Peninsula Daily News Column 4-25-2013 "Independence focus of PA fair"

          It occurs to me that, from time to occasional time, I go on about this-or-that event and achieve previously unparalleled levels of literary excellence in explaining what is going to happen at said event, but I may not do quite as good a job at explaining why you might care, so let’s start there.

          I think most of us have figured out that many of us who populate the North Peninsula are well past worrying about puberty; specifically, we’re “Elders” (or within sight of that worthy goal) and have realized that immortality is likely…elusive – Terminally so; thus, if we’re smart, we start thinking about what these years might look like; VERY specifically, how we want them to look.

          And if someone with too little to do comes along and asks how we want to spend those years, we’re likely to say something like, “I want to stay independent in my own home!” – Or, something a lot like that, but the emphasis is likely to be emphatic.

          I hear you – Me, too – So, the event that I’m about to go on about is emphatically called a (the!), “Staying Independent Fair!” I know that doesn’t exactly roll off your tongue, but if we got too clever about the title, then nobody would know what-the-heck we were talking about and things probably wouldn’t go very well.

          We, at “Information & Assistance,” sat down and said to ourselves, “OK, what might folks actually need or want to know in order to ‘stay independent in their own home’?” – Or something a lot like that, but we were pretty emphatic, too.

          So, on Friday, May 3^rd, from 10:00 in the morning until 2:00 in the afternoon, at the Port Angeles Senior Center (328 E. 7^th in P.A., if that’s news), we’re going to give you an opportunity to learn a whole lot about what you didn’t know about a whole lot of stuff that has to do with “staying independent;” for instance:

·       Blood pressure checks, blood oxygen saturation levels, sleep health and foot care info – The healthier you are, the more likely it is you can stay put;

·       A presentation by Jim Hallett, local financial planner, on finances in (or about) retirement – This is America, money counts!

·       Access to an Elder Law attorney – Ask questions, get answers, on-the-spot;

·       “Environmental modifications,” meaning “how to make your home and the stuff in it as friendly as possible, so you don’t have to be 38 to keep living there;

·       Depression, pain management, dental hygiene and diabetes prevention (or how to live with diabetes and still have a life;

·       “Chronic Disease Self Management” – Learn about how to learn about how to get on top of these things, so they don’t get on top of you!

·       “Balance & Falls” assessments, “Best Use of Your Pharmacy” (there’s a whole more to that these days, than there used to be), Paratransit, vision and vision loss and hearing loss and how to deal with it/them, housing options, library outreach and on and on…

Here’s one of the best parts (he said, modestly): All of us from “Information & Assistance” will be lurking about the entire time, with vast multitudes of info on vast multitudes of subjects, like advance directives, in-home care, Medicare, Medicaid and health insurance in general, assisted living and skilled nursing facilities – Just about anything you can come up with that has to do with “staying independent” – And here’s the best part of the best part: We’ll all just be there, so you can talk.

What often happens to many of us is that we know what’s “wrong,” or what the “situation” is, but we don’t have the foggiest idea what might help, because that’s not the world we’ve lived in; well, it is the world WE live in, so just come on by, find one of us, tell your story and then we’ll start talking (together!) about what might make things better – Remember, you don’t know what you don’t know, because you don’t know it.

This whole thing is free – Very, totally, completely, utterly FREE! Hey, we’ll even throw-in free sack lunches for the first 200 folks, and some of those lunches will have prize coupons for free trips with the Senior Center! There’ll be a “fun zone,” with all kinds of stuff from “Zumba” to “Line Dancing” to “Wii Fit.” The Humane Society is going to show up with critters available for adoption (loneliness kills) – Maybe an herbalist, and a massage therapist and an acupuncturist – And maybe a meteor shower! (Not really, I just threw that in to see if you were paying attention – I’ve cancelled the meteor shower)

Have I left things out? Sure! Because this isn’t “War and Peace,” that’s why, and there’s a limit to how much I can get into one column, so try this: Just come by – Whenever you want, for as long as you want – And see what you see. Just wander around, look at stuff, ask questions (if you have some) and see what you think:

·       maybe something will “help;”

·       maybe several things will help;

·       maybe you’ll realize that you should have been thinking about something that you had no idea you should be thinking about;

·       Or, maybe, you’ll just have a fun and interesting time and be kept off the streets, for a while.

Friday, May 3^rd, 10:00 to 2:00 at the Port Angeles Senior Center, because one of the best ways to “stay independent in your own home” is to GET OUT OF THE HOUSE!



Peninsula Daily News Column 4-18-2013 "Bedrails can be both lifesaver, hazard"

          Some time toward the end of last year I confessed that I had been about to write a column on bed rails when I became derailed by something else that seemed more important, so I didn’t; I did, however, threaten you with making good on that threat at a later date.

          Some of you thought I was kidding: “Bed rails?!” was the response I received from more than a couple of you; actually, it went something like, “…we’re all leap-frogging from one crisis to the next on an hour-to-hour basis, and you want to talk about bed rails?!”

          Well, yeah, I do and here’s why: Bed rails can (and, sometimes, do) kill – Or come close, or injure or just make a bad situation worse. Let’s back up a bit.

          Another thing that kills, injures or sets folks on a permanent downward spiral on a pretty regular basis is falls. It sounds kind of silly – Almost funny, in a funny sort of way – But the truth is, it’s true: Falling over puts many thousands of us on a glide path to permanent disability and/or death every year. Along with falling over, another way someone can fall is to fall “out of,” like a bed.

          There can be any number of reasons why a person could fall out of bed, but the one that most of us can get to the quickest is the scenario where a person has dementia (think, Alzheimer’s): They don’t know where they are or why they’re there, they’re “somewhere else” in their minds or they’re scared or they need or want something or…So, they try to get out of bed, and BOOM! It’s scary, dangerous, can be life-threatening or injure the person to the point where a tough situation just got a whole lot tougher.

          And if you’ve ever been a caregiver in that situation (or are now), you know what I’m talking about.

          So, a rational, caring person thinks, “Prevent the fall!” Good! So, what do we do? We install bed rails to keep the person “safe.” Not good.

          Bed rails look pretty benign and seem intuitive: You (caregiver) can still see “in” – They (person being cared for) can still see out and don’t feel like they’re reclining in a casket, and CLICK! One less thing to have to worry about.

          We usually see bed rails in facilities (nursing homes, what-not) or hospitals, but more and more of us, as we’ve become “caregivers,” have had them installed at home, because that’s the only place where we can afford to take care of somebody who needs to be taken care of. They are, after all, commercially available and we caregiver-types are all about “SAFE” (especially since we can’t hover over our person 24/7, although we try), so it’s one less thing to have to worry about.

          I certainly support the sentiment AND the line of thought, but the research says (you know, “evidenced-based,” and all that) the rate of falls is actually higher with rails and more likely to cause injuries, in addition to a significant risk of asphyxiation, or strangulation, or…Yeah, it’s actually worse. If you’re around these things, look at them from this perspective:

          Bed rails don’t stop folks from trying to get out of (escape from?) bed, so they try; they try to get through (injuries, broken bones, asphyxiation, strangulation), under (same things) or over – BOOM! “Wow! I never thought…” Of course you didn’t! But here we are.

          Now, can bed rails (particularly those with advanced designs) ever be a good thing, like in hospitals? Sure! It all depends upon the person and what’s going on with them and where they are and and and…But if the scenario is one of long-term care (they’re not going to get better and go home and live happily ever after), these things get real scary, real quick.

          I could quote all kinds of national studies and research and statistics and blah blah, but I like you better than that, so I won’t; the fact is, it’s a fact. Does it happen to everybody? Of course not! But here’s the deal: We only have to be wrong once.

          So, let’s go back to the original problem, because it’s still the problem. I mentioned “facilities” earlier, but if you walk through them, you’ll see that, generally speaking, these folks have come up with some pretty ingenious ways of getting around it, like putting the bed on the floor, or with one side against a wall with thick pads on the floor or both or…There are others.

          If you’re a caregiver – At home – You just immediately saw some obvious problems with either or both of those above. I know; so, talk to some pros, do some homework, look into it – Remember, it only takes once for the “solution” to become a bigger problem than the “problem.”

          And if you’re the family of a person (particularly in a facility!) who has fallen out of bed (it happens – I know – I’ve been there), don’t be too quick to holler, “Get some BED RAILS on here!” Yes, the problem needs to be solved, or the threat needs to be reduced (which sounds more like life-on-Earth to me), but setting up a potentially fatal obstacle course might not be the smartest thing we could possibly do.

          I’m sorry. I know that, for some of us, this just means another thing to do – Another thing to figure out! – Another thing to worry about, and most of us didn’t need that, but here we are.

          Yes, you can.

         



Peninsula Daily News Column 4-11-2013 "A little Q-and-A for your edification"

          It’s the 11^th day of April. We’ve made it past the Ides of March and April Fool’s Day, but don’t get too relaxed because the deadline for income taxes is four days away – If that’s news to you, stop right here, right now and GO DO YOUR TAXES! We’ll wait.

          Back? Good! How about we just take it easy today and answer a few of the questions that some of you have been shooting my way, OK? A little of this, a little of that…

Q: I’m hearing all kinds of things about “ObamaCare” and mandated health insurance and something called an “Exchange” and and and…Is there something I need to do?

A: Not if you live in the Medicare world, no – Nothing has changed and nothing radical is on the brink of changing, so just continue your fearless and intrepid navigation of Medicare, and sleep peacefully.

          If you aren’t Medicare-eligible, this touches you: Yes, “ObamaCare” mandates health insurance, with a few exceptions, but we won’t go there today; and, of course, if you already have health insurance (probably through your employer), no worries. If you don’t, you’re going to have to get it, and that’s where the “Exchange” comes in.

          This refers to a “Health Benefit Exchange” (every state will have one and Washington is working feverishly on its own), which is really a fancy phrase for a health insurance marketplace. It will be a website where you can go in, put in your information (like income, number in household, etc) and it will tell you if (a) you’re eligible for health insurance through expanded Medicaid, (b) you’re eligible to purchase health insurance with the financial assistance of a government subsidy, or (c) no subsidy, but you can purchase insurance – Then will show you what your options are, how good, how much, etc.

          If you’re at all familiar with the Medicare Part D drill, this looks a lot like it and, yes, we’ll be around to help, if you want it or need it, but it won’t kick-in until October 1, for coverage beginning January 1, 2014, so don’t get too excited just yet; again, if you’re on Medicare (or will be in the next 6 months), just forget all of this and start planning your May Day party.

Q: What’s all this I’m hearing about amazing little “personal emergency” devices that do all kinds of things?

A: I have no idea what you’re hearing, but I do know what I think you’re talking about. For years, we’ve had these cool little “panic button” gizmos (e.g. LifeLine, LifeAlert, etc) that we could wear around our necks or as bracelets, so if we fell (or whatever) we could summon help. THESE THINGS SAVE LIVES! The only down-sides were that (a) we had to actually wear them, (b) we had to actually use them, and (c) they were tied into our landline phones, so if we did something irresponsible, like go to the store or church or wherever – Oops! We’re on our own.

          Those devices/systems are still around, but they’ve become a whole lot more sophisticated, and some of you may recall my predicting such things quite a while back, but my abject humility forbids me from pointing that out. Now, the emergency alert (“panic button”) can work from anywhere, and instantly turn into a two-way speakerphone! Now, you can add “medication reminders” that can hold up to a week’s supply and the correct compartment will flash when it’s time to take that dose; THEN (if you don’t take it) there will be an “auditory prompt” and/or a phone call from the call center or a text message or an e-mail. If you still don’t do what you’re supposed to do, it will snitch you off to your family or caregiver, then WATCH OUT!

          You can add motion sensors and “vital sign” monitoring (Yes, even that!) and your family can use it to send you photos or e-mails or whatever AND it will walk the dog! (…ok, I’m kidding about that part…); obviously, you can pick-and-choose what functions you want and want to pay for, but it isn’t as outrageously expensive as we might assume. For those of us who live alone and/or family is a ways away, these could be hugely helpful. Care to go shopping? OK, do a web search for “personal emergency response systems” and watch what comes up. No? OK, call any of the numbers at the end of this column and go from there.

Q: I got a call from Social Security wanting to verify my Social Security number…

A: No, you didn’t – You got a call from somebody who wanted to get your Social Security number! Social Security will NEVER do that!

Q: My son says I have to get something called an “advance directive” – Is he right?

A: No, because you don’t “have to” do anything! An “advance directive” is a legal document in which you state what “heroic measures” you do or don’t want, in the event that something medically bad happens to you and you can’t speak for yourself. Do I think these are a good idea? YES! But only because they allow us to speak for ourselves when we can’t speak for ourselves, but do you “have to?” No; and, by the way, if you want ALL of the heroic measures in the event of an event, then doing nothing is exactly the right thing to do.

Q: What does the phrase “dual-eligible” mean?

A: It refers to someone who is eligible for both Medicare and Medicaid at the same time.

Q: Do I have to have a will? I don’t have much of anything.

A: This comes up all the time: No, there is no law that forces you to make a will. Do I think we all should? Yes! – Because we’ve all got stuff, and if we don’t decide who-gets-what before we go tripping into the next phase, somebody (and probably somebody we claimed we love) is going to have to clean up after us or leave it to the State of Washington to do. If that’s the legacy you want to leave…

Q: Will you tell my mother that she should put me on her checking account?

A: No.

          The end.



Peninsula Daily News Column 4-4-2013 "Key to golden age? Really a 'gray' area"

          For a lot of us, for quite a while now, here’s how we thought about life: Live, live, live…DIE!

          Well, OK, perhaps we injected a bit more detail into that line of thought, but on a galactic scale, that’s pretty close.

          And if most of us were offered the prospect of live, live, live then DIE! Suddenly! BOOM! Gone! Most of us would probably go along with it, an understandable degree of reluctance notwithstanding.

          The “problem” for many of us is that many of us won’t have that simple a proposition to deal with. Many of us will have to deal with the space in-between live live live and die – That “gray area” (no pun intended) known as “long-term care.” Don’t let that phrase get you sideways, because it means exactly what it sounds like it means: Somebody needs some level of “care” (meaning, they can’t do everything for themselves anytime and any way they choose to) long-term – They’re not going to get “better,” then rush right back to snowboarding Kilimanjaro.

          That’s the “problem,” especially when we didn’t have children upon whom we can gleefully thrust the burden of ourselves, or a cooperative extended family or a bank account that requires its own bank – Oops. Now what?

          There is no simple or pat answer, and the whole darned country (and, soon, much of the world) is going to be trying to figure out the same thing. What I asked you to do last week was to think about what’s important to you – What are the activities, pursuits, undertakings (OK, maybe not “undertakings”), rituals, habits, values of your life that are genuinely important to you? More than just this chair in this room in this place on this street in this zip code?

          What matters?

          And if you’re feeling somewhat contrary, you could also give a modicum of thought to what doesn’t particularly ring your metaphorical bell, like:

*I HATE yardwork!

*I DETEST having to fix little things around the house!

*I wish I didn’t have to go downstairs to do the laundry!

*I wish I didn’t have to own, maintain or drive a car! But I SURE want to go where I want, when I want!

*I like to cook, but I loathe cooking for one.

*I hate being alone!

*I hate being around people, 24/7!

          You get it.

          Some folks in some places put together a “Golden Girls” kind of scenario, where two, three or four throw in together to spread the load and compensate for who-can’t-do-what – Or doesn’t want to.

          Some take it to more of a “communal” level, which doesn’t necessarily mean that you have to grow your hair down to your waist, eat rutabagas and chant.

          Some put their heads together and buy places that are right next door – A “share the load” arrangement.

          Some communities organize “volunteer banks,” where you get “points” for helping someone else, which you can then “cash in” for getting some help.

          I know of groups of folks who threw-in together and bought an entire apartment house!

          Some folks just focus on making their current place as friendly and accessible and low-maintenance as possible, then focus on their money and their health.

          Some make old friends their durable powers of attorney.

          Get the picture? There is NO picture! We have to make our own.

          So, let’s say you’ve made your own – Is it perfect? I doubt it. Does it sound like you’ll live happily ever after, no matter what might befall you? Of course not – What part of your life ever did?

          Right; but you adjusted – So did I.

          Without getting too philosophical or too spiritual, here’s what I think the “goal” is: To be reasonably happy – Reasonably content – Most of the time; after that, you have to fill in the rest.

          So do I.

          And if you need some ideas for solving particular “problems,” shoot me an e-mail and we’ll talk – But you have to create the picture.

          I’m sorry. I know that none of this was an “answer,” but that’s because there is no answer. We are “BOLDLY GOING WHERE NO ONE HAS GONE BEFORE!”

          Live long, and prosper.