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End-of-Life/General interest
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Here’s to Hospice – But Not For-Profit Please

by Fran Johns

Photo by Dominik Lange on Unsplash

Hospice care: comfort, support, peace. And part of the Medicare benefit.

For years I have preached – to anyone listening, and not many people listen to my preaching – that hospice care is the best and most under-utilized piece of the entire American healthcare system. And I have urged every terminally ill person ever encountered to go on hospice sooner rather than later. The benefits include not just access to nurses and other medical professionals but equipment like hospital beds that make life (and death) easier on everyone.

Hospice got very personal to me when my husband was dying of congestive heart failure. We missed my #1 lecture about invoking the service early because it took him only a few days to go from living fairly comfortably with the disease – as he did for many years – to end stage and a quick death. We should all sign up for this. Still, the hospice bed was a godsend, as was the liquid morphine that I was dispensing as if it were root beer float.   

Hospice and I go way back. In the early 1980s, having always volunteered with arts or educational organizations, I wanted to try something new. Hanging out with really sick people? Being around someone who’s dying? That seemed utterly impossible to me. So I decided to give it a try, and signed up to train as a hospice volunteer. It was, of course, the most rewarding thing I’d ever done. Since then I have worked with (and written about) AIDS support groups (in the 1990s) and assorted end-of-life nonprofits up to and including today serving as a volunteer and board member for End of Life Choices CA.

Two things I have learned and absolutely swear: hospice care is the best, and IT SHOULD NOT BE FOR PROFIT. If you’re a for-profit business in the hospice business where is your profit coming from? Duh. People. Sick and dying people, vulnerable people, the people least likely to stand up for themselves against your money-making.

OK, there are for-profit hospices that are just fine. I put that in quickly, since I have many, many friends who work with for-profits and they will have my head if they read this and think I’m implying every for-profit hospice is intrinsically evil. Not so. But the fact remains: a for-profit business is about profit, and the hospice business is about sick and dying people.

Most recently the for-profit hospice business has been indicted by ProPublica reporter Ava Kofmanin a carefully researched article that appears on the ProPublica site and in the December 5 New Yorker. Endgame: How the visionary hospice movement became a for-profit hustle details one major lawsuit over one egregious case but covers the broader topic as it relates to these abuses. Its final line quotes two men discussing the opening of a potential new hospice. Says one to the other: “We can turn a profit and split it.” And that line says it all.

The National Hospice and Palliative Care Organization (NHPCO) and the National Association for Home Care & Hospice (NAHC) were quick to respond to Kofman’s article, saying it focuses on a few bad actors (which is true) and lamenting that it might discourage people from using hospice care (which would be unfortunate but hopefully is not true.) 

“The hospice benefit is popular, well-regarded, and saves taxpayer dollars compared to keeping terminally ill patients in hospitals or other institutional centers of care,” the responding article reads. “NAHC, NHPCO, and our members look forward to working with federal and state policymakers to implement solutions to address the isolated problems highlighted by the article without jeopardizing access to the Medicare hospice benefit.”

One can hope. 

But when I need hospice care – hopefully not any time soon, but hey, dying happens to all of us – I’m still calling a nonprofit organization.

America Collection/General interest
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Help Celebrate Hug A Cloud Day!

by Fran Johns

Photo by engin akyurt on Unsplash

You can do this! Cloud-hugging (instructions below) benefits all of humankind.

Hug A Cloud Day came about because this is the 250th anniversary of the birth of English chemist/amateur meteorologist Luke Howard, the man who named clouds. The above puffy/fluffy ones are cumulus — if I’m not mistaken — from the Latin cumulo. On Hug A Cloud Day — or any other day, for that matter — it’s okay just to call them beautiful puffy things in the sky. But thanks to Luke Howard, they have names. This information is courtesy of the Cloud Appreciation Society.

Photo by Michael & Diane Weidner on Unsplash

Everything I know about clouds comes from British-based Cloud Appreciation Society, of which I am Member #45,662. (Everything, that is, except for Hug A Cloud Day; I just invented that.) Largely it comes into my Inbox every day in the form of the Cloud of the Day.

In lieu of the daily cloud, though, my Inbox recently brought a portait of Luke Howard, and the information that he’s the guy who, back in 1802, came up with the idea of giving clouds Latin names like those for plants and animals.

Photo by Anna Spencer on Unsplash

So now we have Cirrus, Cumulus, Stratus, Nimbus and endless varieties, all worth appreciating. Or hugging. Here are the benefits of cloud-hugging: a healthy stretch, exercise time if you add a little happy dance, a chance to commune with the universe and balm for the soul. Plus, it’s free.

Photo by Aron Visuals on Unsplash

Here’s how to hug a cloud:

Go outside. If you can’t go outside, go to a window.

Look up.

Stretch out both arms as wide as you can.

Smile at a cloud. It can even be a rain cloud. You don’t have to call it by its proper name; clouds don’t really care.

Wrap your arms around your shoulders.

You have now celebrated Hug A Cloud Day. Your cloud, happily hugged, can now float off and around the planet, to make itself universally available. Free hugs, humans everywhere. Imagine.

America Collection/General interest
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The Joy of Supplements

by Fran Johns

Today’s random health report

Photo by Myriam Zilles on Unsplash

Dietary doomsday may be upon us. For instance, how’s the eicosapentaenoic acid?

And should we be REALLY worried about it?

There’s food — as in breakfast, lunch, dinner, nosh — and there’s Supplement. I grew up on meat & potatoes plus a few vegetables, old-fashioned stuff you cook and eat. But the world seems to be geared to popping pills for daily needs, so I supplement with the best of them today.

One of my children told me to take turmeric with curcumin, so I started swallowing those yellowish pills a few years ago. I have no idea why; sometimes I think they give me desert-sand breath.

Then there’s fish oil. Does everybody take daily fish oil? I sort of think so. That’s where you get the eicosapentaenoic acid. It’s a “fatty acid,” which doesn’t sound particularly yummy when you think about it. Plus, I used to take pride in never having dropped acid.

I am more than a little suspicious of it all. Big Pharma, I think, did a mind control thing on my primary care doctor, the one who said I really should take extra iron, and calcium with vitamin D, and if I’m not mistaken she threw in the fish oil. There is no fish oil capsule smaller than a quail’s egg. After I while, I got a new doctor.

Mostly, I am fascinated with CoQ10. Seriously, now. Had you ever heard of CoQ10 before it began starring in every other commercial on MSNBC?

CoQ10 — I’ve been researching this, no easy task — is an enzyme. More specifically it is “Coenzyme Q, also known as ubiquinone . . .” Most healthy people have plenty of it, but maybe — maybe — scarfing a little more might help with one’s blood pressure or metabolism or headache. Apparently, nobody much knows. Just reading about it gives me a headache.

In the small print of the CoQ10 packages are warnings about diarrhea, nausea and heartburn, little things like that. As to whether taking this happy little supplement can actually do any good, phrases like “the evidence is conflicting,” or “it’s uncertain that adding CoQ10 will have any effect” proliferate.

Maybe we should go back to kale and blueberries.

America Collection/General interest
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Planes, Trains & Automobiles+

by Fran Johns

A 3-day Getaway trip that’s all about the journey

Photo by Martin Sanchez on Unsplash

You’ve gotta love Scenic-Route trains. Or maybe you don’t, if you’re some sort of a lumpy impassive immovable home-bound sedentary stick-in-the-mud grump and bless your heart. But I simply love trains.

Salt ponds with coastal mountains & the City receding at the start of the journey south 

It began, therefore, as a bucket-list trip on the Amtrak Coast Starlight from San Francisco to San Diego. Fourteen hours’ worth of California the beautiful: Bay marshes, salt ponds, golden hills, picture-perfect rows of vegetables and vineyards, tunnels through rugged mountains and finally the indigo grandeur of the Pacific Ocean, right there where it’s always been — albeit still on the wrong side of the street for this East Coast native. 

Vineyards near Paso Robles

Late fall colors, the passing scene 

All that should, truthfully, have been enough. Get on the train, restore the soul, fly home — and that was the original Plan. But it grew exponentially, transportationally-speaking, into a couple of addenda that are worth mentioning.

For starters, the ferry. Maybe there’s one near you. If not, just come on to San Francisco. From Gate G at the Ferry Building, catch the 4:30 eastbound to Jack London Square in Oakland. On a late autumn afternoon, this features a receding view of the sun setting behind the cityscape. Whew.

Ferry view of San Francisco

After the ferry, after the train, it’s likely you will add in a taxi ride or two or (in my case, because something was interrupting the train tracks between Los Angeles and San Diego) a FlixBus, a few cars driven by friends, a couple of hotel rooms and a good bit of old-fashioned walking. I was also treated to a trolley cart of some sort that careened us for what seemed at least a half a mile from train stop to actual station in L.A. — but that was a vehicle not worth a photo.

At the end, fully restored, there’s no place like home.

An end-of-trip Pacific sunset, this one from above San Francisco

End-of-Life/General interest
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Legacy Gifts: Join a Feel-Good Club!

by Fran Johns

Photo by Marc Najera on Unsplash

The invitation is always open. One of the all-around best societies to belong to, and it can cost a lot less than your golf club. Plus, you’ll never miss the money!

The Legacy Society — or whatever name a nonprofit might choose — is an exclusive club you join simply by naming a chosen charity (or two or three) in your will. Membership doesn’t necessarily get you invited to elegant places, five-course dinners, or fancy balls. What it does get you is the feel-good feeling. Leaving the world better? Priceless.

I go to a lot of ‘legacy society’ events. This is because my good husband was 62 when we married and never had siblings, children, or other survivors-to-be. Since I came with children, grandchildren, and a large, cousin-counting family (all of whom he quickly came to love to varying degrees), it felt right to both of us that everything he’d worked so hard for should eventually go to the causes he believed in. So early on we set up a trust, with his estate divided among a great group of nonprofits.

Wills and trusts make clear what happens to your assets when you die. Full disclosure: this writer has zero legal training. What I know is that a living trust can protect you or a loved one during a lifetime, and distribute all or some of your assets to a cause you believe in after you die. This was something well understood by my good husband. Much of his volunteer work involved helping nonprofits create ‘legacy societies’ that would encourage supporters to name the nonprofit as a beneficiary of their trust. Later on he helped me do the same with nonprofits I support. (https://endoflifechoicesca.org.) You simply let your chosen charity know it’s in your will and you’re in the club. They will also happily guide you through the process of joining.

If you have survivors destined to inherit your estate, what better way to remind them of what was important to you — and teach a lesson from the great beyond about how they can make the world better — than leaving a gift to a nonprofit you believe in?

Living trusts are one good way to get that done. In my own case, the income from my husband’s lifetime of hard work and good investments is helping me live comfortably, although he’s gone to his own well-earned rewards. What this means for the charities we chose is that they have to wait until I’m dead and gone. But for the most part they are being polite about it.

Most nonprofits have someone on staff, or a handy advisor, who can help you make even a small amount of dedicated money make a big difference.

At a recent legacy society event, one advisor talked to us about Mackenzie Scott. If you, like me, haven’t thought much about Mackenzie Scott lately, she’s the mega-billionaire who got that way by helping ex-husband Jeff Bezos create Amazon and get his own quadrillions. After they split, she vowed to give away half of her substantial stash. This continues to be good news to a lot of good causes — partly because she doesn’t tell them how to use it. She might not even insist that her name be plastered over the front door, as do some mega-donors we can quickly name. Leaving those decisions up to whatever your chosen charity needs most — which they generally know best — brings extra gratitude.

You don’t have to have Mackenzie’s money; supporting good causes with any donation today, amid the current challenges of economic craziness and post-pandemic stress, is a great idea. But whether you can pitch in today to help a good cause, you can always arrange for something to be pitched in after you cash it all in.

Feel good today, leave the world better tomorrow.

America Collection/General interest
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Last Minute Midterm Week Survival Plans

by Fran Johns

Photo by Brett Jordan on Unsplash

Next Tuesday is election day. On Wednesday I have a root canal.

Clearly, something’s wrong with my planning mechanism. For all I know, I scheduled a colonoscopy for Thursday and just forgot to write it on the calendar. There is a limit to the amount of pain one can endure; I’m hopeful about the midterms but not unrealistic. Next week should at least have included a spa day, if I had only hired a scheduler.

In the olden days there were Secretaries.

CEOs, district managers, sales representatives, all those guys — they were all guys — had secretaries. (Who were all girls. The olden days were before girls became women. You could’ve been 75 years old, but if you were a secretary, you were still one of the girls.) Secretaries kept their bosses from missing meetings or dinners, knew where everything was, found stuff. After a root canal, any good secretary would’ve scheduled a spa day.

I was never a secretary, and certainly never had one. Reporters had editors who seldom created order and usually complicated daily life. I did, of course, immediately after picking up a BA in Art, go to night school to brush up my shorthand. I can still cover a mean story with the help of my efficient speedwriting, but the rest of what they taught at secretarial school passed me by.

And today I just need a secretary. Secretaries were displaced some time in the 1980s by electronic organizers: digital diaries that straightened out address books and calendars and dental appointments. These were eventually displaced by computer systems way too complicated for anyone who can remember what a secretary was. Computer organizers were eventually displaced by old-fashioned humans who discovered a whole new career choice: the professional organizer.

I actually have a professional organizer. For a very large fee she occasionally breezes around my apartment collecting stuff, say to take to the tax accountant so I don’t lose my mind or go to jail. Worth every penny of that fee, she replaced the organizer/financial secretary I did have, who was called a Husband — the very top of the household line. (He, however, may he rest in well-earned peace, operated with amazing efficiency out of seeming chaos, probably because he used to have a secretary.)

If I live long enough to master the switch from my beloved PC to this MacBook Air that threatens my sanity and blood pressure, the theory is that I will then have a brightly lit computer calendar synchronized with my iPhone and life will suddenly be ordered and peaceful.

This, however, will not happen before the midterms. Prayer may be my only hope.

General interest/Optimism Collection
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A (Summer) Book for All Seasons

by Fran Johns

Photo by Todd Trapani on Unsplash

The Summer Book was recommended to me as an antidote to the fall blues: stressed over climate change, midterms, earthquakes, disinformation — I needed a little literary calm.

“You need to read this,” said a friend, handing me The Summer Book. Friends are the best.

This small gem of a book contains a large enough dose of beauty and calm to restore the soul of the weariest American. Or Swede, or any other citizen of the world for that matter. It’s been offering that calm for fifty years, since first published by Swedish author Tove Jansson and translated by Thomas Teal in 1972. London’s Sort Of Books published a new edition in 2003 that has so far been reprinted seven times.

In The Summer Book, six-year-old Sophia (inspired by author Jansson’s niece) spends the summer on a remote island in the Gulf of Finland, in the company of her wise and often cantankerous grandmother. The two slowly build love and respect for each other and the planet. The novel unspools in a series of jewel-box vignettes that make for easy short reads, though you’re likely to become so entranced with the characters and their world that you won’t want to put it down.

Grandmother and granddaughter clamber over rocks and around rugged coastlines, watch storms at sea, glorious days and threatening skies. But they are noticing the tiniest specs of nature at the same time, and discovering lessons in them all. The book is a constant unveiling of wisdom and wonder. Moss, for example, will recover if stepped on once. A second time it will slowly recover. After a third careless footfall it will die.

As Sophia edges resolutely into life, while her grandmother winds her own way out, the two develop a ferocious attachment to each other and to the natural world. They build tiny boats of tree bark, study bugs and weeds, watch seabirds, listen for the breath of the wind. We readers are swept melodically along like invisible guests with VIP passes.

The Summer Book will have you smiling, laughing, nodding in appreciation and discovery — and feeling better about the world.

America Collection/General interest
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Last Flight Home

by Fran Johns

by Fran Moreland Johns | Oct 18, 2022 | Movie Review | 0 comments

(This is reprinted from an End of Life Choices California blog just up. A wonderful story I was delighted to be able to tell; and a great movie. See it when you can!)

“It was like light from a lighthouse,” says David Timoner of the call he got from End of Life Choices California (EOLCCA) when he and his family were facing the toughest time of their lives.

“The wisdom we got from those final days we will carry with us forever.”

Ondi Timoner with her father

David’s 92-year-old father Eli was in the hospital. He had reached a point at which advanced COPD, CHF, and other health issues had become intractable and meant he would have to transfer to a care facility. But Eli knew he wanted to die at home surrounded by those he loved, and he asked about medical aid in dying. His family understood and supported his decision but didn’t know where to turn for help. Vaguely aware of a California law, they still had no idea what to do next.

“The day is a blur,” David says. “I think I googled something like ‘How to end your life legally . . .’ and EOLCCA popped up right on top. I called the number, left a message, and had a call back within the hour.” Lynne, the volunteer at the other end of the phone, was everything David needed at that moment: “Calm, empathetic, and with the answers to all of our questions. Lynne explained how the California law works and reviewed the eligibility requirements.” These, in brief, include the requirement that the patient must be diagnosed as terminally ill, with a six month or less prognosis by two doctors, must make the request himself, be able to self-ingest the medications, and be of sound mind. “Lynne also recommended that my father consider enrolling in hospice care,” David says. She was able to recommend two hospices in our area that she knew had doctors who participate in medical aid in dying. We chose one and brought Dad home.”

Ondi Timoner, an award winning documentary filmmaker, decided to record those days during the then 15-day waiting period mandated after Eli first requested aid in dying medication from the hospice doctor, until he could receive the prescription. She initially intended just to have a family remembrance. After all was over, however, she realized she had the makings of something important.

Ondi’s remarkable film, Last Flight Home, tells the full story. In the ensuing weeks, the Timoner family – Eli and his wife Lisa, their children David, Ondi and Rachel, their grandchildren and friends–would spend invaluable time at home together celebrating Eli’s unique life’s journey. The profound, intimate, loving farewell afforded Eli and his family by California’s medical aid in dying law, is the outcome we at EOLCCA wish for anyone who reaches out to us for similar help and information. That this Southern California family’s experience would be recorded by daughter Ondi and edited into a powerful documentary now being released to widespread acclaim, is a visual testament to the value of medical aid in dying.

At a screening in New York, daughter Rachel told a New York Times interviewer, “And then there is the idea that this film could change laws.” Many of us with EOLCCA worked hard to get the California law passed, and we continue to support expanding the law throughout the U.S. To have had a part in helping Eli Timoner and his family gain peace at his life’s end, and to know that they now join the fight for everyone to be able to make such a choice, is doubly gratifying for EOLCCA.

California is one of a small number of states fortunate to have a law which enables its residents to access this compassionate end-of-life option for the terminally ill. But, from call after call we receive every day, it’s clear that few terminally-ill Californians are even aware of the law, or know enough about it to even begin the process of requesting medical aid in dying from their physician.

Last Flight Home is a film we hope will receive all the top accolades in the film industry for its many-layered and beautiful story. The story behind the film has been well documented in the New York Times. It is one we urge our readers to see as soon as possible and then recommend to friends and family everywhere.

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