Category: USA

General interest/Health/Money/Politics & Causes/USA
Posted on

Hanging in the 'hood – a good option for boomers and beyonders and the economy

by Fran Johns

Say you’re happy in your ‘hood. The sights are familiar, the neighbors are okay, the comfort level is high. Now say you’re 70-something or 80-something and you need a little help now and then, bringing in the papers, getting to doctors’ appointments, changing light bulbs. Do you really want to pull up roots and move to a totally new environment, re-learn where everything is, make new friends among people who never knew your children (or your parents)? The latter is being chosen every day for or by seniors in America; the former is spurring a movement with an interesting variety of formats under the general heading of Aging in Place. I really want an umbrella acronym for this category, but I don’t really want to be an AIP.

On her New Old Age blog for the New York Times a few days ago Paula Span wrote about her dad’s life in a NORC.

In my father’s apartment building in South Jersey, the older tenants start drifting into the small lobby each day around 1 p.m., taking up positions on chairs and couches. The ostensible reason: The mail is about to arrive. The real reason: They relish a chance to schmooze.

“There’s a lot of discussion about the economy,” Dad reports. “And what the president said about the police and that fellow in Massachusetts.” Lesser issues arise, too. Whose daughter is coming to visit. What is on sale at the ShopRite supermarket.

Twenty-five years ago, a University of Wisconsin professor coined a great term for this kind of residence. It is a naturally occurring retirement community, or NORC. The place wasn’t built for seniors; its tenants are all ages, infants through nonagenarians. But a substantial number of residents have been there long enough to grow old together.

Since he still drives, my father heads out each morning to buy the papers, which get passed from one apartment to another. (God forbid you should squander 50 cents for your own copy and read the headlines before suppertime.) He ferries friends to doctors’ appointments. He benefits, too: his pal Manny comes by several times a day to check on him, and neighbors stock his fridge with soup and strudel.

NORCs exist all over; probably half of Miami Beach, Fla., was a NORC at one time. Watching this little community cope with shopping and banking and constant medical visits, I have wondered why services can’t be brought to these residents. Wouldn’t it be more efficient to have a nurse visit weekly, instead of each person making a laborious trip to a doctor’s office? For the senior van to schedule regular excursions to ShopRite? For the high school orchestra to give concerts in the community room, since so few older residents go out after dark?

A number of NORCs do offer this kind of help. Twenty-five states have NORC supportive service programs, according to the queen of NORCs, Fredda Vladeck, who runs the United Hospital Fund’s Aging in Place Initiative. New York leads the list with 54 NORC programs operating in high-rises, garden apartment complexes and neighborhoods of single-family homes; Indiana comes in second. The common mission of the programs, Ms. Vladeck said, is “transforming communities into good places to grow old.”

NORC’s and their cousins the Village aging-in-place concepts are multiplying, but they’re nothing new. They’ve been around for more than a quarter of a century (if you discount the automatic NORCs that small towns and Native American communities offered in ancient America afforded. And they’re proven effective. “Numerous studies have documented the benefits and potential of NORCs, including a Senate report (PDF), a foundation grant report and a graduate thesis,” Span writes.

So why, after 25 years’ experience, are there not more support programs for the millions of older Americans already living in NORCs, and the millions more to come?

Ms. Vladeck, accustomed to lobbying and testifying and organizing, sounded philosophical. “It’s incubating,” she said. “Sometimes, innovation takes a long time.”

If you want to keep your parents out of nursing homes, or want to stay out of a nursing home yourself, learning about how these alternatives work isn’t a bad way to start the plan.  There may not be a long time left, at the rate America’s getting older.

When the Neighborhood Is the Retirement Village – The New Old Age Blog – NYTimes.com.

General interest/Health/Money/Politics & Causes/USA
Posted on

Jail time for texting drivers

by Fran Johns

The life you save may be your own… or possibly mine. Right now, to be honest about it, I am more interested in mine. And mine is regularly at risk from texting drivers.

Today’s front page story by Matt Richtel in the New York Times, with accompanying photo of large driver of large vehicle, small dog in his lap and intricate computer screen to the right of his steering wheel, raises more fear in me than local jihadidsts and prospective death panels. The latter are abstract &/or untrue, the former is real. And preventable. “We are supposed to pull over,” trucker Kurt Long says blithely, “but nobody does.” Richtel also quotes American Trucking Association spokesman Clayton Boyce as saying that truckers “… are not reading the screen every second.” Why is this somehow not comforting?

I concede that time is critical to drivers of large vehicles. But at some point the public good ought to prevail. Those of us over 60 are admittedly better able to remember when it was possible to live without texting (or even cell-phoning) while driving and thus better able to think it could be possible again, at least on a limited basis. We are also able to remember when it was convenient for some people to drive around very drunk and occasionally kill people, before laws were passed to limit that activity. Driving a big rig while texting may seem more important than driving blotto after a party, but the dead are just as dead. Somebody has got to get the attention of our legislators — somebody not indebted to the very powerful trucking industry lobby — so that new laws are enacted.

Walking, whenever time and public transportation permit, is my mobility of choice. On foot, I regularly notice the drivers who don’t notice me because they are too busy texting or talking on cell phones. Pedestrians learn to do this. But if you’re driving down the highway and a large vehicle is barreling toward you or near you, propelled by a minimally-attentive driver, you don’t stand a chance. And I say, send them to jail.

Beloved members of my immediate circle of family and friends have been known to text while driving. I still say, send them to jail. I’ll come visit.

General interest/Health/Money/USA
Posted on

The AwareCar: Smarter than we are

by Fran Johns

OK, I do have a personal relationship with my car — her name is Iris, she plays soothing music (unless my granddaughter’s been in the front seat) while I’m navigating traffic and is a fine, fairly recent replacement for the ’77 Volvo my husband bought new. Although I’d rather walk or take the Muni almost anywhere, Iris keeps my grousing, and driving problems, to a minimum.

But now comes the AwareCar. The AwareCar proposes to figure out when I’m tired or distracted, remind me to put away the cell phone (not a problem, I do not cellphone-talk and drive), check my blood pressure, and when all else fails and I crash into something anyway, send vital information on ahead to the ER so they’ll be ready for me.

The AwareCar is the brainchild of the folks at AgeLab, an MIT project confronting the daunting fact that the 50+ population is the fastest growing segment in the world. Add to this the fact that we’re tending to live longer (unless you’re unlucky enough to be in Somalia or Iraq), with an American turning 50 every seven seconds, and you can see how AgeLab has its work cut out for it. No problem; they maintain that “an aging society is the opportunity to invent the future of healthy, active living.”

Wall Street Journal staff reporter Anne Tergesen recently alerted the world to the coming of the AgeCar, hopefully in time for some of these hordes of hard-driving Boomers. In an interview with AgeLab Director Joseph Coughlin and Associate Director Bryan Reimer (who hold those same titles with New England University Transportation Center) Tergesen quoted Dr. Coughlin’s response to her question, “As they age, what are Baby Boomers likely to want in a car?”:

Unlike their parents, this is a generation that isn’t going to say, “I’m getting older, so I’m not going to travel as much.” The boomers are working more and are far more engaged in daily activities than their parents were at a comparable age. Their expectations are far greater for products that facilitate their independence and mobility as they age. The impact on the car isn’t going to be about design, because no matter how old we get, we want our cars to look forever youthful. Instead, the boomers want the car to allow them to lead a forever-youthful lifestyle. That means it has to provide not only mobility but also safety and semi-automated features.

Thus enters the AgeCar, who is indeed likely to put Iris and her nifty sun roof in the shade. Its prototype — or perhaps more accurately its forerunner — is a Volvo XC90 currently cruising around Cambridge, MA with, Tergesen tells us, “$1.5 million of medical, computer, camera and robotic equipment. The goal? To create an AwareCar capable of sensing when a driver is distracted, faitgued or otherwise prone to accidents — and intervening to ensure a safe ride.”

To which I say, not a moment too soon. My son is about to turn 50.

General interest/Health/Money/Politics & Causes/USA
Posted on

Boomers & the high cost of dying

by Fran Johns

As health reform slogs along, a few critical pieces are already gone for good — or for now, at least. One of the saddest is coverage for end-of-life conversations; one of the saddest elements of our culture in general and healthcare mish-mash in particular is the tendency to treat death as a curable disease. Timothy Egan, in a recent blog for the New York Times, makes an eloquent case for injecting a little reality into all this.

In the last days of her life, Annabel Kitzhaber had a decision to make: she could be the tissue-skinned woman in the hospital with the tubes and the needles, the meds and smells and the squawk of television. Or she could go home and finish the love story with the man she’d been married to for 65 years.

Her husband was a soldier who had fought through Europe with Patton’s army. And as he aged, his son would call him on D-Day and thank him – for saving the world from the Nazis, for bequeathing his generation with a relatively easy time.

That son, John Kitzhaber, knew exactly what his mother’s decision meant. He was not only a governor, a Democrat who served two terms in Oregon as it tried to show the world that a state could give health care to most of its citizens, but a doctor himself.

At age 88, with a weak heart, and tests that showed she most likely had cancer, Annabel chose to go home, walking away from the medical-industrial complex.

“The whole focus had been centered on her illness and her aging,” said Kitzhaber. “But both she and my father let go that part of their lives that they could not control and instead began to focus on what they could control: the joys and blessings of their marriage.”

She died at home, four months after the decision, surrounded by those she loved. Her husband died eight months later.

The story of Annabel and Albert Kitzhaber is no more remarkable than a grove of ancient maple trees blushing gold in the early autumn, a moment in a life cycle. But for reasons both cynical and clinical, the American political debate on health care treats end-of-life care like a contagion — an unspeakable one at that.

Kitzhaber, having seen the absurdities of the system — Medicare would pay hundreds of thousands for continuing treatments but not $18 an hour for an in-home caregiver to help her die as she chose — was among the thousands of us who were distressed to see the debate get sidetracked by misinformation and outright lies. He knows the truth: that changing the way we treat dying people is the only way real economies and compassionate reform will happen. He is not only a politician, currently running for a third term as governor of Oregon, the state that has shown us the way, but a physician. And he’s smack in the middle of the Baby Boomer generation. Egan cites the recent Newsweek cover article by Evan Thomas, “The Case for Killing Granny,” and its on-target line about this being the elephant in the room, “Everybody sees it, but nobody wants to talk about it.

John Kitzhaber, M.D., politician, and son who watched both parents die in a dignified way, cannot stop talking about it. His parents’ generation won the war, built the interstate highway system, cured polio, eradicated smallpox and created the two greatest social programs of the 20th century — Social Security and Medicare.

Now the baton has been passed to the Baby Boomers. But the hour is late, Kitzhaber says, with no answer to a pressing generational question: “What is our legacy?”

The Way We Die Now – Timothy Egan Blog – NYTimes.com.

General interest/Health/Money/Politics & Causes/USA
Posted on

Pills vs. Time: The Power of Patience

by Fran Johns

Another interesting article about slowing down our rush-to-treatment healthcare mentality (see Pills & Perils below) appeared in Tuesday’s ‘Personal Journal’ section of The Wall Street Journal. This one is a lot simpler: do nothing, just wait. WSJ‘s Melinda Beck is writing less about serious afflictions than about the minor problems that plague us all; still it points once again to our cultural tendency to Do Something, whatever it is.

What cures colds, flu, sore throats, sore muscles, headaches, stomach aches, diarrhea, menstrual cramps, hangovers, back pain, jaw pain, tennis elbow, blisters, acne and colic, costs nothing, has no weird side effects and doesn’t require a prescription?

Plain old-fashioned time. But it’s often the hardest medicine for patients to take.

“Most people’s bodies and immune systems are wonderful in terms of handling things—if people can be patient,” says Ted Epperly, a family physician in Boise, Idaho, and president of the American Academy of Family Physicians.

“I have a mantra: You can do more for yourself than I can do for you,” says Raymond Scalettar, a Washington, D.C., rheumatologist and former chairman of the American Medical Association. But, he says, “some patients are very medicine-oriented, and when you tell them they aren’t good candidates for a drug they’ve heard about on TV, they don’t come back. I have colleagues who say, ‘You can take this pill and get better in two days, or do nothing and get over it in 48 hours,’ ” says Dr. Scalettar.

Of course, we know this. Most of us have some genetic strain of either the leave-it-alone-it’ll-be-better-in-the-morning or the shut-up-and-tough-it-out approach to all aches and pains. But we also have those constant messages from the TV set, and increasingly from the computer screen, that say one little pill will make it all better, right this very minute. And we are a right-this-very-minute society.

Almost all viral infections resolve on their own, unless you have a compromised immune system. As a rule of thumb, Dr. Epperly says, infections in the nose, throat, stomach and upper respiratory tract tend to be viral. Infections elsewhere in the body are likely to be caused by bacteria, and those can get worse without antibiotics. About 80% of urinary-tract infections resolve on their own, for example, but about 20% develop into more serious kidney or blood infections. And even if they don’t, the symptoms can be very uncomfortable.

Some chronic maladies follow predictable courses, according to many medical experts ,whether or not they are treated.

Colic is almost always gone in four months. Some 70% of acne is gone three to four years after it first appears. “Frozen shoulder”—a painful restriction of the shoulder joint—is typically painful for three to six months and stiff for the next four to six months, and resolves completely after one to three more months. Temporomandibular joint (TMJ) pain tends to go away by itself in 18 months. Sciatica resolves on its own in three weeks in 75% of cases.

Not many of us do pain and misery very well. As a repeat TMJ sufferer, I can promise you if I tried to wait it out without pain killers for 18 days, let alone months, my entire neighborhood block would evacuate. Pain (see Caitlin Kelly’s Broadside post a few hours ago) is in a category all its own. Actually, though it is hell to pay, sometimes it can serve a purpose. My good husband wound up in the emergency room with a gall bladder infection that would’ve had anyone else, surely including myself, shrieking in agony; he does not feel pain. That is great when you’re young and macho, not so good when you get a few years on you and could use a signal that something’s wrong.

But for the minor issues, things wrong can often right themselves without outside interference. Now… if I could only start over again with everything I should or shouldn’t have taken…

When Doing Nothing Is the Best Medicine – WSJ.com.

General interest/Health/Money/Politics & Causes/USA
Posted on

Some Women's Views of Health Reform

by Fran Johns

First Lady Michelle Obama is making the news in support of her husband’s health plan, hoping to tap into the energies of one group who voted for Obama in large numbers: women. Reform is everyone’s concern, but in many ways it occupies a specific gender niche. As reported by Voice of America’s Kent Klein,

Mrs. Obama says health care reform is a women’s issue. “Women play a unique and increasingly significant role in our families.  We know the pain, because we are usually the ones dealing with it,” she said. The first lady spoke Friday to a gathering of women near the White House, and said the state of the U.S. health care system is unacceptable. “For two years on the campaign trail, this was what I heard from women:  That they were being crushed, crushed by the current structure of our health care.  Crushed,” she said.

A host of women’s groups, blogs, newsletters and web writers have also recently joined in. Posting in the National Women’s Law Center blog, Outreach Manager Thao Nguyen told the poignant story of hearing from a friend that she’d just married her long-time hesitant boyfriend. The marriage news was good news, but its terms took the joy out: having lost her job, it was the only way she could get health insurance.

Her point seemed so logical, but the entire idea was couched in such an insane reality I was simply speechless. Lucy is in her early 30s but she has a pre-existing condition so buying individual health insurance and the unfair, overpriced premiums that come with it was out of the question. Lucy has been living with Dan for 10 years, but unfortunately, he works for a company that doesn’t offer domestic partner benefits.

I couldn’t help but think: is this what our broken, unstable health care system means for millions of Americans around the country? As the economy continues to struggle, employers continue to shed jobs, and every day 14,000 more Americans wake up realizing that they are now uninsured and just one illness away from financial ruin. Are reluctant bachelors around the country going to put away their Megan Fox posters, cancel the “poker nights” (aka X-Box marathons we’re on to you), and start settling down?

My own run-in with healthcare weirdness is minor in comparison to most, but I still remember the shock. Making a routine call to renew the prescription for a bone-building drug I had taken for years to stave off osteoporosis, the message center person said she probably should warn me that rather than the $24 co-pay I’d been having per quarter my cost would now be $230. I do need these bones, but couldn’t see them worth $920 a year. I hung up and started drinking more milk. Had to get breast cancer, for which I now take a covered post- cancer drug which my oncologist prescribes… mainly to keep my bones healthy. Something is bizarre here.

Or maybe we women might bend the old macho adage a little: It’s broke, fix it.

VOA News – Michelle Obama Joins Health Reform Campaign.

General interest/Health/Politics & Causes/USA
Posted on

Pelosi's Plea for Calm

by Fran Johns

However you feel about Nancy Pelosi’s performance as Speaker of the House so far, or however much you agree or disagree with her views, yesterday’s comment (as reported by San Francisco Chronicle Washington staffer Carolyn Lochhead) is worth both consideration and support.

For the first time anyone can remember, House Speaker Nancy Pelosi teared up at a news conference Thursday morning in response to a question about the current state of political discourse.

Visibly struggling to retain her composure, Pelosi recalled a time in San Francisco when emotions ran out of control, referring to the 1978 assassination of Mayor George Moscone and Supervisor Harvey Milk by former Supervisor Dan White.

“We are a free country, and this balance between freedom and safety is one that we have to carefully balance,” Pelosi began. She then became emotional as she recalled the events, startling the reporters gathered for the weekly news conference.

“I saw this, myself, in the late ’70s in San Francisco,” she said. “This kind of rhetoric was very frightening and it created a climate in which violence took place.”

I was not it San Francisco at the time, but those who were affirm that the intensity of anger, fear and hostility abroad in the community at large offered the ground out of which such an appalling act could grow. Many say the movie Milk accurately caught that mood, and watching the movie made my heart rate accelerate. I don’t think we need any more heart rate acceleration in the U.S. right now.

Regaining control, (Pelosi) expressed a wish that “we would all, again, curb our enthusiasm in some of the statements that are made” and “take responsibility” for what is said.

Those of us who have lived through other periods of polarization in this country — the McCarthy witch hunts, the Vietnam war, the battles for civil rights — retain vivid memories of too many brutalities, assassinations and cruelties. Pelosi is right about the need to retain a balance between freedom and safety. Unless we return to some semblance of civility in the public discourse we stand the chance of losing either, or both.

via Emotional Pelosi urges civility in discourse.

1 … 31 32 33 34 35 36