Blond is the new blue.

or,

"He disagreed with something that ate him."

Can anybody guess where this is going yet? It's just a bit of social commentary for today: slightly over fifty years ago, Ian Flemming had his secret agent James Bond posit that Florida was full of older women with blue hair. That's the way it was in the 50s and 60s (and maybe the 40s and 30s, too: I don't know back that far). The point was that there was some kind of artificiality about the Floridian lifestyle, the blue hair being the symbol of it all. Flemming had a way of working that kind of social commentary into his work: in the same work, Live and let die, M states that "the negro races are just beginning to throw up geniuses in all the professions — scientists, doctors, writers ... They've got plenty of brains and ability and guts." Quite a daring statement in 1954.

So where did the blue-haired ladies go? They became blonds! My grandmother did the blue-hair thing back in the 50s and 60s (and 70s). My mother was a blond. In fact, I've started noticing that many women in their, shall we say, gray-hair years are not, gray, not blue, but blond (or brunette or, well you get the point).

This is empowerment. We don't see age as a type of branding: it's the true empowerment of "you're only as old as you feel." A woman's "life" does not end just because her hair turns gray, just because she reaches a certain age. That works for men, too. (Of course, its sad that a person would be judged by the color of their hair to begin with, but that's an entire other train of thought.)

So aging has a whole other dimension now. We age "young" and we look "young" as we age. We carry that with us now into a different type of aging. The older adult of the first decades of the 21st Century will be a completely character from the older adult of the mid-20th Century. Living longer, healthier lives, we will look the part. HOw about that, Ian Flemming?

So angry my Hair Hurts!

That's how I get sometimes. Tonight it was watching We were soldiers once. That's the movie based on the book We were soldiers once, and young, about November of 1965 and the battle of Ie Drang in the Central Highlands of South Vietnam. It's not that that battle upsets me, but the entire idea of 58,000, mostly young, U.S. service men and women, and the Lord only knows how many Vietnamese, both north and south, killed is horrifying. And why was it? Because Lyndon Johnson was afraid of being labeled the President who lost Vietnam to the Communists? I believe that the late 1960s was the time of the height of U.S. power and prestige, that it all started to drift away along with the end of the Johnson administration, along with the Great Society, and that it's never come back since then. Nixon was too busy establishing the new conservative majority, based on his southern strategy of division and racism; Ford was too busy putting Nixon behind him; Carter was too caught-up in his own national malaise; Reagan was too busy solidifying the Nixon strategy of division and wedge-issues; and so it's gone. For U.S. global power, for the U.S. military, for international prestige it was never what it was in the early second half of the 1960s. I'm not saying this is a good or a bad thing, although global strength at the cost of 58,000 lives in a senseless war is not something for which I would argue in favor.

Which brings us to another point. We are faced today with one legacy of Vietnam: survival rates for battle-field casualties are higher. Body armor now protects a soldiers body, and evacuation to first-class medical treatment quickly happens.

This is at the expense of crippling injuries, injuries that the Department of Veterans Affairs, ex- the "VA," seems ill-equipped to handle and that will be a legacy of this war for years, for decades to come. TBI, traumatic brain injury, seems to be at the top of the list of unintended consequences. Way too much head rattling around, too little post-rattling care, what with roadside bombs and other such hazards. How do we plan on caring for these scarred soldiers? It does not seem like there is a plan yet. Of all the lessons learned on the battlefields of Southeast Asia, we still don't do well on the home front.

Odd how Vietnam, for so many reasons, still casts it's long shadow.

Healthcare not Welfare!

Catchy slogan, huh? That's because I stole it, sort of, from a local political campaign, "Healthcare not Warfare." A good lefty sentiment, but not on point for me, at the moment (anyway, it's a primary, and I'm not registered in either of the tweedle-dee/tweedle-dum parties). No, I'm still thinking about why it's so easy to cut benefits programs. Right, it's because there's always a (more expensive) entitlement program to catch people who can't get the benefit: like EISEP and Medicaid.

So the point is, let's get healthcare on track now, and not let the welfare system catch the people who fall through the cracks of our less-than-optimum healthcare system.

Doesn't it make more sense to manage ahead of time and avoid the crisis response system when healthcare as usual fails to provide? That's why we need healthcare, not welfare.

I'm Back

In more ways than one. First, my departure from the world of disability is proceeding apace, although there were some bumps in that road. Second, I have been able to do some travel, in particular a visit to Washington, D.C., to attend a conference sponsored by the Centers for Disease Control. But now I've decided to start writing again, and the first thing that needs addressing is the needs of the disabled population, older or otherwise.

Yes, we all know that New York State is in a budget crisis. Yes, it is expensive to provide the safety net that is mandated in the New York State constitution:


The aid, care and support of the needy are public concerns and shall be provided by the state and by such of its subdivisions, and in such manner and by such means, as the legislature may from time to time determine.


There are a number of programs that seek to address that mandate. Medicaid, the joint Federal/State program, is one way to secure support for the needy. Medicaid, however, cannot be the only means. First, to this observer, it seems to be a reimbursement-driven program, not a needs-driven program. Second, it requires virtual impoverishment, not necessarily a good criteria of need. Finally, there are less expensive options. But Medicaid is a de-facto mandate that does not require a lot of thought to fund: it is there by fiat, so the tough decisions are removed.

Could it be that the legislature, as cited in the constitution, does not take the other options seriously, or that it lacks the political will to vote more expenditures (headline: "Legislature increase spending in some-such program"). Is it just easier to "cut" spending on non-mandated programs but in the end spend more on the mandated ones?

What about EISEP, the Expanded In-Home Services for the Elderly Program? EISEP has a long history of leveraging a wide range of supports, both formal (i.e., funded services) and informal (i.e., non-funded support from friends, relatives, or neighbors). The result is less "formal" costs for the same services, and those formal costs are the ones paid from the State's budget. I would argue that upping the budget for EISEP would -- in the end -- reduce State spending, but that would require somebody to stick their neck out and ask for increases when, in today's political climate, that may not be the politically correct thing to do. So soak the taxpayer again, but let them think it's a good deal!

Why Institutions?

They have been a couple of interesting happenings since I lasted posted here. The most important, I believe, is the recent news that Albany's ubiquitous care provider, The Eddy, is developing new types of housing. The Eddy has always been ready to innovate, to try new things, so it's not surprising to see The Eddy working on new plans for residences. But there is still something that, in the words of Peter Griffen (of "Family Guy"), really "grinds my gears." It's this nagging feeling that people's life trajectories are on the wrong track. No matter how nice the residence may be, why do so many people wind-up in institutions?

A colleague of mine, Constance Laymon of Consumer Directed Choices, has been known to point out that persons wind up in institution even though they have been convicted on no crime. Why do people find themselves in these total institutions? Isn't there something wrong about that? Yes, I want all nursing homes swept away with a sweep of my arm. No, i don't believe that an person should be in those environments.

So what's my alternative? I don't really have a good one, but revamping the concept of the nursing home is essential to human dignity. First of all, though, the structure of the total institution has to be eliminated. (Just to clarify, institutions are a special category of group quarters: prisons and nursing homes are good examples, secure facilities where the resident does not have authority or ability to freely travel.) It's hard to maintain one's sense of self, of individuality, let alone self-respect, when living in an institution. That's no way for people to live in the twilight of their lives, and it's no way for the younger to have to spend their entire lives. This is essential: the sense of self, of intellectual integrity and independence, must be maintained, and any environment that structurally stifles those things is unacceptable.

Bravo to The Eddy for trying new tacks in long-term care, but there's still a long way to go.

Things are getting smaller.

Things are getting smaller: did I say that already? Well, it bears repeating. After four weeks of not moving around a whole lot, I'm starting to move around again, and with that, the world starts to shrink. On Monday morning the 21st, the morning after my accident, the world was about the size of my bedroom. It took a couple of weeks before I could move about with some ease, but as I started to move about easier, as the leg pounded less as I tried to swing it over the side of the bed, suddenly the distance down the hall seemed to shrink to a manageable way to travel. The whole world seems like that.

If you happen to be unable to get around, the world seems like a really big place. I still don't walk all that far without tiring, so the distance from the parking garage at work to my office is about all the walking I can do; in fact, the walk back seemed downright un-doable the the other day. If I have to, I can walk down to the end of my block to get the bus, which saves me the need to step on the clutch of my Subaru; what happens if there isn't a bus stop at the end of the block? What if I had to walk two blocks, or ten? And then if that walk can not happen, the world is an infinitely bit place -- make that, Albany is an infinitely big place. You can't get there from here.

In the City, bus options are pretty good, at least where I am. To my south, in Delmar, it's going to be a bit further to the bus stop. What happens to folks who "age in"? What happens when people don't have the ability to walk as far, or to drive, and their options to travel are taken out of their own hands? My mother, on Long Island, would say that the worst thing that ever happened to her was not being able to drive (I pointed out that living in a country that had gone to war four times, World War II, the Korean War, the Vietnam War, and the Iraq war -- Kuwait hardly counted -- was a significant social upheaval, but she missed that point: I don't think she would be alone). It is scary how we don't have a way to, how shall we put it, degrade gracefully (that's a communications term I picked-up years ago about how communications systems should be designed as they go through the EMP, electro-eagnetic pulse, associate with a nuclear detonation).

The point should be taken, that people are going to become increasingly limited in their transportation options as they age, and if they wish to age in place, to stay in their homes, to be able to get around, they are going to need some transportation infrastructure when their own means fail. Of course, they could be like me and get a disability of sorts earlier on. But then, my disability is of the passing nature.

So for me, right now, things are getting smaller. That may well be only a temporary experience.

Elder Abuse?

Is elder abuse an issue here in the Capital Area? The Eddy, the regions ubiquitous provider of human services, was the subject of an article in yesterday's Times Union. According to the TU, "The Eddy will offer a 24-hour hot line, counseling, emergency housing with nursing care if necessary and, in partnership with Albany Law School, legal advice." If this is a needed service, then this is a sick society: according to the article, "According to the National Center on Elder Abuse, there are between 820,000 and 1.8 million seniors abused each year in the U.S."

But we've really known for a long time about elder abuse. Years ago - - I haven't followed this lately, maybe still - - it was headlined in the newspapers as "granny bashing": grandmothers getting beaten for the social security checks and the like. And it's an international issue, as noted previously. So why, on top of everything else that the elderly have to deal with, are they also the subjects of abuse?

Nothing is really new, is it? The elderly are the weak. The weak are the victims. But isn't it more than just wanting to steal somebody's social security check (or life's savings)? People in nursing homes have been abused by staff: what a paradox, the caregiver, the professional caregiver, becoming the abuser. There are some philosophies (Marxism may be one) that argue that social inequality is the root of all evil; that's certainly a nicer scenario than one that people are just evil. But let's not toss Marxism away too easily. By denying people the ability to meet their basic needs, to force people to live on the margins of society, what do we expect to have happen? By creating poverty, by maintaining poverty, we ourselves lose the moral high ground: so who really is evil?