I've had a nagging physical problem for several months. Testing and treatments have included x-rays, imaging, physical therapy and lots of pain killers, both OTC and prescribed. Beyond that, I have experienced acupuncture, massage and something resembling a Native American Healing.
Progress has been made but 6 months in, this ailment still affects me every dag-goned day.
I had a thought recently (surprise). If I was my client, how would I provide advocacy?
As a result, I have become more active in my own care. Conversationally and through research, a possible link to a cholesterol controlling substance was revealed. The FDA has issued warnings that several statin drugs may have physical and cognitive side effects not previously disclosed.
I've gone cold turkey on the drug and hope to see results in a few weeks. Stay tuned campers, there will be an update.
Many years ago, at a critical point in my professional career, I became a wine guy. I've worked for the little guys, the big guys and the wineries that require bicycle riding to keep up.
The 20+ years of grape growing, jobs in winery production and most recently, in the tasting room have had a tremendous impact on how I view the world:
And at the end of the many days, to remember our special people with a really good glass of wine!
Every Wednesday at noon, music happens at the Wellness and Advocacy Center off of Chanate Road in Santa Rosa. It's a synergistic blend of community, medical/psychological staff and users of the day programs at the center.
The music is way beyond good. A foundation of excellent keyboard, guitar and harmonica are spiced with saxophone, misc percussion and voices.
All comers are welcome to bang on the bongo's, shake a tambourine, sing or bring their own. Everyone that's game gets to solo, the mikes are generously shared.
The sound system is haphazard but can't restrain the seamless shift from blues to rock to rap to country. It's loud and energetic. It's a drug without a prescription. It's amazing!
In my own daily struggles to keep organized and prioritized, the value of good record keeping has really become a passion.
The lesson learned? Put it in a box!
When I first started working with Madeline, she was very proud of her own record keeping. She had been a bookkeeper and claimed to be obsessed with her organization. She was almost insulted by my attempts to inventory her assets.
When she passed and I was able to really dig through the cabinets and files, much was discovered:
2 life insurance policies that were not entioned during client intake or at any other time.
An annuity also not mentioned.
An entire set of estate planning documents that had been replaced by a set of trust-mill documents.
We endure the pain, expense and inconvenience of estate planning to ease the way for those we leave behind. If we truly care for those individuals, we owe them the probability of getting through that difficult post-death transition as smoothly as possible.
For myself, I fully intend to do better. Steps include the purchase of one of those fire & water proof file boxes. That box will contain:
Yes. Yes. Yes.
America's favorite pastime has become speculation about this subject. Wish I had some special insight.
What I am convince of is the need for change. A story:
A client of mine named Ronald was rushed to one of our local hospitals with a severe bladder infection. Spent the night in ER and was transferred into ICU early the following morning where he had a heart event.
Kept in touch with the nursing staff, msw's and discharge planners throughout to make sure that I'd be ready for his discharge.
During his first day out of ICU, I get an urgent call saying that Ronald was being sent home within the hour. A hospital bed and wheelchair had been delivered. By the way, make sure that 24 hour in-home care is in place.
Drove (rapidly) to the hospital to find my client still in isolation, still considered septic. But Medicare was no longer paying for his stay.
Good news for Ronald, the presence of a loud advocate kept him in the care of the hospital until he could be moved to a rehab facility 4 days later. Medicare pays for rehab.
Our current healthcare system, if it is a system at all, has lost the will to care for patients. It has became a system of lists, checkoffs and tight dollars (and many, many layers of paperwork).
Healthcare reform holds promise because it will reward primary care physicians, reward institutions that provide quality care and because it imprints the medical arena with a goal, a philosophy. It hopes to provide payment for the healing process rather than a series of steps and procedures. It hopes to not send Ronald or Joyce or Amalia home too soon, where inadequate care and oversight condemn them to either a rapid return to the hospital or death.
Now that I've tackled faith, this might be an excellent time to get into my family heritage.
The Hughes part of my heritage emigrated from Northern Wales. My Grandfather Evan was the first generation of our direct line born in the U.S.
I had the wonderful fortune as a young man to spend two weeks hitch-hiking through Wales that culminated in spending the night in the local B & B in Llanarmon Dyffryn Ceiriog. My ride into town was the town butcher, Davey Jones (meat lockers). I spent a wonderful afternoon in the town pub, joining locals in watching the England vs Australia Cricket Test whilst quaffing halves of Brains Ale and savoring their famous scampi and chips. The local play by play jumped from English to Welsh frequently, sometimes mid-sentence. I still don't understand cricket.
The graveyard was crowded with memorials of Hughes' long gone and I glimpsed the old family homestead on the bus ride out of town.
Northern Wales remains rural and beautiful. Snow fed streams bisect heather covered hills dotted with rock outcroppings and sheep. Farmers in their wool caps ferry their animals to the livestock auction in Newtown where the cadence of the auctioneer's voice culminates in the slap of his crop on his clipboard. Shop keepers display their names above their doors; Jones, Morgan and Hughes predominate. The world economy was evident in citrus fruit from South Africa and lamb from New Zealand.
Celtic Knots have an ancient history that has much to do with an acknowledgment that there is an inter-connectedness in our lives. The Welsh seem particularly fond of using them in carvings. Welsh love spoons are worthy of a separate exploration at some other time.
I have recently adopted a Celtic knot theme on this site and in my other publications as a reminder to myself that common ground is not that hard to find, that we are connected in many ways. The balance of my Scotch-Irish-German-English Heritage virtually guarantees it.
My wife and I lend our voices to the contemporary music group at our church. We are currently attempting to master a song that is particularly challenging and very beautiful.
On a daily basis, fiduciaries work with clients and their families struggling with loss, dysfunction and death. Very early this morning the words and melody of our new song brought me fully awake and compelled me to write down these thoughts.
"Miracles just happen," announced not by heavenly trumpets but are small events realized in the moment as inspiration and answers to the questions you haven't yet articulated. Consider the times in your life when many things come together for absolutely no reason.
As I drive from appointment to appointment my "silent prayers get answers" readying me for the next challenge. I met just yesterday with the discharge planning nurses and a placement specialist at a local hospital. We quickly developed an appropriate solution to a challenging medical diagnosis and economic reality.
My faith is a choice, it's the comfortable old sweater that warms me when the chill of frustration and despair descends. It reminds me that judgment is not mine and is "the hope that doesn't ever end."
I don't often talk of faith and frequently fail to fully live it. Yesterday and today the words of a song brought me back to it.
One of my clients, partially as a result of his dementia, wasn't real good about filing his taxes for a few years.
We I arrived on the scene, 6 of the previous 7 years had passed without the more than symbolic flashing of the 1040.
I have spent many hours negotiating with the IRS and filing back returns. All of this activity resulted in a payment plan that really is doable within the client's limited budget. And along the way I discovered some extremely helpful IRS Folk (Heather Poppleton, I love you!).
Did you know that the IRS considers each year's return as a separate and unique thing? I mention this because the first time that I thought I had negotiated a deal, turns out it was for just 2 of the six years in question. And every time something goes wrong I get 12 letters! Six by regular mail and six certified. The workers at our local small town post office must think that I am the biggest tax loser in town.
I've been making the regular payments through the online system and guess what, 12 more letters in today's mail! Turns out I didn't apply them to the earliest delinquent return.
Again rescued by another extremely patient IRS dude. We are back on track.
Moral of the story: you can mess wit' some of the gov'mint some of the time but you can't never mess wit' the IRS!
Trying to make a small business succeed requires some effort at marketing. In any business the first step is to identify your target audience.
In this business, the continuing challenge is trying to skillfully direct our message to:
1. the elderly
2. the children of the elderly confronted with the task of helping with the continuing care of their parents
3. the referral network of allied professionals that help us identify those that require our services
4. others, including the disabled, who might need assistance with tasks not related directly to a legal instrument
The challenge then becomes how, with limited time and resources, how to reach them all.
My approach has become making sure that all of the materials that I create and use are senior friendly. That they are respectful of the receivers using concise content that gets my messaged delivered with economy. That my outreaches have broad aspect balanced with focus on key elements.
And, if I really do a good job, make available a sense of who this trustee guy is.
Look at me!
In trying to maintain balance in my life, I give of my time to a local non-profit organization that provides housing for senior citizens. My reward is that I gain experience that helps me in my fiduciary role. In turn, my fiduciary expertise adds to our management conversation.
Recently, a local health professional (in the spirit of advocacy) has taken up the cause for some of our clients that have some complaints about the way our organization is run. As a member of the board it is easy to take offense at an outsider confronting us with accusations and some board members have struggled with this situation.
I am pleased to report that others have responded differently and a new determination to make improvements has emerged. Let us be reminded that a knife is sharpened by contact with a stone. Toss a few rocks in our direction and watch us work, as would skilled surgeons, to bring healing to our community.
Don the Trustee
When my mother passed very suddenly some 16 years ago, I worked as a trustee for the first time. Her trust contained walnut orchards, peach orchards and a small vineyard. One of the properties was within the sphere of influence of the adjacent city and I dove in with the neighbors and started working on annexation. Loved this work back then and still find it very satisfying today.