NOTHING STAYS THE SAME 2

Our current population at Adagio has shifted from Bingo to reading, and re-reading books we know we read before but can’t remember the plot or ending. Books of the past become a new present. Uno and Bingo are for sissies who can’t remember where they left their reading glasses.

In The Great Gatsby, Jay Gatsby says “Can’t repeat the past? Why of course you can!”  Of course he’s wrong, but remembering the past famous people of our culture hints that we were once vital, strong and needed. We can be again as long as our wheel chairs are in locked position. Myrna Loy, Clark Gable and William Powell. Hubba hubba hubba. Lyndon Baines Johnson, the dirty rat.

While we are ensconced comfortably at the dinner table with no one asking difficult questions, we can enjoy the illusion that anything can be done again.

Our kids would no longer be the keepers of the driver’s license. The walker parked by our resident valets would truly be the Chrysler or Chevy of the 50’s. The phone call interrupting our meal would again be someone from our past who needs us to fix a problem in the present. We can walk, bend, dress ourselves and pick up our shoes from the floor. We can get an aspirin from the medicine cabinet independently without written permission from a doctor.

We would reinstate the past in a heartbeat. But first we need a nap.

Our families are often less realistic and argue against change more than we do. During the 30 minutes that the family visits we can fake attention and independence. They aren’t around when we can’t remember if the day is beginning, ending or somewhere in between. They don’t hear us insist we took our pills until we are reminded that we took them yesterday, not yet today. Our family is sure we can follow the directions on the plastic box, day and time.

We are important to them and they can’t bear the thought of losing us. That’s nice. But I think a part of going back to the past is that if we are of diminished capacity, they are the next generation at risk.

There is a time to live on our own and a time to admit to needing assistance. There are assessments a professional can accomplish easily. Then comes the hard part. Getting everyone to admit that the past is not the present.

RAINEY DAY

Is Medicare Stuck in the 1960's?


When Medicare was enacted, it was intended to serve as the foundation of the health care system for seniors and people with disabilities. For years it was seen as a highly successful program that saved the elderly and disabled from financial disaster.


Many, if not most people continue to believe in the promise of Medicare. But this is a fallacy, writes Jane Gross, whose opinion piece, How Medicare Fails the Elderly appeared in the Oct 15, 2011, New York Times.


"Here is the dirty little secret of health care in America for the elderly, the one group we all assume has universal coverage thanks to the 1965 Medicare law: what Medicare paid for then is no longer what recipients need or want today,” Gross writes.


This change, suggests the author, is a result of advances in medicine that now keep people alive well beyond what was considered a normal life span in the 1960’s. Today, much of the care Medicare is mandated to provide does little if anything to cure illness and improve the quality of life of seniors in America.


Medicare will pay for “heroic” care for a senior dying from the natural process of aging. It will pay for diagnostic tests, surgery, and emergency room treatment. It will pay for Hospice.


But what it won’t pay for is what most seniors need: long-term care in a safe and well-run facility, and/or home aides and caregivers to help with the tasks of daily living.


Nationwide, the median annual cost of a nursing home in 2010 was $75,000; room and board in an assisted living facility, with no additional help, was $37,500; and the most basic category of home health aide, who can perform no medical tasks, like the dispensing of medication, was $19 an hour.


 “These expenses are left to the elderly (and their adult children) to pay for out of pocket until their pockets are all but empty,” says Ms. Gross.


Ms. Gross proposes that the “mismatch between what is covered and what is useful” is the “essential flaw” in the way Medicare operates today. Today there are 47 million Medicare recipients, a number expected to rise to 89 million by 2050.


Legislative action is needed now, says Jane Gross. Otherwise the health care future for our seniors is bleak. To read the full article by Jane Gross go to:  NYT Article

DEEP BREATHING

I recently heard a writer admonish us to put oxygen back into deep breathing.

One of our Adagio family recently underwent a medical procedure. Her therapists drilled her on the importance of deep breathing to prevent pneumonia. She came home determined that each of us needs to take deep breaths. Like a drill sergeant she orders, “Breathe. Breathe.”

 
Once the humor of the situation passed I agreed with the diagnosis. Of course we need to breathe but there are many times when we hold our breath.

We hold our breath as a vehicle rockets from two lanes over into the small space between our car and the SUV with Baby On Board in front of us. We hold our breath as we try to abort a sneeze after drinking three cups of coffee,

We hold our breath when our seniors determinedly talk over each other, neither willing to give up air space. We hold our breath when they lurch sideways while maneuvering their walkers. When they declare they didn’t sleep all night and no one came when they called and called. (Snoring was contrary evidence but perceptions count.) We held our breath before calling when a visiting pet ran out the front door and down into the street.

Yesterday between dinner and dessert we were abruptly commanded, “Breathe. Breathe.” I asked when they remembered holding their breath. Any time they were startled was one answer.

I asked if they were sometimes afraid and held their breath. Some answers originated from situations 40 years ago. More currently they said they were afraid when they didn’t understand what was going on. When they thought they might fall. When their family “talked over them” but they knew they were the subject.

At this point our drill sergeant announced “Too much talking. Breathe. Breathe.” And we did.

Guest Blog: Your Aging Parent Refuses to Spend Money on Eldercare

A Guest Blog from Alice Kalso, A Boomer's Guide to Eldercare
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A penny saved is a penny earned. All her life your aging parent has lived by Ben Franklin's words. But now, she needs assisted living or in-home care. The cost scares her to death. Eighty-three-year-old Lois felt that way. Over the years she'd collected diagnoses like barnacles: diabetes, congestive heart failure, and more. She needed medication management, plus help with showers, dressing and other daily activities. As we talked, she fixated on the expense. "It's SO expensive. It's SO expensive," she repeated. "You can afford it," her son said, citing numerous investments. Lois wasn't convinced. So what to do? Perhaps your parent's story is similar. Before you point out the "facts," try drawing her out with an open ended question. Something like: "I know you're really concerned about spending so much money. What troubles you most about that?" You might be surprised at what you hear. Having grown up in the Depression, she may feel a sense of failure at spending money on herself, even though needed, instead of providing a larger nest egg for the kids. I've heard other elders say, "I've always given a substantial amount of money to the church. If I go to assisted living, I won't have as much to give." Still others are paranoid they'll run out of money. They've never spent more than their monthly income. Whatever they say, listen before speaking your peace. And try to affirm their concerns. Then you can calmly point out how what the monthly fees will cover and how life will be better should they get care. Another tactic: Let them know that you'd like to move to assisted living or hire home care so YOU don't worry. The idea of sacrificing for you and your family members may make sense. I often use this phrase: "Remember during your lifetime you always saved for a rainy day?" "Well, right now it's beginning to drizzle." Or "It's pouring!" Have you used other words to help convince your parent to get care? Tell me about it.

THE FORGOTTEN MAN

My father was a business owner who took risks. He paced the floor at night when the money didn’t come in and his suppliers wanted their tenth-of-the-month payment. He understood the risks and the cold fact that there was no agency prepared to give him a pay check if he failed. He contributed to community causes and drove a flatbed truck in the Fourth of July parade loaded with Girl Scouts tossing candy he bought for them. He paid a fair wage and was a respected member of his community. He maintained an Open shop.

I am person C in Dr. Sumner’s tautology. I am a small business owner. I take risks with my retirement investments that could be wiped out in a moment of lax attention. We must reserve funds to replace the roof and appliances that will fail.

I understand that without profit there is no reason to take the risks. We walk a defined profit line and weep because we cannot afford to take “Margaret and Robert” and pay a good wage to our caregivers. We hire certified care givers who have received training and continue to earn education units. Without us they might be unemployed.

As I see literacy programs, millions of dollars for developmentally disabled and needy older seniors being cut, and government bureaucracies being built, I know Margaret and Robert and Mandy and Cindy are not being forgotten. They are being kept in their place.

If you live in the State of Washington, please educate yourself concerning Proposal 1163. It is a repeat of 1029 which passed two years ago because the verbiage was misleading. We and our caregivers renew our background checks every two years. We must have a list of training plus continued education every year to keep our license. Such has been the law for many years (WAC). We always need more education, but not at the prejudiced hand of the SEIU. We turn to the WSRCC which is working hand-in-hand with the DSHS.

Vote No on Initiative 1163. It has the wrong priorities, is misleading, has no funding source and will cost $80 million. Every major newspaper has come out against 1163. WA congressional leaders and our Governor have also rejected 1163.

Greed is universal. Jesus said, “The poor you will have with you always.” Reasons for the poor include financial loss, misguided or no mentorship, disabilities, self-inflicted feelings of entitlement, sloth, usury, among many others. And, the greed that grumbles in each of our hearts.

THE FORGOTTEN MAN

My book review post of September 27 presents a pivotal change in Federal government interference representative in persons A, B, C and X. FDR lifted the descriptive term, the Forgotten Man, from Dr. Sumner’s work and wielded it like a TVA shovel.

“Roosevelt offered rhetorical optimism, but pessimism underlay his policies. Though Americans associated Roosevelt with bounty, his insistent emphasis on sharing—rationing, almost—betrayed a conviction that the country had entered a permanent era of scarcity. Both Hoover and Roosevelt overestimated the value of government planning.”

FDR chose to focus on X as pathetic, needy and unable to supply his own needs. FDR saw segments of the business community surviving bad times and pronounced their Depression success as unfair.

Since FDR, X has become caught in an entitlement trap difficult to escape. X sadly accepts the harsh judgment of a Federal and State bureaucracy that  generously builds itself. It speaks a largess language but demands increasing tax payment from C to build more social agencies and lease multilevel office buildings. Meanwhile it denigrates X with its pity and barely subsistent handouts.

I know X and my heart breaks for her. She is Margaret, age 82, diabetic and in rehab recovering from a broken hip. She has been living with her daughter who is herself recovering from a work-related back injury. The Rehab social workers are attempting to find a Home for Margaret. But they are faced with Washington State paying between $50 to $100 per diem for Margaret’s room and board and nursing care.

I know X. Robert is developmentally disabled, age 32, and may well live into his sixties. His aging parents can no longer care for him. His care expenses have almost wiped out their retirement savings. The State will pay $62 per diem to the Home that will take Robert. This paltry sum doesn't pay his nursing care at $12 per hour for 24 hours seven days a week, to say nothing of room and board.

X is also Cindy and Mandy and Bobbie who became pregnant before they were 16. Their mothers have trudged the welfare wheel all their lives and as these women give birth to more children, the cycle seems destined to continue. 

X is Juan and his family trying to extend their visa to stay in Seattle. Their two sons are attending school where the State social workers catch up to them. Juan is told that he can apply for welfare and his wife will not need to look for work. Juan and Sylvia decide not to sign the paperwork and find minimum paying jobs at the same family restaurant. The restaurant owner acts as their benefactor with the bank, their landlord and Immigration. In six months he finds Sylvia a translating position and he promotes Juan at the restaurant.

X is not forgotten. X is celebrated by government that buys their votes and encourages them to continue their sad dependence.

Laudable intentions. Unintended consequences. Tragic results.