Category: seniors

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Abortion foes stoop to new lows, and new absurdities

by Fran Johns

Two pregnant women. One has someone behind her holding a gun to her head. The other one, a Black woman, is being led by a white man. They are entering an abortion clinic.

Wait! Saved by Georgia Right to Life!

It could soon be against the law to force someone to have an abortion, or to have an abortion that is “racially motivated” in the state of Georgia. SB 529, the Coercion and Prenatal Non-Discrimination Ban sponsored by Senator Chip Pearson and lustily supported by Georgia Right to Life, passed a couple of weeks ago by a vote of 33 to 14. The bill now goes to the House, where HB 1155 will send the same message into the world: Thou shalt not “coerce” someone into having an abortion; thou shalt not abort “on the basis of race or gender.”

If you have not noticed forced or racially motivated abortions being rampant in this country you may wonder what’s up with Georgia Right to Life.

I happen to think I know. My crystal ball says if the rather ridiculous law passes this is what will follow: GRTL will find some poor woman willing to declare, after seeking a perfectly legal abortion, that her doctor actually forced her to have the procedure. A high profile case will ensue, the doctor may or may not be convicted — that part really doesn’t matter — but more and more doors will close against abortions. Once enough doors are closed, GRTL and others eager to dictate what women may or may not do with their own bodies will have achieved their goal. Legal abortion will be denied the women of Georgia.

So, you say, they can just go to another state (until the method proves effective and other states follow along. Other states are watching.) If they have money and resources, that will be true. But the poor and un-empowered women of Georgia will be left without safe choices. And you can believe that there will be plenty of back-alley abortionists in business by then.

A diminishing number of us know what it was like in the heyday of back-alley abortions. The right-to-life people, who are so worried about embryos but don’t believe women have rights, won’t tell you. I will. Filthy men (and sometimes even women) made big money butchering desperate women who had no other choice. So the women lay on kitchen tables or gurneys bought cheap at hospital supply warehouses, had unsterilized objects puncture their bodies and went home — often to die.

There are two problems with the RTL people. One is their righteous zeal. The Alabama Pro-Life Coalition Education Fund, for example, “cooperates with God and other Christians…” Hmm. I, a committed Christian, have talked with God about a lot of things and She never told me She wanted to consign mature women to barbarity. The second problem is with mature women. The RTLers believe a fertilized egg has more rights than the woman within whose body it is harbored. If you find that as hard to believe as the notion that women in Georgia are being herded into abortion chambers against their will — check out Ohio Right to Life‘s opposition to the current H.B. 333. ORTL opposes the morning-after pill because “it may cause early abortion” on the morning after.

If the RTLers could, for one moment, stand in the shoes of just one poor, desperate, pregnant woman from the days before Roe v Wade they might get a tiny glimpse of the terror that comes from being without choices. The RTLers say, Choose Life, which I do, every day, for myself and everyone else humanly possible. If abortion becomes criminalized, as is the RTL aim, uncounted thousands of women will have no choice but the deadly back-alley abortionist.

California/General interest/Health/Lifestyle/New York/seniors/USA
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Moving Mom & Dad: 8 months later

by Fran Johns

“The best thing? Well, there are only three rooms to look for my glasses in.” Nearing the end of her first year after a final move, my sister reports a whole bunch of pluses and only a couple of minuses in her housing choice.

Like millions of other older Americans, my sister Helen and her husband Clare faced the multitude of questions that come with aging in this country: where to live, how to stay active and independent, how to get necessary health care, how to finance it all. After a lifetime in academics and music, they had good friends at home and around the globe, but were beginning to feel isolated in their 4th floor Boston condominium because of limited mobility (Clare has Parkinson’s; they had long since sold the car…) and knew that changes had to be made.

First issue: Housing. Staying in their home was not a good option; though it had plenty of spare room, no family member was available to move in and help. They were far from needing (or being able to afford, for that matter) regular in-home help. Their children were scattered across four states, with families of their own.

The answer for Helen and Clare was Kendal at Ithaca, one of a growing number of retirement communities offering “lifetime” or “continuing community care” in almost every part of the U.S. and many other countries. They chose a two-bedroom, two-bath “cottage” within an easy walking distance of the main facility and its dining room (they have one meal a day there), fitness room, crafts room, library (a large and very well-stocked area where Clare spends most of his disposable time), swimming pool and meeting rooms (where Helen quickly found ways to be useful on multiple committees.) They made the move eight months ago (as reported on this page along with a running bunch of posts on senior housing choices then and since then); I visited again this weekend to see how things are working out. Pretty well. The winter wasn’t all that bad, though April in Ithaca seemed about as cold and ominous as June in San Francisco to this San Franciscan, and they have had no second thoughts.

The bad point: they miss their Boston friends. The good? Not having to worry about home care or upkeep, having a regular cleaning/household helper whom they greatly like, door-to-door transportation to cultural events at nearby Cornell University, Ithaca College and elsewhere, plenty of activities and new good friends, good food (“the desserts are desperately attractive,” Helen says) and health care (mostly right there on the premises.) On this last point, Clare lists one great attraction he sees: “They can’t throw me out.” The crowning bonus, for this fairly happily aging couple, is the proximity of their physician daughter and her husband, who relocated from the west coast to be near their parents, and who are in daily communication and assistance.

Kendal communities are not cheap. Nor are most of the others that offer independent living, assisted living and nursing care in assorted facilities, along the can’t-throw-you-out principle. Helen and Clare paid a hefty lump sum (being able to sell a home you’ve had for decades is the way most people swing this) and their monthly fee, which covers meals, transportation, doctors visits, drugs, etc, etc and etc, is also substantial. They are, though, a good choice for many. One college friend now in such a spot refers to her South Carolina retirement home as “our little corner of paradise;” another very close friend is delighted with her Virginia apartment in a community where her husband now lives in a “memory unit” a few steps away.

If you Google “retirement communities” or “continuing care communities” or similar phrases, literally hundreds of choices pop up. The managers of those facilities can spell out the costs and the benefits; for the pitfalls, it’s a good idea to talk with those who live there or whose loved ones are/have been there.

My demo couple in Ithaca are in the right spot.

California/General interest/Health/seniors/USA
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So many pills… so little memory

by Fran Johns

If you’ve ever had a serious or chronic illness you know the routine: a line-up of all the little pills beside the breakfast plate, or maybe one of those little-old-lady boxes with a cubicle for each day, or perhaps a high-end color-coded wheel of medical fortune.

Now, it turns out, for a mere $100+ or so you can have a machine that does it all for you. Counts out the pills, spits them into a little cup, rings a bell when it’s time to pop another, calls your family if you skip something. When technology can address an issue, count on someone to perfect it. Even if its complexity boggles the mind.

Actually, for aging adults who must rely on a whole bunch of pills, these devices turn out to be a real boon. We learned this in a news release just out from the Center for Technology and Aging, through its Medication Optimization Position Paper, which is far more useful than its tongue-twisting name would have you believe.

The Center for Technology and Aging, a non-profit organization that was founded in 2009 with a grant from The SCAN Foundation (www.thescanfoundation.org,) is affiliated with the Public Health Institute (www.phi.org). It aims to find and advance technologies that help older adults stay independent and lead healthier lives — including technology for monitoring patients, for helping with tasks, social networking… and keeping track of pills.

It turns out, there are pill-counting wonders of every sort and price range. So if you can’t remember which vitamin comes before which super-drug, or you think Mom and Dad won’t remember, there’s a tech-app for that.

California/Environment/Health/Money/Politics & Causes/seniors/USA
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Barbara Ehrenreich speaks out on social, economic inequality — and how to make things better

by Fran Johns

Author/activist Barbara Ehrenreich addressed an enthusiastic audience in San Francisco Monday night, supporters of the Washington D.C.-based progressive think tank Institute for Policy Studies, on whose board Ehrenreich serves. Also on hand for brief remarks and conversation were IPS Director John Cavanagh, IPS fellow and Emmy Award-winning filmmaker Saul Landau and 2010 IPS fellow Tope Folarin.

The event was billed as an overview of such critical current issues as ending the Afghan war, creating a fair tax system, fixing the country’s tattered social safety net, shutting down Wall Street speculation and seeking local and global climate justice. And if that seems a tall order, the mood was decidedly more upbeat than overwhelmed.

Ehrenreich, whose 2001 best-seller Nickel and Dimed exposed the social and economic injustices assailing the working poor, says her current, ongoing focus is on the failure of our social safety net. “It’s not working,” she says, “but it can be fixed.”

To that end, the speakers distributed copies of a recently released IPS study (in cooperation with the Center for Community Change, Legal Momentum and Jobs with Justice.) Titled Battered by the Storm: How the Safety Net is Failing Americans and How to Fix it, the study lists five key findings:

  • Levels of long-term unemployment, underemployment and discouraged workers are reaching historic levels;
  • The percentage of poor children receiving temporary assistance under TANF (the main federal “welfare” program) has fallen from 62% in 1995 to 22% in 2008;
  • TANF benefits are far from sufficient to support the families that depend on them: 2008 assistance payments averaged only 29% of the money needed to bring families up to the official poverty line;
  • Even while labor force participation of mothers has increased, the supply of affordable child care has lagged behind, creating a significant barrier to employment for many, especially single mothers; and
  • Roughly 57% of unemployed people are receiving unemployment compensation; for those receiving benefits, amounts are less than half of wages, and many are losing work-related health benefits.

Saying the safety net has eroded over the last three decades, the report offers an “Emergency Relief Package” totaling just over $400 billion and including jobs program, state and local fiscal relief, insurance and food stamps measures designed to aid middle and low income Americans. These groups, IPS leaders contend, have seen their income decline as the rich get richer. The study also suggests a number of ‘no new money’ measures such as foreclosure relief. Financing could be accomplished, the study says, through tax changes affecting higher income levels, a tax on financial transactions over $100 billion and an end to overseas tax havens.

Her concern with the squeezing of middle and lower income Americans, Ehrenreich says, has grown as their plight has worsened in recent years. “This recession has not narrowed the gap of inequality,” she says, “it has widened the gap.”

California/Education/Health/Lifestyle/seniors/teens/USA/Women
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Two rapes, two unhappy endings

by Fran Johns

Several generations ago, at a college in Northern Virginia, a young woman I’ll call Hannah woke up in a fraternity house bedroom very early one morning, a party still going on downstairs. She remembered, vaguely, going upstairs with a young man she barely knew. She couldn’t remember what she had had to drink, other than too much of it; she couldn’t remember why she had gone with him — she didn’t even find him particularly attractive — or much of anything else except that she had tried to fight him off and been raped.

Hannah managed to get downstairs and go home. She was filled with remorse and recrimination. She told no one, she said, until she shared the story with me three years later. It never occurred to her to cry foul, because in those days it was pretty much okay for young men to “sew wild oats” but too bad if an unwilling woman reaped the results. It was unacceptable for young women to complain, since it was either the woman’s responsibility to look after herself or the woman’s fault that things “got out of hand.” As soon as she found she was not pregnant, Hannah told me, she “just tried to put it out of mind.”

Some things have changed, some things are better, some things stay the same. Here’s a story by Amanda Hess in today’s Washington City Paper, forwarded to me by a friend. It’s about another “Hannah,” in another, but contemporary, college story that happened not far from the one above.

On Saturday, Dec. 9, 2006, Hannah* woke up in her Howard University dorm room with a piece of her life missing. Hannah, a 19-year-old sophomore, had unexplained pain in her rectum and hip. Her panty liner, which she had worn the night before, was missing. Vomit dotted her gloves and coat. Her friend Kerston lay beside her in the skinny dorm room bed. Kerston told Hannah not to shower—they had to go back to the hospital to secure a rape kit. That weekend, Hannah claims that she was provided the following excuses for why she could not receive a sexual assault medical forensic examination: She was drunk; she ate a sandwich; she was a liar; she didn’t know her attacker’s last name; the police had to authorize the exam; she was outside the hospital’s jurisdiction; she wasn’t reporting a real crime; she was blacked out; she changed her story; her case was already closed.

This is the story of the night Hannah was not officially raped. And so far, Hannah has not officially accused anyone of raping her. In the summer of 2007, she filed a lawsuit against the District of Columbia, Howard University Hospital, George Washington University Hospital, both universities, and several doctors she says denied or interfered with her medical care. She seeks damages for medical malpractice and negligence from the medical defendants and the D.C. police, which she says resulted in “the probable loss of the opportunity to see her assailant brought to justice.” Across the board, the defendants denied Hannah’s claims. The parties in the case, which has yet to go to trial, were not interviewed for this story; this account is reconstructed from sworn deposition testimony taken in Hannah’s suit.

The now-elderly Hannah never speaks of her experience. The contemporary Hannah is filled with anger and a sense of injustice. The contemporary story is complex and unlikely to come to any satisfactory conclusion… but then, these stories seldom do.

Test Case: You’re Not a Rape Victim Unless Police Say So – Washington City Paper.

California/General interest/Health/New York/seniors/USA
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ADHD: A sometimes welcome diagnosis

by Fran Johns

“It’s ADHD, that’s what I have,” my friend Ann told me some years ago. She made the announcement with a combination of enthusiasm and relief, as if getting diagnosed with ADHD were the beginning of the end of years of anxiety and frustration — which, in fact, it was.

I had never heard of such a thing. I did know Ann was remarkably creative, that she often jumped from one idea to another, lost her house keys with regularity, frequently left things undone,  pushed herself to achieve and was famous for juggling three or four projects at once. By now, almost everyone in the country knows someone (or is someone) with a similar combination of traits, and almost everyone has heard of ADHD.

The symptoms of adult attention-deficit hyperactivity disorder seem to describe half the people in New York City (and elsewhere): restlessness, impatience, impulsivity, procrastination, chronic lateness, and difficulty getting organized, focusing and finishing tasks.

How do you know you have ADHD, which experts compare to having a mind like a pinball, with thoughts flitting in multiple directions. Maybe you’re just overcaffeinated and overworked? And if you do have it, will there be a stigma? Should you try medication? Will it work?

Parents of children with suspected ADHD face a myriad of similar questions. But the concerns can be just as troubling for adults, whose ADHD often goes unrecognized.

An estimated 8% of U.S. children have ADHD, which is also known as ADD, for attention-deficit disorder, and some 50% of them outgrow it, according to government data. About 4.4% of U.S. adults—some 10 million people—also have ADHD and less than one-quarter of them are aware of it.

That’s because while ADHD always starts in childhood, according to official diagnostic criteria, many adults with the disorder went unnoticed when they were young. And it’s only been since the 1980s that therapists even recognized the disorder could persist in adults.

Even now, getting an accurate diagnosis is tricky. Some experts think that too many adults—and children—are being put on medications for ADHD, often by doctors with little experience with the disorder. Others think that many more people could benefit from ADHD drugs and behavioral therapy.

Ann considers herself one of the lucky ones. She was diagnosed relatively early (although the disorder undoubtedly caused a long list of problems that might well have been avoided) and settled into a drug regimen that has made life greatly more livable for decades. It does not appear she had other problems that often accompany ADHD, as Wall Street Journal health writer Melinda Beck explains in an informative ‘Personal Journal’ article this week.

Complicating the picture further, ADHD frequently goes hand in hand with depression, anxiety and bipolar disorder, and it can be difficult to untangle which came first. “It’s very common for someone to be treated for depression or anxiety for years, and have the therapist not notice the ADHD,” says Mary Solanto, director of the AD/HD Center at the Mount Sinai Medical Center in New York City. But adults whose ADHD is left untreated face a high incidence of substance abuse, automobile accidents, difficultly staying employed and maintaining relationships.

That said, some adults with ADHD are highly intelligent, energetic, charismatic and creative, and are able to focus intently on a narrow range of topics that interest them. David Neeleman, the founder of JetBlue Airways, and Paul Orfalea, founder of Kinko’s, have spoken out about how the disorder helped them come up with innovative ideas for their corporations, despite their having done poorly in school.

“It’s amazing how successful some people are able to be despite these symptoms, and some people are totally paralyzed—there’s a whole spectrum of outcomes,” says Ivan K. Goldberg, a psychiatrist in New York City who co-developed a commonly used screening test.

Generally, ADHD can make life very difficult. It’s thought to be an imbalance in neurotransmitters, the chemical messengers that relay signals in the brain, particularly in the frontal cortex that governs planning and impulse control. Children with the disorder, particularly boys, are likely to be hyperactive, with an intense need to move constantly, which can interfere with learning. (Girls tend to be talkative and dreamy, but they are often overlooked because they aren’t as disruptive.)

Adults more typically have trouble with paying attention, focusing and prioritizing. Managing time and money are particularly difficult.

“What it really is is a disturbance of the executive functions of the brain — it’s the inability to plan things, to initiate them at the appropriate time, not to skip any of the steps and to terminate them at the appropriate time,” says Dr. Goldberg. “An awful lot of these people are very bright but they can’t keep it together. They keep screwing things up.”

It’s that last line that gets the attention of us all. Some of us screw things up more often than others — and wonder if we could blame it on ADHD. Identifying, and treating, those who can is a bright-spot possibility of the future.

ADHD: Why More Adults Are Being Diagnosed – WSJ.com.

California/General interest/Health/Politics & Causes/seniors/USA
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Quality health care at lower cost? It could happen

by Fran Johns

It seems a no-brainer: reward the doctors and hospitals that give the best care, latch on to programs and ideas that offer quality over quantity. But innovation in health care, even when it proves out, has always taken a very long time to work into the system.

In a ‘Talk of the Town’ piece appearing in the latest New Yorker magazine, writer Atul Gawande offers a thoughtful look at some of the hurdles ahead for the newly-passed health bill. They are primarily political: conservatives — even if they’re talking less and less about repeal — will run on pieces they plan to strip out, states will fight the insurance exchanges (such as those that make health coverage near universal in Senator Scott Brown‘s Massachusetts.) And other battle lines will be drawn.

But one primary problem with the dysfunction we are hoping to fix, Gawande points out, is that the current system “pays for quantity of care rather than the value of it.” He illustrates this with a case that makes you cheer, and then feel a little hopeless:

Recently, clinicians at Children’s Hospital Boston adopted a more systematic approach for managing inner-city children who suffer severe asthma attacks, by introducing a bundle of preventive measures. Insurance would cover just one: prescribing an inhaler. The hospital agreed to pay for the rest, which included nurses who would visit parents after discharge and make sure that they had their child’s medicine, knew how to administer it, and had a follow-up appointment with a pediatrician; home inspections for mold and pests; and vacuum cleaners for families without one (which is cheaper than medication). After a year, the hospital readmission rate for these patients dropped by more than eighty per cent, and costs plunged. But an empty hospital bed is a revenue loss, and asthma is Children’s Hospital’s leading source of admissions. Under the current system, this sensible program could threaten to bankrupt it. So far, neither the government nor the insurance companies have figured out a solution.

There is in the new bill, though, a ray of hope:

The most interesting, under-discussed, and potentially revolutionary aspect of the law is that it doesn’t pretend to have the answers. Instead, through a new Center for Medicare and Medicaid Innovation, it offers to free communities and local health systems from existing payment rules, and let them experiment with ways to deliver better care at lower costs. In large part, it entrusts the task of devising cost-saving health-care innovation to communities like Boise and Boston and Buffalo, rather than to the drug and device companies and the public and private insurers that have failed to do so. This is the way costs will come down—or not.

Imagine innovation being rewarded, communities being encouraged to find ways to improve quality of care at lower cost. That’s real reform, and it could just happen.

The next attacks on health-care reform : The New Yorker.

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