"Happy Obama Day"--January 20

Last week after the inauguration of President Obama, I heard someone greet a friend on the street, "Happy Obama Day!" What a way to begin a fresh start.

For me, the historic inauguration was summed up with this story from NPR's Morning Edition about a 105-year-old woman who was on the national Mall for the event. Ella Mae Johnson said, "We were all there; we were there waiting. It didn't matter what my color was. It didn't matter what your color was. And I could not ask for anything better."

Also on the topic of President Obama, check out this story from Smithsonian magazine about the graphic artist, Shepard Fairey, who created the now iconic images of Barack Obama.

An angle on Chinese New Year in America

Happy Year of the Ox!

A recent L. A. Times story tells of families with adopted children from Asia celebrating the New Year:

For the Larsons and thousands of U.S. families who have adopted children from Asia, the Lunar New Year is a moment to help their children reconnect with their homeland and for parents to discover a culture that would otherwise be foreign to them. Lunar New Year, which occurs today, is regarded as the most important cultural holiday among Chinese, Vietnamese and some Koreans.

(Photo by dbking; used by permission.)

Reasons for paying attention to the healthcare system

If you don't have your own personal reasons for considering the immediate and long-term concerns of the American healthcare system, consider these from an interview in the New York Times. A notable and accomplished physician discusses the current medical culture, the President's proposals for change, and aspects of our healthcare that all of us should think about. A prominent topic of the interview is the discussion of advance directives for medical treatment at the end of life.

If you missed the Dallas Morning News series on end of life issues, check out my post on it here.

(Photo by Erica Marshall; used by permission.)

Taking the battle against cancer to a new front

Wired magazine recently offered this interesting piece on how the efforts spent on the usual approach to cancer treatment and research--cure--may be better spent on an often secondary approach--early detection.

The article explores the elusiveness of successful prevention and early detection, in the face of this stark statistic: "If we find cancer early, 90 percent survive, if we find cancer late, 10 percent survive."

As detection and treatments advance, many cancer patients and their families share stories of strength and commitment. For example, see the L. A. Times column by Al Martinez, who shares the story of his adult daughter Cindy:

I'm putting her name in print today so that you can tell me stories of your own fight against cancer; so you can help our family find the strength and courage to defeat the enemy within. We're all family in a way, you and I and Cinelli and Cindy and the rest. We share a mutual village. Cindy was handed to me a long time ago and occupies a special place in my life and in my heart, and I'm not about to hand her back.

(Photo by Mataparda; used by permission.)

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.)