you’re sick: You feel anywhere from lousy-to-dreadful, you’re scared, you don’t know exactly what’s going to happen next or who’s going to make it happen to you or if it will hurt, you can’t account for all the weird sounds you hear (or don’t), you’re getting pretty tired of telling EVERYBODY your date of birth and maybe you’re worrying about how all this is going to get paid for and how the dog/cat/iguana are doing without you and just getting to the bathroom (or not!) is a major undertaking (OK, we won’t use the word “undertaking”) and you just want to GO HOME!

            GET ME OUT OF HERE!

            Another funny thing about sick people in hospitals is that there’s a reason we’re in the hospital, and that’s scary! We’re sick! We’re…scared.

            And if we have a spouse/family member/buddy/significant other who’s trying to take care of us, they’re feeling a lot of the same things PLUS listening to us casually whisper, every 11 seconds, “GET ME OUT OF HERE!”

            So, do you know what happens? Right: By the time it’s getting close to actually GETTING OUT OF HERE, we’re all so myopically focused on GETTING OUT OF HERE that we don’t hear what we’re being told to do once we finally do GET OUT OF HERE because we just want to GET OUT OF HERE! So, somebody gives us a handful of “discharge instructions” written in Martian and we smile and nod and thank everybody and then whisper sweetly and discreetly, to whoever it is that is trying to help us:

            GET ME OUT OF HERE!

            Do you know what happens then? Right: We go home, breathe a huge sigh of relief, inquire after the iguana, and go to sleep; then, what often happens, is that we get sick all over again (or sickER!) because we don’t know what-the-heck to do to take care of ourselves because all these papers are written in Martian and we didn’t really hear much of anything because all we could hear was the sound of our own minds (or voices!) saying, “GET ME OUT OF HERE!”

            And what often happens then is…Right: We end up back in a hospital full of sick people. Oops.

            And this is particularly likely to happen to those of us who have a chronic disease or condition, like heart failure or diabetes or COPD or pneumonia, etc. OOPS!

            So, what if you had somebody whose job it was to actually coach you through what to do when you got home? Who could actually understand those Martian instructions? Who could (and would!) help you figure out the difference between the prescriptions you were taking when you went in and the ones they sent you home with and the ones you’re supposed to be taking now? In other words, walk you through it? Yeah? And what if it didn’t cost you anything? YEAH?         

This coach could (and would!) help you figure out who you need to make an appointment with, and when, how to get there, what to say (and ask!) when you get there and how to keep track of what’s happening to you, the goal being to NOT end up back in the hospital, worrying about an iguana with abandonment issues. Really.

It’s called “Care Transitions,” if you care, but the idea is simply to help you, Patient, transition from this care setting (hospital) to that care setting (HOME!) so you can stay where you want to stay, which probably isn’t in the hospital.

Is this about money and healthcare costs and all that jazz? Sure! If you’re not bouncing in-and-out of said hospital every other day, it’ll save everybody money, so…OK! But that really isn’t the point if you’re you, is it? The point is to make it at home and have your life, right? So, you wouldn’t do this…why?

Right, so here’s what you (or your “person”) needs to do if you’re in the hospital or about to be or just got home and don’t read Martian: Call 417-7315 (Olympic Medical Home Health) or 452-3221 (Information & Assistance) and say, “Care transitions,” or something close to that, or just tell whoever answers the phone what’s going on – They’ll figure it out; OR, tell the folks who are caring for you in the hospital that you want to know about “Care transitions” – They’ll figure it out, too.

That’s all – The rest will happen TO you. What you’ll have to do is try to pay attention and tell the truth and be the best “patient” you can be, so you won’t have to keep being a “patient,” but don’t worry about that too much – These folks understand that you’re sick.

This works – I’ve seen it – And it doesn’t hurt or cost us anything, so why not?

The iguana will thank you.

Peninsula Daily News Column 11-8-12 "Open season starts for Tax-Aide help"

            Does it ever feel to you like the whole world is going to Heck in a hand basket (whatever a “hand basket” is – Or, for that matter, whatever “heck” is)?

            I know; me, too.

            As if Medicare’s “open enrollment” wasn’t enough to drive you back under the covers (we have four weeks from today!), it seems like all we hear about is what’s wrong, or who did what to who, or who is trying to do what to who, or greed, or lies or how the world is going to end soon or…You know. It’s all around us, all the time.

            And we begin to wonder, “What happened??” Oh, sure, we knew “Andy of Mayberry” was a TV show, but…GEEZ! There used to be simple, decent people around who behaved simply and decently, if a bit…oddly. What happened? It’s…scary.

            I’m not personally convinced that “it” is any worse than it ever was; it’s just that media make us privy to every bad, scary thing that happens in the world IMMEDIATELY! But if that’s all you hear all the time, you have to begin to wonder. It’s…scary.

            And in the face of all that sadness and horror, we feel helpless – Powerless; there’s nothing we can do. There’s nothing I can do.

            Yes, there is.

            Where I end up, when I get lost in all that fear and all those discouraging words, is realizing that I can’t fix all of “that” – But I can do a little something to make my little corner of this very strange world a little better, and so can you. Listen:

            This is the time of the year that TAX-AIDE is recruiting volunteers to help them help people who need help; yes, I know it’s “open enrollment” and I know the days are getting shorter and colder and I know that the holidays are coming and I don’t care. This is something that some of us can do to make our little corner of the world better, and it probably won’t be fun – Unless you think being showered with gratitude is “fun.”

            You’d have to show-up in Sequim for “new volunteer orientation classes” on December 4^th and 5^th, and then you’d have to study your little hearts out using IRS-provided materials and tax preparation software to learn how to electronically file tax returns. Sound fun so far? It gets better.

            Then, you’ll get to go back to Sequim on January 3^rd and 4^th for “review classes,” and then you’ll have to pass an IRS test at the “advanced” level (because it doesn’t help people to help them if you don’t know what you’re doing) AND sign a IRS “Standards of Conduct” document that says you’ll act like a good and decent human being- Andy would’ve been proud.

            THEN, you’ll get to work your tail off (metaphorically speaking) all through “tax season!” TAX-AIDE will ask you to work (oh, Yes Virginia – This IS “work!”) at least four hours per week, but they’ll need you more than that; well, I’ve never lied to you before…

            You do not have to be 65 or retired to do this; yes, TAX-AIDE is sponsored by AARP, but you don’t have to be a member or join-up or whatnot - TAX-AIDE serves all comers who are low-to-medium income. Period.

            In my never-ending quest to overstate the obvious, I’m forced to observe that not all of us are cut-out to prepare tax returns; OK, but that doesn’t mean that there isn’t something else you could do to help, right? I mean, they’ve got to have “coordinators” and publicity people and “facilitators” (think “crowd control,” or “hospitality”) and probably “grunts” and “techies” and who-knows what else! Are you willing to at least think about this?

            OK, here’s what you do: Contact AARP at www.aarp.org for an online application. No? OK, try this:

• In Port Angeles, contact Lois Bellamy at 457-1497 or lois_bellamy@mac.com ;
• In Jefferson County, contact David Self at 385-2617 or dcself@olypen.com ;
• In Sequim, it’s Gail Anundson at 582-1295, sequimgail@gmail.com ;
• …and in Forks/West End, try Corinne Spicer at 374-6332, forkstaxaide@hotmail.com .

These folks need to know who’s willing to help by December, so don’t think about this too long; besides, what’s to think about? You’re not going to be able to tear yourself away from the 119^th rerun of “It’s a Wonderful Life” long enough to learn the IRS tax code? Oh, come now!

Helping TAX-AIDE probably won’t save the world from Handbasket Land, but it will help people who want and need that help, so our little corner of the world will be a little better than it was, because of what you did.

And for most of us, my friends, that’s as good as it’s going to get.

Peninsula Daily News Column 11-1-12 "Special enrollment period starts December 8"

            HEADS UP! If you’re planning on attending the 6^th annual “Building Your Caregiver Tool Box” conference on Saturday, November 3^rd (the day after tomorrow), you need to know that it’s been moved to the Dungeness Valley Lutheran Church at 923 N. Sequim Avenue in (you guessed it) Sequim! Everything else is the same: 8:30 to 3:30, free lunches and snacks (free everything!), a chance to learn some stuff that folks like us could stand to learn and a whole bunch of people who are doing the same thing – Taking care of somebody who needs to be taken care of.

            See you there. Now:

My plan for today’s column had been to write about bed rails – Yes, “bed rails.”

            Everybody who works in a hospital or a skilled nursing facility or some such is thinking, “Right, bed rails. I get it.” You’re thinking, “Bed rails?!” Oh, yes I can…

            …and in the future I still may, just to prove to you that I can do it, but not today; no, today is going to be about Medicare (again) because, as per the bumper sticker that would probably make me rich, Medicare…happens.

            Here’s what’s happened this time: As just about everybody who is even distantly concerned with Medicare well knows, we are right in the middle of what most of us call “open enrollment” for Part D and Advantage Plans, so what happened? Well, some Part D, and Advantage Plans decided to leave certain areas, so won’t be around next year, and because they are private plans, they can do that.

            Oops! OUCH!

            So, that’s what we’re about today, and what I’m going to tell you here is Federal stuff – National stuff – So, if this happened to Cousin Clark in Kansas City this will apply to him too, OK? OK. So, if you’re Part D or Advantage Plan (most likely, the latter) is leaving your county in 2013, here’s what you’re looking at:

            In addition to the “open enrollment period” that we’re smack in the middle of, you will also have a “special” enrollment period that will run from December 8^th through February 28^th, 2013 to switch to a new Advantage or Part D plan; remember, this is ONLY if you’re Plan is leaving! – Not liking your current one, or finding a better deal or just being contrary doesn’t count – Your Plan has to be leaving; if they are, you’ve got until 2/28/13. Your new Plan’s effective date will depend upon when you actually enroll.

            IF the Plan that is rudely abandoning you is an Advantage Plan, you could decide to join a Medicare Supplement plan (aka MediGap, MedSupp). If you do that within 63 days after your current Advantage Plan terminates (probably December 31, 2012), the MediGap plan has to accept you WITHOUT A HEALTH SCREENING, which is also known as “guaranteed issue.”

            It’s OK to go back and read that again, because it took me several tries to write it. OK? That could be a very big deal for some folks.

            The “bad news” is that if you’re under 65 on disability, you’re still limited to the MediGaps that will “accept” you. I’m sorry – Really. I know this is a HUGE blow to some of you, and I wish I had a better answer.

            So, what if you’ve been lounging about in the Caribbean and don’t get around to switching to a new plan by December 7^th? Well, if you have LIS (“low income subsidy,” “extra help” – We’ve talked about this before), Medicare will automatically switch you to a new “benchmark” plan that will kick-in January 1^st, UNLESS you choose a new one by December 31^st (go ahead, read that again – It IS confusing). If you get “switched,” CMS (Centers for Medicare and Medicaid Services) will send you a blue letter (yes, BLUE) telling you what plan you’ve been switched TO…

            …but you still have until 2/28/13 to change that; besides, if you do have LIS, you can actually change anytime! Whew!

            Now, if you don’t have LIS and you were carousing in the Caribbean, Medicare will return you to “original” Medicare (meaning, Part A/Part B), with no other coverage, which means no “MediGap” – But you still have until 2/28/13 to do something.

            If any of this is happening to you or somebody you like, start working on this NOW! And, info on available plans for 2013 is up on www.medicare.gov now. Should you decide to move to a different Advantage Plan, be sure to check with your medical providers FIRST, to be sure that they accept that plan; otherwise…Oops!

            I know. If none of that made any sense at all, just call any of the numbers at the end of this column and decent people will help you – For free! – Without trying to sell you anything or make you feel like an idiot, because you’re not.

            No, you’re not; I know that this can all make you feel like you are, but you’re not – It IS unbelievably complicated! And I wish I could tell you when it was all going to start making sense, so regular people could actually understand it, but I can’t, because I don’t know.

            Nobody knows, so here’s the only thing you can do:

            The best you can.

            I’m serious: There’s no magic decoder ring or secret file or wonderful web site or exceptional salesperson or humanistic insurance company that can make this all be fine – And if anybody tells you that there is, they’re either lying to you or trying to sell you something.

            What there is is good people, who genuinely care and will try their best to help, but that’s as good as it’s going to get; in the end, it’s on you.

            It’s on us.

            Here’s what I can absolutely guarantee you: What will happen if you do absolutely nothing?

            Nothing good.