Is it a breach of trust for a physician to market a Medicare Advantage plan?

Posted in Caregiving, Personal on December 2nd, 2009 by Jim Hughes – 2 Comments


My 85-year old dad called this afternoon and read me a letter from his primary care physician.

In essence the letter said that the physician was now associated with a certain Medicare Advantage plan, and that his office would be happy to explain the advantages of this particular plan and answer any questions.  It also presented some of the benefits of the plan, along with other marketing information.

Since it came from his doctor, Dad was wondering if he needed to investigate making a change from his current plan. After all, the doctor was recommending it.

We talked, and agreed that he should stay with the plan he currently has.

To me, this feels like a breach of trust between a physician and his patients. The physician obviously has a financial interest in the plan or he would not be spending money to market it.

What do you think?

Not All Geriatric Caregiving is For People — Sometimes It’s For a Dog

Posted in Caregiving, Personal on July 27th, 2009 by Jim Hughes – 1 Comment

Sometimes, in the midst of providing caregiving for family members, we also end up caring for a geriatric dog.

That’s going on at our house.  Jenny Dog is a mixed breed who is 14 1/2 years old.  That’s geriatric for a dog, no matter what you use as a multiplier to get equivalent human years.  Based on her size, she’s probably somewhere between 90 and 100 in human years.

She’s slowed down a lot, just like people do as they get older.  She sleeps a lot, and is not as interested in exerting a lot of energy unless it is to get a special treat.  She’ll lobby me mercilessly in the evenings for a treat, and I really believe it’s her main entertainment in life.  And any time we come back in from being away, she’ll check to see if we brought in a sack that might contain a morsel of food.  And if we’ve been around other dogs, we get a special check.

She likes to follow me around, knows my habits well, and even tries to anticipate where I’m heading.  She no longer follows me around as I mow, however, and really had rather be inside in the air conditioned space than to even hang out on the porch.

She’s had a couple of major medical issues in her life.  She had heart worms as a pup, but weathered the treatment well.  The major issue has been an intestinal problem where her intestines were swollen and not functioning properly due to food allergies. It was resulting in liver and kidney disfunction as well, but fortunately a good vet figured out what was going on.  Unfortunately for Jenny Dog, it means eating a special vet diet which she doesn’t think is very appetizing.  She’ll do her best to beg, steal, or borrow some human food that tastes better.

During the last week or so, she’s been having some trouble getting her back end up when she’s ready to get out of a chair.  She can still bounce up into the chairs with no problem, it’s just getting back out of them that sometimes gives her a problem.  Just another sign of her aging.  She also has problems sometimes with the tile floor, which is also a common issue with older dogs.  It means that sometimes I have to help her.

And like all of us who are aging, her hearing and sight are suffering too.

It’s become painfully obvious to us that her time is limited.  It’s also a constant reminder that we’re aging, and can’t do some of the things we used to do effortlessly.

And taking care of an aging dog is just another part of this journey.

Perspective Is a Big Deal When Dealing With Fear

Posted in cancer, Caregiving, Illness, Self Care on July 20th, 2009 by Jim Hughes – 2 Comments

Perspective is a big deal, no matter what we’re dealing with in our lives.

Tweet About WSJ Article

Tweet About WSJ Article

For example, we can have cancer, and our perspective may be, “I’m dying of cancer.”

Or, we can choose to have a different perspective:  “I’m living with cancer until I pass.”

This example is from an article in today’s Wall Street Journal discussing a program for helping cancer patients deal with their illness.  While it’s dealing with cancer patients being able to find meaning for their lives in the face of their illness, it has a lot of value for those of us facing other challenges.  I highly recommend that you read it.

With cancer, nearly everyone’s biggest fear is dying.  But it’s usually unspoken, unsurfaced even.  Once it’s surfaced, the fear can be dealt with.  One can choose to adopt a perspective that gives life meaning and purpose, that takes control away from the fear.

But this principle is much more widely applicable.

Any chronic illness — heart disease, diabetes, arthritis, and any of so many others — generates fears.  What if I have another heart attack?  What if I have to live in a wheel chair?  What if I …?

Your fear may not be from a medical condition, but from a situational condition.  What if I lose my lose the ability to live at the standard of living I’ve become used to?  What if I lose my job?  What if I …?

So what fears are you, or those you love, living with that haven’t been dealt with?

How could you, or could they, benefit from a change of perspective?

Worth some thought!

What Are You Communicating About Yourself and People You Encounter?

Posted in Caregiving, Chaplaincy and Pastoral Care, Personal on July 16th, 2009 by Jim Hughes – 3 Comments

We communicate to every person we pass in the hall, encounter in a restaurant or store, or share space with wherever.

We either communicate to each person that they have value, or we communicate to them that they don’t have value to us.

If we make eye contact and smile, we communicate in a very strong way that we have recognized their presence, and that we are pleased to share space with them, if even for a moment.

If we avoid eye contact and a smile or nod, then we likewise communicate in a very strong way.  Except this time the message that person receives is, “I don’t recognize your presence, or if I do, I don’t think you’re worthy of my even brief attention.”

There is no neutral.

I was reminded of this truth again yesterday in a series of Twitter posts by Kay Swain (@sandwichINK).  Kay was writing about some time she spent in a wheel chair, and how people would avoid eye contact and act if she wasn’t even present.  Since Kay writes about caregiving, she was applying the importance of being aware for when those we care for end up in wheelchairs.  Kay’s working hard on making eye contact and smiling now.  She learned the lesson first hand.  Thanks for the reminder, Kay!

Then this morning, my friend David Martin, a chaplain in the Fort Worth area for Lifeline Chaplaincy, wrote an article on the same subject in the Lifeline Chaplaincy blog.  David titled the post, Too Easy to Dismiss.  He also talked about people in wheel chairs, but broadened it to anyone who is “different.”  (It’s perfectly fine with me if you click on David’s link and read it before you finish my post.)

This is one of those subjects it would be easy to rant about.  But I won’t, in part because it’s something I have to continually work on.  So rather than preaching, I’ll settle for asking a couple of questions of myself and you as well.

  1. What do we communicate about ourselves when we fail to notice, make eye contact with, and give a smile or nod to everyone we share space with, even briefly?
  2. What do we communicate about those people to those people we fail to acknowledge?
  3. Do we really want to be that kind of person?

I’m sitting at Panera Bread as I write this.  A young lady in the next booth is also writing, and as she got up and went to refresh her drink, we made eye contact and both smiled.  It wasn’t hard, it only took a second, and it felt good.

Won’t you join me in working on this?

Intergenerational Activities Give Seniors a Boost

Posted in Caregiving, Personal on July 6th, 2009 by Jim Hughes – Comments Off

You’ll only have to look at the photos of my mother-in-law and my dad to see that interacting with their grandkids and great grandchildren gives them a boost!

Reba, Sara, and Ben making apricot turnovers

Reba, Sara, and Ben making apricot turnovers

Reba, my mother-in-law, was able to come spend several days with us recently, and we made sure to build in some time with her great grandchildren, as well as activities with her grandchildren.

One activity our daughter Sara planned with her was learning how to make apricot pies — a treat that’s become a trademark for Reba.  Turned out that Ben wanted in on the activity too.

So for about an hour, Reba gave step by step instructions and some of her tricks learned through experience to Sara.  It was meaningful for both.

And of course the rest of us enjoyed the fruit of that interaction!


Dad showing off his patriotic hat

This past weekend, Dad came over to celebrate the Fourth of July along with Sara and Mark and Kathy and his great grandchildren.

He loves to interact with children by trying to entertain them.

Looking at these photos and reflecting on how much both enjoyed these times reinforces for me the importance of planning intergenerational activities for them.  Not only is it good for them, it’s great for the younger generations.

Things happen in intergenerational settings that simply don’t in more homogeneous age gatherings.  Seniors become childlike.  Children become more adult-like.  Seniors gain appreciation and respect for the younger generations.  Those from the younger generations gain respect and appreciation for the Seniors.

So, when’s the last time you arranged some intergenerational activities for the senior adults in your life?  Why not join me in resolving to do it more?