tag:blogger.com,1999:blog-352025052024-03-06T22:17:32.499-08:00Sometimes I Feel Like a Piece of BolognaA blog about the joys, challenges, and trials of being part of the Sandwich Generation. We'll talk about being squished between our own aging, caring for aging parents, and parenting kids, adult kids, and even grandkids. This season may not be what we envisioned, but let's make it delicious anyway!Pathttp://www.blogger.com/profile/12105041530687619979noreply@blogger.comBlogger369125tag:blogger.com,1999:blog-35202505.post-74580365984440695632014-07-21T23:49:00.000-07:002014-07-21T23:52:26.339-07:00Moving to a New Site<div class="site-description">
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiTOfomWRG2Td1y8jDa01GrkpzV2tsvmw6SxUtzffiTLywlk52WyFqExxhbzrncdwavBVFlUzXfAf2U5Km-rVz8ek2FC4N_oam5LROufHmXmHv3c4N2xq7cRdRGlpYBcw5hfiWF/s1600/P1040763+crop+Isa.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiTOfomWRG2Td1y8jDa01GrkpzV2tsvmw6SxUtzffiTLywlk52WyFqExxhbzrncdwavBVFlUzXfAf2U5Km-rVz8ek2FC4N_oam5LROufHmXmHv3c4N2xq7cRdRGlpYBcw5hfiWF/s1600/P1040763+crop+Isa.jpg" height="182" width="400" /></a></div>
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<span style="font-family: inherit;"><span style="font-size: small;">Friends, I've been blogging here for almost eight years, but it's time to move on. I'm not going away, but simply changing my address and refocusing a bit. I've started a new blog at <a href="http://pursuingsplendor.com/blog/" target="_blank">An Ordinary Woman Pursuing Splendor</a>. There I focus on <span style="font-weight: normal;">"</span></span></span><b><span style="font-family: inherit;"><span style="font-size: small;"><span style="font-weight: normal;">Practical Biblical Problem-Solving Strategies Amid Life's Disappointments, Challenges, and Crashes." Of course, that includes a lot of GenSandwich issues. I hope you'll visit the new blog and follow for updates. And THANKS for your support over the years.</span></span></span></b></div>
Pathttp://www.blogger.com/profile/12105041530687619979noreply@blogger.com4tag:blogger.com,1999:blog-35202505.post-41352418225152292072014-02-06T06:43:00.000-08:002014-02-06T06:43:00.330-08:00Are You Aware Of The Two Midnight Medicare Rule?
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One of the changes in the <a href="http://www.beckershospitalreview.com/racs-/-icd-9-/-icd-10/cms-delays-two-midnight-rule.html" target="_blank">2014Medicare proposed prospective payment regulations</a> is the two-midnight rule. This
rule requires that inpatients must remain in the hospital over two midnights in
order to qualify for inpatient reimbursement.<span style="mso-spacerun: yes;">
</span>Any stay shorter is considered outpatient, which has a much lower reimbursement
rate. <span style="mso-spacerun: yes;"> </span>Fortunately these rules have been
delayed until September 30, 2014, but it’s important that you stay on top of
this. It could have severe financial ramifications for you or your aging
parent. <span style="mso-spacerun: yes;"> </span> </div>
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<span style="mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Hospital leaders have
vigorously <a href="http://www.beckershospitalreview.com/racs-/-icd-9-/-icd-10/hospital-leaders-to-congress-two-midnight-rule-is-arbitrary-confusing.html">opposed</a>
the two-midnight rule during the past year, arguing that the policy is unclear
and undermines the medical judgment of physicians. The Centers for Medicare and
Medicaid Services (CMS) introduced the policy to better monitor Medicare
payment of short inpatient stays and ensure inpatient admissions are medically
necessary. But the fact remains that this is yet another unintended (or
intended?) consequence of Obamacare that will affect care for the elderly. </span></div>
Pathttp://www.blogger.com/profile/12105041530687619979noreply@blogger.com2tag:blogger.com,1999:blog-35202505.post-11314264211648324542014-02-05T18:24:00.003-08:002014-02-05T18:27:39.185-08:00Beware of Medicare Scams<style>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">Over the years, I've warned readers of Medicare, Social
Security, and other scams targeting seniors. It looks like there is one
circulating in <a href="http://interact.stltoday.com/pr/business/PR020414084915819" target="_blank">Missouri and Illinois now</a>. If you are a senior or care for one, be alert for these scams. Warn your
loved one (again) to not respond with personal information. </span></span></div>
Pathttp://www.blogger.com/profile/12105041530687619979noreply@blogger.com0tag:blogger.com,1999:blog-35202505.post-79306544825619432682014-01-21T12:23:00.002-08:002014-01-21T12:31:01.731-08:00Caring for the Caregiver: This Year I’m Taking Care of Me<div class="separator" style="clear: both; text-align: center;">
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2013 was a hard year for me. What about you? In fact, I’m just now coming up for air. Christmas just came down last weekend. I just didn’t have the energy to take it down earlier. So there…<br />
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It seems that Mom has become more difficult this year. Not really sicker, but more needy, more clingy, and worst of all, more unkind. Meanwhile, hubby has had a back injury and almost needed surgery. But he didn’t pass the cardiac clearance, so we are re-thinking that. But for the past several months, he’s been in pain. And you know men in pain… So I reached the end of the year pretty much at the end of me.<br />
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Then I saw these caregiver resolutions in a post on <a href="http://caring.com/" target="_blank">Caring.com</a> and decided I need to implement them (or something like them) this year. Not all of these apply to all of us, but let them be a jumping off point for your own declarations.<br />
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Here’s the sample from Caring.com to start you off. <br />
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<li>I will organize and dispense all my loved one's meds. . . but not beat myself up for forgetting the occasional dose.</li>
</ul>
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<li>I will apologize when I lose my temper, but realize that caregiving is so chock-full of temperature-riling situations that eternal calm is impossible.</li>
</ul>
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<li>I will be there for my loved one, but I will continue to run my own life at the same time.</li>
</ul>
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<li>I will let myself grieve and cry and feel sad, instead of trying to keep a chipper smile on my face all the time.</li>
</ul>
<ul>
<li>I will accept or ignore criticism for what it's worth (or not worth) rather than letting it eat at me.</li>
</ul>
<ul>
<li>I will quit blaming myself when bad things happen. Bad things happen.</li>
</ul>
<ul>
<li>Finally, I resolve to take care of me this year, not just my loved one. Because eventually I may be the one who needs care, and better it be later than sooner.</li>
<li><h3>
<b>I resolve. . . not to try to be perfect this year.</b></h3>
</li>
</ul>
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How about you? How are you going to take care of YOU this year? Share with us your declarations.<br />
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Photo Credit: <a href="http://www.flickr.com/photos/mistermoss/1314808684/" target="_blank">Peat Bakke</a> <br />
<br />Pathttp://www.blogger.com/profile/12105041530687619979noreply@blogger.com2tag:blogger.com,1999:blog-35202505.post-48784387989731387422014-01-16T18:02:00.001-08:002014-01-16T18:02:43.500-08:00Related by Chance; Family by Choice: the Critical Mother-in-Law/Daughter-in-Law Relationship<a href="http://www.amazon.com/gp/product/0825443253/ref=as_li_tf_il?ie=UTF8&camp=1789&creative=9325&creativeASIN=0825443253&linkCode=as2&tag=sometifeellik-20" target="_blank"><img border="0" src="http://ws-na.amazon-adsystem.com/widgets/q?_encoding=UTF8&ASIN=0825443253&Format=_SL160_&ID=AsinImage&MarketPlace=US&ServiceVersion=20070822&WS=1&tag=sometifeellik-20" /></a><img alt="" border="0" src="http://ir-na.amazon-adsystem.com/e/ir?t=sometifeellik-20&l=as2&o=1&a=0825443253" height="1" style="border: none !important; margin: 0px !important;" width="1" />
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How’s your relationship with your daughter-in-law (DIL)? Or is that too touchy of a subject? I think a lot of moms of sons are surprised by the challenges of adding a new woman to the family, especially if we have a close relationship with our sons. <br />
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I was blessed with a friend who was years ahead of me in the mother-in-law (MIL) business. She was so diligent in maintaining a good relationship with her DIL. She pointed out that when a young man marries, the new wife often sees the MIL as competition. At first that didn’t make sense. Don’t we both love the same man? But that’s precisely the point. And to complicate the matter, most families don’t seem to put words or even cognition to that dilemma, so other conflicts arise to express it. Since they aren’t the real issue, they often don’t get resolved. Hurt feelings abound. And the son we love is caught in the middle. Another thing that happens is making the transition from child to adult and developing an adult relationship with your son and his wife rather than a parent/child relationship. If you’ve been close, that’s a hard transition for both parents and son. And here, the new wife gets caught in the middle. <br />
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Deb DeArmond has written a wonderful book about this issue. <a href="http://www.amazon.com/gp/product/0825443253/ref=as_li_tf_tl?ie=UTF8&camp=1789&creative=9325&creativeASIN=0825443253&linkCode=as2&tag=sometifeellik-20" target="_blank">Related by Chance, Family by Choice: Transforming Mother-in-Law and Daughter-in-Law Relationships</a><img alt="" border="0" src="http://ir-na.amazon-adsystem.com/e/ir?t=sometifeellik-20&l=as2&o=1&a=0825443253" height="1" style="border: none !important; margin: 0px !important;" width="1" /> (Kregel Publications, 2013) talks to both mothers of sons and wives of those sons, addressing the most common glitches in this vital relationship. It’s helpful to see both sides of the issue, as well as the side of what she calls “the man in the middle”—your son. The book is easy to read and features questions and personal evaluations at the end of each chapter to help you be more honest with yourself. And who wouldn’t want the goal: a better relationship with the wife of your son and the mother of your grandchildren.<br />
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If you’ve felt that your only option in dealing with your adult son and his wife is to “wear beige and keep your mouth shut,” the book is for you. If you’ve had misunderstandings with your DIL, there’s hope for reconciliation. And if you have a good relationship, you’ll learn ways to make it great. <br />
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I’m so thankful for the wonderful relationship we have with our DIL. She’s a treasure, and we tell her that regularly. It hasn’t always been easy, and still isn’t. But we’ve both worked hard and continue to find ways to make our family work. I feel like I’ve given and changed a lot, but I’ve also been very aware of the many concessions she has made to include and honor us. And ultimately, that’s what this relationship is about. Each party respecting the other and creating a delightful, God-honoring extended family.<br />
Pathttp://www.blogger.com/profile/12105041530687619979noreply@blogger.com1tag:blogger.com,1999:blog-35202505.post-1528920012463121232013-11-14T12:58:00.002-08:002013-11-14T13:03:42.457-08:00HEADS UP – CREDIT CARD SCAM!<style>
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<span style="font-size: small;"><span style="font-family: inherit;">I saw this on Facebook recently,
but it has been vetted by <a href="http://www.snopes.com/crime/warnings/creditcard.asp" target="_blank">snopes</a>. <span class="hascaption">
I’m posting it here just in case you haven’t seen it. We’re seeing so many scams with both credit
cards and Medicare, but this is one I wouldn’t expect my mom to catch on to. Be
sure you alert your families. Thanks to <a href="http://wholenewmom.com/">WholeNewMom.com</a> for sharing it.</span></span></span></div>
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<span style="font-size: small;"><span style="font-family: inherit;">This is a heads up for everyone regarding the latest in Visa fraud.
Royal Bank received this communication about the newest scam. This is happening
in the Midwest right now and moving.<br />
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This one is pretty slick, since they provide YOU with all the information,
except the one piece they want.<br />
<br />
Note, the callers do not ask for your card number; they already have it.<br />
<br />
This information is worth reading. By understanding how the VISA & MasterCard
telephone Credit Card Scam works, you'll be better prepare to protect yourself.
One of our employees was called on Wednesday from 'VISA', and I was called on
Thursday from 'MasterCard'.<br />
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The scam works like this: <br />
<br />
Person calling says - 'This is (name) and I'm calling from the Security and
Fraud Department at VISA. My Badge number is 12460, your card has been flagged
for an unusual purchase pattern, and I'm calling to verify. This would be on
your VISA card which was issued by (name of bank). Did you purchase an
Anti-Telemarketing Device for $497.99 from a marketing company based in Arizona
?' When you say 'No', the caller continues with, 'Then we will be issuing a
credit to your account. This is a company we have been watching, and the
charges range from $297 to $497, just under the $500 purchase pattern that
flags most cards. Before your next statement, the credit will be sent to (gives
you your address). Is that correct?' You say 'yes'.<br />
<br />
The caller continues - 'I will be starting a Fraud Investigation. If you have
any questions, you should call the 1- 800 number listed on the back of your
card (1-800-VISA) and ask for Security. You will need to refer to this Control
Number. The caller then gives you a 6 digit number. 'Do you need me to read it
again?'<br />
<br />
Here's the IMPORTANT part on how the scam works - The caller then says, 'I need
to verify you are in possession of your card'. He'll ask you to 'turn your card
over and look for some numbers'. There are 7 numbers; the first 4 are part of
your card number, the last 3 are the Security Numbers that verify you are the
possessor of the card. These are the numbers you sometimes use to make Internet
purchases to prove you have the card. The caller will ask you to read the last
3 numbers to him. After you tell the caller the 3 numbers, he'll say, 'That is
correct, I just needed to verify that the card has not been lost or stolen, and
that you still have your card. Do you have any other questions?'<br />
<br />
After you say no, the caller then thanks you and states, 'Don't hesitate to
call back if you do', and hangs up. You actually say very little, and they
never ask for or tell you the card number. But after we were called on
Wednesday, we called back within 20 minutes to ask a question. We were glad we
did! The REAL VISA Security Department told us it was a scam and in the last 15
minutes a new purchase of $497.99 was charged to our card. We made a real fraud
report and closed the VISA account. VISA is reissuing us a new number. What the
Scammer wants is the 3-digit PIN number on the back of the card. Don't give it
to them. Instead, tell them you'll call VISA or Master Card directly for
verification of their conversation.<br />
<br />
The real VISA told us that they will never ask for anything on the card, as
they already know the information, since they issued the card! If you give the
Scammer your 3 Digit PIN Number, you think you're receiving a credit. However,
by the time you get your statement you'll see charges for purchases you didn't
make, and by then it's almost too late and/or more difficult to actually file a
fraud report.<br />
<br />
What makes this more remarkable is that on Thursday, I got a call from a 'Jason
Richardson of MasterCard' with a word-for-word repeat of the VISA Scam. This
time I didn't let him finish. I hung up! We filed a police report, as
instructed by VISA. The police said they are taking several of these reports
daily! They also urged us to tell everybody we know that this scam is
happening. I dealt with a similar situation this morning, with the caller
telling me that $3,097 had been charged to my account for plane tickets to
Spain , and so on through the above routine..<br />
<br />
It appears that this Is a very active scam, and evidently quite successful..<br />
<br />
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</span></span>Pathttp://www.blogger.com/profile/12105041530687619979noreply@blogger.com0tag:blogger.com,1999:blog-35202505.post-1771966579796201352013-11-05T12:55:00.000-08:002013-11-05T13:09:07.227-08:00A Mother’s Heart for Her Disabled Children<a href="http://www.amazon.com/gp/product/0857214454/ref=as_li_tf_il?ie=UTF8&camp=1789&creative=9325&creativeASIN=0857214454&linkCode=as2&tag=sometifeellik-20" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" src="http://ws-na.amazon-adsystem.com/widgets/q?_encoding=UTF8&ASIN=0857214454&Format=_SL160_&ID=AsinImage&MarketPlace=US&ServiceVersion=20070822&WS=1&tag=sometifeellik-20" width="131" /></a><img alt="" border="0" height="1" src="http://ir-na.amazon-adsystem.com/e/ir?t=sometifeellik-20&l=as2&o=1&a=0857214454" style="border: none !important; margin: 0px !important;" width="1" />
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<span style="font-size: small;"><span style="font-family: "Trebuchet MS",sans-serif;">I have great admiration for anyone who does caregiving at
any level. Whether it’s parenting our kids, caring for our aging parents, caring
for a disabled spouse, or caring for the needy in our community, caregiving
involves sacrifice, a laying down of our lives for another. You know that. Your
life and your desires get consumed by the needs of the other. </span></span><br />
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<span style="font-size: small;"><span style="font-family: "Trebuchet MS",sans-serif;">But there is one level of caregiving that I confess I can’t
even imagine – that of
caring for a disabled child. Especially
one who has a limited life expectancy. I’ve known several women who do this and
they have my constant admiration. Their job won’t end, other than in death. Their
hopes and dreams for their child are crushed every day. They have to learn a
new level of sacrifice every day.</span></span></div>
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<span style="font-size: small;"><span style="font-family: "Trebuchet MS",sans-serif;"><a href="http://www.catherine-campbell.com/" target="_blank">Catherine Campbell,</a> a nurse from Northern Ireland, has captured this journey well in <i>Under the Rainbow: A Mother’s
Experiences of the Promises of God</i>. Catherine had not one, but two daughters
with profound genetic disabilities. In the book she gently shares her journey.
Her heartbreaks. Her delights. Her unwavering faith in the goodness of God. <i>Under
the Rainbow</i> is a story of faith and hope in the midst of daily lifegiving. It
is the story of a mother's journey with God through heartache and loss. It
reveals with remarkable honesty the disappointment, devastation and even anger
she feels when confronted with what some would see as unfortunate genetic
mistakes. In time, she comes to see it differently. If you have a
disabled child or know someone who does, this would make a lovely Christmas gift.</span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Trebuchet MS",sans-serif;">I reviewed another of Catherine's books, <a href="http://generationsandwich.blogspot.com/2012/08/god-knows-your-name-in-world-of.html" target="_blank">God Knows Your Name: In a World of Rejection, He Accepts You</a> last year. You might check that out as well. </span></span><br />
<br />
<span style="font-size: x-small;">(This book was provided by Kregel Publications for review).</span></div>
Pathttp://www.blogger.com/profile/12105041530687619979noreply@blogger.com0tag:blogger.com,1999:blog-35202505.post-34886543701782415012013-03-05T01:00:00.000-08:002013-03-05T09:46:25.294-08:00Fear, Faith, and a Fistful of Chocolate<a href="http://www.amazon.com/gp/product/162029169X/ref=as_li_tf_il?ie=UTF8&camp=1789&creative=9325&creativeASIN=162029169X&linkCode=as2&tag=sometifeellik-20"><img border="0" src="http://ws.assoc-amazon.com/widgets/q?_encoding=UTF8&ASIN=162029169X&Format=_SL160_&ID=AsinImage&MarketPlace=US&ServiceVersion=20070822&WS=1&tag=sometifeellik-20" /></a><img alt="Faith, Fear, and a Fistful of Chocolate" border="0" height="1" src="http://www.assoc-amazon.com/e/ir?t=sometifeellik-20&l=as2&o=1&a=162029169X" style="border: none !important; margin: 0px !important;" width="1" />
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<span style="font-size: small;"><span style="font-family: inherit;"> </span></span><br />
<span style="font-size: small;"><span style="font-family: inherit;">Are you a fear<span style="font-size: small;">ful person?</span></span></span> Wait, before you answer, think about it. Fear comes in so many different forms that it can sometimes be deceptive. Sometimes it looks like worry or anxiety or "concern." Sometimes it looks control or obsessions or codependency. Sometimes it looks like guilt or loneliness. Yep, those are all forms of fear, and both men and women fall victim to this demon. As caregivers, it's easy to let all of these forms of fear as we juggle more balls than humanly possible and always feel we're falling short.<br />
<br />
I know you don't want to spend your precious free time reading anything heavy, so here's a suggestion that's light and fun. With her own brand of off-beat wit and wisdom, inspirational humorist
Debora Coty addresses heart needs of women worn down by everyday fears -
financial, health, relationships, loss, pain, the unknown, and the what ifs in her latest book, <a href="http://ow.ly/hyrj3" target="_blank"><i>Fear, Faith, and a Fistful of Chocolate: Wit and Wisdom for Sidestepping Life's Worries.</i></a><br />
<br />
With fresh spiritual insight, Debora shares hope, true life stories, scriptural lifelines, and a few LOL's along with simple, practical tips for sidestepping fear with faith. And a fistful of chocolate! But don't be deceived. Her playful attitude packs a punch and will cause you to pause. Each chapter includes a page of questions that will help you personalize it and nail down some changed in behavior and attitude.<br />
<br />
<i>Fear, Faith, and a Fistful of Chocolate</i> is a beautiful book. It's printed on high quality pink polka dot paper, making it a great gift book. Actually, I think I'll give a copy to my mom, who has a patent on fear. The book isn't as straightforward as I would like, but I have a feeling its light-hearted approach will be just right for her. It's also a nice size and very light in weight, which will also make it perfect for her.<br />
<br />
To sweeten the pot, if you act in the next two days, you can enter to win a Kindle Fire and meet Debra at her Litfuse Facebook party on March 7<i>.</i> Just click on the picture below to enter.</div>
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<b>Enter Today - 2/14 - 3/6!</b><b>
</b><a href="http://litfusegroup.com/campaigns/fear-faith-and-a-fistful-of-chocolate-by-debora-coty-giveaway-facebook-party-and-blog-tour"> <img alt="Fear Faith and a Fistful of Chocolate Debora Coty Kindle Fire Giveaway" height="150" src="http://litfusegroup.com/wp-content/uploads/2013/01/Fear-Faith-Giveaway-300.png" width="170" /> </a></center>
Pathttp://www.blogger.com/profile/12105041530687619979noreply@blogger.com1tag:blogger.com,1999:blog-35202505.post-81011128627811749592012-10-03T01:00:00.000-07:002012-10-03T01:00:01.679-07:00Because You Care: Spiritual Encouragement for Caregivers<a href="http://www.amazon.com/gp/product/0736943285/ref=as_li_tf_il?ie=UTF8&camp=1789&creative=9325&creativeASIN=0736943285&linkCode=as2&tag=sometifeellik-20"><img border="0" src="http://ws.assoc-amazon.com/widgets/q?_encoding=UTF8&ASIN=0736943285&Format=_SL160_&ID=AsinImage&MarketPlace=US&ServiceVersion=20070822&WS=1&tag=sometifeellik-20" /></a><img alt="" border="0" height="1" src="http://www.assoc-amazon.com/e/ir?t=sometifeellik-20&l=as2&o=1&a=0736943285" style="border: none !important; margin: 0px !important;" width="1" /><br />
<br />
<span style="font-size: small;"><span style="font-family: inherit;">Are you a caregiver? Or perhaps you know one. If so, <i>Because You Care: Spiritual Encouragement for Caregivers</i> is a delightful little book by two caregivers: Cecil Murphey and Twila Belk. Cec has been caring for his wife with chronic illness since their marriage more than 50 years ago. Twila’s husband was diagnosed with a progressive rare muscle disease called “inclusion body myostitis” several years ago. They weave their faith-filled stories through 48 short pages of beautiful prose and photography. </span></span><br />
<span style="font-size: small;"><span style="font-family: inherit;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: inherit;">I love the heart of both authors as they share their love for their spouses. As a burned out caregiver, I found hope and courage as I savored their stories. They gave me new ideas and new vocabulary for serving those I care for. Full of gentle wisdom, their personal stories of caregiving will help you face some of the ups and downs of your journey, including:</span></span><br />
<ul>
<li><span style="font-size: small;"><span style="font-family: inherit;"> Feeling guilty for doing too much, too little, or nothing at all</span></span></li>
<li><span style="font-size: small;"><span style="font-family: inherit;"> Answering other’s well-meaning but insensitive questions</span></span></li>
<li><span style="font-size: small;"><span style="font-family: inherit;"> Watching someone you dearly love suffer or die </span></span></li>
</ul>
<span style="font-size: small;"><span style="font-family: inherit;">This is a wonderful gift book for the caregiver in your life. Maybe even for you.</span></span><br />
<span style="font-size: small;"><span style="font-family: inherit;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: inherit;">This blog tour, sponsored by Kathy Carlton Willis Communications, is offering a prize basket that includes:</span></span><br />
<ul>
<li><span style="font-size: small;"><span style="font-family: inherit;">Book—<i>Because You Care: Spiritual Encouragement for Caregivers</i></span></span></li>
<li><span style="font-size: small;"><span style="font-family: inherit;">Book—<i>Hope and Comfort for Every Season</i></span></span></li>
<li><span style="font-size: small;"><span style="font-family: inherit;">Hallmark journal, list pad, and memo pad stack</span></span></li>
<li><span style="font-size: small;"><span style="font-family: inherit;"> Glade “Angel Whispers” candle</span></span></li>
<li><span style="font-size: small;"><span style="font-family: inherit;">Hershey’s Bliss dark chocolate</span></span></li>
</ul>
<span style="font-size: small;"><span style="font-family: inherit;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: inherit;">To enter the drawing, simply leave a comment here. Good luck!</span></span><br />
<br />
<br />Pathttp://www.blogger.com/profile/12105041530687619979noreply@blogger.com3tag:blogger.com,1999:blog-35202505.post-80953703984401426022012-09-13T01:00:00.000-07:002012-09-12T22:49:49.538-07:00ObamaCare Cuts Will Lead to Seniors’ Deaths<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiD3zxMLPS9lZCgfgTJi8CG6cl5a-_3fYxsGJdeOHi73xAg002hmbBbnlCu_mVtDpozPNHhHjDGrrB_MfUHwJ76nkoubwQ7cs2H4awZJR3eEI5szk9CQGC-qwZIJld9cV_INGb4/s1600/Doctor+hand+3901813960_c0f9cbde47.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiD3zxMLPS9lZCgfgTJi8CG6cl5a-_3fYxsGJdeOHi73xAg002hmbBbnlCu_mVtDpozPNHhHjDGrrB_MfUHwJ76nkoubwQ7cs2H4awZJR3eEI5szk9CQGC-qwZIJld9cV_INGb4/s320/Doctor+hand+3901813960_c0f9cbde47.jpg" width="277" /></a></div>
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<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">We’ve all heard a lot about the pros and cons of ObamaCare. I'm sure we each have our opinions. But increasingly, we’re hearing about hidden or not-so-hidden aspects of the plan that will affect real seniors. Often the ones you and I care for. I recently wrote about the rationing that’s already happening in my <a href="http://generationsandwich.blogspot.com/2012/06/medicare-managed-care-chronicles-after.html" target="_blank">five part series on my mom’s care. </a></span></span><br />
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;"><br />Now Betsy McCaughey, Ph.D., author of <i>The Obama Health Law: What It Says and How to Overturn It</i>, <a href="http://www.foxnews.com/opinion/2012/09/12/obamacare-cuts-to-hospitals-will-cost-seniors-their-lives/" target="_blank">documents that one way ObamaCare will save money</a> is by paying less to hospitals and doctors. The government claims ObamaCare won’t hurt seniors – just those greedy providers. Hmmm, let’s think about that. If the government pays less to providers, the providers will have no choice but to provide less care. Although they are caring professionals, they, like all of us, can only provide the care they are paid for. They're businesses, not philanthropists. And for a fragile senior or person with a chronic illness, that can be harmful. Even fatal. McCaughey backs up these assertions with facts, figures, and historical data on hospital expenditures. I'm sure many of us can already back it up with real life. If you care for an elderly loved one or are over 65 yourself, consider this report when you vote in November. <br /> <br />Photo courtesy of <a href="http://www.flickr.com/photos/truthout/3901813960/" target="_blank">Flickr Creative Commons/Truthout </a> </span></span>Pathttp://www.blogger.com/profile/12105041530687619979noreply@blogger.com3tag:blogger.com,1999:blog-35202505.post-35708162399885403762012-08-24T01:00:00.000-07:002012-08-24T01:00:09.909-07:00Aftermath: Growing in Grace Through Grief<div style="font-family: inherit;">
<span style="font-size: small;"><a href="http://www.amazon.com/gp/product/1596693436/ref=as_li_tf_il?ie=UTF8&camp=1789&creative=9325&creativeASIN=1596693436&linkCode=as2&tag=sometifeellik-20"><img border="0" src="http://ws.assoc-amazon.com/widgets/q?_encoding=UTF8&ASIN=1596693436&Format=_SL160_&ID=AsinImage&MarketPlace=US&ServiceVersion=20070822&WS=1&tag=sometifeellik-20" /></a><img alt="" border="0" height="1" src="http://www.assoc-amazon.com/e/ir?t=sometifeellik-20&l=as2&o=1&a=1596693436" style="border: medium none ! important; margin: 0px ! important;" width="1" /> </span></div>
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<span style="font-size: small;">One of the givens in being a GenSandwicher is that whatever you’re dealing with now, it probably won’t get better and it probably won’t end well. I think that’s one of the most difficult parts of caring for aging parents and spouses. With our children we put up with diapers, spills and tantrums, knowing that in all likelihood, this too will pass. The child will grow, mature, and become someone we enjoy being with. Not so with eldercare. While we might experience briefs ups and downs, the general trajectory is toward a train wreck. The memory will fade more. The behavior will escalate. The sickness will progress. And then, our loved one will die. I'm not sure that as Americans we are prepared for such events. We often allow institutions to do much of our care giving because of distance, other commitments, or even a lack of willingness. No matter. At some point, we will be faced with the reality of death and disability. We will have decisions to make. And we will grieve. </span></div>
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<div style="font-family: inherit;">
<span style="font-size: small;"> It’s the grieving that many of us find difficult and confusing. Especially if our loved one lives far away or if our earlier relationship with the person wasn’t all that great. But the grief comes to each of us in our own way and time. <i>Aftermath: Growing in Grace Through Grief</i> by Margaret McSweeney is a book you might want to pick up when the time comes. The book is partially excerpts of an earlier book by her mother, Carolyn Rhea and partially Margaret’s processing of her own grief over the loss of her parents and brother—becoming an adult orphan. It sounds confusing. I wasn’t sure she could pull it off, but she did – and well. </span></div>
<div style="font-family: inherit;">
<br /></div>
<div style="font-family: inherit;">
<span style="font-size: small;"><i>Aftermath</i> is a comforting excursion through her grief process, organized around the Kubler-Ross five stages of grief – denial, anger, bargaining, depression, and acceptance. She adds shock in the beginning. In each chapter, she shares excerpts of her mother’s journals as she dealt with the death of her husband. McSweeney weaves in her own experiences of the same loss. Then she offers comfort from the Scriptures and counsel from experts. Each chapter has room for journaling, making it ideal for a grief group or for your own personal processing. </span></div>
<div style="font-family: inherit;">
<br /></div>
<div style="font-family: inherit;">
<span style="font-size: small;">Following these chapters, she offers other helpful suggestions for processing loss. <i>Aftermath</i> is a gentle book, one that will be an excellent companion as you face the inevitable in your care giving.
</span></div>
Pathttp://www.blogger.com/profile/12105041530687619979noreply@blogger.com1tag:blogger.com,1999:blog-35202505.post-87108934861700704392012-08-09T01:00:00.000-07:002012-08-09T21:10:51.450-07:00God Knows Your Name: In a World of Rejection, He Accepts You<a href="http://www.amazon.com/gp/product/1854249835/ref=as_li_tf_il?ie=UTF8&camp=1789&creative=9325&creativeASIN=1854249835&linkCode=as2&tag=sometifeellik-20" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" src="http://ws.assoc-amazon.com/widgets/q?_encoding=UTF8&ASIN=1854249835&Format=_SL160_&ID=AsinImage&MarketPlace=US&ServiceVersion=20070822&WS=1&tag=sometifeellik-20" width="131" /></a><img alt="" border="0" height="1" src="http://www.assoc-amazon.com/e/ir?t=sometifeellik-20&l=as2&o=1&a=1854249835" style="border: none !important; margin: 0px !important;" width="1" />
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<span style="font-size: small;">Do you ever feel anonymous in the midst of your care giving?
Between aging parents, children, grandchildren, work, and all the other
responsibilities we carry, it’s easy to feel like an automaton. It’s easy to
wonder if anyone knows your name, let along God! If this describes you, then
let me recommend a book I just completed: <i>God
Knows Your Name: I</i><i><span style="color: #262626;">n a World of Rejection, He Accepts You</span></i> by
Catherine Campbell.</span></div>
<div class="MsoNormal" style="font-family: inherit;">
<span style="font-size: small;"><br /></span></div>
<div class="MsoNormal" style="font-family: inherit;">
<span style="font-size: small;"><a href="http://www.catherine-campbell.com/" target="_blank">Campbell</a> is a nurse, writer, and inspirational speaker from
Northern Ireland. In addition, she had two children with genetic disabilities,
so she knows a bit about being overwhelmed and undervalued. She writes about people
who feel nameless, hopeless, worthless, helpless, powerless, and loveless. You’ll
enjoy the way she weaves together stories from both the Old and New Testaments
with stories of contemporary women from around the world. I especially loved
the way she researched the sociological, political, and religious context of
the biblical stories, and used this information to craft richly layered stories
that will capture your heart and your imagination. Even though I was familiar with
all of the Bible stories, Campbell brought them to life better than any other
author I've read, stressing the poignancy of the sad situations. And she did
the same with the contemporary stories. </span></div>
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<span style="font-size: small;"><br /></span></div>
<div class="MsoNormal" style="font-family: inherit;">
<span style="font-size: small;">So if you’re feeling a bit anonymous, or know someone who
is, you’ll appreciate <i>God Knows Your Name</i>.</span></div>
<div class="MsoNormal" style="font-family: inherit;">
<span style="font-size: small;"><br /></span></div>
<div class="MsoNormal">
<br /></div>
Pathttp://www.blogger.com/profile/12105041530687619979noreply@blogger.com1tag:blogger.com,1999:blog-35202505.post-5381507584200837142012-06-29T01:00:00.000-07:002012-06-29T01:00:05.677-07:00Medicare Managed Care Chronicles: After all, she’s 91… … (Part 5)<div style="font-family: inherit;">
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<span style="font-size: small;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhgoD7SRfbsOJ7cFJhw1IzytuZGPAIUQqlD655tb4al0z-dpg1tiXYDXjHtYDVIAK_InOMFa2ryNb-lAgD1SycdcWroeSXAMo69SdYbdKBXN3xEpKCK56DRAzs11MnhcuNYqmaS/s1600/Bureaucrat+iStock_000010936662XSmall.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="277" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhgoD7SRfbsOJ7cFJhw1IzytuZGPAIUQqlD655tb4al0z-dpg1tiXYDXjHtYDVIAK_InOMFa2ryNb-lAgD1SycdcWroeSXAMo69SdYbdKBXN3xEpKCK56DRAzs11MnhcuNYqmaS/s320/Bureaucrat+iStock_000010936662XSmall.jpg" width="320" /></a></span></div>
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<span style="font-size: small;"><br /></span></div>
<div class="MsoNormal" style="font-family: inherit;">
<br /></div>
<div class="MsoNormal" style="font-family: inherit;">
<span style="font-size: small;">Mom’s PT documented that she was still progressing, that she
was still a fall risk, and that she was benefiting from the exercises and
activity. He noted that he had not yet released her to walk independently. He
indicated that she is alert and oriented and understands her limitations. He
said that statistically, a patient’s diagnostic level drops a level upon
discharge to home or assisted living, so discharging prematurely is dangerous.
Later in the day he called United Health, and was told that a denial had <i>not</i> been issued, that they were still
reviewing the case. That it was still pending. United Health redirected him to
the HMO, which confirmed that a denial had been issued. The rep would not
budge. She cited Mom’s <i>age</i>, and the
fact that they have a fixed amount of money, and Mom had spent that so she had
to be denied. </span></div>
<div class="MsoNormal" style="font-family: inherit;">
<br /></div>
<div class="MsoNormal" style="font-family: inherit;">
<span style="font-size: small;">Given the multiplicity of mixed messages, we felt we had no
choice but to move Mom to assisted living. She was clearly not ready, but was
being forced to a lower level of care that <i>she</i>
has to pay for. She was discharged with orders to receive both home PT and OT two to three times per week in
assisted living. That didn’t happen. She had a few visits and is now being
discharged by home health. No one can tell me why. As a Medicare subscriber,
she has the <i>right</i> to receive care to
restore her to her prior level of functioning, as long as she is progressing. She
was progressing until she was denied that right by United Health and her HMO.</span></div>
<div class="MsoNormal" style="font-family: inherit;">
<br /></div>
<div class="MsoNormal" style="font-family: inherit;">
<span style="font-size: small;">By June 7, I still had not received a decision on the “expedited
appeal,” now a week late. I called again and received terrible customer service
from United Health who gave me a lot of misinformation. I finally spoke to a helpful
supervisor, who offered to receive and forward a summary of my complaint. I wrote
up the entire sordid affair and forwarded it to him, but have had not official response.
Finally on June 8 I received a written confirmation of the denial--dated May
30!</span></div>
<div class="MsoNormal" style="font-family: inherit;">
<br /></div>
<div class="MsoNormal" style="font-family: inherit;">
<span style="font-size: small;">It’s been a steep learning curve. Indeed, both private
insurance and Medicare are already throwing granny under the bus. The elderly
are not getting the care they have paid for and deserve. And we aren’t even
under Obamacare, which <i>removed</i> $500
billion from Medicare. Folks, we’ll be dealing with this type of ordeal for the
rest of our lives, fighting for care for both our parents and for us Boomers
who become eligible for Medicare over the next 20 years. If you’re old, don’t
expect to have your insurance cover you. Expect age discrimination. Expect to
spend many hours fighting coverage battles. And even if you are extremely
tenacious, expect to lose. </span></div>
<div class="MsoNormal" style="font-family: inherit;">
<br /></div>
<div class="MsoNormal" style="font-family: inherit;">
<span style="font-size: small;">Photo Credit <a href="http://www.istockphoto.com/stock-photo-10936662-at-you-a-problem-with-documents.php?st=c796632" target="_blank">iStockphoto </a> </span></div>Pathttp://www.blogger.com/profile/12105041530687619979noreply@blogger.com0tag:blogger.com,1999:blog-35202505.post-55735262092672146672012-06-28T01:00:00.000-07:002012-06-28T01:00:09.681-07:00Medicare Managed Care Chronicles: After all, she’s 91… … (Part 4)<style>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhxnhw5SauA2elpdZ7C3XqsA_eIUG1terspZUa5dmZIt2Iy56uXw-uAXpfIVi_oPHANTw366QWBV3nn0EYb_Ik48k34dDGn11yO9ZfYvAozewaAVH6iOR5OupDROPeaOPYfHiZH/s1600/Bureaucrat+iStock_000010936662XSmall.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="277" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhxnhw5SauA2elpdZ7C3XqsA_eIUG1terspZUa5dmZIt2Iy56uXw-uAXpfIVi_oPHANTw366QWBV3nn0EYb_Ik48k34dDGn11yO9ZfYvAozewaAVH6iOR5OupDROPeaOPYfHiZH/s320/Bureaucrat+iStock_000010936662XSmall.jpg" width="320" /></a></div>
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<span style="font-size: small;">When I again spoke to the HMO clerk, she was clear that the
decision was hers and she was not willing to reconsider, even though she had
considered only the selective portions of the medical record that upheld her
opinion. She (who had never seen my mother) declared that Mom had reached her
plateau (contrary to the PT notes) and after all, <i>she is 91</i>. The fact that she could transfer from bed and walk with
standby was sufficient for to make this decision, contrary to the professionals
who know my mother and were working with her! Too bad--there was nothing more
she could do. </span></div>
<div class="MsoNormal" style="font-family: inherit;">
<br /></div>
<div class="MsoNormal" style="font-family: inherit;">
<span style="font-size: small;">I was appalled! This is clearly a case of age discrimination
and of an insurance clerk overriding the professional opinions of the staff
treating the patient – the very thing Americans have feared with national
health insurance now happening before my eyes with a private pay patient. </span></div>
<div class="MsoNormal" style="font-family: inherit;">
<br /></div>
<div class="MsoNormal" style="font-family: inherit;">
<span style="font-size: small;">Photo Credit <a href="http://www.istockphoto.com/stock-photo-10936662-at-you-a-problem-with-documents.php?st=c796632" target="_blank">iStockphoto </a> </span></div>Pathttp://www.blogger.com/profile/12105041530687619979noreply@blogger.com0tag:blogger.com,1999:blog-35202505.post-63313427822243118872012-06-27T01:00:00.000-07:002012-06-27T01:00:06.186-07:00Medicare Managed Care Chronicles: After all, she’s 91… … (Part 3)<style>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhgoD7SRfbsOJ7cFJhw1IzytuZGPAIUQqlD655tb4al0z-dpg1tiXYDXjHtYDVIAK_InOMFa2ryNb-lAgD1SycdcWroeSXAMo69SdYbdKBXN3xEpKCK56DRAzs11MnhcuNYqmaS/s1600/Bureaucrat+iStock_000010936662XSmall.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="277" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhgoD7SRfbsOJ7cFJhw1IzytuZGPAIUQqlD655tb4al0z-dpg1tiXYDXjHtYDVIAK_InOMFa2ryNb-lAgD1SycdcWroeSXAMo69SdYbdKBXN3xEpKCK56DRAzs11MnhcuNYqmaS/s320/Bureaucrat+iStock_000010936662XSmall.jpg" width="320" /></a></div>
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<span style="font-size: small;">The next day (May 31) we learned that the initial denial had
been issued by her HMO’s case manager. We had not even known of her existence
until this point. This was beginning to feel like a shell game, never knowing
who to talk to or who had the authority. I asked her surgeon and PT to help
with the appeal. Both agreed and made calls. The PT had run more tests and
stated that Mom was still a fall risk. The clerk never returned the physician’s
call. Remember, their professional opinions had been overridden by an insurance
clerk! And the decision seemed to be age-related. I didn’t think the death
panels had been activated yet. </span></div>
<div class="MsoNormal" style="font-family: inherit;">
<br /></div>
<div class="MsoNormal" style="font-family: inherit;">
<span style="font-size: small;">I also called United Health again, trying to figure out who
had the authority to reverse this decision. I was told I could file an expedited
appeal, meaning they to respond within 72 hours. However, if they upheld the
denial we would be responsible for any additional days. The rep said the
clinical staff would review all of the information and contact both the PT and
the physician for more information. You can imagine the uncertainty this
creates for the patient and family, not knowing if the insurance they have paid
for and depended on for years will continue to cover needed services. It puts
the entire burden of risk on the patient and none on the insurance. Not quite a
fair situation! The rep was quite glib in saying that if Mom needed skilled
care, of course she should stay in rehab, but of course, he could not assure us
that the care could be covered. We decided to keep her at rehab until a family
member could move her on Saturday, June 2, not knowing if it would be covered
or not. The rep also indicated that if we were denied, there was yet another
level of appeal, but it seemed like a moot point since by then she would already
have moved.</span></div>
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<br /></div>
<div class="MsoNormal" style="font-family: inherit;">
<span style="font-size: small;">Photo Credit <a href="http://www.istockphoto.com/stock-photo-10936662-at-you-a-problem-with-documents.php?st=c796632" target="_blank">iStockphoto </a></span></div>
<div class="MsoNormal" style="font-family: inherit;">
<br /></div>Pathttp://www.blogger.com/profile/12105041530687619979noreply@blogger.com0tag:blogger.com,1999:blog-35202505.post-207357436328916802012-06-26T01:00:00.000-07:002012-06-26T01:00:01.854-07:00Medicare Managed Care Chronicles: After all, she’s 91… … (Part 2)<style>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhxnhw5SauA2elpdZ7C3XqsA_eIUG1terspZUa5dmZIt2Iy56uXw-uAXpfIVi_oPHANTw366QWBV3nn0EYb_Ik48k34dDGn11yO9ZfYvAozewaAVH6iOR5OupDROPeaOPYfHiZH/s1600/Bureaucrat+iStock_000010936662XSmall.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="277" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhxnhw5SauA2elpdZ7C3XqsA_eIUG1terspZUa5dmZIt2Iy56uXw-uAXpfIVi_oPHANTw366QWBV3nn0EYb_Ik48k34dDGn11yO9ZfYvAozewaAVH6iOR5OupDROPeaOPYfHiZH/s320/Bureaucrat+iStock_000010936662XSmall.jpg" width="320" /></a></div>
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<span style="font-size: small;">We waited all weekend for a response. Did we need to move
her or not? It was a time of uncertainty, which caused her blood pressure to
rise and her progress to regress a bit. The rehab facility staff said the delay
was unusual. Responses to appeals were usually received quickly, usually within
the hour. We were at a loss to know what to do. It was a holiday weekend. No
one could answer any questions. Her discharge date was scheduled for Memorial
Day. We had made arrangements with Assisted Living, but they could not receive
her on the holiday.</span></div>
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<span style="font-size: small;">We didn’t receive any response until two days <i>after</i> Memorial Day, on May 30 at 4:00 pm
when staff informed me that they had received a verbal denial. I called HSAG again.
The rep said that the earlier denial would stand. The last covered day would be
May 30 (today). I asked her the reason for the denial. She said that the
patient was medically stable and ambulating independently for 200 feet. This
was <i>not true</i> and <i>not</i> what the record said. The rep said that they had determined
that she had hit her plateau. <i>“After all,
she is 91.”</i></span> </div>
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<span style="font-size: small;">Photo Credit <a href="http://www.istockphoto.com/stock-photo-10936662-at-you-a-problem-with-documents.php?st=c796632%20" target="_blank">iStockphoto</a> </span></div>
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</span><span style="font-family: inherit;"> </span></span>Pathttp://www.blogger.com/profile/12105041530687619979noreply@blogger.com0tag:blogger.com,1999:blog-35202505.post-44290705990409400682012-06-25T01:00:00.000-07:002012-06-25T01:00:00.864-07:00Medicare Managed Care Chronicles: After all, she’s 91… (Part 1)<div class="separator" style="clear: both; text-align: center;">
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I confess, I'm still amazed at the craziness of being a GenSandwicher. Especially in dealing with the health care system. And we don’t even have ObamaCare yet! For the next five days, I'm going to share how I've spent the past months of my life. I hope it will alert some of you remain vigilant and determined in seeking coverage for your Medicare- and managed care-covered aging parents. Mom’s insurance is a Medicare Advantage program run by United Health and managed by an HMO. Your experience may differ depending on your specific situation.<br />
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Mom fell and broke her hip in mid-April. She was in the hospital for a few days, then moved to rehab for about six weeks. Mom’s last week in rehab was amazingly frustrating. Her physician and physical therapist (PT) agreed that she was making good and steady progress toward reaching her prior level of functioning, which is apparently what the professional standard of care is. Although they recommended she remain in rehab for several more weeks, we had heard rumors that an insurance denial was in the works. It finally came in at 3:00 pm the Friday before Memorial Day. Her last day of covered care was to be on Memorial Day. Really?<br />
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All of the rehab facility staff we needed to help with our appeal had already disappeared for the weekend, leaving me with a clerk who had never done a Medicare appeal. In case you also haven’t navigated an appeal, here’s my experience. There is a number you call to a group called HSAG to file a Medicare appeal. After the requisite time on hold, I was asked why I was appealing the decision. I quickly went through all the reasons: she’s still progressing, had not reached her prior level of functioning, was still a fall risk, had not been released to do much without standby assistance, her physician and PT believed she needed more time, etc. I went through it quickly because I assumed I'd be asked clarifying questions. The clerk simply took the information (or so she said) and thanked me. She said that she would forward the appeal to the United Health appeals and grievances department, which could take up to two days to make the decision. When I asked the reason for the denial, she indicated that the patient had reached her “expected level of recovery” since she could get out of bed and to the bathroom. <i>“After all, she is 91 years old.”</i> <br />
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Yes, but prior to her fall, she was living independently in her own home, driving the old people around, cleaning, shopping, managing her finances. Living life. To justify the denial they now say, <i>“After all, she is 91 years old.” </i><br />
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Photo Credit <a href="http://www.istockphoto.com/stock-photo-10936662-at-you-a-problem-with-documents.php?st=c796632" target="_blank">iStockPhoto</a>Pathttp://www.blogger.com/profile/12105041530687619979noreply@blogger.com1tag:blogger.com,1999:blog-35202505.post-20663560027709222312012-05-16T01:00:00.000-07:002012-05-16T01:00:02.197-07:00Taking Care of the Caregiver<div class="separator" style="clear: both; text-align: center;">
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<br /><br />I've been writing about being a caregiver on hospital duty. On Monday, I wrote about <a href="http://www.generationsandwich.blogspot.com/2012/05/hospital-duty-part-6-taking-care-of.html" target="_blank">taking care of yourself when your loved one is in the hospital</a>. Today I saw a great article called <a href="http://www.care2.com/greenliving/relaxing-can-be-hard-4-tips-to-learn-how-to-unwind.html" target="_blank"><i>How to Unwind: 4 Tips for Caregivers</i></a> which offers even more ideas for taking care of yourself, whether you are at the hospital or caring for a loved one at home. <br /><br />Today I spent most of the day on the phone trying to manage Mom’s care in a rehab facility that’s four hours away. I had hoped she would be discharged when I'm there next week, but it doesn’t look like that will happen then, and her therapists want her to go from rehab to assisted living before going home. So, tomorrow I get to spend the day on the phone arranging for assisted living. This puts me way behind on my own work, and leaves “fun” somewhere in the “in between” moments. I need reminders like this to enjoy the moments when I can. Otherwise, life becomes very barren...<br /><br />What do you do to take care of yourself in the midst of caregiving? Share your strategies with us.<br /><br />Photo Courtesy of <a href="http://www.flickr.com/photos/joost-ijmuiden/4486825903/" target="_blank">Flickr Creative Commons/Joost J. Bakker IJmuiden</a> Pathttp://www.blogger.com/profile/12105041530687619979noreply@blogger.com0tag:blogger.com,1999:blog-35202505.post-20164076202678892222012-05-14T01:00:00.000-07:002012-05-14T01:00:04.345-07:00Hospital Duty – Part 6 Taking Care of Yourself<div class="separator" style="clear: both; text-align: center;">
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<br /><br />Since my primary goal when I'm on hospital duty is to be available to talk to the caregivers, I try to not leave the room for long. This is especially true if I'm waiting to see a particular doctor. I tell you, those docs are like phantoms. They can be in and out before you know it, and with my luck, my lunch break will be the 35 seconds they decide to come and look in on the patient. So I arrive in the morning as self-sufficient as possible. For me, that means food and activities.<br /><br />Food is the most important thing in my bag. I bring anything I can eat without leaving the room. This might include power bars, cut up fresh fruit, dried fruit, crackers and cheese, a sandwich, … and of course, chocolate. And water. What I have available is somewhat dependent on where I'm staying. If the hospital is near my home, I have more flexibility. For my sister’s last hospitalization, I stayed with a friend in Sacramento. Before leaving home, I filled a plastic tub (yep, the big ones!) with enough food to feed an army. Every day I would select what I thought I might need during the day and pack it in my tote bag. If I know I have a time when no one will want to talk to me, like during surgery or a procedure, I might go to the cafeteria. But if that isn’t possible, this girl isn’t going to starve.<br /><br />I’m not one to just sit idly by while the patient sleeps. While I need to be alert, the reality is, the patient will spend a lot of time sleeping. Conversation is minimal and there are big and small blocks of time that need to be filled. This, of course, depends on your personality. I always bring a book or magazine, but I also have to watch the amount of weight I carry. In the first few hospitalizations I was able to use my iPod Touch and then my iPhone to check email. Thankfully, all of the hospitals we’ve used offer free wifi – a wonderful perk for family members. When it became apparent that I was in for more long days of another hospitalization, I gave in and bought an iPad. With that, I can write, update a blog, type longer emails, and generally try to keep my business on life support. I also have many books on my Kindle app, so that eliminated the weight of the book or magazine. It was expensive, but for me, my personality type, and my business needs, it was worth it. <br /><br />If you’re spending days in the hospital, usually in a not-too-comfortable chair, it’s important to get exercise. You won’t be able to do aerobics or cardio in the room, but be sure to take time to walk the halls when you can. I would usually stay within eyesight of the patient’s room, but would make sure to walk briskly for 15 or 20 minutes a couple of times per day. Between that and the sometimes VERY long trek to the parking lot, I managed to at least keep the blood flowing. <br /><br />One more area of self-care has to do with the sights you see. I'm pretty good with blood, surgical wounds, etc. I was even good with my sister’s huge open sores. I was able to be a great support during the tortuous dressing changes. I thought I was doing fine. But after a week or so into her third hospitalization, I found myself getting very irritable and not sleeping well. After awhile, I realized that I was experiencing secondary PSTD from watching her be “tortured” every day. I needed to do some self-care to be able to continue supporting her. With a bit of refocus, I was able to continue caring for her while also caring for me.<br /><br />You generally won’t know how long you need to be on duty. You may have an idea, but things change. Remember that for you, this is a marathon, not a sprint. You need to put on your own mask before helping your loved one.<br /><br />Photo Courtesy of <a href="http://www.flickr.com/photos/rsutphin/3080818405/sizes/m/in/photostream/" target="_blank">FlickrCreativeCommons/RhettSutphin</a> <br /><br />Pathttp://www.blogger.com/profile/12105041530687619979noreply@blogger.com2tag:blogger.com,1999:blog-35202505.post-58869846236207030572012-05-09T01:00:00.000-07:002012-05-09T01:00:03.009-07:00Hospital Duty -- Part 5 Dealing with Nurses<div class="separator" style="clear: both; text-align: center;">
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The nurses serving your loved one can be you ally or enemy. They can work with you or keep you in the dark. It’s always my aim to work with them, to support them in any way I can, and to be as friendly and gracious as I can be. When I arrive I the morning, I check the white board in the room and find out who is staffing my loved one. There is always an RN and one or two other staff. These others vary by facility, but are always lower levels of licensing. In California, you will find Licensed Vocational Nurses (LVNs) and Certified Nursing Assistants (CNAs). As soon as possible, I make contact with each of these people and introduce myself if they don’t know me. I check on what’s happened through the night and any scheduled procedures for that day. I always try to be positive and upbeat. It will pay off when I need something.<br />
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It’s important to know who does what in your hospital. For example, only an RN can give medications, start an IV, or do certain other procedures like complex dressing changes. If you ask one of the other staff for this, all they can do is give the message to the nurse. Generally bed changes, grooming, and toileting are done by the other staff. Don’t ask the RN. <br />
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Nurses these days are overworked and under-appreciated. Many work 12 hour shifts. They may or may not have time to review the patient's full record, especially if things are changing quickly with the patient. This is where my notebook and I shine. I'm often the only person in the room who knows the what’s been done and what the history is. I assume that they know what they’re doing until I see something that concerns me. Then I'll ask a question. Either, “what” or “why,” or if I'm sure something is not right, “Are you aware…?” The what’s and why’s educate me. For example, one nurse mentioned that my sister should not have an IV because the antibiotic she was on was hard on the veins. There were two IV nurses checking her arms for a good IV site. After a bit I said, “By the way, are you aware she’s on vancomycin?” They obviously hadn’t checked her chart. “Oh, that changes everything!” they said and proceeded to order a picc line. Incidents like this happened several times per hospitalization.<br />
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I always try to check out with the nurses when I'm ready to leave. And I always try you be upbeat and gracious. It usually pays off with both information and suggestions, and better care for the one who often doesn’t feel well enough or alert enough to be gracious. So work with your nurses. Be their asset, not a nuisance. You’ll be glad you did. <br />
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Photo Courtesy of Flickr Creative Commons/<a href="http://www.flickr.com/photos/christianacare/3856170197/" target="_blank"><span class="name" id="yui_3_4_0_3_1336371890748_1672"><b class="username" id="yui_3_4_0_3_1336371890748_1676">Christiana Care </b></span></a>Pathttp://www.blogger.com/profile/12105041530687619979noreply@blogger.com0tag:blogger.com,1999:blog-35202505.post-84344948904802421112012-05-08T01:00:00.000-07:002012-05-08T01:00:10.107-07:00Hospital Duty -- Part 4 Dealing with Doctors<div class="separator" style="clear: both; text-align: center;">
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My goal is to talk to every doctor on the case at least one a day. In the hospital system Sis and Mom are in, a hospitalist has primary responsibility for inpatients, with specialists being called in as needed. I’m usually able to get the hospitalists to agree to come while I'm there since they are in the hospital all day. Specialists, on the other hand, are coming from their practices and they come when they come. However, I would tell each one when I expected to be there and many have accommodated me. I keep a list of questions for each provider so I can use their time efficiently. By being the constant voice for the patient, I find that most physicians not only work with me, but even appreciate my participation as long as I don't try to do their jobs for them. Again, the patient is usually too sick to ask good questions or remember what’s said. They need an advocate who is tracking for them.<br />
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Photo Courtesy of Flickr Creative Commons/<a href="http://www.flickr.com/photos/tamaiyuya/6103129560/sizes/m/in/photostream/" target="_blank">Yuya Tamai</a>Pathttp://www.blogger.com/profile/12105041530687619979noreply@blogger.com0tag:blogger.com,1999:blog-35202505.post-64000321317633552572012-05-07T01:00:00.000-07:002012-06-24T22:48:33.618-07:00Hospital Duty -- Part 3 Take Good Notes<div class="separator" style="clear: both; text-align: center;">
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<span style="font-size: small;"><span style="font-family: inherit;">One of the keys to my effectiveness as a patient advocate is the spiral notebook I maintain for each patient. This is simply a chronological record of everything I learn and questions I have. On the inside front cover, I list the names and telephone numbers of each physician. This is particularly important as in my sister’s case where she’s seen at least a dozen docs over the past year and a half. I also keep track of the names of office staff I've talked to. They appreciate being called by name the next time I call back.</span><br style="font-family: inherit;" /><br style="font-family: inherit;" /><span style="font-family: inherit;">Each day I'm at the hospital I note the date and anything of importance that happens that day -- tests, physician consults, med changes, allergies, answers to questions, problems, names of helpful staff, ... anything ... I also log telephone calls both during and between hospitalizations. This binder has been invaluable over time. I'm usually the only person in the room with an accessible record of care, especially over multiple hospitalizations. I can't tell you how many times my notes have prevented duplicate tests or treatments or even treatment errors. This not only protects the patient, but also helps the staff do their job better. So as soon as you know you’re in for hospital duty, grab a notebook!</span></span><br />
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<span class="name" id="yui_3_4_0_3_1336361825089_966"><b class="username" id="yui_3_4_0_3_1336361825089_970"><a href="http://www.flickr.com/photos/tamaiyuya/"></a></b></span>Pathttp://www.blogger.com/profile/12105041530687619979noreply@blogger.com0tag:blogger.com,1999:blog-35202505.post-58947306286767780102012-05-04T01:00:00.000-07:002012-05-03T22:14:49.373-07:00Hospital Duty -- Part 2 -- Your Presence is Required<div style="font-family: inherit;">
<span style="font-size: x-small;">I know this isn't always possible for GenSandwichers, but if a loved one is in the hospital, it's important for them to have an advocate on site at least during the day. It would be ideal to have someone in the room 24/7 but I know that's almost impossible for most of us. But try to be present as much as possible during the day.<br /><br />When Sis and Mom were in the hospital, I would arrive as early as possible, which for this night-person was usually 9:30 or 10:00 am, and would stay at least until after dinner. The exact times depended on what was being done that day, how important my presence was, and how far I had to drive. If a procedure was scheduled early, I would be there for that. Otherwise, I would arrive by 10:00. <br /><br />Why is this important? These days you don't get to stay in the hospital unless you're very ill. This usually involves pain meds, painful tests, and even surgery. The result is that the patient is usually in no condition to advocate for herself or understand what is being done for what reason. She's often sleeping, groggy, in pain, and disoriented. And some, like both Mom and Sis, are afraid to advocate for themselves. They take on even more of a passive victim spirit than usual. They don't want to offend or inconvenience the staff, so they let things go. <br /><br />So my job is to advocate for them. My job is to not be afraid. Of course I try my best to be polite, innocent, even humorous so as not to offend, but I'm awake and alert and the patient isn't.<br /><br />Of course, it helps if you know something about medicine, but that isn't a requirement. My rule of thumb is to ask questions until I understand. If I can't get an answer from one person, I ask the next one. I keep asking until I learn the terminology and understand the concept. Then I can explain it to the patient. I find that most staff is willing to answer questions if I'm sensitive to the timing. And since I relieve them of some of their more mundane responsibilities, they quickly learn to value my presence and work with me. <br /><br />So if possible, be present as much as you possibly can.</span></div>Pathttp://www.blogger.com/profile/12105041530687619979noreply@blogger.com0tag:blogger.com,1999:blog-35202505.post-3149760150221223702012-05-01T01:30:00.000-07:002012-05-03T22:06:59.423-07:00Hospital Duty -- Again!<div style="font-family: inherit;">
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<span style="font-size: x-small;">Back in October I wrote a series of <a href="http://generationsandwich.blogspot.com/2011/10/sandwich-with-pickle-on-side-part-1.html" target="_blank">four posts</a> chronicling the saga of my sister’s hospitalizations. After she was
discharged to home in September, she seemed to live in limbo for the next
several months. I would visit once a month and watch the wounds get worse. Things
looked pretty hopeless. She saw another wound doctor, who refused to do
anything until she had the vascular surgery. But no one would touch her.</span></div>
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<span style="font-size: x-small;">Then in March she got a referral to a vascular surgeon in
Sacramento who was willing to attempt the surgery. In fact, she seemed pretty
confident. Sis was admitted on March 27 and thus began round two of my hospital
duty. The surgery was March 30, and it was successful! She was discharged April
4. I spent the whole 10 days with her at the hospital, all day, every day. She
was discharged to a nursing home and I drove home, arriving a full two hours
before my kids arrived for Easter.</span></div>
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<span style="font-size: x-small;">We had a wonderful five days together. I cooked Easter
dinner for 12 (with lots of help from my guests). Meanwhile, Sis’s hubby
checked her out of the nursing home and took her home. He felt he could provide
better care and I think he was right. </span></div>
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<span style="font-size: x-small;">When the kids left, I had three days to finalize prep for a
training conference I was doing on Saturday. In my exhausted condition, that
one about did me in. I kept telling my body that it just had to make it through
Saturday evening. It did – barely. I hurt all over. Sunday I slept.</span></div>
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<span style="font-size: x-small;">Then the other shoe dropped. Sunday evening, about 9:00 pm,
Mom called. She had fallen and thought she had broken her hip. Why she called
me rather than pressing her lifeline button I don’t know. But she did. I told
her to press her button and wait for the paramedics. I called the hospital an
hour later and sure enough – broken hip. I repacked my suitcase and was on the
road again Monday morning.</span></div>
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<span style="font-size: x-small;">Mom had surgery Monday night. All went well. I stayed with
her through Friday, when I drove home for my Saturday class. Mom was discharged
on Thursday and moved to rehab. I went to my all-day class Saturday, slept
Sunday, and headed back on Monday. Spent the week with her at the rehab
facility. Drove home Thursday to celebrate our anniversary on Saturday. I think
I'm home for awhile…</span></div>
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<span style="font-size: x-small;">So, for the next several posts, I'm going to share what I've
learned about hospital duty. And I've learned a lot. </span></div>
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<span style="font-size: x-small;">Photo Courtesy of <a href="http://www.flickr.com/photos/boliston/2529247354/" target="_blank">Flickr Creative Commons/Boliston</a> </span></div>Pathttp://www.blogger.com/profile/12105041530687619979noreply@blogger.com0tag:blogger.com,1999:blog-35202505.post-58241068632127491552012-04-03T00:30:00.000-07:002012-04-03T00:30:02.443-07:00Will Narcissism Compromise our Eldercare?<div class="separator" style="clear: both; text-align: center;">
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<span style="font-size: small;"><br />Those of us in the Boomer generation know that our prospects for receiving eldercare are not as good as those of our parents. For starters, we had fewer children to spread the load. While it takes two of us, plus my hubby, to care for Mom, Hubby and I have one son and one DIL. And in addition to us, they have her mom. And, they will hit the care giving stage at least ten years younger than we did -- while still caring for children at home. They will be more sandwiched than we are. <br /><br />Add to this an article in <a href="http://www.caring.com/blogs/fyi-daily/who-will-take-care-of-you?utm_medium=email&utm_source=suggests&utm_content=20120331">Caregiving.com</a> that suggests that the younger generation also lacks the emotional temperament to provide good care. They cite a culture of narcissism as a barrier to both family and institutional care from the younger generation. <br /><br />The author describes a key element to narcissistic behavior as “chronic empathic failure: the ability or willingness to recognize, perceive, and relate to the emotions of another person, to experience the world from another’s point of view…empathy develops over time, reinforced constantly by positive experiences of emotional attunement with others….” He says the young generation risks "favoring self promotion over helping others" and may have a harder time forming relationships.<br /><br />I'm grateful that our kids are not narcissistic. They do have empathy. But they're also very busy with their own lives. They care, but aren’t in a position to drop everything and sit at the hospital for a week like I've been doing. That’s the luxury of people my age. But how do we prepare them for the inevitable care giving they will need to do? Your thoughts?</span></div>
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<span style="font-size: x-small;">Photo courtesy of<span class="name" id="yui_3_4_0_3_1333251216019_1955"><b class="username" id="yui_3_4_0_3_1333251216019_1959"> <a href="http://www.flickr.com/photos/batega/1865482908/">Josep Ma. Rosell</a> </b></span></span><span style="font-size: small;"><span style="font-size: x-small;"> via Flickr Creative Commons</span></span></div>Pathttp://www.blogger.com/profile/12105041530687619979noreply@blogger.com3