Peninsula Daily News column 5-19-11 "Forks Family Fair slated this Saturday"

A couple of weeks ago (on May 6, to be achingly exact), we celebrated an “Information & Assistance Fair” with about 150 of our closest friends at the Port Angeles Senior Center, which I, for one, thoroughly enjoyed. If you made it – Thanks! If you didn’t, you can always call 452-3221 (1-800-801-0070) and get access to all the same stuff, and all the same people, for free. Decent people will help you, without trying to sell you anything.

                Now, having lived here for 30+ years, I know what a lot of people on the West End are thinking: “Swell – Just another agency that thinks civilization ends where the lake begins.”

                OK, granted, the “civilization” discussion might be another matter, but to get to what you’re really thinking, I say, “Hah!” (Well, I didn’t really say “Hah!” – I almost never say “Hah!” – But I thought it…) and I thought “Hah!” because the day after tomorrow (May 21, to be achingly exact), we’re throwing the first annual “Forks Family Fair” in…Port Angeles!

                No, I’m kidding; obviously, we’re throwing the “Forks Family Fair” in Forks! At the Recreation Center, to be achingly exact (90 Maple Street, to overstate the obvious) from 10:00 a.m. to 2:00 p.m., and you care about this…why?

                Well, for 4 hours on a Saturday, you can get access to a whole lot of information in one place, for free, without having to sit through any speeches or programs. You can just wander around, gather up info, talk to any of us who will be lurking about and leave when you’re darned good-and-ready; for instance:

• Are you taking care of somebody who needs to be taken care of, whether they like it or not? Then, you’re a “caregiver” – Whether you like it or not, so you might want to see what’s available for Family Caregivers or “Relatives as Parents;”
• How about Olympic Medical Home Health?
• How about an expert on Veteran’s Disability?
• How about face-painting for kids (well, I assume it’ll be mostly kids, but one can never be sure…)?
• Free (Yes, FREE) sno-cones!
• …or, for that matter, free refreshments!
• Or, maybe you have a few thousand questions about health insurance and/or Medicare and/or Medicaid? Yup, people will be there who know what they’re talking about and will NOT try to sell you anything!
• …and “Sunshine & Rainbows,” and “Concerned Citizens” and “OlyCAP” and “Assured Hospice” and and and…
• …and, of course, good old “Information & Assistance” – Us.

See? Where else are you going to find this on a Saturday?

Now, here’s the best part: Maybe you don’t even know what you’re looking for – Maybe you just know what’s wrong, or what might be wrong or what could go wrong or what you’d rather not have be wrong, and you just need to share it with someone who will actually listen and give you some ideas without asking you for money – Come on.

Yes? Day after tomorrow, May 21, 10:00-2:00, at the Rec Center, free. Or we can just grab a couple of sno-cones and debate where civilization really ends…

Now, just a quick little something from a reader who has, obviously, “been-there, done-that,” and the subject is finding a caregiver. What people often mean when they use that phrase – “…finding a caregiver…” – Is finding someone to hire to come in and “help,” which can mean anything from helping with the housework to helping with errands and chores to helping with VERY “personal” care.

There are generally two ways to do that: (1) search out one of a number of local “homecare agencies,” interview them, get their rates and off you go; (2) find someone to hire, privately, on your own, so let’s talk about #2.

The good news is that, sometimes, you can find a saint who will change your family’s lives, for less than you might have to pay a homecare agency. The BAD news is that, sometimes, you might find a “predator” who will steal you blind – Or worse; it’s a crapshoot, on a good day.

If you’re thinking “AGENCY!”Go to http://www.o3a.org/, where you can find a list of all the homecare agencies in the area. If you’re thinking, “Nooo…I really need to save a few bucks, so I’m going to look around…”, then do a couple of things:

1. Get a copy of our booklet, “How to Hire In-Home Help,” then read it – Twice;
2. References, references, REFERENCES!
3. …and now, a suggestion from a reader you cares, and that reader says:

“…you might want to encourage people looking for caregivers to do some of their own background search by looking at Washington State court records online.

Go to http://dw.courts.wa.gov// Click on Name Search, click on Accept, then type in last and first names. A middle initial might help distinguish the person from others with the same name.

This works to investigate anyone who has lived in Washington State and has gone to court for any reason.”

While I haven’t actually tried it, it sounds like a good idea – There is no such thing as too much info on a person you are going to bring into your home. In the booklet mentioned above, “How to Hire In-Home Help,” you’ll also find info on how to run your own background checks.

Enough? OK, see ya Saturday. You bring the chocolate chip cookies and I’ll bring the sno-cones – You’re on your own with the face-painting…

Peninsula Daily News column 5-12-11 "Helpful tips on Alzheimer's Disease"

I learned a long time ago that it’s not my job to have the best idea – It is my job to know the best idea when I hear it. This is one of those.

                Not long ago I attended a free educational seminar on aspects of Alzheimer’s and memory loss. At that seminar, I picked up a terrific little booklet called, “Survival Tips to Help with Memory Loss,” put together by “Dungeness Courte Alzheimer’s Community” in Sequim; basically it’s a “help guide” for caregivers of folks with Alzheimer’s (or, actually, any form of dementia). It’s excellent.

                It’s so “excellent” that, with permission from “Dungeness Courte,” I’m reproducing it here. I had nothing to do with its contents – I’m not that knowledgeable or insightful. The only “edit” I’ve made is to change all the “her/hims,” ”she/hes” and “them” to “he” – To save space and the reader’s sanity.

                If anything here helps even one caregiver get through a day, it was column-space well spent.

                Here it is:

PACING Reasons: He is scared and unsure of where he is.

What you can do to help him:

• Walk with him.
• Hold his hand.
• Tell him that he is safe and loved.
• Offer him a snack he can carry in his hand as he walks.
• Keep the walkway clear so he is safe from falling.
• Try to distract him from pacing. Ask him to look at a magazine or work a puzzle with you.

LATE AFTERNOON BEHAVIOR Fidgeting and acting nervous, becoming easily upset, and wanting to go ‘home’ when he is already home are types of late afternoon behavior; to him, ‘home’ means feeling safe.

What you can do to help him:

• Give him a hug.
• Tell him where he is.
• Tell him he is safe.
• Tell him you are not leaving.
• Change the topic.
• Turn on more lights.
• Close the blinds or curtains.
• Ask if he is hungry or if he will help you in the kitchen.
• Offer an easy activity, like sorting spoons or forks, or ask him to wipe off the table.
• Use a happy voice and make everything seem like a lot of fun.

USING THE BATHROOM

What you can do to help him:

• Mark the bathroom clearly with a sign that says ‘bathroom’ or a picture of a toilet.
• Watch for cues, like fidgeting with clothing, or pacing.
• Write down the time of day that toilet accidents happen to better predict future accidents.
• Walk with him to the bathroom every 2 to 3 hours. Don’t make a big deal out of it. Don’t wait for him to ask. Say, ‘We need to go to the bathroom’.
• Carry extra toileting supplies with you when you are away from home.

REFUSING CARE

What you can do to help him:

• Keep a daily routine.
• Don’t ask, ‘Do you want to…bathe, brush your teeth or get dressed/’ In a happy voice, say, ‘We need to…’
• Have all supplies ready before you start an activity.
• Explain to him, in simple terms, what you will be doing.
• Make sure his refusal is not because he is afraid or does not understand what you are asking him to do.
• If he begins to fight, step away. Try again later.

HOME SAFETY

What you can do to help him:

• Try to make his world simple.
• Use plain-colored placemats, tablecloths, bath towels and sheets.
• Block off stairs so he can’t fall up or down them.
• Have all of your house locks keyed to the same key.
• Place safety latches up high and down low on doors leading to the outside.
• Have him wear an ID bracelet if he wanders, and sign him up for the Alzheimer’s Association’s ‘Safe Return Program’.
• Use locked cabinets for soaps, cleaners, poisons and medicines.
• Take up all throw rugs.

WANDERING

• Make sure that he wears a medical ID bracelet.
• Keep a recent photograph of him to help police if he becomes lost.
• Keep all of the doors locked.
• Consider installing a keyed deadbolt.
• Place safety latches up high and down low on doors.
• Enroll him in the Alzheimer’s Association’s ‘Safe Return Program’.
• Make sure he gets enough exercise and sleep.
• Let him do chores, such as folding clothes or helping with dinner.
• Place cloth of the same color over doorknobs, or paint doorknobs and doors the same color as the walls.

COMMUNICATION

• Pay attention to what he is trying to tell you.
• Keep what you are telling him short and simple, but not child-like.
• Use one-step instructions when asking him to do what you want. This will decrease his frustration level and make each activity a success for him.
• Don’t tell him more than he needs to know at one time.
• Be patient. Give him lots of time to answer your question.
• Give him lots of time to finish what he is trying to say.
• Don’t argue with him. It is easier to agree with him and do what you had planned, anyway.
• Don’t try to reason with him, you will just get angry and he will not know why. Change what you are talking about to something he likes.
• Don’t correct or fuss at him for getting something wrong. Does it really matter? It may only make him feel bad.
• Don’t say, ‘I just told you that’. Just repeat the answer you have already given him.
• Don’t ask him to remember things that happened in the past. Talk about what you remember happening and how he was a part of it.
• Don’t say, ‘You can’t’. Say, ‘Do as much as you can and I will help you’.
• Don’t demand things from him. Always show him what you want him to do.
• His entire day depends upon how you speak to him. Speak very calmly and know that your body language needs to reassure him.

EATING

• Serve meals at the same time every day.
• Serve foods with different colors and textures.
• Make the table a calm place to eat.
• Use plain-colored dishes with no pattern to set off the color of the food on the plate so he can see the food.
• Use a shallow bowl with a lip on it if he keeps pushing the food off the plate.
• Put only the knife, fork or spoon he needs to eat with next to the plate.
• Allow plenty of time to eat. Don’t rush him.

If he refuses to eat, it may be because:

• He has too many choices on his plate. Try offering one food item at a time.
• He may not know how to get started. Show him the act of eating.

IN THE CAR:

• Keep the car keys out of sight.
• Always talk to him about where you are going.
• Tell him where you are going, as you leave the house.
• If he wants to know why he can’t drive, tell him the doctor or insurance company said he could not drive anymore.
• Open the car door for him.
• Help him put on his seatbelt. Tell him each car’s seatbelt is different if he has difficulty putting it on.
• Use the child safety lock feature on the car doors so he is unable to unlock the door from the inside.
• Make trips in the car to places he likes to go, as well as places he has to go.
• In the later stages of Alzheimer’s disease, having him sit in the backseat is safer and less scary for him.
• If he refuses to get out of the car when you get to where you are going, don’t argue with him. Drive around the block and try again.
• If he refuses to get out of the car at home and someone else is there, ask them to meet you at the door and invite him to come in.

That’s it. That’s a lot. Thank you, Dungeness Courte.

Peninsula Daily News column 5-5-2011 "Mom made us perfectly imperfect"

I’ll see you tomorrow, right? For the “9^th Annual Information Fair” at the Port Angeles Senior Center, between 10:00 and 2:00, right? Good!

                But that’s not what I’m here to talk about today; no, today I want to point out that where there’s life, there’s hope – And here’s why.

                This Sunday will the eighth day of May, 2011, which will make it “Mother’s Day;” if that’s news to you, I’m going to guess that you’ve either just completed your annual hibernation OR you are a young, single male.

                Now, granted: I, too, find it difficult to envision young, single males zipping right by the sports section and the comics to get to this particular column, but on the off-chance that has actually occurred, allow me to point out that you are in VERY SERIOUS TROUBLE, and it would behoove you to figure out what you’re going to do about this potentially lethal mega-faux pas RIGHT NOW.

                Most of us live in the “hump of the bell-shaped curve,” which refers to a graphic representation of most polls, research and studies of whomever doing or thinking whatever. It just means that most of us aren’t “outliers” – “Extremes,” if you will.

                Most of us aren’t fabulously wealthy and most of us aren’t totally poverty stricken (although I readily agree that it can often feel that way). Most of us aren’t engaged in the “right wing conspiracy” and most of us aren’t contributing to, or steadfastly implementing, the “left wing agenda.” And most of us aren’t perfect people who routinely appear on the covers of magazines that are strategically situated just above the breath mints, nor do we scare crows at 1,000 yards; no, most of us are somewhere in-between: Basically, good, decent, reasonably sane people who are just trying to make our way without seriously hurting anyone else in the process.

                And it’s for those of us who are perfectly imperfect, residing obliviously in the hump of the bell-shaped curve, that I’d like to share a few quick “pre-Mother’s Day” thoughts, remembering that we started with, “…where there’s life, there’s hope.”

                Sure, I know all about the commercial hype and it’s “…all just a bogus promotion to boost retail sales…” and blah blah blah, but the fact is, here we are – And the fact is that mothers expect something to happen today. Now, Mom, tell the truth: You do. You’d like your “kids,” who could range anywhere from 5 years of age to 68 or whatever, to do something to recognize the fact that you changed your entire life to accommodate her, him or them.

                Whether or not it was “planned,” you went through nine months of physical discomfort, to grossly understate the obvious, not to mention the emotional and financial toll that is routinely taken and routinely ignored, then who-knows-how-many-years of trying to keep her, him or them from (a) killing themselves (or somebody else); (b) fed; (c) clothed; (d) warm, and (e) becoming a reprehensible reprobate, the latter often being the most challenging.

                I suspect you were not always successful, and I suspect you screwed some of it up. I’m absolutely certain that if you could replay the tape, you’d do some things differently – And since you (and most of us) see yourself as the primary “source” of said offspring, you feel responsible for the result; you were, I can guarantee, perfectly imperfect.

                Those of us who were produced by mothers managed to sleep through the nine-month part; then, we just assumed the food/clothes/warmth/part, because we had no idea who else to hold accountable – Since you were THERE, it must be your job – Thus, most of us kid-types tend to focus most of our memories on your less-than-perfect attempts to make us be as close to “perfect” as possible, and here’s what we know: You failed.

                You, Mom, dropped the biological ball and failed to make us rich, happy, healthy, sane people who would attract rich, happy, healthy sane mates with whom to produce rich, happy healthy and sane families. We manage to remember things that we thought you did “wrong,” which may or may not be the same things that you remember as “wrong,” but we’re pretty sure we know whose fault it was.

                So are you.

                But where there’s life, there’s hope – We’re here! We actually have an opportunity to achieve relative happiness – To perfect our imperfection! – To do whatever it is we need to do in order to say, “It was worth the ride.” And we’re pretty sure that we know that WE are solely and uniquely responsible for our successes and achievements.

                Stop laughing, Mom.

                You gave us life, which gave us hope so, in exchange, we’re going to give you…chocolate!  (Doesn’t really work, does it?) How about a card that somebody else wrote and produced? Or roses that somebody else grew? Hey! Let’s go to brunch at a restaurant that someone else owns, where someone else cooks and someone else makes money doing it??

                Yeah, OK, any or all of those beat-the-heck out of nothing, but here’s what we all know that only a very few of us will actually say: The real gift is the time spent – In-person, on the phone, going to get this-or-that and delivering or sending this-or-that – The time spent. The only thing you have less of than money – The time.

                It will always be about the “time,” because that’s what Mom gave away – The time.

                So, on a day that could be any day, less-than-perfect people from less-than-perfect families will get together (one way or the other) and, in a perfect world, exchange “time” for time, while we nurse our guilt, our delusions, our illusions and our “memories,” none of which make much real difference for most of us, because we still have tomorrow.

                We have time. We have life.

                And where there’s life, there’s hope.    

                  

Peninsula Daily News column 4-28-2011 "9th annual information fair set May 6"

                Do you ever wake up in the morning and think about all the different
places you could be? Tahiti? Cancun? Philadelphia? Or the ever-popular first-choice, the bathroom? (OK, me, too)

                But, it’s true: We could be any number of places doing any number of things, within the often-restrictive parameters of our imaginations and circumstances. And since, for many of us, our “circumstances” have become even more restrictive in the last couple of years, we might find our choices somewhat…contained.

                Given that unhappy fact, I have a happy idea: On Friday, May 6, a week from tomorrow, you could choose to be where I’m going to choose to be…Well, at least between 10:00 and 2:00 – After that, where I’ll choose to be is none of your business.

                But between 10:00 and 2:00, I’m going to be lurking about the Port Angeles Senior Center (328 E. 7^th in P.A., if that’s news), with a cadre’ of cohorts, because we’re presenting the “9^th Annual Information Fair!”

                What?

                What do you mean, “what?”? We’ve been doing this for 9 years! OK, maybe you’ve been spending every May in Philadelphia – Here’s the deal:

                This is where we get all of “us” (“Information & Assistance”) in one place at one time, and set up a bunch of tables on different subjects, like “Medicare” or “Long-Term Care” or “Medication Management” or “Medicaid” or “Family Caregiver Support” or or or… Then you get to wander aimlessly about and see what might be helpful or interesting to you or yours.

                The best part is that we’re all there, so if you ask one of us a question that another of us knows more about, we can walk you right over to that somebody and you can take care of your business on-the-spot, rather than calling somebody else at some other time who might be in some other place at some other number…You know how that goes.

                Maybe you need “Respite.” Maybe you need to talk to somebody about “Advance Directives” or “P.O.L.S.T. forms.” Maybe you need help at home and have no idea where to look or what you’re looking for. Maybe you’ve got someone you care about in a facility, and things aren’t going so well – Or maybe you need to find a facility.

                Maybe you’re thinking that someone close to you needs a guardianship. Maybe you’re worrying about your sister in St. Louis. Maybe Part D is looming on your horizon and you’d like to have somebody talk you all the way through it. Or maybe you couldn’t find your car keys.

                Or maybe you have no idea what you’re looking for – You don’t even know what you’re wondering about or what to even ask! You just know what’s happening to you or yours – What’s “wrong,” or could go “wrong” – And you just need to tell someone the story, who might be able to help.

                Then, between 10:00 and 2:00 on May 6, you’ll be in the right place.

                No program, no speeches, no polite applause; well, if you want to be there between 10:30 and 11:30, you could sit down in another room and listen to Paul Corning, from the Attorney General’s “Consumer Protection Division,” talk about consumer fraud and identity theft, as well as mortgage and foreclosure issues – That would be worth the doing! Then you could mosey back in with the rest of us and cruise the tables (Note: Paul will also be staffing a table with information, and answering questions, after his presentation, so you’ll have a 1-on-1 shot).

                A free lunch! I’m serious! I’ll bet you didn’t get that in Philadelphia!

                Door prizes! Access to an Elder-law attorney! (No, we are NOT giving away the Elder Law Attorney!)

                What else do you want??

                Seriously, these really are fun, because we really can just talk. I can honestly tell you that I work with some of the best and smartest people around, and we’ll all be there, so why don’t you be, too?

                We’ll have all kinds of info on all kinds of topics that you can take with you, tables where you can sit down and/or eat and/or talk or just…Rest – No programs, no speeches, no polite applause.

                  So, when you wake up in the morning on Friday, May 6, and think about all the different places you could be, the Port Angeles Senior Center between 10:00 and 2:00 would be a GREAT choice for Choice #2!

                …first things, first.

Peninsula Daily News column 4-21-2011 " A look at some statistics for seniors"

                Statistics, like the Bible, the Constitution or “talk radio,” can be used to “prove” almost anything, because many of us are so assaulted by “facts” that we’re bewildered by the facts – Electing, instead, to believe whatever it is that we believed before the assault – It’s the downside of the “information age.”

                Occasionally, however, it’s rather interesting to just look at some facts – Some statistics – And attempt to decide for ourselves what (if anything) we think about them; so today, just for a few minutes, let’s look at what “we” look like, without headlines or screamers screaming at us about what to believe. If I suffer the uncontrollable need to make an editorial comment, I promise to clearly identify it as such, OK?

                So, here are some selected stats from a “Profile of Older

Americans: 2010,” put out by the Federal “Administration on Aging” – I did

the selecting:

• For openers, they appear to define “older Americans” as 65 or better; as we’ll see, in many cases, MUCH better. You and I both know that “older Americans” means “people that are older than me;”
• Anyway, the “older population” numbered 39.6 million in 2009, which was an increase of 4.3 million (12.5%) from 1999; in other words, one out of every eight folks in the U.S. of A. is 65+ (Mark says: …and we have an interesting tendency to VOTE!);
• Those of us who get to (or have gotten to) 65 or better have an average life expectancy of an additional 18.6 years (17.2 for males, 19.9 for females) (Mark says: So, settle in for the long-haul, and if you’re planning for retirement or your “golden years,” figure on needing a bit more moolah, huh? – Because we are just not dying according to the accepted actuarial table);
• Speaking of money (which many of us often do), the median (meaning “middle”) income of us “older Americans” in 2009 was $25,877 for males and $15,282 for females (Mark says: Doesn’t sound like much, does it? That’s because it isn’t, and those are ANNUAL figures! So, back to planning: The odds are that “Mrs.” will carry on beyond Mr., so if “Mr.” is doing the “financial planning” in the household, you might want to think beyond your additional 17.2 years);
• Money is always depressingly fascinating: According to what we told the Feds in 2008, our collective, major sources of income are Social Security (87%), income from assets (54%), private pensions (28%), government employee pensions (14%) and earnings (25%!). Mark says: Interesting! I’d wager that the “income from assets” and “private pensions” have dropped precipitously in the last couple of years, but did you get the part about 25% of us are working? “Earnings?” So, we don’t get feeble, stupid and disappear at 65?? But I’m sure you also got the part about…
• …Social Security; in fact, good, old Social Security constituted 90% of the income received by 34% of beneficiaries in 2008, 21% for married folks, 43% for non-married (Mark says: Well! Apparently we do better if we’re married, but then, statistics can be used to prove anything. And if our national leaders feel the need to mess with Social Security, I’d suggest that they do it very, VERY carefully);
• OK, back to the gender-gap: Older women outnumbered older men by 22.7 million to 16.8 million. Older men were much more likely to be married than older women (72% vs. 42%), and 42% of older women, in 2009, were widows (Mark says: No kidding. Who would’ve thought? Sparing us all the obvious wisecracks about it being VERY cool to be an “older man,” once again we have to think “planning’);
• Did I say “planning?” Half of older women 75 or better (49%, actually) live alone (Mark says: Think about that: One out of two – That’s a lot of women trying to put one foot in front of the other, day-after-day, alone. And if you’re one of the “kids,” think about that!).  More broadly, 30% of all of us “older Americans” (11.3 million, but who’s counting) live alone. (Mark says: …hmm…Well, “living alone” isn’t necessarily “bad,” if you’ve figured out how to make it work for you…Have you figured that out? Have you even thought about it? Sorry – I’ll try to get away from this “planning thing”);
• Speaking of “voting blocs” (which I actually hadn’t, because I was too busy “planning”), our 65-or-better crowd is going to grow from 35 million in 2000 (“Y2K” didn’t work) to 40 million in 2010, to 55 million in 2020, which is only nine years away (Mark says: If that doesn’t impress people who ought to be impressed, they are simply UNimpressable!);
• …and in case some idiot still thinks that we’re all goofing around the golf course, 475,000 grandparents 65 or better had the primary responsibility for grandchildren who lived with them (Mark says:…and that number is growing. If you’re one or two of them, and you could use some help, call any of the numbers at the end of the column – It won’t cost you anything);
• …but just in case some other idiot thinks that none of us are having any fun, only 11% (3.7 million) of “older” Medicare enrollees received “personal care” from anybody in 1999.

“Personal care” means exactly what you’d guess it means: Somebody else’s hands on your body, helping you do stuff (sometimes, VERY personal stuff) that you’d vastly prefer to be doing yourself; now think about that:

Granted, 3.7 million folks is a LOT of folks! But it isn’t the 35.3 million (look at the increase from 1999, and do the math) that we saw above; in fact, roughly 10%-ish. So, what?

Well, it is still true in my world, and has been for the 24 years that I account for, that folks are more afraid of nursing homes than they are of morgues, so the fact is that most of us will never see the inside of one unless we (a) go to visit, or (b) are in, short-term, for rehab; otherwise, not likely.

So, that means that we have a lot of life left in us, and EVERYBODY needs to realize that! Everybody – Including us.

Mark says: Go do some planning, help somebody, get comfortable and have a little fun, because most of us aren’t going anywhere, anytime soon.

Peninsula Daily News column, 4-14-2011 "Civilian view of Medicare distilled"

                Tomorrow is the 15^th day of April. If that is news to you, I uncharacteristically suggest that you PANIC, because our red, white and blue Uncle has an ever-diminishing sense of humor when it comes to individuals not paying their taxes, as opposed to corporations not paying taxes, which he finds infinitely more endearing.

                If your situation is such that you are not required to pay taxes due to the fact that you are (a) a corporation, or (b) “low income,” this may be the one time of the year when you can unabashedly celebrate your circumstances -  We, who are about to pay, salute you.

                Speaking of large, governmental undertakings, a couple of weeks ago, to our unanimous relief, I finished up a three-week medley on “The Medicare Machine from 30,000 Feet”; since that happy ending, however, a rather considerable number of you have expressed various and sundry opinions on the matter of Medicare, with a few miscellaneous questions thrown in, about the state and the origin of said Machine – The phrase “conspiracy theory” pathetically understates the gist of most submissions.

                Nonetheless (or, less-the-none), being the true blue journalist that I am, I feel compelled to share a distillation of these observations, courageously dismissing “fact,” “history” and even political persuasion, in my usual swashbuckling, journalistic style; thus, near as I can tell, the civilian view of Medicare (which flies in the face of conventional political wisdom, a phrase that defines “oxymoron”) goes something like this:

                In the early days of our national odyssey toward confusing the term “healthCARE” with the phrase, “health INSURANCE,” people who made decisions for people who were considered incapable of making decisions, noted two distinct facts: (1) There was getting to be a lot of old, and relatively poor, people, and (2) should the number of old, poor people continue to grow, there appeared to be an entrepreneurial niche’ in which to develop a lucrative industry that accomplished virtually nothing, except to add dollars to pockets that were chuck-full of dollars – Dismiss “value-added,” and think, “opportunity!”

                Thus was born “health insurance” and, in there somewhere (because we are steadfastly avoiding being confused by facts), Medicare, and the approach is elegant in its simplicity:

                If healthCARE could continue to escalate its cost to the level of being unaffordable, people could probably be convinced that it made sense to send money to people who would, ostensibly, send back that money to people who were providing healthcare to people who needed healthcare, because the people who needed the healthcare didn’t have enough money to pay the people who provided it.

                And if, again, the costs of healthcare could be driven upward to point of orbital, people could probably be convinced that it made sense to pay some money out-of-pocket before the people you sent money to would send money to the people who provided you with healthcare, on the off-chance you needed healthcare, or – Better yet! – Drive UP the costs of this thing called “health insurance” to the point where people were afraid to use it, because using it would increase the costs of their health insurance, so they would die without using healthcare; thus, the money they paid for health insurance would stay squarely where it belonged, which was in the pockets of the people that people sent money to, so they would pay that money for something that, as it turns out, people were afraid to use.

                WHEW!

                But that’s not all, because here’s the most conspiratorial piece of the Conspiracy Theory: As a subset (or, “fringe benefit”) of the above: IF this health insurance/Medicare “thing” could adequately confuse, frustrate and intimidate (think, STRESSED-OUT!) unrich, old people to the point of medical capitulation, they would, likely, die sooner, providing the ever-elusive answer to reducing the number of poor people – Population control! – Which is why Medicare has never paid for “long-term care.”

                And the latter could be most effectively achieved by inventing concepts like “deductible,” “co-pay,” “benefit limits,” “managed care,” “benefits coordination,” et cetera ad infinitum, which would, eventually, replace the old cliché “…it isn’t ‘rocket science’” with “Well, it isn’t health insurance!”

                OK, maybe not, but it does make you stop and think – Or, think – Or, stop – Or stop thinking…BUT! As is often the case on this fascinating planet where God is considered to have no sense of humor, there is an unintended, and somewhat contradictory, side-effect to all of this; Consider:

                As our national life expectance has continued to increase in spite of health insurance, various forms of dementia (think, Alzheimer’s) have emerged as a leading means of retiring retirees; Now, how does one attempt to prevent dementia? Right! By developing new neuronal pathways.

                And how does one develop new neuronal pathways? Right! By learning new things and attempting to master the unmasterable.

                And what is the most unmasterable thing you can imagine? Right: Medicare!

                So, belay the Sudoku, cancel the crossword, relegate the quantum physics text to the doorstop and simply perseverate on your Medicare “Explanation of Benefits!”

                …and try to remember that tomorrow is April 15^th.

               

Peninsula Daily News - 4-7-11 "Beware of predators posing as caregivers"

Regardless of the meteorological fact that “Spring” officially began on March 20^th, most of us will believe it when we see it, but the fact is that the weather isn’t as bad or as cold or as wet as it was not long ago.

                And certainly the days are longer, so we begin to emerge (in one way or another) from the cocoons we built in late Fall to prepare for Winter, where most life is inside; funny, too, because our minds and hearts focus more on “inside” – Internal, quiet, insulated – Cocooned.

                But whether we’re “inside people” or “outside people” or, as is the case with most of us, some combination thereof, life seems to begin again – We “emerge,” to rejoin the world. “Life” returns. “Light” returns, so, sometimes, we see things a little more…Clearly.

                Most of us heard about the “Mickey Rooney thing” a while back. The short version is that Mr. Rooney appears to have been the victim of “financial exploitation.” There are a number of definitions of “financial exploitation,” but the National Center for Elder Abuse defines it as “…the illegal taking, misuse or concealment of funds, property or assets of a vulnerable elder,” and that’s as good a definition as any.

                In other words, somebody comes along and “takes over:” Sometimes it’s an “outsider,” a “predator,” a lowlife who has made it her or his business to put her or his nose into an elder’s business, usually under the guise of “caregiver” – Or lover. It isn’t “theft,” in the sense of pick-it-up-and-walk-out-the-door, it’s a little at a time – My car broke down, the “collectors” are after me, my niece needs emergency surgery, I can’t afford the rent, I can’t afford a coat, I can’t afford a fur coat – And, on and on and on – “Til it’s all gone, and so are they.

                Often, though, it’s a friend or a neighbor – Or most often: Family. That’s right, “family – Maybe “blood,” maybe by marriage, whatever, but Family – The people you are supposed to be able to trust. And it almost always starts by “helping” – Helping pay the bills, helping to figure out the insurance, helping to take you to the bank, helping to take-care-of-business, helping to manage all that annoying paperwork – Helping. Helping themselves.

                Maybe early dementia or memory loss is involved, maybe it isn’t; it certainly wasn’t with Mr. Rooney. It was the slow, insidious taking-over of an elder’s money and assets – Of an elder’s life. And if you don’t think that happens in our little towns and rural areas, wake up and smell the roses, because I’ve seen it happen for years.

                Shortly after Mr. Rooney’s act of incredible courage, the Financial Crimes Enforcement Network, which is under the U.S. Department of the Treasury, issued an “advisory” to financial institutions on what to watch out for to stop financial exploitation. Yes, I realize that most of us don’t work for financial institutions, but it’s a pretty darned good list of things that friends and family – The “good guys” – Can watch out for, too, so here you go:

• Frequent large withdrawals, which could include maxing-out ATM withdrawals, on a daily basis;
• “Insufficient funds” – All of a sudden;
• Uncharacteristic non-payment of bills, or uncharacteristic attempts to wire large sums of money;
• Debit transactions that seem “out of character” (…because they are);
• Closing CD’s or accounts, without regard to penalties.

Yes, I know: A lot of us might not “see” that kind of thing, but here are some things we might see:

• A “caregiver” (or whomever) seems to be particularly interested in an elder’s finances, or doesn’t allow him or her to speak for herself/himself – Or won’t leave their side during conversations;
• An elder seems, suddenly, fearful or submissive, or seems worried about eviction or “ending up in a nursing home” if money isn’t given to…;
• A new “caregiver,” relative or “friend” suddenly begins conducting business on behalf of an elder, without having all the “…ducks in a row;”
• The elder seems to move away from old, long relationships and toward new “friends” – Or strangers;
• All of a sudden, he or she doesn’t seem to know what’s going on with his or her business, and doesn’t want to talk about it;
• Suddenly, there’s a new person with a new power-of-attorney, or whatever…
• …and on and on and on…

If it smells bad, it probably is.

What do you do? Well, if you see something that seems to be illegal, CALL THE COPS! There is no penalty for being wrong.

If you see things that look like any of the things listed back – Things that seem, or feel, “wrong, call Adult Protective Services at 1-866-ENDHARM (1-866-363-4276) now – Right now.

Can I promise you that these folks can stop the abuse? No, and neither can they, but they’ll try, and often, just “shining a light” will send the vermin back into their holes.

Might you be sticking your nose into someone else’s business? Yes, but look at this way: Someone else already has.

And if we’re going to talk about HURTING, I’ve got to remind you about seriously considering a getting the “Shingles shot.” Most people report unbelievable pain, and people have actually committed suicide to make it stop – No, I’m not kidding. And the fact that you’ve had it once does NOT guarantee that you couldn’t be in for an encore.

Does Medicare pay for it? Not usually, but many insurances do, as do some Medicare supplement plans. Hey, look: Medicare doesn’t pay for a lot of things, like not roller-skating in buffalo herds, but that doesn’t mean it isn’t a good idea.

 Looking for something nice to do for an elder you like? Good, then YOU pay for it and call it a gift; besides, you can probably use the karma.