Poetry to cope with one's mortality

In an essay that pays tribute to a friend who died of cancer, a writer in the New York Times magazine shared how her friend's poetry expressed the "clarity" cancer brought to his life.

She quotes her friend, Jason Shinder: "Cancer is a tremendous opportunity to have your face pressed right up against the glass of your mortality."

In a brief poem, he expressed his inner fear of his disease:

I've been avoiding my illness

because I'm afraid

I will die and when I do,

I'll end up alone again.

However, his journals of poems also express his philosophical belief in hope and something bigger than self:

"The hours are left for vanishing and also for joy and for blessing and gratitude."

(Photo by Deb; used by permission.)

Fiction is more beautiful than reality . . .

. . . at least when it comes to escaping the Nazis.

This story from the New York Times tells of the von Trapp family (of Sound of Music fame), which is now in its third generation of operating a ski lodge in Vermont. Like any other family, the von Trapps have had their share of happiness as well as disputes.

Also from the Times, a soon-to-be-released memoir was revealed to be a fabrication. In the "memoir," the author claimed he survived a Nazi concentration camp in his childhood and then grew up to meet and marry the girl who showed him kindness by throwing apples to him over the camp fence.

The fiction of both stories is beautiful like a fairy tale, but, unfortunately, true-life inspirational stories are exceptionally rare.

(Photo by Emi Yañez; used by permission.)

End of life series from the Dallas Morning News

The Dallas Morning News ran an excellent five-part series on end of life decisions and difficulties. The "Edge of Life" series follows a palliative care team at Baylor University Medical Center. Nurse Min Patel and several of her patients discuss, prepare for, and address the family, health, and spiritual dimensions of dealing with death in the face of modern medical technology.

My nut-shell summary:
Old way: "Aversion to their own mortality was at the core of doctors' inhibitions in helping patients at the end of life . . . . It made physicians hide behind stiff white coats, rush from room to room, and turn clinical and cold when they couldn't fix or rescue."

New way: Palliative care professionals address all relevant issues head-on. "[They] can't fix everything, but [the patients] don't have to go it alone." The outcomes are better for all those involved when they realize "that using more drugs and devices wasn't always the best way to show love."

The stories in this series are so touching it makes you wish all death and grieving could be as good as this featured approach aspires to.

Also, check out my previous post on hospice care.

(Photo by blueskygirl; used by permission.)

Gay marriage in a positive religious light

Gay marriage is not going away as a national issue (rightfully so), and Newsweek takes a look at the frequently overlooked religious dimension of the pro-gay-marriage advocates. The author explores the biblical references to family, marriage, sexuality, and love, and how the biblical interpretation has evolved over the centuries.

In support of gay marriage, the following excerpt summarizes the article:

People get married "for their mutual joy," explains the Rev. Chloe Breyer, executive director of the Interfaith Center in New York, quoting the Episcopal marriage ceremony. That's what religious people do: care for each other in spite of difficulty, she adds. In marriage, couples grow closer to God: "Being with one another in community is how you love God. That's what marriage is about."

(Photo by tico24; used by permission.)

Nursing home "five star" rating system

Medicare has launched a new online system for rating and comparing nursing homes. Besides the various tools to explore nursing home information, the site also provides some basic information on alternatives to nursing home care.

In a charmingly colloquially phrased opinion piece, the Honolulu Advertiser summarizes the new system this way:

The long-term care of Hawai'i's kupuna [honored elders] will become a bigger issue in the future, as more of the population gets older and in need of more intensive care.

Certainly, efforts to put more state and federal funding into at-home care — so-called "aging in place" — should be a priority. It can be more cost-effective, more comfortable for the kupuna and help open up nursing home beds for those who really need that higher level of care.

Making sure Hawai'i's nursing homes offer the highest quality care possible is a joint responsibility — the government, the industry and consumers all have a role to play.

The rating system, while not perfect, provides a useful measure of how we're doing and more important, how we can improve.

A recent report (pdf) on effectiveness of programs for helping low-income Wisconsin residents to live at home or in facilities than nursing homes shows that alternatives cost less than typical nursing home care. The next big goal is to expand the programs across the state so that the alternatives are available to all who want them.

(Photo by laughlin; used by permission.)

End of life decisions

Jane Gross of the New York Times, continues her excellent blog on aging, with which she frequently reflects on her own mother's aging, final illness, and death. This entry is indicative of her series, both in its personal dimension and in the useful information provided.

Gross shares the process of her mother's decisions and actions just before her death:

She often longed for the oblivion of Alzheimer’s disease. But her sharp mind — she never skipped a beat — entitled her to organize her own death, within legal limits, which she did by deciding to stop food and hydration. We had discussed and researched this option, and we had read enough to be reasonably confident this manner of dying was not a frightful ordeal but rather a gentle death. We trusted that an enlightened nursing home like the one she was in wouldn’t force her to eat and drink. They had readily accepted earlier decisions to forgo diagnostic tests or hospitalizations, and later antibiotics for pneumonia.

Our study of what is known as V.S.E.D., or “voluntarily stopping eating and drinking,” was impressive for amateurs, if I do say so myself. My mother had a pretty good death, on her own terms, and we had the nursing home’s full support. I’m proud and grateful to have been able to advocate for her and to have been by her side.

The end of life process will only continue to get more attention as hospice and palliative care programs expand and become better known. Also, advance directives for health care and good powers of attorney for health care can undergird a person's decisions, even when the person is not capable of expressing his or her wishes at the time.

(Photo by mike 23; used by permission.)

We love our pets... part five

If you need something to lighten your mood, or if you want to see what some people do when they have more time or money than most of us, check out the doghouse designs featured in the L.A. Times. The gallery of photos is entitled "Dogitecture."

Many designs parallel human residential styles: modern, country, green. The photos with dogs are the best, such as the big house with the little dog, the dog lying on the roof of the doghouse, and, my favorite, the St. Bernard in front of the Swiss chalet.

We love our pets--part four

Divorcing and pet custody?

Earlier this year, the Santa Barbara Independent ran this piece on divorce, pet "custody," and hints on prevailing in court on the subject.

A man famous for his amnesia passed away

Last week Henry Gustav Molaison, known to his medical and scientific observers as H.M, died at age 82. At age 27 Molaison was the subject of surgery to treat severe seizures he experienced, but ultimately the surgery left him with amnesia--he could not remember anything beyond selected memories of his pre-surgery life.

Here's a snippet from the New York Times obituary for him:

For the next 55 years, each time he met a friend, each time he ate a meal, each time he walked in the woods, it was as if for the first time.

And for those five decades, he was recognized as the most important patient in the history of brain science. As a participant in hundreds of studies, he helped scientists understand the biology of learning, memory and physical dexterity, as well as the fragile nature of human identity.

From the Times account, it seems that he led a pleasant, if not traditionally fulfilling, life.

In conjunction with noting Mr. Molaison's death, Slate.com offered a brief explanation of amnesia, including this description:

There are two main types of amnesia: retrograde and anterograde. Retrograde means you lose your memories from before the surgery, injury, or whatever incident caused the memory loss. . . . Anterograde means you lose the ability to form new memories but can still recall things from before the inciting event. That was the case with H.M., who could remember scattered childhood memories.

(Photo by erat; used by permission.)

Pearl Harbor anniversary

The anniversary of the bombing of Pearl Harbor was December 7, and the Honolulu Advertiser had this piece about the annual remembrance and the dwindling number of veterans who were there. Most surviving veterans are in their eighties and nineties, and the last official reunion was held in 2006.

Here are comments from one of the veterans at the remembrance:

"I feel very proud that I've survived," said [George] Smith, of Washington. "I'm very honored by all these people. I'm no hero. I was simply doing my duty."

In a related anniversary, on December 18, 1944, the U.S. Supreme Court decided Korematsu v. U.S., which upheld the racially discriminatory Japanese interment camps during World War II. Here is a link to the ABA Journal's short piece on Korematsu.

(Photo by Andrew Shimabuku / The Honolulu Advertiser.)

International Day of Persons with Disabilities

December 3 is the United Nation's International Day of Persons with Disabilities. This year's theme is "Convention on the Rights of Persons with Disabilities: Dignity and justice for all of us."

Slate.com offers this incredible photo gallery of persons living with various disabilities--truly a testimony to the power of the human spirit.

(Photo by Dan Kamminga; used by permission.)

New link: Exceptional Parent

Check out the Exceptional Parent website for numerous resources for parents and family members of those with disabilities. I have added the link to the list on the right.

To access articles or information, you need to register, but it is simple and free. In addition, you can see topics covered in the print version of the Exceptional Parent magazine, and you can subscribe or order individual copies.

Mental perception can be "fooled"

A fascinating piece on psychology and mental perception appeared in the New York Times.

"[N]euroscientists have shown that they can make [mental roleplaying exercises] physical, creating a “body swapping” illusion that could have a profound effect on a range of therapeutic techniques. At the annual meeting of the Society for Neuroscience last month, Swedish researchers presented evidence that the brain, when tricked by optical and sensory illusions, can quickly adopt any other human form, no matter how different, as its own."

The end result, through special camera-equipped goggles, creates an alternate point of view by fooling the brain into "inhabiting" the body of another.

(Photo by reportergimmi; used by permission.)

Can surrogacy ever go "mainstream"?

Recently, the New York Times magazine told the story of a woman whose child was carried by a gestational surrogate.

In expressing her conflicting emotions, the author writes, "It was a desperate measure, to be sure, and one complicated by questions from all the big sectiors: financial, religious, social, moral, legal, political."

Even amidst her mix of feeling inferior and feeling elated, the new mother shares her joy of participating in the miracle of life: "The miracle of [our son's] existence speaks to the generosity of humanity--and to the magical, unified coordination of more than a dozen people in the act of his creation."

Earlier this year, Newsweek reported about military wives who become surrogates for numerous reasons, including the extra income.

(Photo by anyjazz65; used by permission.)

Father Damien's leper colony has come a long way

In 1873, Father Damien, a Belgian priest, arrived in Hawaii to begin a mission for those permanently exiled from society, patients suffering from leprosy, now known as Hansen's disease.

As the New York Times reports, a community of patients remains in the village on Molokai where the mission began. "Today, just 24 patients are left: 24 people who experienced the counterintuitive twinning of loneliness and community, of all that dying and all that living. Here, you may have grieved over the forced surrender of your newborn; you may also have rejoiced in finding a life partner who understood. "

The story of the survivors is a testament to their dignity, which was first championed by the nineteenth century missionary who lived, served, and died among them.

Nebraska's safe haven law for children focuses on only infants now

As reported in the L.A. Times:

Nebraska on [November 21] closed a loophole in a controversial law that had allowed parents to abandon children as old as 18 at hospitals. The unicameral Legislature voted 43 to 5 to make abandonment legal only for infants up to 30 days old. Gov. Dave Heineman signed the emergency bill [the same] afternoon, and it takes effect [November 22].

Nebraska's law had been controversial for nearly three months as people from Nebraska and across the country abandoned their children in that state. Some children were as old as young teenagers. Now, the state's law is more in keeping with its original intent and that of similar laws around the nation, which is to protect infants when a desperate (and often very young) parent feels compelled to abandon the baby.

However, Nebraska's recent experiences show that parents of children of all ages can become desperate in the face of economic, health, and behavioral difficulties. Desperate even to the point of abandoning the children. A related story in the Times included this quotation:

[C]hildren's advocates as well as parents . . . say the state has done nothing to address the problem exposed by the safe-haven law: desperate families quietly struggling to raise mentally ill children with little help from the government. "There are parents like me who really need help," [one parent] said. "I don't know how to help him. I don't know what else to do."

Video games with a special mission

This story in the Washington Post tells about video simulators that help veterans learn new ways to do old tasks. For example, a veteran with injuries may need to learn to drive with one hand or with adaptive controls. Also, the simulators can help reduce stress as veterans recover from their injuries.

Here's a bit of the story:

Soldiers serving overseas are taught a different set of driving skills than the rest of us: Speed up when driving through overpasses, don't use turn signals and don't stop at intersections. [The] new driving simulator is designed to help bring those instincts back to civilian levels, where the rules of the road take priority.
. . .

[M]odified game controllers are useful for amputees seeking to take part in the pastimes they enjoyed before they lost a limb, as well as for patients who need to rebuild hand strength.

How much can and should children pay for their elderly parents' care?

Jane Gross, the blogger of the amazing New York Times' "The New Old Age," shares her experience and other good information about adult children's responsibilities for their parents' long-term care. Some thirty states even make adult children legally responsible for such support.

Here is an excerpt from Adult Children, Aging Parents and the Law:

At the end of my mother’s life, for six months, a year at most, Medicaid paid for her care in a nursing home. She was broke by then, after living on a pittance since she was widowed at 58, using the proceeds from her house to pay for six years of assisted living and part of her nursing home stay and never seeing a penny from a long-term care insurance policy that cost a bundle but covered none of what she needed. She had given my brother and me no up-front money to hasten her eligibility for Medicaid and died with $26 to her name and nothing to leave to her children. The good news was we didn’t even have to put her will in probate.

. . .

I sometimes wondered why adult children weren’t legally responsible for their parents’ financial support, assuming they had money in the bank. Don’t get me wrong; I didn’t want to pay for her $14,000-a-month (yes, $14,000) nursing home bill. But I could have, if truth be told, at least for a while.

(Photo by makelessnoise; used by permission.)

A new ray of light (and hope) for children with autism

A diagnosis of autism is heartbreaking for the parents of a young child whose development is delayed or impaired. Now, the Washington Post reports that a new study seems to indicate that some children with autism spectrum disorders can be treated and possibly even "cured." Of course, the study raise hopes for parents, and therefore these early results are controversial if they only offer a false hope. Yet, the study may lead to a fuller understanding of autism and the treatments and teaching techniques to assist the children effected by the disorder.

"I don't know that the children 'recovered,' though they did improve . . . to the extent that they no longer met the diagnostic criteria," [Vanderbilt University professor of pediatrics and psychology Wendy] Stone said. "Almost all continued to have some form of developmental disorder."

"I think the most hopeful message we need to give parents," said Geraldine Dawson, chief science officer of the nonprofit group Autism Speaks, "is that all children with autism are capable of learning and developing new skills with the help of early intervention."

We love our pets... part three

In addition to doctors, nurses, high-tech treatments, family, and friends, cancer patients have another ally in their care and survival--a pet. The Washington Post reports testimonials from breast cancer survivors about how their pets helped them cope with cancer. The cancer survivors even made a calendar featuring photos of themselves with their pets (see the calendar photo gallery here).

There are some common themes in the way the women talk about how their pets have journeyed with them through their cancer. "Just their warm heartbeat lying next to me was incredibly healing," says Connie Reider, who finds purpose in a workshop she teaches for cancer survivors called INscape, the Healing Art of Photography, and finds comfort in her Portuguese water dog named Splash.

The organization behind the calendar project is Critters for the Cure.

(Photo by Carol Guzy - Washington Post)

Same-sex marriage proponents reflect

For at least a couple decades, gay-rights proponents have made strides by comparing discrimination based on sexual orientation to discrimination based on race. However, such a comparison seems to have fallen short in California's recent passage of a constitutional ban on same-sex marriage (after the state's supreme court had ruled last spring to allow gay marriages under California's constitution).

Now, proponents of same-sex marriage are reflecting on what prompted the majority of voters to vote for Barak Obama but vote against gay marriage. For one, the "homophobia is like racial discrimination" argument did not hold up with enough voters.

A recent piece on Slate.com reconsiders the anaolgy, especially in terms of gender roles, including this comment:

If we avoid the tempting but misleading analogy to race and look at what's directly at stake, the combination of widespread opposition to same-sex marriage and equally widespread support for other gay rights is easier to understand. Gay rights in employment and civil unions don't require the elimination of longstanding and culturally potent sex roles. Same-sex marriage does. And while a lot of people reject the narrow and repressive sex roles of the past, many others long for the kind of meaningful gender identities that traditional marriage seems to offer.

Across the nation today, many people rallied in support of same-sex marriage. Here's the coverage from the New York Times.

(Photo by Jeff Belmonte; used by permission.)

Biology and family dynamics blur

In a slightly irreverent telling of the scientific and medical news, William Slateren writes in Slate.com about "another guy got his mother-in-law pregnant." No, it's not a made-for-tv, sordid interfamily love triangle.

When a "mother" was unable to bear her own child because she had had a hysterectomy, the woman and her husband had her egg fertilized with his sperm (so far, so good), and then the embryo was implanted in the woman's mother. Yes, the baby's grandmother was the surrogate.

For quite a few years, assisted reproduction, surrogacy, and the peeling apart of maternity have been taking various twists and turns. As usual, the law has had to catch up with people's family arrangements. In many cases, the law isn't even in the rear-view mirror yet.

(Photo by Jose Miguel Serrano; used by permission.)

Meeting your own family from down the street

Adopted children often grow up wondering what their "real" families are like. In an essay in the New York Times magazine, a man describes meeting his birth parents. As it happened, after years of looking for his birth mother, it turned out that his biological mother and father had eventually married and ended up living not too far from where the man grew up with his adoptive parents.

He describes his sharing his experience with his wife this way: "I showed her all the photographs [from my birth mother], which she took and framed and added to the wall of our apartment devoted to family pictures. Even now, the pictures . . . cause me to do a double take as I walk by them, not so much wondering, Who are those people, as thinking, Oh, there you are."

An old family, which felt like a new family, now feels like an old family.

(Photo by Jeff Belmonte; used by permission.)

We love our pets... part two

Vets and pets. Veterans who have injuries or disabilities from war are receiving help from service dogs. This piece in the New York Times tells the stories of wounded soldiers and the ways their dogs help improve their physical and mental health. A nice story to honor our country's vets. The story includes a slideshow of photos too.

(Photo by soldiersmediacenter; used by permission.)

Dirge Without Music by Edna St. Vincent Millay

I am not resigned to the shutting away of loving hearts in the hard ground.

So it is, and so it will be, for so it has been, time out of mind:

Into the darkness they go, the wise and the lovely. Crowned

With lilies and with laurel they go; but I am not resigned.

Lovers and thinkers, into the earth with you.
Be one with the dull, the indiscriminate dust.
A fragment of what you felt, of what you knew,
A formula, a phrase remains,--but the best is lost.

The answers quick and keen, the honest look, the laughter, the love--
They are gone. They are gone to feed the roses. Elegant and curled
Is the blossom. Fragrant is the blossom. I know. But I do not approve.
More precious was the light in your eyes than all the roses in the world.

Down, down, down into the darkness of the grave
Gently they go, the beautiful, the tender, the kind,
Quietly they go, the intelligent, the witty, the brave.
I know. But I do not approve. And I am not resigned.

(Photo by dbking; used by permission.)

"Mama Africa" lived an inspiring life

The great South African singer, Miriam Makeba, died this week. Her story and singing are nearly legendary. Check out her obituary from the New York Times. National Public Radio also has her story with audio links from Morning Edition.

Here is part of the Times story:

Music was a central part of the struggle against apartheid. The South African authorities of the era exercised strict censorship of many forms of expression, while many foreign entertainers discouraged performances in South Africa in an attempt to isolate the white authorities and show their opposition to apartheid.

From exile she acted as a constant reminder of the events in her homeland as the white authorities struggled to contain or pre-empt unrest among the black majority.

Ms. Makeba wrote in 1987: “I kept my culture. I kept the music of my roots. Through my music I became this voice and image of Africa, and the people, without even realizing.”

(Photo by Georgios Kefalas/AP)

"The long arm and the hungry mouth of the law"

Schools, nutrition, and bake sales collide in this recent story in the New York Times. I am all for teaching children about healthy eating and nutrition, but a cupcake ban?!! Why should school policies or state regulations take the place of ordinary common sense and self-discipline?

In Berkeley, Anna X. L. Wong, a kindergarten teacher at Jefferson Elementary, incorporates “good foods” versus “bad foods” into the curriculum and offers her students healthy snacks, including edamame.

UGH!

(Photo by D'Arcy Norman; used by permission.)

Talking about money with family members

The New York Times offers this "conversation" between adult child and parent.

This excerpt could be from either side of the conversation:

I don’t know whether you’re in over your head on your mortgage, for instance. I don’t know about your other debts either, whether you’re using credit cards responsibly. You talk a good game about your job, but I’m not sure how much security you really have.

So here’s an offer: I will start opening my finances up to you, but how about you doing the same for me, O.K.? You’re an adult, but I worry about you plenty, as I always have.

(Photo by cmiper; used by permission.)

Learning to combat dementia

The New York Times offered this fascinating piece on how learning, especially in the Montessori method, has been found to assist those with Alzheimer's disease to remember and learn. Something in how the brain acquires, stores, and processes memory is prompted by physical and motor learning.

Check out this excerpt:

Montessori-based programs for the elderly build on the work of Barry Reisberg, a New York psychiatrist who coined the term “retrogenesis” to describe the way the mind’s deterioration reflects its development: the first faculties to develop are the last to go. For instance, children around age 2 begin to understand their image in a mirror as a reflection of themselves, rather than a separate person; people in advanced stages of Alzheimer’s lose that distinction and are often frightened by mirrors, especially in bathrooms, where they think a stranger is watching them. Understanding this helps gerontologists recognize the problem not as random disorientation but as a predictable condition.

. . .

Similarly, just as physical skills and habits develop early, people with severe memory loss can often sing, read, manipulate a screwdriver or play a musical instrument even when they have difficulty maintaining a conversation. Montessori techniques build on these skills and habits, with the goal of improving quality of life and independence by using cognitive strengths to neutralize weaknesses, making frequent use of repetition to create unconscious learning.

(Photo by joguldi; used by permission.)

Reluctance by Robert Frost

Out through the fields and the woods

And over the walls I have wended:

I have climbed the hills of view

And looked at the world, and descended;

I have come by the highway home,

And lo, it is ended.

The leaves are all dead on the ground,

Save those that the oak is keeping

To ravel them one by one

And let them go scraping and creeping

Out over the crusted snow,

When others are sleeping.

And the dead leaves lie huddled and still,

No longer blown hither and thither;

The last lone aster is gone;

The flowers of the witch hazel wither;

The heart is still aching to seek,

But the feet question, "Whither?"

Ah, when to the heart of man

Was it ever less than a treason

To go with the drift of things,

To yield with a grace to reason,

And bow and accept the end

Of a love or a season?

Studs Terkel relayed many great stories

Studs Terkel, the great American story-teller, died on October 31 at age 96.

An excerpt from the L.A. Times obituary:

Blending journalism, history, sociology and literature, Terkel traipsed across the country, tape recorder at the ready, for the next 3 1/2 decades [beginning in the late 1960s].

"I tape, therefore I am," Terkel used to say. "Only one other man has used the tape recorder with as much fervor as I -- Richard Nixon."

. . . Terkel said he had but one goal for each of his books: to open new worlds for his readers. He wanted them to feel what it was like to be a laid-off factory hand during the Depression. Or a soldier facing his first enemy fire. Or a black businessman, or a poor Latino. Or a Miss USA.

"If I can get that in a book," Terkel said, "that's what it's all about."

Thus, in "Hard Times," he probed the guilt many senior citizens felt for having survived the Great Depression. In "Working," he let Americans vent about their jobs -- and found a depressing majority saw themselves as automatons. In "The Good War," he got his subjects to discuss racism, officers shot in the back by their own troops, and other topics that mainstream historians had shied away from."

No one has done more to expand the American library of voices," President Clinton said upon awarding Terkel a National Humanities Medal in 1997.

And his epitaph: "Curiosity did not kill this cat."

When the "Supremes Court" rules on a break-up

"It is our opinion that stopping in the name of love is not only the compulsory duty of the philandering party, but it would be irresponsible for him to do otherwise, pursuant to the aforementioned instances in which we have been both good and sweet to you, as well as the imminent risk of breaking the court's heart. Think it o-o-ver."

This is an excerpt of an Onion story, "Supremes Court Upholds Stopping in the Name of Love in 2-1 Decision."

I can't wait until Tina Turner joins the court and they rule on "What's Love Got to Do with It."

Gender, wealth, and inheritance

An essay on Slate.com considers various aspects of inheriting wealth. The female writer discusses the expectations and burdens of a family's presumed dynasty, especially how things like "philanthropy, longevity, and serial marriages begetting multiple heirs have eroded patriarchal estates."

In the end, the trouble and heartache may outweigh the financial benefit of the estate. This is especially true if the will or trust was not well planned. Consider the following excerpt:

Economists say there are four bequest motives: accidental, egoistic, strategic, or altruistic. People leave money to others because they are bighearted, manipulative, self-centered, or disorganized. Endowing a middle-aged offspring's undercapitalized retirement is not on the list. As my contemporaries take, well, stock, I hear frequent tales of affluent fathers lacing their legacies with dissension, hurt feelings, or misunderstanding by passing on assets in an ungenerous or disorderly manner. Unsettlingly, their daughters find themselves unraveling wills, insurance policies, and asset preservation plans rather than simply mourning their parents.

Based on her experience, the writer recommends personal financial independence as the key to a secure future, rather than relying on a family windfall. Good advice for everyone no matter our stage in life.

(Photo by Eleaf; used by permission.)

Hospice care with expansive options

Hospice care has become more familiar as we as a society acknowledge the natural last stages of dying. Along with the physical stages of death, a patient frequently reflects on relationships, personal accomplishments, and spirituality. Now, even when a person is not necessarily religious, chaplains and similar advisors offer comfort and companionship on the final journey of life. The New York Times recently reported on the nonsectarian dimension emerging in hospice chaplaincy.

In the Madison, Wisconsin region, HospiceCare offers in-home and hospice facility care options. It also offers family services, medical information, and other assistance. You can check out their excellent website for more information.

(Photo by tiarescott; used by permission.)

How public do we want our personal health?

Personal illness, even serious illness like cancer, sends us into an inner retreat sometimes. In a recent "My Turn" essay in Newsweek a cancer survivor describes his ambivalence in beating his cancer when others have not and in the public acknowledgment of surviving embodied in the Cancer Society's Relay for Life.

Here's an excerpt:

When darkness fell, and I'd suffered through the promised laps, I sat on the ground with my family beneath the moon. We listened to the roll call of those locals who had died from cancer—names of old friends and familiar mountain surnames—lilting off into the cool night air. Brown paper candle luminaries representing victims formed a circle of light on the ground around the track, and people took turns reading as photos of the fallen were projected on a movie screen.

It was then that I realized something profound about my day. It wasn't humiliating. It wasn't cheesy, or corny, but just right. My mom was right to sign me up. The people that really know me—the ones who watched me grow up, who coached me in little league and went to the Presbyterian church with my family—were here for me and all of the rest of the men and women who'd lived through their own lonely cancer hell. It mattered to them that I was still here. That is no small thing.

Book review: "But I Don't Want Eldercare"

Here is a helpful book review from Madison's Capital Times on a caregiver's guide to helping aging parents stay well, But I Don't Want Eldercare.

The review includes 8 rules from the book--my favorite two are "Your parents and your are the experts," and "The labels must go."

The personal side of medical practice

"I thought about how easy it is, with the time pressures of medical practice, to ignore social history, habits, the sorts of things that make a patient into a real person — and vice versa."

That's how a physician reflected upon going to a young patient's funeral and learning about the personal life of the man he had been treating. The complete New York Times essay is here. The sentiment is probably true for many people we think we "know"--professional acquaintances, clients, neighbors. Imagine the richness we can add to our lives if we simply say to someone, "Tell me about yourself."

(Photo by Kerry; used by permission.)

A new link to Alzheimer's association

I have added the Alzheimer's Association to my helpful links on the right side of the blog. The excellent site offers an abundance of information, especially about medical information, local resources, and care options.

Recently, the New York Times reported that Alzheimer's disease is more prevalent in Latino populations. Researchers are exploring the connections between income, education, and dementia. Also, family and cultural dynamics are factors in the care and treatment of the disease. Even if the research is too preliminary to be conclusive, it is very interesting.

Assisted living options

The New York Times' excellent series, "The New Old Age," continues with 10 Things to Know About Assisted Living. The general information is quite good about what to consider in looking at assisted living arrangements. Another general web resource for all types of elder residential options is "A Place for Mom," which is a national referral service.

However, remember that although nursing homes are heavily regulated on the federal and state levels, assisted living apartments and homes are regulated much less, and only on the state level. So, whether looking at the services a facility offers, the medical options, or any other contract terms for assisted living, consult local or state resources too. For example, in Wisconsin, Community Based Residential Facilities (CBRFs, for short) can offer home-like settings for many types of needs, (dementia/memory care, for one), but CBRFs can only offer limited medical care. As a starter on Wisconsin resources, see the Department of Health Services website section on CBRF resources.

For more information on a national level, check out the Assisted Living Consumer Alliance.

(Photo by jonrawlinson; used by permission.)

Glossary for wills

Sometimes it seems like lawyers speak a language all their own. Over the centuries of English and American law, traditional terms and "legalese" have formed around how people inherit property, whether by a will or in cases where there is no will.

Here is a glossary of a few terms.

Will: (1) A document by which a person directs his or her estate to be distributed upon death (Black's Law Dictionary). (2) Under the Wisconsin statutory definition, a will includes any addition or amendment (usually known as a "codicile") made after the original will. Even though making a will seems straight-forward to most people, formalities of how it is written, who witnesses it, and how it may be changed or revoked are all part of state law. For example, here is a link to the Wisconsin statutory section on wills.

Testator: A person who has made a will; esp., a person who dies leaving a will. (Black's Law Dictionary). Likewise, "testate" is the state of dying with a valid will, see "intestacy" below. This is a simple definition, but the term is not in our everyday vocabulary.

Heir: (1) A person who, under the laws of intestacy [see definition below], is entitled to receive an intestate decedent's property. (Black's Law Dictionary). Although many people consider any descendant who may receive a decedent's property, either by will or by law, to be an "heir," the term only applies to those who receive when there is no will. Under Wisconsin law (and probably most other states), a surviving spouse is an heir.

Beneficiary: (1) A person nominated in a will to receive an interest in property other than in a fiduciary capacity. (Wis. Stat. 851.03). (2) Black's Law Dictionary offers a broad definition that includes a person who receives a benefit under any type of legal arrangement, such as will, trust, insurance policy, or guardianship. (Of course, Wisconsin statutes define "beneficiary" differently in different contexts too, but for probate purposes, it is defined as in (1).)

Intestacy: The state or condition of a person's having died without a valid will. (Black's Law Dictionary). How an intestate person's estate is distributed is determined by state law. Here is a link to Wisconsin statutes for intestate succession.

Issue: Descendants of a person, i.e., children, grandchildren, etc., including those who were adopted or born outside of marriage. (See, e.g., Wis. Stat. 851.13). Again, the concept is not difficult, but the term is not in our everyday vocabulary.

Residue: The part of a decedent's estate remaining after payment of all debts, expenses, statutory claims, taxes, and testamentary gifts have been made. (Black's Law Dictionary). This is the part of a person's estate that is "left over" after specific distributions (like "I give my diamond brooch to my granddaughter Susie") are made. For most people, this is the bulk of their estate, which is given in proportions rather than in set amounts because the value or nature of the estate is not known until the testator's death.

Executor (also known as "personal representative"): A person named by a testator to carry out the provisions in the testator's will. (Black's Law Dictionary). In Wisconsin, an executor is called a "personal representative," and Wisconsin statute provides for a personal representative's powers and duties.

(Photo by myuibe; used by permission.)

Connecticut now has same-sex marriage

From the Washington Post: "The Connecticut Supreme Court overturned a state ban on same-sex marriage [on October 10], ruling that it 'discriminates on the basis of sexual orientation' in violation of the state constitution." Read the entire article from the Post.

The Human Rights Campaign offered this jubilant announcement of the decision. Now, Connecticut, Massachusetts, and California have full marriage equality for all couples.

(Photo by _www.alvaroarriagada.com ; used by permission.)

Home plate as my head stone

Apparently many baseballs fans want to stay close to their favorite sport, even after they are gone to the great beyond. This New York Times article considers the motivations and methods behind people having their ashes scattered at one of the city's ball parks, not to mention the ambivalence when a stadium is demolished.

"No one can say how many people’s ashes were sneaked in, often in film canisters or plastic baggies, and scattered at the two ballparks [Memorial Park and Shea Stadium]. Some relatives had access the teams say they do not allow. Ms. Hasson said her father had known someone on the grounds crew who let her in before a game, let her husband run the bases and let two of her father’s friends sit in the Mets’ dugout. . . . [Then,] 'the guys who worked on the grounds crew raked the ashes into the mound so it wasn’t obvious.'”

Just a few months ago, the state of Wisconsin began offering a form (known as "authorization for final disposition"), which allows a person to designate someone (as a "representative") to make decisions regarding the disposition of the person's body after death. Typically, the range of decisions encompass arrangements for funeral services, cremation, burial, etc. By designating someone, a person can avoid potential disputes among loved ones. The representative named has first priority in making such arrangements. (The statute also names the priority of family members who can make decisions, even if the form is not used.)

Also, the state form allows the person to give directions for any of the arrangement. According to the statute, the representative is required to follow the directions of the deceased, "unless the directions, instructions, and suggestions exceed available resources from the decedent’s estate or are unlawful or unless there is no realistic possibility of compliance."

(Photo by Mayr; used by permission.)

International adoptions are down

For most Americans, "international adoption" means American couples adopting children from other countries. Over the past couple decades, this type of adoption has benefited children in need of families and U.S. couples who have usually exhausted state-side options for adoption or assisted reproduction. However, when standards by foreign governments or the scruples of certain agencies have been lax, issues such as child trafficking have arisen. Other times, children have been separated from their birth parents without full documentation of the parents' voluntarily giving up their right. When countries monitor their adoption process more closely or provide adoptive parents within their own nation, the prospects for adoptions by Americans from those countries slow or dwindle.

Recently, China has taken measures that make the process longer and more expensive for an American couple to adopt a Chinese orphan. Newsweek reported the details of the shrinking pool of international children available for adoption. The magazine website's interactive chart shows trends of various countries over the past decade.

Similarly, Korea is promoting adoption within its country. The New York Times reports "last year, for the first time, more babies here [in South Korea] were adopted by South Koreans than foreigners, as the government announced recently with great fanfare: 1,388 local adoptions compared with 1,264 foreign ones. What is more, South Korea — which still is one of the top countries from which Americans adopt — has set a goal of eliminating foreign adoptions altogether by 2012."

As plans in various countries continue and succeed, the "best interests" of the children involved will most likely be served, such as preserving their cultural and ethnic identities, assisting their sense of self-identity, and maintaining any family ties that may remain. The flip-side for many Americans is the shrinking range of opportunities to address a future without children to call their own.

(Photo by iandeth; used by permission.)

Special needs trusts

The Wall Street Journal recently included an article on special needs trusts.

Here's a bit of statistical information from the article:

More than 41 million Americans, or almost 15% of the population age 5 and older,
have some type of disability, according to the 2007 Census survey data. Some 6.2% of children age 5 to 15, or 2.8 million children, have disabilities, the Census Bureau found. And individuals with disabilities are living longer than ever before. That means that many disabled children will outlive the parents who support them.

To address the future needs of such children when they become adults and especially after their parents are gone, parents can prepare documents for the health-related and financial well-being of their children. Parents should consider special needs trusts, sharing information with relatives for the relatives' estate plans which may benefit the child with disabilities, powers of attorney or guardianships, and letters for caregivers. Because the laws regarding special needs trusts are complicated and vary from state to state, it is highly adviseable that parents check with a well-qualified attorney when they wish to explore or pursue such a trust.

One starting point, especially for those with modest-sized estates, is the Wisconsin Pooled and Community Trusts (WisPACT) website. WisPACT is a special needs trust with subaccounts for individual beneficiaries, where each subaccount may be relatively small, but the pooled assets of all the beneficiaries can be professionally invested and managed.

Frozen embryos and the couples who make them

Debate and concerns over frozen embryos and assisted reproduction have been churning for several years now. However, there is no resolution on the horizon. The issues are deeply personal, ethical, and often legal. The range of feelings and opinions is captured well in this L.A. Times article. For many couples with embryos they no longer want or need, the compromise between implanting the embryos for pregnancy and destroying them is donating them for research. But such a decision is not straight-forward. Many in the political arena wish to elevate embryos to a status (nearly) equal to full personhood.

An excerpt:

"People are not quite sure where this set of issues belongs," says Yuval Levin, bioethics director for the Ethics and Public Policy Center, an ecumenical think tank in Washington that publishes the New Atlantis. "To some it's an element of the abortion debate. For other people it has to do with science and medicine. We've never really thought through what the moral status of the embryo is."

That's beginning to happen. The proposed Colorado amendment states, "The term 'person' or 'persons' shall include any human from the time of fertilization." If it is passed, the courts would have to interpret the meaning of those words, says Kristi Burton, sponsor of the initiative and founder of Colorado for Equal Rights, which focuses on the rights of unborn children. The goal of the amendment, says Burton, a college student, "is to respect and protect all life."

Fertility advocates are skeptical that "personhood laws" wouldn't limit their choices for reproductive healthcare. In August, Resolve released a statement opposing the Colorado amendment.

"The motivation is abortion," says R. Alta Charo, a professor of law and bioethics at the University of Wisconsin at Madison. "If the Supreme Court allows states to declare embryos as personhood, you would be in a position to say immediately that all abortions have to stop."

(Photo by cyancey; used by permission.)

A new link: Coalition of Wisconsin Aging Groups

"The Coalition of Wisconsin Aging Groups, a grassroots membership organization directed by seniors in Wisconsin, pursues justice and quality of life for people of all ages through legal and legislative advocacy, education and leadership development." (Mission statement of the coalition.)

CWAG's website has abundant resources for elders, including information on legal services and resources. They also have newsletters and other publications in a resources section.

Needless to say, the organization and its website are a valuable resource to the community of elders, their families, and their advocates. I have added the link to the CWAG website to my list of sites on the right.

Who gets the engagement ring when a couple breaks up?

First-year law school property class included the topic of who gets the engagement ring when a couple breaks up before the wedding. As in many cases, the answer is "it depends." In such a case, it depends on state law; but many states consider an engagement ring a conditional gift, which must be returned if the condition (of getting married) is not met.

A recent story in the New York Times, looks at the various aspects of this question. For many lay people, the question is not always a legal one, but rather an emotional and personal question of who deserves the ring, i.e., whether the jilted party should have some consolation prize.

In exploring the topic more deeply, the article also considers whether the ring should be returned if one of the parties dies before the wedding (which still technically prevents the condition from being met).

Also, paralleling a recent listserv query of family law attorneys in Wisconsin, the article asks whether the ring becomes marital property subject to division in case of divorce. In discussing Wisconsin law, some attorneys considered it a completed gift because the wedding had occurred, therefore it would be the wife's individual property. Others cited state statute that property brought to the marriage or acquired during the marriage was subject to property division. Still others noted that the statute also excludes gifted or inherited property. BUT, yet another attorney noted that the statute applies to gifts from someone OTHER than one of the parties. Obviously, if you ask two attorneys any question, you're likely to get three or more opinions.

As the article mentions too, often the value of the ring is not enough to warrant the legal fees to litigate over who gets it, except for the case in which the ring was worth nearly a quarter million dollars!

(If the couple (or one of the parties) had assets like that, wouldn't you think they would have had a pre-nup? But, that would interfere with the romance, huh.)

(Photo by Somma, used by permission.)

Collaborative divorce means less fighting

Family Circle magazine ran this collaborative divorce article, which is a good, straight-forward introduction to the idea that divorce doesn't have to be a battle to the end. If divorcing spouses agree that they want to part on peaceable terms, especially for the sake of children, then the collaborative process is a strong option instead of the adversarial, "I'll see you in court" approach.

The article says that "those willing to put in the effort up front are likely to encounter the following win-win advantages: less bitterness, lower expenses, quicker results, and a custom solution."

Although the results vary depending on each couple and their circumstances, collaborative divorce attorneys I've spoken with say the savings of cost and time may be minimal in the period up to the judgment of divorce. However, over time there is a probable savings because the couple usually does not have to re-visit issues of child support and alimony (maintenance), not to mention pay for therapy for the children traumatized by a nasty divorce. In addition, nearly all couples who use the collaborative process have greater control over the process and the outcome, compared to adversarial divorce, which is subject to a litigation timeframe and the judge's determination of the case.

Of course, collaborative divorce is not suitable for every divorcing couple; personal temperaments or particular situations may be too volatile for the collaborative process to succeed. For example, couples in marriages involving domestic violence or substance abuse may not have adequate trust to proceed with collaborative divorce.

A couple weeks ago, I attended a two-day seminar by the Collaborative Family Law Council of Wisconsin. (After I told my mother about my positive experience with the training, she noticed the article in Family Circle and sent it to me.) Also, the International Academy of Collaborative Professionals website has more information.

(Image by chavezonico, used by permission.)

Well-deserved tributes to Paul Newman

Even with the rightfully due tributes to his handsome looks and excellent acting, I am most impressed with all the tributes to Paul Newman's love of his family and his humanitarian endeavors.

I especially liked the references to his stunning blue eyes--"aquamarine gaze-blazers" (on Slate.com) and "Windex-blue" (in the L. A. Times).

The L. A. Times obituary is especially impressive, and, of course, mentions his "Newman's Own"-based philanthropy:

"As a result of his business success, Newman donated more than $250 million to 1,000 groups, including the Scott Newman Center -- devoted to anti-drug education -- and several Hole in the Wall Gang camps, designed for children with life-threatening diseases, with locations in France, Ireland and Israel as well as the U.S. Every summer, Newman stayed at the original camp in Ashford, Conn., where he told ghost stories and staged shows with other celebrities for children who knew him only as the face on the lemonade carton."

Indeed a life well lived.

(Photo from the trailer for the film Exodus (1960).)

Taking care of yourself, part one

I include entries about personal health and healthcare because so many aspects of our lives are affected by our health--our family lives, our professional lives, and our sense of well-being and self-worth. In the legal arena, health issues affects our finances (possibly causing bankruptcy), our families (like assisted reproduction), and our estates (linking finances and families, such as special needs trusts or powers of attorney).

The New York Times runs excellent articles on health topics, including this recent essay on how we define our health, and this article on using the internet to find abundant health information. The second article includes lists of websites with medical information on general health, diseases, and research.

Also, in terms of estate planning, we often limit our thinking to what happens to our stuff after we die, but we need to remember to give some directions for when we are still living, but may not be able to express our wishes directly. Enter advance directives, the most important of which is the health care power of attorney. Wisconsin has a state form for health care power of attorney, by which an individual age 18 or older may designate someone (the health care "agent") to make decisions on the individual's behalf when the individual is incapacitated (as defined by state law in the document).

But don't stop with just filling out a form. A health care power of attorney is only as meaningful as the conversations you've had with your designated agent. You want your agent to make decisions as you would. So, discuss your wishes and philosophy of medical care with your agent, family, and friends. Even if it is difficult to talk about serious injury or illness that would require your agent to act on your behalf, consider how much harder it would be for your loved ones to try to guess what your wishes would be and who you would want to speak for you.

(Photo by Lee Maguire, used by permission.)