The Greatest Wealth Transference....

[jhawks99]

That's hard to read, I can't imagine living through it. Hoping for the best for everyone and happy birthday to Annie.

[japhy]

When you hear Annie's life story, it is a lot of ups and downs. The downs have been some real punches to the gut. Her resilience and ability to remake her life is an impressive thing. I love that about her.

I have a natural detachment about life in general. In spite of that I do have empathy towards my fellow human beings. The events of the last year have dropped Annie to her knees as much as anything could. I can stay detached while writing, but reading it back afterwards; the brutal irony of the dates, it is hard to read.

This morning she was laying in bed; pretty sure she was ruminating on these events. At 6:30 AM she got a text from one of her interns, "Happy Birthday!". She started chuckling, "right....it's my birthday....feels more like Groundhog Day".

A year ago she was planning her path for the 10 year gap between her retirement and mine. Businesses she might start up, organizations she might join. Dignity through work, life meaning through career; that sort of Puritan work ethic stuff that made America great. She told me over the holidays she is rethinking that. She might take a part time job at Costco instead, for the health insurance, and spend the rest of the time getting more involved in the shit I am stirring. She is also an artist. But her day job has been more restrictive of her time and is location dependent so she doesn't get to take off and travel to some of the events I do.

There was the time I got a text saying there was a pop-up experimental film festival in a week at the Frontier Drive Inn. The CU Film Dept would be there and some folks from MCA Denver and some film industry folks. The text message said, "it will be more fun if you are here". Are you really driving 12 hours out there just to see 4 hours of films on the drive-in screen with a bunch of people you don't know? When a group of people decades younger than you says "it will be more fun if you are here", fuck yeah, Dok and I jumped in the Tacoma and hit the road. When you get the invite for the Format Festival in Bentonville with the message, "Nick will be there and we will be hanging out"; wait you are going to pay that kind money and go to a festival in AR? You don't even like AR or festivals. Duly noted. I texted her on Sunday from the festival that I was having breakfast with Nick Cave and Bob Faust after a night of wandering the festival grounds with them and Doug Aitkin and the response was, "god damnit I should have gone". There was the invite that said, "we are having dinner on Ron Rael's ranch and Kelly Whittaker from Wolf's Tailor is gonna cook dinner for us on the horno in Ron's yard and we will make our own blue corn masa tortillas and we will prolly all sleep in his yard after a night of tequila". Her immediate response was, "are you seriously going to drive 12 hours to eat dinner and sleep in someone's yard?"

OH FUCK YEAH! I am loading the truck now!

The next day she said, if you are gonna go do some shit like that, I'm goin with you this time. On the drive back she admitted it was worth it. I forget what the price per person is for a chef's tasting dinner at the Wolf's Tailor, but we agreed we would probably never pay for that. Besides, it would be a let down from the dinner Kelly cooked for us in Ron's yard and there would not be the general sense of camaraderie and joy as we helped make tortillas with our hands that night under the stars.

Here's the thing. These kinds of crazy invites don't come around all the time. As a matter of fact most people never get invited to this sorta shit ever in their lives, other than Gutter of course. If Tucky calls and asks if you wanna sit in his muthafuckin bitch slouchy chair or some other such nonsense, you gotta strap it on and say, what time should I arrive bitch?!!!

Anyway, Annie doesn't get these types of invites. She has determined she better keep her schedule open for the next decade at least so that she can tag along. The invites will likely continue after I'm gone, but just in case; best to accept each opportunity as though it could be the last.

That perspective is the gift of the last year's events for her. She seems to have found it sorta liberating.

[Sparko]

Really good narrative Japh. It helps

[japhy]

We're just here to help, trust us.

A growing number of Americans are finding insufficient coverage options or jaw-dropping medical bills after unknowingly signing up for Medicare Advantage.

Today, more than half of seniors are enrolled in these privatized plans. The appeal is easy to understand when looking at the minimal or zero premiums and perks like dental care and gym memberships.

However, some have found the darker side after signing up for the plans.

If you want to go back to traditional Medicare, for instance, your options will be limited. You also might have to travel much farther for healthcare and be stuck with a doctor you don't want.

And many of these things aren't advertised to seniors when they pick up Medicare Advantage marketers' calls.

According to a Senate Finance Committee report by Oregon Democratic U.S. Senator Ron Wyden, customer complaints about Medicare Advantage's marketing skyrocketed to double from 2020 to 2021, bringing the total to 41,000.

Some Americans might not even be aware of the difference between traditional Medicare and privately run Medicare Advantage, but one in five seniors reported issues getting care due to the prior approval process, according to a recent Retirement Living study. Another study found half of beneficiaries switched to a different plan after five years.

"Imagine foregoing your original Medicare you paid your entire life into for gym membership," Brandon Selfors, a Medicare broker and the founder of Tampa-based Bridge Insurance. "Sounds ridiculous but that is over half of seniors in the U.S. who traded their birthright for a privatized plan."

"These plans are pushed too quickly on seniors who only have seven months to make a potentially life-altering decision."

Retired Pharmacist Cheryl Mozer, who lives in Blue Springs, Missouri, said she's seen it time and time again. While elderly patients generally enjoy their Medicare Advantage plans while healthy, it takes a turn for the worse when their health begins to decline.

"When their health declined and they needed expensive care costing thousands of dollars, such as rehab following a hospital stay, we had denial after denial as being 'medically unnecessary' even though their doctors said it was necessary," Mozer told Newsweek.

While Mozer said seniors are occasionally able to win their appeals, it took away "precious time" while they were ill.

"I tell every elderly person I know not to sign up for an Advantage plan," Mozer said. "It is not worth the stress when you are ill and need care."

"All of the advertising on TV hooks people in," Mozer said. "Yes, they may get free dental and a gym pass, but denial for expensive care is the issue."

And once you are in, the government has rules that make it hard to get out of these plans, Mozer said.

Linda Muñoz, a 70-year-old senior loan officer, said she didn't realize until this December that she had an Advantage plan. She initially chose an Aetna Advantage plan because it was the most affordable, with the premium paid by the deduction she'd otherwise pay to the Social Security Administration.

"The representative I spoke with said that I would be covered for my minimal drug needs and some dental and some over-the-counter drugs," Muñoz told Newsweek. "I am a 70-year-old healthy individual so the explanation seemed to fit my needs."

However, after visiting her dermatologist, she found out she was limited to doctors contracted with Aetna, so hundreds of dollars in bills were not covered despite having $165 deducted from her SSA payment monthly, she said.

"I'm now in a situation where I have a plan that I have to fight for coverage with, but I'm very concerned about my future needs and being stuck in a program that may well turn out to be less coverage than I could have, presently being employed, with my employer," Muñoz said.

And even when looking at the official information, it's easy to be led astray and make the wrong decision.

"The 200-plus page Medicare plan booklet hardly makes these decisions easier," Muñoz said, adding she has a post-graduate degree and still found herself confused and deceived.

"In fact, it seems like the government is in league with the insurance companies to put together information that is absolutely designed to confuse the consumer... What hope does the senior, whose educational experience might be less and whose economic situation might be worse than mine, have?"

[japhy]

So Annie’s mom is about to be released from the super max rehab facility.

Turns out she never went to the psych ward when her last episode occurred. We didn’t know that for a couple of days. The first few days in the psych ward she is always incommunicado so Annie didn’t try to reach her.

So mom you are at PM Health, I thought they were taking you to Sanford psych ward.

Sanford is done with me, they don’t want to see me anymore, they told me to go away.

Well, it was because of your neck brace, they aren’t equipped to help you with the physical rehab and the fact that you were taking the neck brace off while still dealing with an unhealed broken neck.

THEY DON”T KNOW THAT!

Actually they do, they were told that is why the care facility called the ambulance to take you there.

Well there is nobody working at this place, they haven’t fed me or given me my meds in days. My hands are so swollen from my rheumatoid that I can’t button my pants. I need someone to bring me some new clothes that fit. I am so weak I can’t stand up. (nurses report she walks down the hall multiple times a day to physical therapy and picks things up and moves them around her room with no issues) and I can’t call you because my phone is broken.

Wait, you have your phone?

NO, they took it away!

The ease at which self-canceling statements are made, one right after the other is always startling.

I haven’t had anything to eat in days and no one here likes me.

How do you know that no one likes you?

Well today when I went down to eat breakfast and then lunch; no one would sit with me.

For years Annie’s mom has been getting treated for kidney disease, it was stage 4 about 10 years ago. Recently she had tests run in conjunction with her UTI and there is no sign of kidney disease, everything functioning as it should, no signs of damage. Annie is now wondering if there ever was kidney disease and how long has this currently mental issue been on going but mom has just been high functioning.

Flash forward a week and we have been notified that mom will be released and go back to the care facility. Her psychotic bout is easing up and the new meds seem to be stabilizing her mindset. She still has to wear the neck brace for a couple more weeks. She is pissed about the neck brace, it hurts all the time and she can’t sleep. She is also mad that she isn’t going “home”. My mom says the same thing often, I want to go “home”. They can’t tell us what or where “home” is but where they live now is not “home”.

My mom called last week. She was trying to help her friend Marie bust out of the memory care facility.

No, not to join the circus.

If we can reach her parents “they” said she can go “home” with her parents. These women are in their mid 80s and their parents have been dead for decades but still it’s worth a shot. FREEDOM is just a phone call away! It seems they had been dialing random phone numbers for much of the afternoon hoping some sequence of buttons would reach Marie’s folks. Finally, they pushed the button that had a photo of my face on it to see if I knew Marie’s parent’s phone number. When I answer she thinks I am Francis, her brother. I tell them I have no clue what their number is.

Well it’s good to hear your voice, how are you?

Doing well, you sound good today, like you have purpose in life today.

Yes, I am helping my friend Marie. I better go, we need to reach her parents.

OK, I love you, good luck.

I love you too Francis.

There is universality in the desire to get back “home”. The desire to get home is very strong and it gets repeated over and over again. Maybe it’s a desire to get back to a place where there is a strong happy or loving memory. Sometimes “home” is a house on the southside of Chicago, sometimes it’s an apartment in Los Angeles where I (japhy not Francis) was born, sometimes it is a house in Excelsior Springs where she lived with my dad, or a farmhouse in Lourdes. It varies, but it is NOT where she lives now, of that she is certain.

When your memory is scrambled at the end of every day, like shaking a snow globe of recent events, you probably have no happy memories of the place where you live. When I visit, mom has no memory of my visit the next day. I suspect memories are part of what makes a place “home”. It would be like waking up in a hotel room every morning. You are safe and warm and dry but there are no memories of times past, spent with loved ones there. The king bed was great. Not having to share the bed with two large dogs, two cats and another person on the far side of the animal herds was pretty fuckin comfortable. No one kicked me unexpectedly in the groin while I was sleeping or spun around and sat on my head and that was cool. But I will still enjoy getting back “home”.

I think I get it now.

https://www.youtube.com/watch?v=Fb2q141rMNE

[jhawks99]

That truly sucks for everyone involved. I hate to imagine myself stuck in a facility waiting for the inevitable but know it's a real possibility. Fortunately, my Mom was able to stay at home until the end. My brother and his kid were able to maintain the house and take care of her with home hospice. The fight to make her leave would have been epic and probably would have destroyed the family. She did not want to be away from her dogs.

I half expected Simon and Garfunkel when I clicked your link. That that one works well too.

[japhy]

I half expected Simon and Garfunkel when I clicked your link. That that one works well too.

https://www.youtube.com/watch?v=Q5Hbs0s6_sQ

My daughters started calling me "papi" after they watched this movie. I accept it as a term of endearment.

[japhy]

Fortunately, my Mom was able to stay at home until the end. My brother and his kid were able to maintain the house and take care of her with home hospice. The fight to make her leave would have been epic and probably would have destroyed the family. She did not want to be away from her dogs.

That is one of those outcomes most of us hope for. It's good to hear that it can happen.

My great grandparents lived independently in a home they built themselves until they were in their 90's. One day my great grandmother climbed a ladder in the kitchen to reach something on top of the cabinets and fell and broke her hip. They put a hospital bed in her living room and my great grandfather and aunt took care of her for just over a week and then she passed in her sleep. It was enough time so that her entire family was able to come back and visit once. The next week my great grandfather passed in his sleep.

On top of everything else, they got a twofer on the funeral. It was about as perfect a script as anyone could ask for.

[japhy]

It has been a roller coaster of a week for Nanny.

She started out last weekend being taken to urgent care. Her eye hurt and was red. She had been fussing with it relentlessly for days. She was determined that something was itching and so she scratched it until she had to go have it looked at. The doctor told her to quit picking at and it will be fine. She harrumphed and went back to the facility.

Tuesday, the facility calls. She refuses to get out of bed or eat. They let her lay in bed through breakfast but this continues at lunch, she won't eat or drink. They are going to send her to the ER. My sister intervenes and takes her herself. She gets checked out, everything is normal. Nanny is just in a funk. So they put her on an IV and start pumping fluids because she is dehydrated. First the IV made her knees hurt. My sister and nurses put pillow under her knees, agitation persists. Now the IV is making her cold, they cover her with a blanket. Now the IV is making her underwear hurt! My sister can't decide whether to laugh or cry. Mom is getting testy with the nurses. They raise the IV to the ceiling to pump liquids faster and empty bag faster get her the hell outta there. She goes back to the facility and my sister buys her a burger on the way back and she chows down and everything is right with the world, she is feisty and back in the saddle. No clue what the fuss was all about.

Today, an old guy sits at Nanny's girl's table. Nanny don't like the weird old guys sitting at the girl's table. The old guy slaps one of Nanny's posse and then grabs her by the hair and starts pulling her by the hair. Now Nanny is a mostly mild mannered woman, all of 5 foot tall and 85 pounds. But this aggression against her girls will not stand. Nanny comes across the table throwing hands on this old bastard, pummeling him about the head and taking his ass out. The nurses pull her off. Old dude heads to the ER to get his shit checked out. Nanny is in the cooler, calming down. I guess the nurses were kinda proud of old Nanny takin care of business.

If only her Jayhawks had that kinda fight in them.

[Shirley]

Man, your poor sister, and Mother. Getting old isn't for sissies.

I'm sure they did, but any older woman whose behavior changes like that for no other discernible reason needs, among other things, to be checked for a urinary tract, i.e., bladder infection. I always hoped it would prove to be the case, because it's a reversible reason for mood and behavior changes, unlike a lot of other causes. It's relatively easy to check, generally easy to treat, and presto, they're back to their baseline!

No one knows precisely why, but strange behavior and mood changes attend UTI's in older people in a way they almost never do younger people. I've seen it frequently, both professionally, and personally. (With my Mother.)

[japhy]

The first thing they checked was for a UTI. Nothing there. Annie's mom presents as psychotic when she gets a UTI. The change win her is wild.

Nanny's recent behavior in the previous weeks presents as late stage dementia. She is constantly confused and can't remember what occurred 15 minutes before. Once she gets flustered, she can't form sentences. This was the first time she has refused to get out of bed or refused food. My sister took the opportunity to remind the staff at the facility that Nanny has a DNR directive.

[Shirley]

Sorry japhy, it's not easy watching your mother, or any loved-one, dwindle away like this. Of course, over time, you can't help but begin to yearn for an end, and then you feel pangs of guilt for even thinking that.

Be nice to your sister. It can be exhausting if every time something goes out of whack, which it inevitably does, you have to drop everything and go "intervene" with the problem de jure.

[japhy]

My sister has the best temperament for the job. And she has a remote work job with the DOD that gives her a lot of flexibility. She was laughing about the situation this morning and referring to Nanny as "Champ".

At this point may sisters and I all want her suffering to end. There are a few minutes every day when she seems happy but mostly it is confusion and fear. There is no guilt in wanting her suffering to cease. Death would be a relief for her. Nanny even says that in her lucid moments.

I have never seen my mom threaten to punch anyone. It would be laughable at best. I facetimed with her and brother-in-law and sister today. About three times during our conversation she put up her dukes and faced off with brother-in-law. She seems to be embracing her new persona, the Missouri Mauler aka Champ. We never talked about her fight, we figured let's not get her riled up again. Not sure if she even remembers the event. Annie says it must be muscle memory. Her arms now have a taste for fisticuffs.

[pdub]

Sorry japhy.
Life rules and sucks.

[Sparko]

Love the fight in her Japh.