Friday, 03 July 2015
Happy Holiday Weekend – Independence Day 2015
American Independence Day is a great, dramatic story. Here are its bare bones.
Thomas Jefferson, just 33 years old in the year of 1776, resisted writing the Declaration of Independence. He was John Adams' choice and Adams prevailed.
Quoting Adams' later recollection, John Meacham, in his Pulitzer Prize-winning 2013 biography, Thomas Jefferson: The Art of Power, includes this exchange between the two men:
“You should do it,” Jefferson said.
“”Why will you not? You ought to do it.”
“I will not.”
“What can be your reason?”
“Reason first,” [said Adams] you are a Virginian, and a Virginian ought to appear at the head of this business. Reason second, I am obnoxious, suspected and unpopular. You are very much otherwise. Reason third, you can write ten times better than I can.”
“Well, if you are decided. I will do as well as I can.”
“Very well. When you have drawn it up, we will have a meeting.”
Not that it was Jefferson's document alone. Among his influences were Locke, Montesquieu, philosophers of the Scottish Enlightenment, Adams, of course, and Benjamin Franklin took on some editing, contributing the phrase, “self-evident.”
According to Adams, says Meacham, delegates to that Continental Congress in Philadelphia, cut large passages including those condemning the people of England and a denunciation of the slave trade – all in all about one-sixth of Jefferson's document was removed.
The Declaration was ratified by the Congress on 2 July and when, six days later it was read aloud in front of the statehouse in Philadelphia, the crowds cheered, “God bless the free states of North America.”
Meacham tells us that the men in that muggy statehouse room with horse flies “bedeviling...the silk-stockinged legs of honorable members” knew, of course, that with their signatures, they had committed themselves to a treasonous course of action and what its consequences might be:
”Jefferson loved the story of an exchange between the fat Benjamin Harrison of Virginia and the wispy Elbridge Gerry of Massachusetts. 'Gerry, when the hanging comes, I shall have the advantage; you'll kick in the air half an hour after it is all over with me.'”
As we know, after a bloody awful war, things turned out differently and here we are celebrating this great, important document again, this beacon of personal freedom (even if we do not quite live up to it these days), on its 239th birthday. Meacham again:
”...the author of the document saw his words as sacred. Describing the desk on which he wrote the declaration, Jefferson later said: 'Politics as well as religion has its superstitions.
“'These gaining strength with time may one day give imaginary value to this relic for its association with the birth of the Great Charter of our Independence.'”
Here is that desk which lives nowadays in the Museum of American History at the Smithsonian Institution:
Most American schoolchildren in my day were required to memorize the first paragraph of the Declaration of Independence:
“When in the Course of human events, it becomes necessary for one people to dissolve the political bands which have connected them with another, and to assume among the powers of the earth, the separate and equal station to which the Laws of Nature and of Nature's God entitle them, a decent respect to the opinions of mankind requires that they should declare the causes which impel them to the separation.”
You can read the rest of it here.
It is fitting that on the 50th anniversary of the signing of the Declaration of Independence, 4 July 1826, Thomas Jefferson died at his home in Virginia at 12:50PM. For me, it is an astounding and pitch-perfect coincidence that John Adams died on the very same day in Massachusetts at 6:20PM.
Adams's last words were recorded at his bedside as “Jefferson survives.” He died not knowing his old friend and rival had preceded him by just a few hours.
Now. Because backyard barbecues on the Fourth of July are as traditional as parades and fireworks, here, for some fun and silliness, are those Tiny Hamsters again, this time having a Tiny BBQ for Independence Day.
Enjoy the holiday weekend, everyone.
Wednesday, 01 July 2015
60 is Not the New 40
Nor 70 the new 50 but people are still trying to sell that to us.
If you pay too much attention to media chatter, you can easily be convinced that old age is a nice, smooth continuation of midlife. If you do it right – that is.
Drink gallons of protein liquid, spend three hours a day at the gym, drop hundreds of dollars on brain games, stand on one leg while washing dishes and you too can climb Mt. Everest.
More: if that 91-year-old can finish a marathon, so can you. Or start a business; everyone's an entrepreneur these days even if they don't know what Six Sigma is. Oh, and if you pump yourself full of enough Botox, no one will know you're a day over 40.
Of course, all this is twaddle, hogwash and most of all, wishful thinking. Old age has been stigmatized for so long that the young people who write all that advice for old people refuse to believe there isn't something they can do to prevent it and they want us to be their guinea pigs.
Perhaps, they must think, if they goad us hard enough and long enough into continuing to live – or try to - as we did 20 or 30 years ago, they will learn how they can live forever.
When my professional life came to an end 11 years ago, nothing changed. I had already begun this blog so I just segued from 15-hour days (including the four-hour commute) to – oh, 10- to 12-hour days doing all that was needed to churn out these pages.
That sentence makes it sound like this is chore. It is not. I enjoy this as much as most of the paying jobs I had over more than four decades and because none of them were nine-to-five jobs, for these past 11 years, long hours have been nothing different from what I had always done.
As healthy as I am (and I do not take that lightly), I'm slowing down. These days I notice the hiccups in my brain, the nanoseconds it takes sometimes to get to the next thought when I'm writing. That's new.
Nor is my focus as pointed as it once was. My fingers can be flying across the keyboard as they always have translating thoughts and ideas in my head onto the page, when I suddenly “come to” realizing I've spent three or four minutes wondering if there might be a better synonym for one of the words I just typed.
By then I've lost my train of thought and I have finally learned that I might as well go do something else for awhile before I can get back to it.
I am more easily distracted these days and distraction is, of course, the enemy of focus and concentration. All of this is due to age – I'm 74 now, compared to 63 when I started Time Goes By.
It takes longer for me to clean the house nowadays and it also takes longer to think. For quite awhile, I had been spending more hours to get the same amount of work done on the blog, always scrambling for time, always behind, always dropping something I wanted to do which is why, a few weeks ago, I cut back publishing days to four instead of six.
After about two months on this new schedule, I almost feel reborn. The biggest difference is time, time to read at my leisure, time to write without rushing, time to choose topics more carefully.
Most of all, there is time to sit quietly with myself; time to let thoughts drift by while I watch them come and go; time to think about if and how all this information about ageing I've been collecting for 20 years applies to me; time to reflect on some of the big life questions.
While I wasn't looking, my life has become simpler. I take care of my daily needs – food, exercise, sleep, laundry, etc. I pursue my curiosity about how we age, enjoy writing something about that in these pages and I have returned to some other intellectual interests I had let slide for too long.
Although I miss living in a big city, New York specifically, I have arranged the details of my home so that it pleases my sensibilities to be here. Aside from New York, I've lost interest in travel but for a drive to the Oregon coast now and then.
Small as it sounds, a big pleasure during the season is shopping the weekly farmers' market and how agreeable it is each week having a short visit with some of the vendors who have become a certain kind of friend over our mutual enjoyment of good food.
Compared to the hustle and bustle of my 40 mid-years, it is a quiet life and from the outside it undoubtedly looks boring. But it is far from that on the inside and I like my life – particularly now that I have created this new breathing space.
I don't see how old age could possibly be intended as an extension of midlife. Even though, as I described above, my thoughts are a little slower, my mind is exploding with them.
I am gaining insights into myself, my life, relationships, beliefs and more, with a depth and detail I never had when I was younger – nourishing my soul you might say. I'm peeling away layers that for a long time kept me from even trying to understand some of the events and people in my life.
Except that I arranged for the time, I don't know why all this activity is happening right now but surely it is more important than skydiving at my age or trying to prove how young I can appear to be so that others might be more comfortable with the idea of ageing.
Old age is an excellent time to make sense of ourselves and the world around us. Don't let anyone pressure you out of it.
Monday, 29 June 2015
Does Hollywood Ageism Have Anything To Do with You and Me?
In recent weeks there has been a minor flurry of media information – tidbits, mostly – about age and work in relation to female movie stars. I had been sitting on a quotation from actor Maggie Gyllenhaal, wondering what I might do with it until TGB reader Jim Hood mentioned it in an email:
“I’m 37,” Gyllenhaal said in an interview with The Wrap, “and I was told recently I was too old to play the lover of a man who was 55. It was astonishing to me. It made me feel bad, and then it made feel angry, and then it made me laugh.”
A couple of weeks later, the same website asked 69-year-old actor, Helen Mirren, about Gyllenhaal's experience:
No, you're not imagining it. Mirren did say, “fucking” outrageous. And so it is.
At the same time, however, I am a bit queasy about well-off movie stars complaining about the kind of roles they get. Especially Mirren who continues to make three or four films a year, more than most actors get at any age.
Is it wrong that 50- and 60-something male movie stars are most frequently paired romantically with ingenues? About the only time we see old male actors in movies with age-appropriate love interests are when one of the two is dying. Of recent vintage, Amour comes to mind along with Still Mine.
Okay, maybe The Second Best Marigold Hotel but what a disappointment that movie was with Richard Gere shoehorned in for no apparent reason than his good looks.
Maybe I should mention the most famous reverse age movie, Harold and Maude. But I've always thought there was something mildly creepy about it – the movie, not their age difference - and anyway, one movie in 45 years with an old woman and young man does not balance hundreds of the opposite.
This isn't a new problem for older women in Hollywood. They have been complaining forever about lack of roles in general, let alone not being cast as a romantic interest when they have passed an imaginary use-by date.
In 1972, I produced a television interview with Bette Davis (of “old age ain't for sissies” fame) in which she lamented that back then, no one was writing movies for women actors of a certain age. It hasn't changed much since then, certainly not in the realm of romance.
So is this important? Does it matter that female movie actors - especially stars who make zillions of dollars compared to most of the rest of us - don't get to kiss the leading man after age 35 or 40?
I'm only half convinced that it does – in the sense that celebrities are role models for the rest of us, especially young people who emulate their hair styles, fashion, even behavior. (Cosmetics, automobile and fashion companies don't pay movie stars to shill for their products for no reason.)
If we, the public, repeatedly see movies and TV shows in which old men only pursue 20-something women, I'm pretty sure that has at least as much effect on beliefs about who is attractive and worthy of attention as the commercials starring those same actors enhance the bottom line of the products.
And that in turn may have a great deal to do with your and my lives. If we hardly ever see, in our entertainment, older women as worthy – whether as sex objects or responsible adults – might not we, for example, be refused jobs after age 50 or 60 like those female actors are?
And if I buy this idea, I think it affects men too because for at least the past decade, more than half the movies released in the United States are about bionic, humanoid, Borg-like heroes more suited to video games than real life and against which no human male – of any age - can compete.
Based on all that, Maggie Gyllenhaal's lost movie role with a 55-year-old man might not be as funny as she thinks.
Or maybe it is. I'm not sure. What I'm trying to work out is whether the fact that Maggie Gyllenhaal, Helen Mirren and Bette Davis don't get to make love to an actor their own age on screen has anything to do with the fact that I couldn't get anyone to hire me after age 62.
Sunday, 28 June 2015
ELDER MUSIC: They Wrote the Songs
This Sunday Elder Music column was launched in December of 2008. By May of the following year, one commenter, Peter Tibbles, had added so much knowledge and value to my poor attempts at musical presentations that I asked him to take over the column. He's been here each week ever since delighting us with his astonishing grasp of just about everything musical, his humor and sense of fun. You can read Peter's bio here and find links to all his columns here.
Today I'm devoting a whole column to a topic I occasionally rabbit on about, and that is the original writer of songs made famous by others.
I'm sure that you'll know all of the selections today but perhaps you won't be quite as familiar with the original versions by the people who created them in the first place.
In my not too humble opinion, the versions by these folks are superior to the famous covers. You may disagree with that - after all, the first version of a song is usually the one that gets implanted in the brain. That happens to me all the time.
However, I think it's always instructive to hear how the writer intended the song to sound.
Let's get started with a sadly neglected singer and songwriter, TOM JANS, and the song that really inspired me to write the column.
Tom made a bit of a name for himself in the seventies in singer/songwriter circles as a performer and writer of fine songs. Not only as a solo artist, but he teamed up for a while with Mimi Fariña, Joan Baez's sister.
Alas, he had a serious motorcycle accident and died not too long afterwards, almost certainly due to serious injuries sustained to his kidneys.
His most famous song would have to be Loving Arms, covered really well by Dobie Gray and also recorded by Elvis and a whole bunch of others. Here is Tom with his song.
What annoys me is those people who claim to be knowledgeable about music and then claim that, because he's a songwriter himself, Harry Nilsson wrote Everybody's Talkin'. No he didn't.
Sorry, I've calmed down now that I've got that off my chest. It, of course, came from FRED NEIL who did a far superior version of the song some years earlier.
HANK BALLARD, along with his band mate Cal Green, were inspired by a gospel song by The Sensational Nightingales. They put new words to the tune and came up with a song that rather inspired a new dance craze. They called it The Twist.
Hank and his band The Midnighters recorded the song and it was moderately successful. It came to the ears of Dick Clark who wanted to feature them on American Bandstand but the group was unavailable at the time.
Dick loved the song and got his friend Earnest Evans to record it. Earnest was a great admirer of Fats Domino and changed his name to Chubby Checker as an homage. As you know, this new version went through the roof.
Today, though, I'm playing Hank and The Midnighters' original. I think Chubby studied this one very closely.
JOHN STEWART was a fine singer and songwriter who first came to prominence writing songs for, and then eventually joining, the Kingston Trio.
Later, as a solo performer, when he wasn't on the road, he'd spend time writing songs. Well, that was his job after all.
One day he wrote Daydream Believer and he thought the day a total failure as that's all he produced and he didn't think much of it. His good friend Chip Douglas heard the song and thought it would be good for The Monkees. Chip was a producer on their TV program.
The Monkees really loved the song and wanted to record it but the record company demanded that they change the word "funky" to "happy.” John replied that meant that the song made no sense at all and he wouldn't let them.
Well, came the reply, they won't be able record it. John decided that "happy" was really growing on him. He said that the song set him up for the rest of his life. Here it is.
Pretty much everyone featured today are known to some degree but we come to someone who isn't, at least not by me. He was certainly a writer of famous songs, but I imagine few people who listen to music know his name. He is MARK JAMES (or Francis Zambon to his mum and dad).
The person who covered his song, in complete contrast, was the most famous person on the planet, Elvis. As you'll hear, Elvis not only listened to the song but the arrangement as well and copied it pretty much exactly. Suspicious Minds.
BRENDA HOLLOWAY had the help of her sister Patrice, Frank Wilson and Berry Gordy in writing her song.
Brenda was going to be the next big thing at Motown after a couple of well-charting singles. However, The Supremes, who had done nothing much at all before, suddenly had a worldwide number one hit and Berry concentrated on them from then on.
Back to Brenda and the song she co-wrote, You've Made Me so Very Happy, a big hit for Blood Sweat and Tears a couple of years later.
Okay, I'll admit that Ray Charles did a wonderful cover of I Can't Stop Loving You, even better than the one by DON GIBSON whose version is pretty good.
Don was a writer and singer of the saddest, lonesome-est songs ever recorded. Here's his take on his own song.
DAN PENN was another who had someone cover one of his songs better than he did it.
Not just better than his but better than anyone else who has tackled the song and there have been quite a few of them. I'm talking about James Carr who did the terrific version of one of the great soul songs, The Dark End of the Street.
However, here is Dan.
BOBBY CHARLES wrote a number of songs you'd recognise immediately.
He was a New Orleans native and wrote songs for various musicians from that city but most notably for his friend, Fats Domino. This is one of Fats' biggest hits but it's Bobby's take we're interested in today: Walking to New Orleans.
He has a little help from the great man himself on this version.
JIMMY WEBB has written songs for a whole bunch of people but he's probably most associated with Glenn Campbell.
I could have chosen a dozen (or more) from Glenn's repertoire, however, I have a previous column devoted to Jimmy so I've decided on one I didn't include in that one. Well, not Jimmy's version anyway.
Here is Wichita Lineman.
Saturday, 27 June 2015
INTERESTING STUFF – 27 June 2015
ELDERS BENEFIT FROM SUPREME COURT DECISION TOO
It was an important win for the American people on Thursday when, in a 6-3 decision, the Supreme Court upheld Obamacare subsidies. A loss could have meant the destruction of the entire law.
And it's not just people under age 65 who benefit, you know. There are Medicare provisions in the law too. Here is what Max Richtman, the president and CEO of the National Committee to Preserve Social Security and Medicare (NCPSSM), emailed right after the Thursday Court decision was announced:
”Seniors in Medicare...will save, on average, about $5,000 over the next 10 years due to lower drug costs, preventive services with no out-of-pocket cost and reductions in the growth of health spending.
“Since passage of Obamacare, more than 8.2 million people with Medicare saved over $11.5 billion on prescription drugs. These are real people who will face real threats to their health security if the quest to dismantle Obamacare is ever successful.
“No doubt the enemies of health care reform will continue their zealous mission to roll back Obamacare’s successes but today we have reason to celebrate. Tomorrow we’ll resume our fight to ensure seniors continue to benefit from the enormous savings Obamacare provides them and their families.”
JON STEWART'S DONALD TRUMP GIFT
Last week, we mentioned that although Donald Trump said he is running for the Republican nomination for president, it was not official because he had not yet filed the required documents with the Federal Election Commission (FEC).
Well, he did that this week and there is no happier person in the land than The Daily Show host, Jon Stewart. Trump's candidacy is any comedian's wet dream – the joke fodder is endless. Take a look, from last Tuesday's show:
AND THIS: beginning today at 12N EDT and running until 6 August when the last new Daily Show is broadcast, Comedy Central is streaming a 42-day, online marathon of every episode of the program since Jon Stewart took the reins in 1999.
They are calling it Your Month of Zen and you can follow it here.
THE SILENCE OF OWL FLIGHT
What makes owls deadly to rodents and other small animals is how quietly they can fly. Now, scientists are studying owl flight to see how they can apply it to help reduce the noise wind turbines produce:
”...by using a 3D-printed material meant to mimic the surface of owl wings, he and his colleagues were able to lower the noise level of a wind turbine blade by about 10 decibels,” reports Grist.
Nice to know but I'm pretty sure Jan Adams of Can It Happen Here? emailed the story because of this amazing video. Enjoy.
GOOD NEWS ABOUT CORONARY HEART DISEASE
According to a story in The New York Times, the death rate from coronary heart disease has dropped 38 percent in just ten years. A big reason is increased speed of treatment:
”With no new medical discoveries, no new technologies, no payment incentives — and little public notice — hospitals in recent years have slashed the time it takes to clear a blockage in a patient’s arteries and get blood flowing again to the heart..."
”Disparities that used to exist, with African-Americans, Hispanics and older people facing the slowest treatment times, have disappeared, Dr. Harlan Krumholz, a cardiologist at Yale, and his colleagues said in a paper in Archives of Internal Medicine."
The improvements in treatment have spilled over into the care of stroke victims. Neurologists watched with envy as cardiologists slashed their times...The payoff from the changes has been breathtaking, experts say.
“'Heart disease mortality is dropping like a stone. This is a reason why,' said Dr. Eric Peterson, a cardiology researcher at Duke. 'And stroke has fallen to fifth as a major killer. This is a reason why.'”
It's good news and this is equally good reporting of it at The New York Times.
ROCK STAR BERNIE SANDERS
The crowds at Vermont Senator Bernie Sanders's campaign speeches grow larger with each appearance. So unexpected was the attendance at last Tuesday's speech in Denver (estimated at 5,000) that many had to be seated in an outdoor sports arena nearby where they could hear but not see him.
This is what just the indoor crowd looked like there:
In an appearance on last week's Real Time with Bill Maher TV show, Sanders received a standing ovation from the audience almost worthy of a rock star. Wow! Take a look.
Whatever the outcome for Senator Sanders campaign, the growing support for his progressive agenda can only be good for the United States.
LITTLE PIGGY SUE
Yes, I know. It's emotionally manipulative and it's a commercial for Vodaphone in New Zealand. And it worked on me.
HUGE LIST OF SENIOR DISCOUNTS FOR YOU
TGB Reader Steve Kemp sent a link to the largest list I've ever seen of senior discounts. There is not a single restaurant I go to or ever would, but that might not be true for you. And there are a lot of other stores and services included.
It's posted on the Facebook page of someone named Jim Ryan. What a whole lot of work he put into this.
JOHN OLIVER ON ONLINE HARRASSMENT
I'm beginning to feel foolish each week carrying on about how impressive John Oliver and his crew are at the essays they produce for HBO's Last Week Tonight. But they haven't failed me yet: useful, excellent, important and funny.
WATCHING CAT VIDEOS IS GOOD FOR YOU
Do you ever lose yourself down a rabbit hole of cat videos (if that's not mixing metaphors) only to find when you climb out that you've lost an hour, even more, of your life to them?
I have and not infrequently, I'm appalled at how I've wasted an evening.
Now, a woman who is an assistant professor of media at Indiana University undertook an online “exploratory survey” of 7,000 (self-selected) respondents about who watches cat videos and why.
Publishing a story about her results in The Conversation, Jessica Gall Myrick reports that her findings
”...suggest that certain people are, in fact, more likely than others to view copious amounts of internet cat videos. It also showed that cat videos can positively influence the emotions of viewers.
“According to my study, if you currently own or have previously owned a cat – or if you’ve volunteered to assist pets in the past year – you’re more likely to watch cat videos...
“People in my study reported experiencing more positive emotions and having higher energy levels after watching cat videos than before. They also reported lower levels of negative emotions after viewing online cat-related content.
“In short, most of us get a little psychological 'pick-me-up' when we watch Lil Bub climb the stairs or view a hilarious Grumpy Cat meme.”
You can read more of Ms. Myrick's survey results here. Meanwhile, I'm interpreting her study to mean I can post as many cat videos as I want. Such as this one:
You've heard of Snakes on a Plane? Here's a cat on a plane. Thank reader Cathy Johnson for this.
Interesting Stuff is a weekly listing of short takes and links to web items that have caught my attention; some related to aging and some not, some useful and others just for fun.
You are all encouraged to submit items for inclusion. Just click “Contact” in the upper left corner of any Time Goes By page to send them. I'm sorry that I won't have time to acknowledge receipt and there is no guarantee of publication. But when I do include them, you will be credited and I will link to your blog IF you include the name of the blog and its URL.
Friday, 26 June 2015
House Calls, Telemedicine and Medicare
Medicare is in the third year of testing its Independent at Home demonstration project to see if it can improve care and cut costs for some of its more frail patients with house calls. The idea is to test
”...how well a house call approach really works and how to pay for it. About 8,400 frail seniors with multiple chronic conditions — Medicare's most expensive type of patient — are receiving customized home-based primary care from 17 programs around the country,” according to a story at Yahoo! News.
The study was created by The Affordable Care Act and legislation is pending in Congress to extend the project another two years. Meanwhile, Medicare has released an analysis of the project's first year. Results so far?
”...it saved an average of $3,070 per participating beneficiary.”
Meanwhile, in Cincinnati,
”Donna Miles, 68, awoke on a wintry February morning and the pain had not subsided, she decided to see a doctor,” reports Kaiser Health News.
“So she turned on her computer and logged on to www.livehealth.com, a service offered by her Medicare Advantage plan, Anthem BlueCross BlueShield of Ohio. She spoke to a physician, who used her computer’s camera to peer into her mouth and who then sent a prescription to her pharmacy.
“'This was so easy,' Miles said.
These two developments, small as the trials are so far, are crucial to the future of elder healthcare and here's why. The 65-plus population the United States has grown dramatically since President Lyndon B. Johnson signed Medicare into law 50 years ago.
In 1965, there were approximately 18 million people age 65 and older in the United States. Today, there are about 41 million and in 2050, there will be more than 88 million.
This is a problem. There are few enough doctors to go around now and it is becoming well known that remaining in our homes, where nearly 90 percent of elders want to be as they age, is less expensive than living in care residences but for some, getting out and around becomes problematic.
Telemedicine and house calls will make remaining home more feasible and can save time (for physicians and patients) and save money too. Not to mention that it makes getting care for people with mobility problems a whole lot easier.
And, house calls these days are a far cry from what I remember as a kid 65 years ago. According to the Yahoo! News report:
”Forget the little black bag of yore. Today's house calls can result in an EKG in the living room, and on-the-spot tests for infections. Providers can use portable X-rays, check medicine bottles to tell if patients are taking their pills, spot tripping hazards, and peek in the kitchen to see if healthy food is on hand.
"'It helps you avoid the emergency situations,' said Naomi Rasmussen, whose 83-year-old father in Portland, Oregon, is part of Medicare's Independence at Home study.”
Videoconference technology has been available for 20 years and I've read dozens of reports over the years of how it will revolutionize healthcare but it has been incredibly slow to get going. Hardly anyone can use it yet.
”...fewer than 1 percent of Medicare beneficiaries use it,” reports Kaiser. “Anthem and a University of Pittsburgh Medical Center health plan in western Pennsylvania are the only two Medicare Advantage insurers offering the virtual visits, and the traditional Medicare program has tightly limited telemedicine payments to certain rural areas. “And even there, the beneficiary must already be at a clinic, a rule that often defeats the goal of making care more convenient.”
Nevertheless, the innovation is moving forward, if slowly. Many more younger, non-Medicare, patients have access to telemedicine, the number of insurance providers that offer the service is increasing and Medicare is tiptoeing toward change too:
”Medicare Advantage plans have the option to offer telemedicine without the tight restrictions in the traditional Medicare program because they are paid a fixed amount by the federal government to care for seniors. As a result, Medicare is not directly paying for the telemedicine services; instead, the services are paid for through plan revenue.
“Republicans and Democrats in Congress are also considering broadening the use of telemedicine; some of them tried unsuccessfully to add such provisions to the recent law that revamped Medicare doctor payment rules and to the House bill that seeks to streamline drug approvals,” reports Yahoo! News.
To me, telemedicine and house calls are such a no brainer – for patients of all ages - that it is frustrating to see how slowly they are developing. It's not like there is any doubt; they ARE going to happen.
Wednesday, 24 June 2015
Decisions About Being Old and Single
Letters. We get letters. This one from a reader (let's call her A) who has been thinking about how she will live – or might like to live – if she winds up single in her late years after the “very long relationship” she is still enjoying now.
”Would I stay in the big house?” she writes. “Would I downsize? Would I move nearer my children? Would I stay in my city? I waver daily and at times each option seems to be the obvious one.
“My sister is certain she will make no change. My sister-in-law is certain she will downsize...
“I know decisions will be made for us in the event of our own decline in health but [my] question supposes we are still hale and hearty. “
The only thing I know about this question is that no one can answer it for anyone else. And that, obviously, is not much help.
Plus, although “hale and hearty” is a requisite in A's consideration of staying put or changing housing, I think any of us would be negligent not to give at least a nod to the fact that health becomes an iffier proposition in late life than when we were younger.
Among the unknowables of old age, the certainty I keep in mind is that healthy as I am right now at age 74, at any moment of any day, something can happen that will require changes to my living arrangement if not entirely disable me.
Not that I have take steps to incorporate that possibility into my decision making. Yet. It's on my agenda.
But there is nothing wrong, too, with pondering possible changes while assuming good health. Of course, one's financial position will affect what choices are available.
If you have little idea of how you want to live when single and old, there are a lot of basic questions: Do you like your community? Do you have friends there you are comfortable with? Do you like the climate or are you looking for a change? Are you happy in the house you have or is it too big for you now?
If change is on the agenda, the questions multiply. Will a single-family house or apartment in a new place work? Do you like urban or suburban or rural? How will you choose a new location? What are your criteria?
In addition, there are many kinds of housing options only – or mostly – for old people. Age restricted communities; NORCs, that is Naturally Occuring Retirement Communities; retirement communities defined by interests, activities and income; Continuing Care Retirement Communities (CCRC) that can take you from independent living to assisted living and finally, nursing care.
Co-housing is another option and don't forget the Golden Girls option – a group of three or four or five friends sharing a big house together.
Not to mention that if after all the homework you decide to stay where you are, there are many kinds of remodels, renovations and adjustments that can be done, especially in the area of universal design, to make a home comfortable and convenient for growing old.
This is a bare overview of possibilities. One reason is that as the baby boomers inch further and further into old age, the 65-plus generation is becoming larger in proportion to the entire population than it has ever been and there is a lot of experimenting going on.
This is a good thing and also confusing. So to get to A's specific question:
”What do your readers plan to do? Do any of them, like me, change their minds regularly?”
Although A doesn't mention it, obviously it would be useful if those of you who have already weathered this life passage told us something of how you made decisions and how they have held up over time.
I know there is a deep and rich body of knowledge on this subject among TGB readers.