body, happiness, health, leisure, mind, retirement, security, soul

Age Well San Diego

Yesterday San Diego’s Health and Human Services Agency, in partnership with Sharp Healthcare, AARP California, The San Diego Foundation, ABC Channel 10, and Kaiser Permanente Senior Advantage, held its 11th Aging Summit. It’s the first I had heard of and the first I attended. The woman sitting next to me said she had attended the previous one, two years ago, where the audience was so small they could be seated around a few tables in front of the stage. This year more than 2,000 people registered to attend the event in San Diego with another 500 people connected via webcast in a North County location.

I attended for two reasons: my recent injuries result from reduced bone density, a consequence of aging; and my book club’s decision to discuss Atul Gawande’s book, Being Mortal, which deals with issues of aging and what constitutes living well at the end of life at our next meeting in a week.

I can’t think of a better way to describe my reaction to the event’s program and workshops than to fall back on a boomer phrase: it blew my mind.

I had no idea San Diego was so committed to dealing with the inevitable increase in the number of people over the age of 65 in the future. San Diego not only has one of the best climates for people of all ages, it is clearly one of the most progressive places for a retiring population to live out final years.

The speakers threw out a number of facts, including the following:

  • In 1900, the average life expectancy in the United States was 47. In 2000 it was 78. A recent cover of Time magazine showed the picture of an infant with the heading, “The first child to live to 142 years of age has already been born.”
  • One speaker mentioned experiencing a serious infection and blood poisoning when she was a child and the complicated birth of one of her children. She pointed out that had those things happened just ten years earlier than she experienced them, they may have led to death.
  • Today in San Diego 21,000 grandparents live with and provide substantial support for their grandchildren while the parents remain absent.
  • For every case of elder fraud abuse we know of, there are likely another 23 cases we will not hear about because the victim is too embarrassed to tell anyone.
  • Right now 65,000 people living in America are over 100 years old. That’s four times as many people as there were in 1990. The number is expected to increase eight-fold by 2050.

The event launched the Age Well San Diego Action Plan, which focuses on five areas of concern for an aging population: Health & Community Support, Housing, Social Participation, Transportation, and Dementia Friendliness.

That last one, ensuring San Diego provides a dementia-friendly environment for the increasing number of people over the age of 65, provides a good starting point for describing the current situation in San Diego–and probably in most other urban centers.

Nick Macchione, Director of the San Diego Health and Human Services Agency which runs Live Well San Diego, reported that in 2014, the number of people in San Diego with Alzheimer’s was 85,000. He also cited an easy-to-remember shortcut regarding Alzheimer’s: 5-5-35. Those numbers translate as 5 behaviors lead to 5 health consequences which 35% of dementia patients exhibit. Studies that report on these behaviors and consequences have concluded this means that about one third of patients with Alzheimer’s could have avoided it by making different lifestyle choices.  I couldn’t write fast enough to record which studies Nick mentioned, but I found this report that corresponds closely with his points.

The five behaviors: unhealthy diet, smoking, physical inactivity, drinking alcohol, and having no friends.

The five consequences: hypertension, cardiovascular disease, cancer, type II diabetes, and depression.

The data behind these numbers explain why social participation is one of the themes of Live Well San Diego. In addition, each of the four other themes in the Age Well San Diego Action Plan include elements to address dementia.

This is the third year of the five-year Age Well San Diego program. The first two years were spent in researching and listening to the community in order to ensure the Action Plan addresses the right issues. That leaves three years for the community to work together to take the steps in the plan, which will lead to data collection so the successes can be replicated and expanded upon.

I knew San Diego is a great place to live when we moved here. But it’s an expensive place to live. And the Age Well San Diego Action Plan addresses the financial pressures on all San Diegans, including those over 65, so that the gift medicine has given us to live at least 30 years longer than our grandparents expected to live is seen as an opportunity, not a burden. San Diego is truly a wonderful place to live.

Note: The Poway Unified School District Transition Program; San Diego-Imperial Chapter, Boy Scouts of America; and San Diego Police Department Volunteer Traffic Patrol also provided assistance during the event.

 

Advertisements
body, happiness, health, leisure

The Better Way to Travel for My Demographic

The doctor who diagnosed my stress fractures used a phrase that chilled my heart: “in your demographic.” The meaning was clear. I could no longer expect things to be as they were 10, 20, or 30 years ago. My husband pointed out that I need to write down what I learned from the trip because, given my demographic, I might not remember everything when I next decide to travel.

I made some good decisions before my sister and I left for Norway. But since most of my working life was spent moving from country to country every one to three years, and lots of traveling while serving at overseas posts, I thought I knew enough about preparing to travel. I was wrong. What worked during my working years wasn’t always the best option now.

Well Done!

First, the things I did right.

I knew I didn’t want to waste any time in the morning with my hair. So I took the same step as I did before embarking on my year of roving in Africa: I had my hair cut short.

Before the cut

After the cut

I loved the style before the cut, but I knew it would take at least 30 minutes every morning to get it looking right. It worked while I was in Africa. While my hair may be a bit thinner than it was then, I was confident having short hair would mean I could shower, comb my hair, and let it air dry. Total time required after the shower–about 1 minute. This was one change that being in a new demographic really played no role. I know my hair will grow back so I can have that style back.

I also had a manicure and pedicure to have my fingernails and toenails cut as short as reasonable. I wanted to sure I wouldn’t be tempted to take clippers to my toenails and risk cutting into the skin or leaving jagged edges because it’s getting difficult to bend my knees and twist my leg enough to cut the nails straight. The polish also helped prevent nail breaks, at least for the first week.

In addition to packing all my prescription medicines and recommended supplements, I brought small amount of all the medications I might need. More on that later.

woman walking in walking shoesI walked every day in advance of the trip, wearing the shoes I expected to wear to get used to them. I bought a new pair of fitness shoes which had amazing reversible insoles with bubbles on one side that would give me a foot massage while I walked. I worried that too much walking would aggravate the arthritis in my hip which I had been working on improving for the previous six months after a flareup that nearly ruined a trip my husband and I took to England the previous fall. All right, I know, that should have been enough of a warning.

I picked up a purse that had RFI shielding to protect credit card information from being stolen. The purse was also smaller than what I had been using as a “purse” for traveling on planes. That improved moving through airports, though the extra weight I used to put into my purse was now in my carryon bag.

At the last minute I made a decision to bring a camera as a backup for my phone. I didn’t think I’d need it, especially since it meant carrying one more item in my purse. But each day either my phone or camera battery ran out, making it essential to have a backup.

Needs Improvement

Now the things I didn’t do so well. In these instances, my sister showed me how I could have done it.

I brought a large suitcase, but I didn’t fill it because I looked forward to picking up items in Norway. My sister brought a smaller suitcase which opened in the middle, allowing her to separate the items and cover half of them to hold them in place

My suitcase where everything shifted every time I lifted it

My sister’s suitcase where everything was kept securely in place with a minimum of shifting of contents

Now I don’t blame my sister for giving me the things that didn’t fit in her suitcase. After all, mine had room. If I hadn’t brought such a large suitcase, we would have had to find another way to get the items home.

That brings me to the second suitcase lesson. More significant than the size of the suitcases were the number and position of the wheels on them. Mine had only two wheels so that I had to pull the weight of the case whenever we moved. Even my carryon case had only two wheels. My sister’s had four wheels so that she could roll it across the floor.

Bad suitcase

Good suitcase

I did bring two pairs of reasonable shoes for all the walking we did. But I also brought two pairs of not so reasonable shoes. One pair had no support in it, but it looks nice. The other had heels. I tried putting the latter on to go to breakfast one morning and I couldn’t even get out of the room before I realized they wouldn’t work. And I relied on the former when my heel began to hurt because the two pairs of good shoes hit just the point on my heel that hurt. Even worse, I left behind a third pair of shoes that would have been excellent for the walking. Because they were old and didn’t look pretty.

My sister also brought both a camera and her smart phone. Like me, she experienced the battery for one or the other running out. But her camera had a feature mine doesn’t–she could wirelessly download the photos she took with her camera to her tablet so she could share those while we were on the road. I could share photos I took with my phone, but those camera shots had to wait until I returned home for downloading.

I brought over-the-counter medication I thought I might need, but I overlooked the most likely problem–catching a cold. And yes, of course I caught a cold. Fortunately, my sister had brought a small first-aid kit that included both daytime and nighttime remedies for the symptoms of a cold. It got me through the remainder of the trip, though I did have to buy tissues in large quantities in Trondheim.

What have I done as a result of the lessons I learned?

  • We now have spinner suitcases with four wheels and hard sides, three sizes: carryon, medium, and large.
  • The doctor who diagnosed my stress fractures recommended a store that specializes in providing good quality shoes. It was the same store I bought one of the pairs I brought with me. I now have a second pair which do not twist at all. I bought them for their support, not for their appearance. I plan to remove shoes that do not provide my feet with enough support from my closet and go back to the same store, not DSW, when I need a new pair of shoes.

The rest are just plans–plans to replenish a first aid kit with more remedies for common maladies, plans to include spare batteries for my camera, plans to buy a new camera with wireless downloading possibilities.

But first, my heels need to heal. And I’m glad to say that my hip didn’t bother me at all.

Have you had to make changes in your routine due to age? What has been the most difficult?

 

Image credits:
Featured Image: Tommaso Pecchioli
Manicured nails: Sarah Cervantes
Shoes: Grant Ritchie

two women having wine at a table outside a restaurant
body, health, the alternative

Getting to Know You

I’ve lived with my body for almost 70 years, but recent events have made me feel I’m getting to know myself all over again. Let me explain.

Gokstad Viking ship in the Viking Ship Museum in Oslo, Norway

In May I traveled with my sister to Norway for ten days. It was my first trip there and my sister’s second. We didn’t want to be part of a large tourist group, so we used a company to plan an entirely customized tour just for the two of us. We didn’t travel to the typical sites–fjords along the west coast. My sister had already seen those sights. Instead we traveled to parts of Norway that we know our ancestors came from, inland areas.

It was an absolutely wonderful trip.

We walked all over Oslo, Lillehammer, Røros, and Trondheim. Well, we walked less around Trondheim because my right heel hurt from all the walking we had done before. My self-diagnosis was tendonitis. I ruled out all the other possible causes for heel pain because I thought I knew what was involved in each of them. I wrapped my foot in ice packs, took anti-inflammatory drugs, and elevated my foot whenever we were in our hotel room. By morning my foot felt fine. I thought my heel just needed time to get better.

But I was wrong. By the time I returned home and saw a doctor, both heels hurt. The diagnosis was stress fractures in both my heels. For at least six weeks, I must cut back my activities, stay off my feet while they heal, and rely on a wheelchair when I must get around.

That’s when I was introduced to my new body. The almost 70-year-old one that I had been ignoring. The one where lowered calcium levels in my bones puts me at greater risk of more fractures. One where reduced muscle tone from decreased activity level, along with the number of prescription drugs I take, puts me at greater risk of falls–and broken bones.

The doctor who diagnosed the stress fractures introduced me to my new body. But the real learning came from a book for my book club: Being Mortal by Atul Gawande. In his book, Gawande points out that the changes I am just beginning to see are part of the normal process of living when life expectancy extends beyond what we now call middle-aged. It wasn’t all that long ago that 40 or 50 years was all most people got to live. At some point, later for the lucky ones, something struck individuals that caused a rapid decline and death. People lived–until they died.

But medicine has changed so much that we have treatments for those “somethings.” Now, treatments allow people to recover from any number of accidents, conditions, and illnesses that previously were fatal. And that means the lucky ones live longer but have to deal with the conditions and illnesses–and their consequences.

We live long enough for our bones to lose the calcium needed to keep them strong. The enamel of our teeth, made of the hardest substance in the body, wears away. Our blood vessels, joints, the muscles and valves of our hearts, and our lungs absorb the calcium our bones stop accepting, causing stiffness. And because the vessels the blood flows through are among those that become hardened, lined with mineral deposits, the heart must work harder to move the blood throughout the body. The heart muscles thicken. But the rest of our muscles become thin.

And then there’s the brain. I knew ten years ago I started having trouble remembering names and sometimes even words. But I hadn’t realized that the brain actually shrinks over time. By my 70s, my brain will have shrunk enough that there will be an inch to spare between my brain and my skull. That leads to a greater risk of cerebral bleeding if the head is injured, such as during a fall.

Even worse, according to Gawande, “By age eighty-five, working memory and judgment are sufficiently impaired that 40 percent of us have textbook dementia.”

This is the new body I am getting to know. How you met yours yet?

If you’d like to know more about the company we used to plan our trip to Norway, add a comment to ask for details. I’ll get back to you.

Image credit for featured image: Jez Timms

body, health

I’m Baaack!

It has been quite awhile since I last posted here. I’ve been posting on my other blog, one devoted to reading and writing, not health, wealth, and all that makes life better than the alternative. But August has been a tough month and has brought me back here, to celebrate what’s better than the alternative.

At the end of July, my husband wasn’t feeling well. I suggested we go to the urgent care clinic closest to our house where he was diagnosed with an infection. Something minor. Something easy to treat. Or so we thought.

He did have an infection. I had had the same infection a few months back, the reason I recognized his symptoms. In my case, a quick test confirmed the infection and a trip to the pharmacy to pick up an antibiotic, followed by a long nap, was all I needed to get better. We expected the same would apply to him.

But he didn’t get better. In fact, he got worse. So much worse that when he saw his primary care physician a week after that trip to urgent care, the doctor sent him straight back to urgent care, this time at the hospital our doctor is associated with.

The doctors there discovered his blood contained a very high level of potassium. They ordered an EKG to see if his heart was in trouble. It wasn’t.

 

But his kidneys were.

After I had hung around the urgent care intake rooms for hours, the doctors and nurses urged me to get something to eat and reassured me they would get him into a room while I was away. They told me to come back once I had eaten.

When I returned, they gave me his room number–Room 15 in the ICU. ICU. That’s Intensive Care Unit. Not exactly what I had expected when they said they would get him into a room.

My first reaction was to wonder if the hospital was so full they could only find space for him in the ICU. That’s the denial phase. He couldn’t be so ill that the staff needed to monitor him 24/7, could he?

It turns out, he was that ill. His kidneys were no longer functioning. The culprit, the doctors were 95% certain, was the antibiotic he was prescribed for that minor infection. The same antibiotic I was prescribed for the same minor infection eight months before.

Apparently, he is allergic to that drug. At any rate, we’re going to consider him to be allergic because we don’t want to repeat the exercise to confirm it.

The first week of August centered around his treatment in the hospital. They did a biopsy of one of his kidneys to rule out more serious causes. You know, like cancer. The doctors said the biopsy results were good, indicating the problem was typical of an allergic reaction. But good is relative.  His kidneys were not functioning. He needed dialysis to help his kidneys do their work. And the kidneys need time to heal.

The next two weeks of August centered around dialysis and follow-up with doctors. Twice a week we made a thirty-minute trip to a dialysis center where we sat in a room for the three to four hours needed to filter his blood through a machine.

Along with dialysis comes a limited diet. Foods with high levels of potassium were not permitted. And you can be sure that everything he wanted to eat, now that his appetite was back, was on the list of foods with high potassium levels. Vegetables were particularly difficult to work into his meals. Vegetables low in potassium are ones that have little color and even less flavor: bean sprouts, celery, cucumbers, eggplant, mushrooms, onions.  And most things he wanted to add for flavor–salt, soy sauce, salsa–are also high in potassium.

At the end of the second week and after four out-patient dialysis sessions, the doctors concluded his kidneys are functioning sufficiently to eliminate the dialysis. But his need for a daily dose of strong medicine to help the kidneys heal will likely remain for several weeks, if not months. One doctor finally used words that made us both sit up and listen. “You’re not ill,” she told my husband. “You are very, very ill.”

He’s no longer on the dialysis diet. Now we’re on the more varied diabetes diet. The drug he needs to treat the kidneys elevates the level of blood glucose, making it necessary for him to watch what he eats as well as to take insulin since most medications to treat diabetes in pill form are not advisable when kidneys are compromised.

Have I learned anything from all of this?

First, I will always step up to the Consultation window at the pharmacy when picking up a new drug. I did when I picked up my husband’s medication and am so glad I did. Not because the pharmacist warned of the side effects my husband experienced. There was no warning. Kidney failure is not a listed side effect on any of the information available about that drug. So I know I didn’t ignore a warning. Had I not taken the time to wait to speak with the pharmacists about the medication, I would have wondered if I should have known to bring him to urgent care again.

And second, I will pay much closer attention to my husband’s complaints when he isn’t feeling well. He doesn’t get sick often. He usually just plunges forward in his usual day if he feels a cold or even the flu coming on. So when he stayed in bed for days at a time, I should have realized he was really not well.

In support of that second lesson, I am happy to point to the fact that married men are healthier and live longer than single men. This Harvard study only hints, in the final paragraph, that wives insisting their husbands see a doctor is a positive factor in the health of men. Personally, I think it’s the main reason.

body, happiness, health, mind, the alternative, wisdom

How to Improve Your Chances to Live Longer

There really IS something that’s better than the alternative – thinking positively about the future. This article detailing a longitudinal study by Yale researchers, reports that the brains of those whose attitudes towards aging were negative showed shrinkage in the hippocampus, the part of the brain that is important for memory formation. And the same brains also showed a buildup of protein plaques and twists associated with Alzheimer’s.

Is this another chicken vs the egg example? Well, does it really matter? Even if the correlation is that hippocampus shrinkage and protein plaque buildup come before the negative thoughts, humans can control thoughts. So think positively about what aging brings you. Freedom from working from 9 to 5. Lower costs at matinee movies. Senior discounts at many restaurants. Celebrate! Don’t castigate. Applaud the future. Don’t condemn it.

What do you have to lose?

leisure, mind

Book Review: The Execution of Noa P. Singleton

An unforgettable and unpredictable debut novel of guilt, punishment, and the stories we tell ourselves to survive.

Book cover for The Execution of Noa P. SingletonThose words are part of the marketing package for the novel. I couldn’t have said it better myself. But I didn’t realize it would be unforgettable until I finished it. And its unpredictability explains why it took me a long time to get past the first chapter. But every time I logged on to Goodreads, I would be reminded it was still there, waiting for me to finish. I am very glad I picked it up again.

This is a mystery about a murder on many levels. Did Noa really murder Sarah? Why didn’t she say anything in her own defense during her trial? Why did Sarah’s mother change her opinion of the death penalty? Did the fact that her father was absent, and therefore unknown to Noa during childhood, play a role in the events? What does the P in her name stand for? Some of these questions remain at the end of the book, but enough are answered for the reader to be satisfied. For the story to stick and poke at memories and childhood secrets.

The most important questions all begin with Why. Why did Noa say nothing in her own defense? Why is she so determined not to satisfy Sarah’s mother’s curiosity about the event? Why does Noa lie? Why did she drop out of Penn? Those questions remain largely unanswered, only hinted at. And that is the strength of the book. Because we don’t get those answers from Noa, we end up asking similar ones about our own lives. Those questions raise thoughts of own own guilt, our own family relationships as well as our relationships with others. Those questions bring up thouhts of what we might have done differently. For those reasons, this book will stay with me for at least as long as the 450-some days it took me to finish reading it.

mind, security, soul, wisdom

Non-Immigrant Visas, Visa Waiver Program, and Refugees

 

I watched news clips recently of Assistant Secretary for Consular Affairs, Michelle Bond, in Congress being questioned about where the 9,500 people with terrorist connections whose visas have subsequently been revoked are. She couldn’t answer the question. And Congressmen appeared to take delight in having put her on the spot. I’d like to come to her defense with one statement – it isn’t the responsibility of the Assistant Secretary for Consular Affairs or anyone else in the Department of State to know where anyone is once they enter the United States or to take action to ensure the removal of such a person. It is the responsibility of the Department of Homeland Security.

There is so much talk these days about the need to “fix” the vetting process for the issuance of visas of all types, for approving refugees for entrance, and for getting rid of the visa waiver program, but I am concerned that the discussion is based on multiple misunderstandings. I served in two countries as a consular officer – Germany and Barbados – where I only issued non-immigrant visas, including fiancee visas – and it has been a long time since I had that responsibility, so I’ve only cited examples that I know are still processed the same way today.

Checks and Balances

Department of State Seal by DonkeyHotey, on Flickr Department of Homeland Security by DonkeyHotey, on Flickr
Department of State Seal
(CC BY 2.0) by  DonkeyHotey 

The decision to allow someone – anyone – to enter the United States for either a temporary visit or as an immigrant or refugee involves multiple agencies which ensure there are checks and balances in place. Sometimes the process begins with the Department of State (State). Sometimes the process begins with the Department of Homeland Security (DHS). Agents from Customs and Border Patrol (CBP), a part of DHS, make the decision to allow travelers to enter the United States. In all cases, at least these two federal Departments are involved. There are checks and balances in place already.

Non-Immigrant Visas

The simplest type of visa is a non-immigrant visa, but simplest doesn’t mean simple.

First, there are many different types of non-immigrant visas and some of them require additional documentation before they can be issued. For example, student visas can only be issued if the applicant has an I-20 form from the school the student plans to attend. Each school has its own requirements for the issuance of an I-20. When I worked at San Francisco State University, the American Language Institute (ALI) issued I-20s for its students to be able to study English prior to attending college or university.  But having an I-20 in hand still does not guarantee the applicant will receive a visa because of the next condition.

Second, anyone who applies for a non-immigrant visa is presumed to be an immigrant and must overcome that presumption to the satisfaction of the consular officer. There is no checklist. If there were, people who wanted visas would manufacture the evidence called for in the checklist and the decision would be reduced to a matching exercise. Letter from employer to verify the applicant has a job when he returns? Check. Letter from bank to verify the applicant has enough money in her bank account to cover the trip? Check. Letter from a minister/politician/well-known personality to verify what a good guy the applicant is? Check.

Instead of a checklist, a consular officer reviews the information on the application form and passport, including the pattern of travel indicated in the passport, and evidence the applicant chooses to include to demonstrate their strong ties to their home country. If the type of visa the applicant needs requires additional documents, such as the I-20 mentioned for student visas, the applicant must have it and still overcome the presumption the individual plans to remain in the U.S.

Third, there are several types of ineligibilities. Most people who were determined ineligible could still travel to the U.S., but first they must receive a waiver of the ineligibility.

Sometimes the ineligibilities change from time to time. Who does that? Congress, of course, based on the feedback their members receive from their constituents. For example, long before I arrived in Germany to work in the non-immigrant visa section, having been a member of the SS during World War II was an ineligibility, lumped together with membership in the Communist party. Under that ineligibility, there was still a way for the ineligible applicant to travel to the U.S., with a waiver. But just prior to my arrival in Germany, a new ineligibility without the ability to obtain a waiver was added for those persons who participated in the persecution of Jews and others during the Holocaust. Understandable.

Here’s how that played out in one case. An elderly man who had traveled on a visa with a waiver to see his daughter several years earlier, applied again, aware that it would take some time for the waiver to be processed. But instead of that little bit of extra paperwork, we needed now to interview him much more closely to see if his actions as a member in the SS were so abhorrent that he would never be able to obtain a visa again or if he was a “foot soldier” and therefore eligible for a visa, this time without a waiver. That process took so long that he died before we received approval to issue him a visa.

Fourth, in all cases, a security check is also completed before a visa is issued. That check includes derogatory information from all federal agencies. Many times these checks result in even more restrictive processes must be followed, waiting for a specific agency to give the go/no go decision to the consular officer.

Fifth, since 9/11, many additional forms have been added in specific cases, such as a supplemental form for student and exchange visas and detailed travel histories.

Sixth, visas have been made much more tamper resistant than they were in the days I served as a consular officer. Visas now include the digital photo and biometric information of the individual.

That’s for the simplest of the visa types. And it’s just the beginning of the checks and balances.

Business/Tourism Visas – B1/B2

Let’s just stick with the most basic of non-immigrant visas – the B1/B2 business/tourist visa. If a consular officer is convinced that the applicant’s intentions are consistent with business/tourism and that the applicant plans to return from the U.S. at the end of the stay, a visa will likely be issued. But a visa is not “permission to enter” the United States. It is “permission to apply to enter” the United States. The agency that permits people to enter the United States is Customs and Border Protection (CBP), a part of DHS. If the CBP agent believes the person’s intentions do not match the issued visa, the agent can order a secondary inspection. If evidence is found that indicates the person intended to stay for a longer time or permanently (letters from the family in the United States welcoming him, cards of congratulations from her former colleagues, dozens of suitcases instead of the one or two most tourists bring), CBP can send the person back where they came from. And if that happens, the airline that accepted the person on the flight eats the cost. So even the airlines have a role in determining if the passenger’s visa is appropriate for the trip.

If a person has a valid visa, issued by a consular officer based on the facts on the application and as stated by the applicant, but the applicant was lying and somehow manages to get past CBP, there is still another check. An applicant who arrives on a non-immigrant visa may request to adjust their status to permanent resident or student or temporary worker or au pair, each of which has different requirements. In those cases, a copy of the application is sent to the consular section where the visa was issued in order for the consular officers to determine if there was fraud involved in the application. If the consular section staff provide information to indicate the visa was obtained through fraud, United States Citizenship and Immigration Services (USCIS), another DHS agency, uses that information, along with whatever else they have to determine if the applicant’s status is adjusted or the person is deported.

Discussions including demands that the vetting process be fixed focus on what else must be done. Adding steps to an already lengthy process for issuance of immigrant visas or adjudicating refugee requests will have the unintended consequence of increasing the number of people willing to try to get in without a visa instead of their requests being processed systematically, through multiple agencies. And I don’t think that is what anyone wants.

Uncategorized

Thanks x Two

Happy Thanksgiving!

Thank you, Stuart M. Perkins.

Storyshucker

On a recent evening commute, a woman boarded the bus and rushed towards me. Rather than sit, she seemed to fall into the empty seat beside mine, a mound of heavy coat, thick scarf, and several bags. She wedged a bag between her feet and dug through her purse producing a pen and ragged notepad. Flipping frantically through its frayed pages, she peered at me over glasses perched on the tip of her nose.

“I have to make a list of things I’m thankful for.” she said with irritation.

I didn’t ask why, but glanced at her notepad. She was grateful for some important things, with “health” and “job” written so far on her list. She saw me looking.

“I need ideas. What are you thankful for?” She sounded aggravated.

I thought back to when my daughter was small. I told the woman how my daughter’s eyes lit up when we…

View original post 462 more words

happiness, leisure, mind, soul, wisdom

connect, respect, protect

tv_flashpoint01I hate to admit this about any television program, but I’ve become a Flashpoint junkie.  I never watched this Canadian television program when it debuted, but ION Television bought up the rights to the series from CBS and has been rebroadcasting the seasons nearly every day recently. I recorded them without realizing what the series was about. The title was intriguing enough to catch my eye.

Initially, I thought this series would be so easy for Second City TV, if it still existed, to parody. Instead of the three and sometimes even four black vans with dark-tinted windows and flashing blue lights making their way in single file through Toronto’s downtown streets without problems, I’d like to see them encounter normal downtown traffic, preventing the last vehicle from keeping up with the others, peeling off one more at successive traffic lights until they are each on their own. Or, instead of the six members of Team One jumping out fully covered in their armored vests, pants held tight just above the knee with a holster for weapon or equipment, and carrying high-power long guns, able to jog from the vans to the site of the emergency without breaking a sweat or even breathing heavily from exertion, I’d like to see one of them trip on that gear and fall down, knocking the others over like dominoes.

But I’m willing to suspend my disbelief regarding all their gear because I am charmed by their motto — connect, respect, protect — and by how they approach both those they are there to protect and those they need protecting from.

Unlike episodes of U.S. cop shows where the SWAT team arrives with a battering ram to break down the door so those with the long guns can start shooting at anyone in sight, Team One members follow their motto — protecting those who need it, respecting everyone in the area, and connecting with those holding guns, knives, bombs, or hostages to defuse the situation, ideally without anyone being injured. Like all law enforcement officers Flashpoint team members train to keep fit physically as well as to maintain their sharp shooter skills, but they also train to improve their negotiation skills and to recognize behavioral clues that indicate state of mind so they can adjust their plan accordingly. They use the clues to determine how to connect with victims and witnesses, to gather information to learn the suspect’s motivation, and to help anticipate what the suspect will do next.

I’ve picked up some negotiation tactics myself as a result of watching the shows.

  • First, establish rapport by telling the other person your name and asking for his.
  • Second, point out that nothing done up to this point is irreversible. It is possible to end the standoff right here and right now.
  • Third, you always have a choice, but some choices are better than others.
  • Fourth, consider the consequences of the choice you are contemplating now, and then consider the consequences of other choices so you can identify the best option, the best choice, for now.
  • Only use force when necessary, and deadly force is always the last option.

These tactics are appropriate in less than life-threatening situations as well — well the first four anyway. Imagine a situation when a friend has disappointed you, or you feel that you have disappointed a friend. First, establish rapport — with the other person or even with another side of yourself — by finding common ground, something to agree on. Second, point out that the friendship is still what is important. It is possible to close the distance between one another right here and right now. Third, you always have a choice, but some choices are better than others. Fourth, consider the consequences of the choice you are contemplating now and then consider the consequences of other choices so you can identify the best option, the best choice, for now.

Perhaps I am just rationalizing my Flashpoint habit by finding something positive, some lesson, some take away — it isn’t just entertainment; it’s educational, too! But the clincher for me is that motto — protect, respect, connect. A good story that illustrates the power of those three words is worth telling, and retelling. If you haven’t watched Flashpoint yet, I encourage you to check it out.

body, health

vaccinations

Our local pharmacy has already started advertising flu shots, offering bonus bargains on the day someone gets vaccinated. It seems early to me; we are still in the hottest months of the year here in San Diego. But better early than later or never.

Vaccinations for the flu, for pneumonia, for shingles can be truly life saving for seniors as the effects of these illnesses are far more serious in later years. According to a report from the Alliance for Aging Research, “[t]he risk of death from pneumonia and influenza, already higher for older adults, skyrockets for the very old: It is nearly 130 times higher in people age 85 and older than in those 45 to 54….”

The likelihood of seniors acquiring shingles increases with age as well. According to a 2013 report from CDC Advisory Committee on Immunization Practices, about half of all people who live to be 85 will come down with shingles, an extremely painful skin rash with few treatment options. Ten percent of adults who come down with shingles develop an even longer-lasting form of the disease that may continue for months or even years. If shingles rashes develop on the face, the patient may become blind.

Shingles vaccines are recommended for anyone over the age of 60 and are free for those on Medicare. Yet fewer people have gotten this vaccination than the manufacturer projected when it became available in 2006. Shingles does not spread from person to person, but anyone who has had chicken pox already has the virus that causes shingles.

Those between the recommended age of 60 and 65, the age of Medicare eligibility, may feel the pinch of price since not all insurance companies will cover the $200-$250 vaccination. Further, most doctors do not administer the vaccination in their offices, requiring patients to go to a pharmacy. As soon as I became eligible for Medicare, I asked for the shingles vaccine. I can’t understand why anyone would not. I remember what chicken pox felt like. I don’t want to experience its cousin.