Angil Tarach-Ritchey's Blog

I probably should have written this post months ago but I was hopeful I’d have more energy and could keep up.  If you aren’t aware, I have been battling breast cancer since October 2013.  I had been on chemo since November of 2013 and it caused me to step back from most of my work, hence no new blog posts or articles.  I also had the unfortunate finding of a massive size kidney stone which required kidney surgery March 3rd, so I have been focused on my health and family, and bits of advocacy as I feel up to it, or literally can.  Chemo hasn’t been very kind but I finished my last treatment April 14th. Yae for that!  The journey and battle are not yet over.  I will have surgery to remove the cancer at the end of May, followed with somewhere between 16 and 30 radiation treatments, beginning around 3 weeks after surgery.

Giving our oldest grandson a bit of love

Making the best of chemo

I am taking a lot in as I travel this patient journey and the state of healthcare and my experience  in it, once again, and will have some future articles about the good and bad of what I’ve experienced.  The only thing I want to say now that I urge every patient to do is take someone with you to all doctor appointments, tests and treatments to be your second eyes and ears because you can’t remember it all.  You also want an advocate that will ask questions you haven’t thought of, or someone who will advocate for better clarification of what is being said if you don’t understand, or the provider is talking too fast to comprehend it, or even for your advocate to take notes. My wonderful husband has been with me for every appointment, test, and treatment.  I am not only extremely grateful for his loving support, but he has kept me on track and reminded me of things discussed with my medical team that I failed to remember.  He has asked questions that concerned him or that I forgot to ask.  Even though I’m a nurse the role is reversed when I am a patient and the effects of illness, chemo and the other medications I am on prevent me from being at my best, so I am grateful that I have had my husband by my side to help me.

Get and keep copies of everything!  Every lab test, diagnostic test, physicians, nurse practitioner’s, or physician assistant’s report because one health complaint can lead to a series of doctor appointments, labs, and tests and you will easily lose track of what’s been done and what the results are.  If you are seeing more than one doctor have each doctor send copies of everything, including their notes and reports to your primary physician to keep him/her abreast of everything going on, which will be included in your file in your primary physicians office.

It doesn’t hurt to also get a business card of every physician you’ve seen and line them up on a copy machine where you can make copies that you can give to any new physicians, so they can easily look over the doctors you’ve seen on one sheet of paper.  Keeping everyone on the same page should help eliminate repeat tests and is an easy way for doctors to consult with each other should they have any questions or want to discuss your case.

One doctor appointment that I had in December of 2003 turned into a 5 year battle for a diagnosis of 2 chronic illnesses, Sjogren’s Syndrome and Chronic Fatigue Syndrome.  By the time the diagnosis came, I had been through 13 doctors of almost all the specialties, traveled to the Cleveland Clinic twice, had 2 surgeries, countless lab and diagnostic tests, and medication trials out the wazoo!  I even sat with the board of my health insurance company, with my family, battling a denial to the Cleveland Clinic. These are old lessons I learned back in the early to mid 2000′s that I am now revisiting with breast cancer and sharing personally with some friends dealing with significant health challenges.  I have personally gone back into 5 years of my filed health documents to look up results as new information has come out about possible causes of autoimmune diseases.  It was a lot easier than trying to track it all down!

Healthcare is requiring us to be our own advocates like never before!  Don’t be intimidated to speak up for yourself or a loved one.  Ask questions, make sure you are comfortable and trust your physician, or get a new one.  Expect to be treated with respect and dignity, and for your physician, physician’s assistant or nurse practitioner to listen to your concerns, complaints, and questions.  You should never feel intimidated by your healthcare provider.  The only way you will improve your health or maintain it is if you feel comfortable confiding and speaking to your physician.  If you don’t understand what you are being told or the healthcare provider is speaking too fast or has an accent that makes it difficult to understand, speak up.  You MUST know what is going on with your health and what the plan of care is to improve it.

Lastly, don’t hesitate to get a second opinion when you are diagnosed with a serious or chronic illness.  Because Chronic Fatigue Syndrome (CFS) has no definitive test and is diagnosed based on symptoms and a certain criteria set, I sought more than one opinion and was actually diagnosed with CFS by three different physicians.  Remember, you are in charge of your own health and healthcare.  Take the lead and take a trusted advocate with you.

Tags:  Advocacy, Angil Tarach-Ritchey, breast cancer, Cancer, chemo, chemotherapy, healthcare




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 Wake up call for Baby Boomers! Time is urgent!  The Guilt of a Family Caregiver  Old Age: a quiet, often tragic world (2)  Writing "Behind the Old Face"  Behind the Old Face: Aging in America and the Coming Elder Boom has been released! Copyright © The Elder Boom Foundation [Where my time has gone and my healthcare tips for you], All Right Reserved. 2014.

In October of 2012 Medicare enacted new federal regulations by penalizing hospitals with high readmission rates.  There was an incredibly high rate of seniors being readmitted to the hospital within 30 days of a prior admission.  The 2010 rate of re-admissions ranged between 12.2% and 26.7% across the nation, with an average of nearly 20%.  When 2 out of 10 people return to the hospital and are sick enough to be re-admitted it makes sense that something needed to be done, but this may not have been the best way to go about it.

Medicare is penalizing hospitals by reducing their overall payments to the hospital for the calendar year by 1-2% in 2013 for high re-admissions in 3 categories, Heart Attacks, Pneumonia, and Heart Failure, but they have been adjusting that rate since the ruling by fractions of a percentage. They are also considering adding other medical conditions such as lung disease. Obviously this is a huge financial loss for hospitals with high rates of re-admissions.  It seems to target hospitals in poorer areas where its more difficult to keep or return people to good health, due to of the lack of education, finances, and resources many patients are dealing with in poorer areas.  These patients tend to eat less healthy meals, forgo medications they can’t afford, fail to follow up with physicians because of a lack of transportation and the money for co-pays.  There is much less of a focus on improving health in the more socioeconomic deficient neighborhoods, where many are just trying to get by.  The supports are not available to assist with literacy, education, transportation, and funds to pay for medications, co-pays, and healthier meals and a healthier environment.

There is a lot of discussion about this in healthcare and the news because it becomes a moral issue when healthcare providers are penalized for their patients lifestyles which is beyond their control and how much responsibility is put on the hospital to work in people’s lives outside of the hospital. The New York Times published an article in May of this year titled Hospitals Question Medicare Rules on Readmissions  that poses these issues a bit better.

Spending time in hundreds of private homes as a case manager, RN, and homecare agency owner, I can tell you that it’s very difficult to change long standing unhealthy habits.  The likelihood of getting an 80 year old to quit smoking or to give up the fried foods in place of more fruits and vegetables is poor.  Starting an exercise program when an elderly person has another condition like arthritis, back pain, or shortness of breath from COPD, or emphysema is not likely either. There is more of an effort to keep seniors from returning to the hospital with programs such as checking on patients after discharge, and helping them enroll in healthy living programs, so there is some benefit to the mandate by hospitals being forced to better understand why patients are having difficulties following discharge orders, or improving their health.  When your work is only in the hospital its hard to understand what is going on in homes and the community after patients leave the hospital.  This forces hospitals to understand they are only part of the healthcare system and can benefit from a team approach with providers out in homes, the community and in long term care facilities.

I personally think that Medicare has gone about reducing re-admissions in the wrong way, but besides that I am seeing another part of the scenario that I believe is harmful to patients.  I am hearing about a lot of seniors going to ER for whatever is causing them to seek emergency care and being held in the observation room for days at a time.  Observation rooms were initially added to observe patients for less than 24 hours.  If the patient is stable and there is no further cause for concern they are discharged home with instructions.  If they are unstable or their condition worsens they would then be admitted to the hospital.  In the last 3-4 weeks I have talked to a few different family members who said their elderly loved ones were held as long as 3 days in observation, and another was held for the same time frame but was housed in the hallway of the emergency department and didn’t even get into a room.  After the 3+ days of being held in “observation” they were discharged home.  One patient had one hospital admission and had gone back twice within a month, which is when she was held in observation.  She was told that Medicare may not cover her 2nd trip to ER and the subsequent 3 day hold in observation.  I have to wonder if she was told that because she was never re-admitted and only held in observation?  If they would have gotten to the cause of her complaint, or treated it in some way, she wouldn’t have returned, but they didn’t.

I am seeing a trend here to reduce the possibility of re-admissions by holding seniors in observation rather than admitting them to the hospital.  This is not good for patients!  If a senior is too sick, weak,  injured, or suffers from another condition making it unsafe to go home, or it will be in their best interest to go to a rehabilitation facility for therapy or care, Medicare will not cover any of it unless the patient has spent 3 full 24 hour days in the hospital once the physician orders the patient to be admitted, and that does not include the day of discharge.  When physicians write orders they are required to date and time them, so from the time the physician writes “Admit to the hospital” and dates and times it, the clock begins.  Medicare requires a full 72 hours of admission before they will pay for rehab. If the hospital holds an elderly person in observation for three days, decides to then admit the patient and discharges them to rehab 2 days later, they will be responsible for 100% of the charges at the rehab facility.  If they were actually admitted to the hospital for the full 3 day criteria, Medicare would pay 100% for the first 20 days.  The patient then pays a portion of the daily charges from day 21-100.  Seniors have been sent to rehab facilities only to later find out they are responsible for all charges.  This is a very poor practice.  Rather than look out for some of the most vulnerable patients, some providers have failed them.

You must be a healthcare advocate for yourself and your family.  If you have an aging loved one who ends up in an observation room you may have to push for an admission.  If it looks like your loved one will be on observation for over 24 hours insist on speaking to the doctor about admitting your loved one so they don’t find themselves with an outrageously expensive bill.

Whether we agree on how Medicare is handling readmission rates or not, I think we should all agree that what is best for patients should come first.

This

Tags:  Emergency Room, geriatrics, Hospitals, medical care, Medicare, nursing, Readmission rates




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 The Guilt of a Family Caregiver  Wake up call for Baby Boomers! Time is urgent!  Old Age: a quiet, often tragic world (2)  Behind the Old Face: Aging in America and the Coming Elder Boom has been released!  Writing "Behind the Old Face" Copyright © The Elder Boom Foundation [Are Hospitals Sidestepping Admissions to Reduce Re-admission Rates?], All Right Reserved. 2013.

This morning I read an article by Michael Baxter of © Investment & Business News 2013,  titled “Baby Boomers Not Saving Enough”.  I find it to be another reminder that we are not prepared for our aging future. To read the full article…

How many analysts, economists, aging authorities, retirement planners,  reporters, and media outlets do we need to tell us how unprepared we are for the coming Elder Boom™ before we act to create a better aging future? As an eldercare expert and nurse in this field for over 3 decades,  I can tell you that we are not listening to the warning signs.   Most Baby Boomers don’t want to think about it, as if it will somehow go away.  It will not go away.  The system will not fix itself.  Medicare, private health insurance and Social Security will not get massive windfalls and all of a sudden start paying for or start giving you enough to pay for long term care!  Medicaid programs are not going to get the windfall either!  People, we are on our own!   You cannot count on the government to care for you and we shouldn’t have that as our first plan anyway.  Yes this is bold and maybe even a little harsh but someone needs to start telling it like it is.

We are on our own to care for ourselves in old age.   There won’t be enough facilities to house us all.   There won’t be enough professional caregivers, geriatric physicians and nurses, or family members to care for the vast majority of us who will need care. Where will you go?  Who will care for you?  Where will you get the money and be able to find a qualified, trustworthy, ethical, and compassionate person to provide care for you, or more than one, if your care is complex and full-time?  Who will care for your spouse or parents when you have to work or want to create your own life, career, and family?  How will anyone afford nearly a quarter-million dollars a year to live in a 10×10 space in a nursing home for more than a year or two, if at all?   Hospitals are discharging people quicker than ever.  They will not start keeping people longer because no one wants to pay, so are you prepared for care following a surgery, injury, weakening illness, or a chronic illness like Alzheimer’s Disease?   Are you working hard your whole life, saving what you can, and contributing to a 401k or other retirement plan only to watch it quickly disintegrate, like dust in the wind, to pay for a few weeks or months of care, only to end up broke and without care and assistance anyway?  That is the reality of our future if we don’t act now!

I call you to join me in action if you have any concerns about your aging future or that of your loved ones. We don’t need any more reminders of the impending crisis. We only have to finally stop ignoring the warnings and work together to create an aging future to look forward to. We can make our future  the real  “Golden Years”, which are positive, uplifting, values us as we age, and affords us the ability to hang on to the money we’ve worked so hard for to enjoy with our family and friends, or even donate to a worthy cause, rather than leaving us broke and dependent.

If you are done with fear and worry about your aging future, fill out my contact form, consider getting a copy of Behind the Old Face: Aging in America and the Coming Elder Boom to better understand the future we can have, and share this with family, friends, co-workers and with your social media contacts.  Urge them to get involved too.  For less than 2 Fast Food meals you can see if the E-version of my book is worth your aging future. I am not just looking out for your aging future, I am looking out for mine, my husband’s, my family and friends that I love. You will be very happy you acted now before its too late and you are in the midst of the crisis or we will be in the middle of the crisis wishing you had. The choice is yours.

Of course you are welcome and I hope you will join in action whether you buy or read my book.  The book is not the most important thing and never has been.  Acting now is the most important.  I just want you to know  my book is available if you want to know more

Our Aging Future!

about me and my perspective, the current state of eldercare, what it’s like to age with some great and even sad life stories from several amazing seniors, or a detailed and viable vision for our future living and care that will have us looking forward to it rather than dreading it.

I know I want my aging future to be more than living in a nursing home or sitting in the house day after day without any socialization or feeling of value.  I’m planning a happy future enjoying family and friends and doing something meaningful to contribute to my friends and neighbors!

 Its time we started the Elder Boom Revolution to Great Aging!

 

 

 

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Comments:  0 (Zero), Be the first to leave a reply!You might be interested in this:  
 The Guilt of a Family Caregiver  Old Age: a quiet, often tragic world (2)  Wake up call for Baby Boomers! Time is urgent!  Behind the Old Face: Aging in America and the Coming Elder Boom has been released! Copyright © The Elder Boom Foundation [In Response to "Baby Boomers Not Saving Enough"], All Right Reserved. 2013.

As I wrote an article for Dorland Health today, and researched statistics I found a report from the Families and Work Institute which is from their 2008 survey, The Elder Care Study: Everyday Realities and Wishes for Change.  Even though this report is a bit outdated it contains some great information and a bit of light into why Baby Boomers are ignoring their aging future.

An actual excerpt from the report on working family caregivers states;

In terms of their own aging, the caregivers present a bleak picture.  Having experienced the elders’ aging and ailments, family caregivers tend to be both more aware of the challenges of growing old and more discouraged about it. Many seem to find it too difficult, too depressing to imagine themselves as being in the care recipient’s shoes. Their wishes are more about what they do not want to happen to themselves, than what they do want.

These are:

• not to be a “burden” to others, especially to their children;


 • not to burden themselves or others with unaffordable expenses; and
 • not to end up in a nursing home.
 
 
Among hopes for their own aging, family caregivers most often cite being able to     live in their own homes, maintaining good health and remaining independent for as  long as they can. Yet, ultimately, far too many wish to escape from aging as it now  plays out in America:

I don’t even want to think about it. I want to pass in my sleep of old age. It’s an ugly time of life—the last few years of suffering.

I would rather die in a car wreck than put anyone through what I had to go through taking care of my mother.

These statements are very common according to my experience yet what are we doing to put a rest to our fears.  I’ve personally said “I am not living in a nursing home.”  Who wants to burden anyone with care of care costs, but unless we do something in the next 5 years to remove those fears they will become our reality.  To better understand our current and future care costs Genworth Financial has an excellent cost comparison by State.  Once you click on your state go under the map to calculate future care costs to find a drop down menu to choose between 10 and 30 years from now.  I know you will find future care costs as shocking as I have!  Understand that you may not need care for 40 years, but the costs for us Baby Boomers, even 20 years from now are so high that it will affect you as well, because it will be an economic crisis for the country, business and individual families.

I know we can create a better aging future for us all that will be positive, supportive, values seniors, community, and living at home, without exhausting every penny we have on care costs.  We only need to combine our education, experience, skills and resources to create something we will look forward to rather than dread.

There is a vision for senior living and care I present in my book Behind the Old Face: Aging in America and the Coming Elder Boom        I don’t propose to have all the answers to every problem by any means but the inter-generational cooperative community model I present is a very viable option for millions of seniors if we just act on it.  We can hide our heads in the sand and enter into one of the biggest crisis’ this country has ever seen and regret our inaction or we can take our fears and turn them into creative action and advocacy to create the kind of aging future we all would happily look forward to and accept.  The countdown has begun.  Whether we act or not, the next 5 years will pass and the Elder Boom will be met with devastation or peace, our choice!

If you are ready to act, fill out the contact form and we will begin this exciting journey together!

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 Old Age: a quiet, often tragic world (2)  In Response to "Baby Boomers Not Saving Enough"  Writing "Behind the Old Face"  Are Hospitals Sidestepping Admissions to Reduce Re-admission Rates?Copyright © The Elder Boom Foundation [Wake up call for Baby Boomers! Time is urgent!], All Right Reserved. 2013.

I want to take a moment to send out my

prayer for everyone to have a blessed Easter and to truly know the joy and depth of what our Lord has done for us.

From my family and I to yours, Happy Easter!

Tags:  aging, Behind the Old Face, Easter, Elder Boom, ElderBoom, seniors




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Comments:  1 (One) on this itemYou might be interested in this:  
 Wake up call for Baby Boomers! Time is urgent!  Behind the Old Face: Aging in America and the Coming Elder Boom has been released!  Old Age: a quiet, often tragic world (2)  Writing "Behind the Old Face" Copyright © The Elder Boom Foundation [Happy Easter!], All Right Reserved. 2013.

The most prominent emotion I’ve seen in family caregivers is guilt.  Guilt for not doing more.  Guilt for not being 100% happy with their caregiver role.  Guilt in not being everything to all people at all times.  Guilt for feeling the emotions that come with giving so much of their lives up to care for a loved one.  Guilt for taking any time for themselves or having any enjoyment away from the person they are caring for.  Guilt about the decisions they make.  Guilt about taking time away from other family members, friends, work, or the household.  Guilt because they imagine that great caregiver’s somehow know more, have it easier, and make the right decisions all the time.

Does this sound like you or someone you know?  Well let’s have a realistic look at the emotion of guilt.  According to Wikipedia Guilt is defined as; an emotion that occurs when a person believes that they have violated a moral standard.  According to Dictionary.com guilt is; 1.  the fact or state of having committed an offense, crime, violation, or wrong, especially against moral or penal law; culpability: He admitted his guilt.  2. a feeling of responsibility or remorse for some offense, crime, wrong, etc., whether real or imagined.  3. conduct involving the commission of such crimes, wrongs, etc.: to live a life of guilt.

When we actually define the word we see that it has no place in the mind and heart of a family caregiver  who is giving of their time, energy, finances, love, and is making the best possible decisions he or she can for the person they are caring for.  Unless someone is out to specifically hurt or take advantage of the care recipient, and some do, most are truly sacrificing, offering more love than they realize, and doing their best for the person they care for, even at their own expense.

There is no room for negative emotions that are imagined by you as a family caregiver.  Guilt will only zap the life out of you and take the energy you need to care for yourself and your loved one.  I truly have not met a loving family caregiver who didn’t want to do the best for their loved one.  I have always found that I need to really emphasize how important self care is to family caregivers because they are too focused on making sure everyone and everything else is ok, and never put themselves on the “to do” list.

Providing care to a loved one is the most loving selfless thing you can do.  Millions of family members are spending day after day, and year after year, tending to the needs of spouses, parents, other family members, and friends, who may not even know who they are, or who may treat them in a negative way because of the ravages of Alzheimer’s or another type of dementia.  Giving without getting anything in return, other than knowing the person you love is safe and cared for, is what unconditional love is all about, but rarely seen outside of this role.   What is there to feel guilty about?  There is absolutely no intentional offense, crime, or wrongdoing in those family caregiver’s who are making decisions from a place of love.

It’s normal to get exhausted, feel sad, and even angry about the situation, because caregiving can be very difficult, and depending on the physical and mental health of the care recipient, often is very difficult.  You often lose sleep.  The majority of you deal with family or friends who don’t agree with what you’re doing or deciding,  or don’t want to help at all but still want to criticize you.  Yes, I said majority, because families that all agree, give support to each other, and work at sharing the responsibilities are rarer than anyone believes.  You may be juggling time with a spouse or partner, children or grandchildren of your own, tending to the responsibilities of a household, and working part or full-time outside of the home.  You often let activities you enjoy fall by the wayside and even lose friends because you have no time or don’t take the time to maintain those relationships, or your friends don’t understand this role of yours and quit making time for you.  You often have had to take on all or most of the financial, living, and health decisions and responsibilities of the person you’re providing care to.  Can you see how much you  really give when you see it in black and white?  Who wouldn’t get exhausted, get sad, angry, or even resentful at times?  But guilt?  Again, no room for guilt.

If you are a family caregiver, exchange the guilt by giving yourself credit for being the incredibly strong and loving person you are.  Know that when you make decisions from a place of love, you are doing the very best you can.  Be proud of that.  Only allow yourself to take on positive thoughts and feelings that will put life into you, not suck the life out of you. Be kind to yourself and give yourself permission to fill  up with adequate rest, time away from the caregiving role, time to tend to your other relationships, and time for whatever gives you enjoyment.  Laugh!  Laugh at yourself, laugh at the silly things that happen in the course of a day, or the things that may even be ridiculous , but find as much humor as you can in your everyday life.  Schedule time off every week, not just when you are “caught up” with everything and feel you have time, because you will continue to neglect yourself!

The only thing you should feel guilty about going forward is for not providing the best care you can by caring for yourself first!  Picture your loved one as a car.  Cars have a lot of parts that need to be in good shape for the car to even function.  Your loved one has lost the ability to steer the car so you have taken over the steering wheel to guide the car in a safe, smooth, and comfortable direction.  You are responsible to keep the steering maintained with steering fluid, only yours is losing fluid fast and will soon be depleted.  The steering becomes more physically difficult and veers off onto a bumpy and possibly even a dangerous road.  You know in the back of your mind you need to refill the steering fluid but you won’t take the time because you believe you can, and should, make it to the destination as quick as possible.  Unknown to you the car is soon going to be so difficult to drive that you will either give up or you will run off an embankment and not have the ability to drive again.  You soon drive off the embankment and find yourself needing someone to steer your car.  Now you have two cars without anyone steering.  Looking back, do you think it would have been best to just do the minor maintenance and avoid having two cars off the road?  The trip would have been much more enjoyable with easy steering, smooth roads and safe conditions, but you chose to ignore that and take the difficult, bumpy, stress filled, and dangerous road.  This might be a crazy analogy but it most resembles what happens to family caregivers and care recipients when caregivers don’t take the time to maintain their own health and happiness.  It really is a decision.  Truly, the maintenance is much easier and enjoyable than the consequences of not attending to your responsibilities of caring for yourself so you can take care of another.

I end by praising all of the family caregivers who give more love than most will ever experience.  You are special and an awesome example of what unconditional love means!  Now just love yourself in the process and the guilt will be a past emotion.

 

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 Old Age: a quiet, often tragic world (2)  In Response to "Baby Boomers Not Saving Enough"  Are Hospitals Sidestepping Admissions to Reduce Re-admission Rates?  Writing "Behind the Old Face" Copyright © The Elder Boom Foundation [The Guilt of a Family Caregiver], All Right Reserved. 2013.

The tragedies of the world sometimes occur quietly.  This was the case recently with an elderly woman in a nursing home.  This lady—we’ll call her Ruth Brown—came to the nursing home in a very confused state mentally.  Her husband was dead and she had no near relatives to care for her, but she was not destitute.  Her husband had been a wealthy man, and had set a good deal of money to be applied to his wife’s care after his death.  She was to have a private room and good care and the situation was hopeful.

This lady was quite reclusive for some time and lived in her room like a snail in its shell. Because she was confused a legal guardian was appointed to manage her affairs.  This seemed best at the time.

But Mrs. Brown improved.  She began socializing with others and in time was quite rational again, with only one exception–she could not accept her husband’s death.

But this was not the end of the story.  Mrs. Brown’s distant relatives—and heirs—decided that too much money was being spent on her care.  At the rate it was going, their own portions would be somewhat diminished by the time she died.

Mrs. Brown would have to be moved not only out of her private room, but out of the nursing home to another less expensive one.  She heard of this and objected strongly.  It was her money, she said, and she wanted to stay where she was. It was the only home she had and she knew the people around her.

Her objection fell on deaf ears.  She was no longer in control of her life or money.  The nursing personnel who cared for her, and had seen her slow improvement, objected.

The guardian and the bank were reasoned with, but Mrs. Brown was moved to accommodate some distant relatives who never visited her, nor even dealt with those caring for her personally.  She refused to go until the ultimate time when she could refuse no longer.

Then she moved, plunging once more into the world of confusion from which she’s just emerged.  Whether she will ever emerge again is doubtful.

Everybody saw what was happening but nobody could do anything. It was all very legal, but a woman’s inner self may have died because of it.

Where is justice for the elderly?

Mrs. Jennie Johnson (fictitious name) is a patient in a local convalescent center.  She is a petite lady of 96, not standing over 5’1” in her primly laced black shoes.  Her movements are quick and birdlike, and her voice is eager and breathless. Don’t , however, let this fool you!

Jennie Johnson has a will of iron and molds her life to suit your liking.  When she broke her hip two years ago, she willed that she would get up and walk again.  And she did.

“I could have stayed in a wheelchair after that,” she murmurs, smiling, “but then I’d haver a hard time getting out and about.”

And she does get out and about.  She asks politely, but firmly, to be taken out for an afternoon of lunch and shopping.  A new hat or even a dentist appointment delights her.  She is delighted by the house-plants in bloom that line her windowsill. Her hair is done up properly, and she is scented with cologne.  Her room is delightful to visit because it reflects the life of a charming, lively woman.

Mrs Lucille Babcock (fictitious name) resided in the same nursing home.  She was not delightful to visit.

Mrs. Babcock was a lonely, confused woman who felt herself to be abandoned by those she loved into an environment which she couldn’t tolerate. When she first came to stay at the nursing home, she was a fairly alert woman, not critically ill, and in general quite charming as a person.  Unfortunately she was caught up in a vicious cycle.

Mrs. Babcock didn’t know anyone at the nursing home, and she didn’t want to. They were all so very old, she felt, and she wanted to be near young people.

She wanted to go back to her home, but her daughter didn’t feel she could manage her mother’s care alone.  The daughter came to dislike visiting Mrs. Babcock because of her own strong sense of guilt, and Mrs. Babcock’s pleas to be taken away.

It is a rare individual who is unmoved at the site of a parent’s tears.  The daughter visited less frequently, and Mrs. Babcock grew ever more distraught.  She began sitting by the front door, crying and waiting, or insisting that her things be packed to go.  As she grew more confused mentally, she even tried to leave the home in her wheelchair—to no avail.

Efforts were made by the personnel to calm her and encourage the family to visit more.  Mrs. Babcock was taken out shopping, and she was included in a coffee discussion group.  She began to relate to others socially, but still all her hopes centered on improving enough to go home as her daughter promised she could when she was well.  And she did improve a great deal.

But she was not taken home.  When she finally realized in great despair that she was never going home, she died in a matter of weeks.

What was the difference between Mrs. Babcock and Mrs. Johnson? It involved more than their state of physical health.  The differences were in their attitudes about themselves and their families’ attitudes and feelings.

Mrs. Jennie Johnson feels needed.  Her daughter cannot visit much, but she never allows her to feel forgotten.  She receives cards and letters, cookies and plants.  Mrs. Babcock’s family implied wordlessly that she was excess baggage to them.  Mrs. Johnson feels that she is helping her daughter by living in a nursing home.  Mrs. Babcock simply felt she’s been shut away and forgotten.

Had Mrs. Babcock’s family been able to overcome their own feelings enough to help Mrs. Babcock feel needed and useful, or had young volunteers, perhaps, visited with her and appreciated her lively wit and clever mind, she might have settled in as happy as Mrs. Johnson and lived to 96 as well.

Mrs. Babcock died, as others will die, of loneliness and desperation, unless we learn how to show the aged they are still useful and needed as persons.

The Mrs. Babcock’s of the world have much to offer.  Cannot the rest of us take a little time to discover what it is?

I know Mrs Brown, Mrs. Babcock and Mrs. Johnson.  I have met many of them many times throughout my career, but I didn’t write the article.  This was an article sent to me by a friend, and son of a former client of mine and loved man I feature in my book. The stories of these 3 ladies was written by Shirley Brugger in December of 1974 for the Tacoma Washington Tribune.  I could have easily wrote this story today.

I only got to the part when Mrs. Babcock died of loneliness and despair before the tears streamed down my face.  I have said many times that eldercare hasn’t changed, but Shirley’s article was the confirmation that brought my thoughts to black and white right in front of my eyes.

We still don’t value our elders, they still die lonely desperate lives in nursing homes across the country, and distant relatives are still stealing from wealthy elderly relatives.  I can easily recall names of former clients who also were forced to less than satisfactory care and ripped out of the home they loved and the friends they had so the greedy self-centred and uncaring family members could reserve their inheritance.  I’ve cared for those who have been forgotten, who don’t ever get a Christmas card or visit.

Can’t we do better than we did nearly 40 years ago?  Will you be the one who dies a lonely death in a nursing home one day, or will we create a better aging future which includes focusing on worth, emotions, inclusion and legal protections for seniors from these evil perpetrators that are most often family?

I hope this encourages you to call an elderly relative, stop for a visit, or send a card on a regular basis, just to let them know they matter.  Let’s be the voice for those who can’t speak and advocate for protections and creating something better for ourselves and future generations.

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 Wake up call for Baby Boomers! Time is urgent!  The Guilt of a Family Caregiver  Writing "Behind the Old Face"  In Response to "Baby Boomers Not Saving Enough"Copyright © The Elder Boom Foundation [Old Age: a quiet, often tragic world (2)], All Right Reserved. 2013.

I am very happy to announce my book, “Behind the Old Face: Aging in America and the Coming Elder Boom“, is now available!

This book comes from my 30+ years experience spending time with seniors, listening, chatting, caring, laughing, crying, helping, observing, and advocating. I have been amazed, empathetic, sympathetic, joyful, filled with deep laughter, love, sadness, anger, grief, respect, sadness, compassion, understanding, disbelief, happiness, and a host of other emotions throughout the decades I have spent time with aging adults, family caregivers, and healthcare professionals. I have witnessed the best in care, the worst in “care”and everything in between.

I believe God put “Behind the Old Face” on my heart several years ago, which I have written about in more detail in the book. I am extremely grateful for the blessings, people and opportunities that have enabled the book to be written and published. It has been a difficult, yet wonderful journey to get to the place I am now, sitting here announcing the release of the book. Never having wrote a book like this before, I now understand what it takes to write and publish a book, and couldn’t be happier with my publisher, Jared Rosen at Dreamsculpt!

There have been too many people who have contributed to my life and this book to name them here. I have been humbled by the immense encouragement, support and contributions so many have made to me along this journey and throughout my life and career. I feel my heart is overflowing with gratitude as person after person comes to mind.

I am excited to share my heart and work with you and hope you will read the book and share it with your family, friends, co-workers, groups you are involved with and on social media. You can read a bit from the book and/or purchase it here. Behind the Old Face: Aging in America and the Coming Elder Boom

I would love to hear what you think about the book. Please go to my website to post your thoughts on my “Comment” page http://www.elderboom.org and sign up for news, updates and a free download, 19 tips to save on prescription drug costs

Remember….Together we can do more!

Tags:  Behind the Old Face, Book, Caregiver, Caregivers, Caregiving, Elder Boom, ElderBoom




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 Wake up call for Baby Boomers! Time is urgent!  Happy Easter!  In Response to "Baby Boomers Not Saving Enough"  Old Age: a quiet, often tragic world (2)  Are Hospitals Sidestepping Admissions to Reduce Re-admission Rates?Copyright © The Elder Boom Foundation [Behind the Old Face: Aging in America and the Coming Elder Boom has been released! ], All Right Reserved. 2013.

If you have followed my blog you know I haven’t posted much in the last few months. I have been very busy and I am happy to announce the release of my book “Behind the Old Face: Aging in America and the Coming Elder Boom” is scheduled for November 12th!

This book has been on my heart and in my mind for 8 years or so. Maybe it has been there since I began in eldercare in 1977, but didn’t surface until 8 years ago. Either way I will be sharing it with the world in 26 days and that is exciting! I won’t get into any details about how this book came about, because it’s included in the book. I will say however, that God put the book and title on my heart. I am extremely grateful I have been given the passion, experience and talent to do the work I have and finally see the book become a reality.

So many wonderful people have been a part of this process, my heart is filled with joy and sincere gratitude for what each person has and continues to do. From pushing me to get the book done, to cheering for me on Facebook, to allowing me to be privileged enough to be privy to their life stories, to giving financial gifts to pay publishing costs, to helping me get the word out, to praying for me and my family, to encouraging and supporting me, to guiding me through the entire process, to editing and helping create what the book has become, I am so thankful to each person who has helped me along the way. There really aren’t words to describe how blessed I feel by the love and generosity I have been given.

I have been working with my publisher, Jared Rosen from Dreamsculpt, since last year and it has been an awesome experience! He had belief in the intention of my book from the first email I sent him and he responded with “when can we talk, I like what you’re doing”. From our first conversation I knew I wanted to work with him, and it has been great since. I have learned a lot from Jared and grown as a writer and visionary for the future of aging. Jared has the ability to bring forth more than some words that end up in a book. His process expanded my thoughts, ideas, and the possibilities of what can be. I really don’t know how I would be here, ready to release the book, without him. I know eldercare and the difficulties and beauty of aging, but other than some research I’d done, I didn’t know squat about publishing!

The book is getting wonderful feedback and has already been endorsed by 2 nursing organizations, NurseTogether and Nurse Talk, which is a true honor. Even my husband said “I knew it would be good, but not this good!” That meant a lot too. I know he is a fan of my work and probably a little partial to me, but for him to express that I even impressed him, was a very heartfelt moment for me. My brother Joe, who has always been my biggest cheerleader but hasn’t picked up a book in years said he couldn’t put it down.

What makes me happy is to know the the intention of the book is coming through.

Authors write with intention. Whether the intention is to entertain you, make you laugh, cause a stir in your emotions, or keep you on the edge of your seat, there is intention. Since my passion and focus is to improve the treatment, living and care of aging adults, the book’s intention supports that focus.

Now the real work begins to get my book in as many hands as possible. It’s not about how many book’s I sell or where my book ranks, it’s about the intention. I’m not going to try and tell you that sales and good rankings don’t matter at all, because that would be a lie. If I want to continue my advocacy work and get the message heard I need an income and rankings matter for future books and attention to the matters at hand, but that has never been the purpose or focus of this book. If readers receive the intention of the book good things will happen for the elderly now and into the future and that is why spreading the news is so important. I have put an enormous amount of time, effort, knowledge, research, experience, money and thought into the 178 pages that come from my heart. I kept every senior I have met, cared and advocated for, laughed with and cried over in my thoughts as I wrote every word. They all matter to me and are the driving force behind my advocacy work and Behind the Old Face.

I invite you to see a preview of the book in my M2E Book “The Aging Question: A Vision for the Coming Elder Boom“, which is a mini-media Ebook that includes text, photos and video clips of 2 of the wonderful seniors I interviewed for Behind the Old Face.

I hope you will read the book to better understand aging, now and into the future. If you find it worthy, please tell your family, friends, co-workers and business associates about it so together we can see better treatment, living and care for aging adults!

Angil Tarach-Ritchey can be reached for questions or comments at Angil@behindtheoldface.com or other contact options at http://www.elderboom.org

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Comments:  1 (One) on this itemYou might be interested in this:  
 Behind the Old Face: Aging in America and the Coming Elder Boom has been released!  Old Age: a quiet, often tragic world (2)  Wake up call for Baby Boomers! Time is urgent!  Happy Easter!  In Response to "Baby Boomers Not Saving Enough"Copyright © The Elder Boom Foundation [Writing "Behind the Old Face" ], All Right Reserved. 2013.