Archive for the 'EHSC' Category



George Hohman

George was a significant asset to rural Alaska and did a lot of good as state senator, including his work on the permanent fund and for elders. Unfortunately, being effective for rural Alaska also means being a target.

This news story is a fair summary of a remarkable person.

BETHEL, AK (2006-11-24) Residents in the Yukon-Kuskokwim Delta are giving thanks this week for having known George Hohman. The former state senator and Bethel city manager passed away peacefully Monday after a long illness. He was 74.

© Copyright 2006, APRN

A little bit more background–
George joined the military in 1952, studied Russian language at the Presidio in Monterey. In 1954 he was sent to Fort Richardson in Alaska where he was a Russian translator, and then to the Pnbilof Islands to study the influence of the Russian language on the Native language in that area. He returned to Alaska with his family in 1962 to teach for the Bureau of Indian Affairs in the Yukon-Kuskokwim Delta. He taught in the villages of Emmonak, Nunapitchuk, Bethel and was principal/teacher in Kwigillingok for two years.

In 1972 he successfully ran for the State Senate. George represented the Yukon-Kuskokwim and Bristol Bay Districts in the Alaska State Legislature for 16 years, serving in both the House and Senate.

Grabbing public toilets

The comment left here

pointed out that generic grab bars in public toilets were not best suited to individuals at home.

Here are examples from our publicly funded senior center. Click on the pictures below to see a larger version. Try the frailty simulation with either toilet [When you visit the senior center –
https://theelderlies.wordpress.com/2005/08/06/ when-you-visit-the-senior-center/]

Place one hand behind your back and stand on one foot. Now, sit down. Then, stand up.

I think each wall tile is 4 inches square (on a side, a.k.a., 4 by 4 inches).

This bathroom is as it appears after (and before) the $280,772 Alaska state community development block grant for senior center improvements. [Bethel Senior Center Building Grants
https://theelderlies.wordpress.com/2005/08/17/senior-center-building-grants/]

This first photo is of our “handicapped” toilet (one of two women’s toilets in the Bethel senior center ground floor.) There are 2 bars, to an elder’s right and back (as seated). Click on each photo to see a larger view.

EHSC “Handicapped” toilet

Here’s the only other woman’s toilet on the first floor. For both, note the grab bars, the extra stall width, the floor to seat height. We fortunately have a variety of older body-types (and abilities) so having just the one standard inflexible set of fixtures levels the playing field and provides equal opportunity aches, pains, strains, ligament tears, fragility fractures.

EHSC Second women’s toilet, 2006

How well did you do on the tests?


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Ethnic stereotyping and ageism

The post office box this week held an issue of the New Yorker which generated mixed feelings. Many New Yorker cartoons (http://www.cartoonbank.com/) are funny because they skewer our fallacies and foibles using the stereotypes we all have about each other. Most of the stereotypes protrayed are of rich white folk.

This recent cartoon is funny because it reveals the biased attitude many employers have towards older workers. Unfortunately, the medium of expressing a worthy idea is based upon an ethnic stereotype which is problematic, at the best.


by Lee Lorenz

Hold it—we almost forgot his benefits package.” (Two eskimos sending a third out to sea on a small slab of ice.)

ID: 122851, Published in The New Yorker September 11, 2006, http://tinyurl.com/fzgsq

The stereotype underlying the cartoon’s point about ageism is false. Recently we had a physician lie about just such a scenario, up north. People were quite hurt by the accusation.

JAMA falls foul of fabricated suicide story [JAMA is Journal of the American Medical Association]

by Deborah Josefson, San Francisco

An essay published in JAMA’s Piece of my Mind section, has stirred controversy after it was revealed that the events depicted in it were fictional.

The essay was written by a medical student, Shetal Shah, and appeared last October (JAMA 2000;284:1897-8). In his essay, Mr Shah described an encounter with a 97 year old Inuit [sic. Eskimo people live in Alaska and Inuit people live in Canada.] man, a toothless elderly member of the Siberian Yupik tribe, who, feeling useless, came to say goodbye to the young medical student before committing suicide by walking off into a frozen tundra in the morning fog.

In a letter to JAMA, Dr Michael Swenson, a physician with Norton Health Sound in Nome, Alaska, and Shah’s tutor during his elective, denied the existence of such a patient. Moreover, Dr Swenson charged that Mr Shah’s false account promulgates false stereotypes about the Inuit people and perpetuates ancient myths…. Dr Swenson said that he understood Mr Shah’s tweaking of events to make them more of a story but said that the account was entirely fictional and as such reflected more of our culture’s prejudices towards elderly people than those of the Siberian Yupik….

Read the story in the British Medical Journal, on-line here

http://bmj.bmjjournals.com/cgi/content/full/323/7311/472/a

I’m not sure there is any evidence for any such a scenario in the past, except maybe under extreme conditions of long ago.

Certainly, such a slur against a large group of US citizens should not have been printed in the New Yorker. As the response to the BMJ article said,

When will medical journals learn to leave anecdotes for Cosmopolitan and fictionalized accounts for the New Yorker? The author’s explanatory note is lame in the extreme. BMJ 2001;323:472 ( 1 September )

On the other hand, I am not as troubled by Sam Gross’ cartoon at the bottom, in part because he skewers every stereotype and in part because it highlights so well the predominant establishment attitude around here about caring and valuing older people.

This is 2006. We have no nursing home; we had an assisted living residence, which was never used as such. Another assisted living residence was promised to open September 2005. After several people inquired publicly, the health corp. finally announced it might open in 2008.

July 15, 2006, Assisted living home construction could begin soon

Construction on an Assisted Living Home in the YK Delta for elders and adults with disabilities may be just beyond the horizon.

“Establishing an assisted living home is important because we have an aging population in our region and we don’t have a facility where we can take care of them properly,” said Gene Peltola, CEO of the Yukon-Kuskokwim Health Corporation.

Despite the fact that the elderly make up one of the fastest growing populations in the YK Delta, the region remains as the only area in Alaska that has no long-term assisted living facility.

http://www.ykhc.org/1253.cfm

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~


by Danny Shanahan

“Remember, son, it’s never too early to start saving for retirement.” (Father talking to son as he pushes an elderly Eskimo out to sea on an ice floe.)

ID: 46757, Published in The New Yorker November 26, 2001, http://tinyurl.com/gqwvu

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~


by Christopher Weyant

“It’s your mother. She’s floated back.” (Two eskimos watch a third float back on his ice floe.)

ID: 122883, Published in The New Yorker September 18, 2006, http://tinyurl.com/znx2s

I have never appreciated mother-in-law jokes as they are inherently misogynist. The above is next week’s New Yorker take on Eskimos.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

by Sam Gross

“Are you sure this ice floe is going to pass by the nursing home?” (Elderly Eskimo on ice floe shouts back to family who are waving good-bye.)

ID: 42864, Published in The New Yorker November 22, 1999, http://tinyurl.com/j6soq

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Ann Fienup-Riordan, Ph.D. has explored Alaska Eskimo stereotypes and other portrayals in the movies—
Freeze Frame book jacket

http://www.washington.edu/uwpress/search/books/FIEFRP.html

“Freeze Frame, Alaska Eskimos in the Movies” by Ann Fienup-Riordan, Pub Date: August 2003,
ISBN:Paper: 0-295-98337-X


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Bath falls common among older adults, but can be prevented

This isn’t new news but the use of videotape for actual “ethology” (observation of behavior) is a good idea. It is most worthwhile to remind everyone that ordinary bathroom fixtures are not suitable for those needing assistance and are not appropriate for older people; frequently not even appropriate for anyone, tall or short, lithe or lazy. See the Bethel Senior Center for what should be banned in public facilities (When you visit the senior center). Emphasis added.

Public release date: 13-Sep-2006,

http://www.eurekalert.org/pub_releases/2006-09/uomh-bfc091306.php

Installation of proper equipment essential

ANN ARBOR, Mich. — Getting in and out of the bathtub or shower can be a perilous journey for older adults, even when they have bathrooms already equipped with safety features, according to research by the University of Michigan Health System.

Researchers videotaped people ages 60 and older who demonstrated (while fully clothed) how they normally climbed in and out of the shower or tub. One-third of the 89 participants in the study had difficulty, such as plopping onto a tub seat or hitting the side of the tub or the shower threshold with their legs.

“We found that there are a lot of independently bathing older adults who have trouble or are unsafe getting into and out of the tub or shower stall,” says lead author Susan L. Murphy, ScD, OTR, an occupational therapist and research assistant professor with the University of Michigan Medical School’s Division of Geriatric Medicine, part of the Department of Internal Medicine. The study appears in the Journal of the American Geriatrics Society.

“For older adults, losing the ability to bathe is associated with having falls, fracturing bones, and even being admitted to a nursing home. It is important that we take steps to help to prevent bathing disability before it occurs,” Murphy says.

One of the major problem areas the researchers found involved sliding glass doors in showers. Three-quarters of participants who used shower stalls with sliding glass doors tried to utilize the door for stability or balance.

“This is extremely unsafe because shower doors were not designed to support a person’s weight,” Murphy says. “This problem could be easily remedied by educating older adults not to use the door as a support or possibly replacing it with a shower curtain, which was used only rarely by older adults in this study.”

Participants in the study were residents of two congregate housing facilities and had no cognitive impairment. They were videotaped as they demonstrated how they used their environment while getting into and out of the shower or tub – that is, whether they used grab-bars, towel bars, shower curtains, glass doors, tub seats, and other parts of the tub to assist themselves.

The videotapes were also evaluated for the participants’ fluidity of movement and whether they had difficulty negotiating the environment. While the majority of people using both tubs and shower stalls used safe environmental features such as grab bars, many used unsafe features in addition to the safe ones. Nineteen percent of participants using a tub were evaluated as using unsafe features, and more than 70 percent of those with shower stalls used unsafe features, such as the glass door, towel bar or a tub seat. One participant had a plastic lawn chair as a tub seat, a particularly dangerous device given curved shape of the tub floor.

Some safety problems researchers observed can be fixed easily such as the installation of a shower curtain in place of a door, and proper instruction about built-in bathroom safety features (such as grab bars designed for weight-bearing) for new residents of senior housing facilities. A focus on better designs of bathrooms in senior housing facilities was also suggested by the researchers.

“We think the results from this study demonstrate the need for healthcare professionals to become involved in helping to prevent bathing disability, instead of just treating people in the hospital after they have had a fall in the bathroom,” she says. “While bathrooms in senior housing facilities are designed to be safe, we have found that older adults often do not know the difference between a grab bar and a towel bar. They also have unsafe strategies of getting into and out of their shower or tub. Occupational therapists often see older adults for bathing problems and would be ideal to intervene with older adults before they start to lose the ability to bathe.”

###

In addition to Murphy, the authors on the paper were Neil B. Alexander, M.D., professor in the Division of Geriatric Medicine, Department of Internal Medicine, and director of the Geriatric Research, Education, and Clinical Center, VA Ann Arbor Health Care System; Linda V. Nyquist, Ph.D., senior research associate-social sciences, Institute of Gerontology; and Debra M. Strasburg, M.S., P.T., research physical therapist, VA Ann Arbor Health Care System.

The research was supported in part by grants from the AARP Andrus Foundation, the Department of Veterans Affairs Office of Research & Development, and the National Institute on Aging (NIA) Claude Pepper Older Adults Independence Center. Murphy is a recipient of a K01 Mentored Research Scientist Development Award from the National Center for Medical Rehabilitation Research, and Alexander is a recipient of a K24 Mid-Career Investigator Award in Patient-Oriented Research from NIA.

Citation: Journal of the American Geriatrics Society, Aug. 2006, “Bath Transfers in Older Adult Congregate Housing Residents: Assessing the Person-Environment Interaction.”

Contact: Katie Gazella, kgazella AT umich DOT edu
734-764-2220
University of Michigan Health System


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Bethel fuel sales tax corrected

Ordinance 06-05, to amend the sales tax code to provide an exemption for senior citizens’ heating fuel, was finally passed on 2006 July 25. The vote was 4 to 2 and 1 abstention. For, Hugh Dyment, Tundy Rogers, Andy McGowen, Mary Kenick. Against, Thor Williams, Dan Leinberger. Abstain, citing conflict of interest, David Trantham.

The ordinance was originally submitted in February 2006 by Councilor Trantham and again by Councilor Rogers. Hearings occurred at the March 28, April 11, April 25, June 13, and July 25 council meetings. The delay in action was a result of examining the costs of modifying the exemption (by the finance committee) and the request by several councilors to have the ordinance re-written. The ordinance was not re-written and was finally voted upon.

The finance department estimated that perhaps 85 people would take advantage of the exemption. A limited ad hoc survey found elders can be paying $350 to $600 per month for 75 to 100 gallons (coldest months). The City might lose $14,700 in annual tax; seniors might save $173 per year.

It should be noted —

  • as the finance department notes, there are no data on who might use the exemption and how many gallons of fuel oil (diesel) would be involved
  • 75 to 100 gallons a month seems like a lot of fuel. The amount depends primarily on the quality of housing and heating. For older people who are enrolled tribal members, their tribe or tribal housing consortium has a trust responsibility to ensure adequate housing

The finance committee recommended unanimously against the ordinance because it might result in requests for special treatment or exemptions from other groups and individuals. Churches were used as a specific example. Therefore, correcting the fuel oversight would result in a drain on City finances.

Councilor Dyment promised to create an ordinance for the next council meeting, which would cut $24,000 from other City services because of the senior exemption.

It should also be noted —

  • the ordinance corrects an oversight in the existing municipal code which grants a recognition to older Bethel people, because they are older, and is not means tested
  • some, but not all, churches currently have a city government subsidy (reduced garbage fees).
  • sales tax income is not guaranteed income for budgeting purposes
  • as the price of fuel goes up, the number of gallons sold tends to decrease. Why cut $24,000?
  • this is not the first time that the elderly have been blamed for City deficits

Exemptions and subsidies do subtract from potential City income. As you can see below, elders’ exemptions are only R, S, and T of the alphabet list. There was no data presented as to the financial hit of senior exemptions out of the total exempted sales tax income. If the issue were one merely of tax income and city spending, then perhaps all exemptions should be revoked, not just the ones for older people.

Certainly, the illegal exemptions should be revoked first.
[ORDINANCE #04-28, AN ORDINANCE AMENDING SECTION 13.16.010 OF THE BETHEL MUNICIPAL CODE TO REMOVE CHURCHES FROM A MONTHLY FLAT RATE OF $45.00 TO A RESIDENTIAL SERVICE RATE WITH A FLAT RATE OF $12.00. Introduced by: City Manager Herron Date: November 30, 2004
Public Hearing: January 11, 2004, Action: Adopted
Vote: 4-2 (Rodgers, Dyment)
ENACTED THIS 11th DAY OF JANUARY, 2005 by a vote of 4 in favor and 2 opposed. Hugh Dyment, Mayor]

Initially, the Finance Director said eight churches would qualify; then eleven. But there are 16 announced places of worship in the newspaper. And there are other organizations with Federal tax exemptions as churches.

The Supreme Court has held that “[t]he First Amendment mandates governmental neutrality between religion and religion, and between religion and nonreligion.” Epperson v. Arkansas, 393 U.S. 97, 104 (1968).

This principle of neutrality “is part of our settled jurisprudence” and “prohibits government from abandoning secular purposes in order to put an imprimatur on one religion, or on religion as such, or to favor the adherents of any sect or religious organization. ” Texas Monthly, Inc. v. Bullock, 489 U.S. 1, 8-9 (1989) (plurality opinion) (quoting Gillette, 401 U.S. at 450). According to the text of the ordinance, the purpose for allowing churches to receive the same rates as residences for solid waste collection is that “churches are not like an ordinary business for profit” and “churches receive gifts and donations (not revenue), so Chapter 13.16.010 of the Code should charge churches with the lowest charge for solid waste services so as to treat churches fairly.”

Although government may provide a benefit to religious organizations without violating the Establishment Clause, the government must either provide this benefit to both religious and non-religious organizations that meet the same neutral criteria or the benefit must lift a substantial burden on the exercise of religion. Here, it is extremely unlikely that the commercial charge of $45 for solid waste collection places a substantial burden on the exercise of religion.

Thus, the ordinance can only be justified if it is extended to non-religious organizations as well. While it is true that residential dwellings receive the lower rate, if the city is going to extend the lower rate to churches, it should also extend the same rate to nonprofit organizations because the same rationale that was put forward for allowing churches to pay the lower rate (they do not have any revenue) would also apply to nonprofit organizations. Now, it may be the case that Bethel has no nonprofit organizations, which is why they were not included in the ordinance.

The Supreme Court has also held that providing a government benefit to one religious denomination while denying it to another constitutes an unconstitutional preference for one religion over others. See Bd. of Educ. v. Grumet, 512 U.S. 687, 706-07 (1994) (“whatever the limits of permissible legislative accommodations may be, it is clear that neutrality as among religions must be honored”).

Fuel oil sales tax was overlooked in the city codes which provide —

4.16.040 Exemptions.
R. The sale to a senior citizen of food intended for consumption by the senior citizen, his or her spouse living in the same household, or the unemancipated minor children of either the senior citizen or his or her spouse, who live in the same household. The senior citizen shall display at the time of the sale a current and valid senior citizen exemption certificate issued to the person under Section 4.16.050C of this chapter. For purposes of this subsection, “food” is defined in accordance with 7 U.S.C. 2012(g) (definition of “food” for purposes of the Food Stamp Act);
S. The payment of rent by a senior citizen on a single dwelling occupied as the senior citizen’s primary residence and permanent place of abode. The senior citizen shall provide proof at the time of payment of a current and valid senior citizen exemption certificate issued to the person under Section 4.16.050C of this chapter;
T. Payment for telephone, electric, water sewer utility services by a senior citizen on a single dwelling occupied as the senior citizen’s primary residence and permanent place of abode. The senior citizen shall provide proof at the time of payment of a current and valid senior citizen exemption certificate issued to the person under Section 4.16.050C of this chapter;

There is an additional credit —

13.16.070 Senior citizen credit.
A.
Any Bethel citizen at least sixty years of age residing in their own household shall receive up to a twenty-five-dollar monthly utility credit, if they are the primary source of income, after making application for such at the city utilities office.

B. All other Bethel citizens at least sixty years of age that do not meet the conditions of subsection A of this section shall receive up to a ten-dollar monthly utility credit after making application for such to the city utilities office.

C. Each residential unit shall be limited to one credit application. (Modification 2 of Ord. 85, 1980: prior code § 11.16.080)


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O’Folks (off their rocker)

Old age isn't a disease.

Arctic sunset

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