reference to the limited fiduciary capabilities in the
planning industry (and more) and why they may/will remain as
such given sophomoric DOL rules and flaccid organizational
enforcement. Specific commentary to sexism and ethical
and moral lapses of society impacting women. Not the standard
for investors and advisers. The economic changes from
the Great Recession caused major adjustments in
investing. One of the major issues is the flip flop
of the correlations in bond funds versus equities
coupled with a truly lower return and an increased
overall risk. It will take a lot more effort to provide
adequate return for those in need and the discussion will
address pros and cons particularly for retirement purpose
Emphasis on risk, Click for full article.
1/12 Caregiver support groups
it was suggested to me that I might benefit from an
Alzheimer’s support group for caregivers, I remember smiling
politely and thanking the well-meaning party. I also remember
my exact thought as I turned away. “ Oh you think so, do you?
You don’t even know me! I certainly don’t need to emotionally
dump on strangers who, like me, are barely keeping it
together. Why would I do that to them? Why would I do that to
say that I was resistant to the idea would have been an
understatement. I could not accept that I deserved, let alone
needed, any help. My mother was the one who was sick. She had
been diagnosed with Alzheimer’s disease five years prior to
being moved to Pittsburgh, where I was her primary caregiver.
I believed, therefore, that my entire focus should be on her
care. I did not understand that I could become sick as well -
sick with the stress of caregiving.
progression of my isolation had been insidious. I had not
noticed that I had begun to cancel social engagements because
“Mom might need me.” I could not see that there was a
connection between my inability to concentrate and my
obsessive wondering about Mom’s condition and care. I had also
failed to notice that friends had stopped calling. No one knew
what to say to me anymore. There was only one topic, as far as
I was concerned. I had, in fact, created my own little world,
with my mother and myself as the only inhabitants. Everyone
else had minor roles to play. No wonder I thought I was all
alone, that my situation was unique and, therefore, that no
one could fully understand how I was feeling. Having cut
myself off from anyone or anything that might have helped me
to gain some perspective, I became overwhelmed with feelings
of self-doubt and hopelessness.
was out of desperation that I finally “gave in” and agreed to
try a support group. At the meeting, I found myself blurting
out that I had had a terrible interaction with Mom that day.
Not only had my mother not recognized me but, for the first
time, she had swung at me defensively. It wasn’t the action
that had rattled me. I understood it - intellectually. It was
how it affected me emotionally that had left me completely
unnerved. I was so angry, I told the group, I was ready to,
“spit bullets.” And I was ashamed of myself. I had to admit
that, even though I knew it was irrational, I was angry at the
disease and, yes, for a split second, angry at my mother. It
was horrifying to make that admission. I felt like an
abandoned child, I told them. If I was going to have that kind
of response, was I even emotionally fit to be around Mom?
I took a breath. I waited for the appalled silence and
judgemental looks that I assumed would follow. Neither
happened. Instead, the group assured me that every person
there had had similar feelings at one time or another. This
was a revelation to me. It was also a tremendous relief.
that point on, I opened my mind and heart to what the support
group had to offer. I learned that, although I might FEEL
overwhelmed sometimes, that was not the same thing as actually
BEING overwhelmed. I learned that Mom was not the only person
affected by her diagnosis. I was going through something
profoundly difficult, too. Acknowledging this was neither
selfish nor self-centered. I learned that, since there was no
instruction book for going through this experience, no emotion
I felt would be considered weird or inappropriate by anyone
else on the same journey. I learned that we, the family
members, were all coping as best we could and that no two ways
of doing this would look exactly the same.
learned that all of us had similar questions as well as
similar emotions. Was it wise to take our loved ones out to a
restaurant? Should they be told about the death of a dear,
childhood friend, or should we just not mention it? How were
we to live with ourselves if we didn’t tell them? Wasn’t that
we discussed each issue, possible solutions emerged. I learned
that it was alright to laugh together when a “strategy” went
very differently than anticipated. Laughing at ourselves made
it possible for us to feel safe, accepted and not judged. I
learned how it felt to trust a group of strangers, solely on
the basis of our common choice to be with our loved ones on
their journey with dementia.
is a saying that, “a burdened shared is a burden halved.” For
me, the support group experience proved this to be true, but
it also gave me so much more. There is a healing power in not
only receiving help, but in giving it. Perhaps the support
group’s strength was simply its ability to generate hope. The
hope that, together, we family members could do this - walk
with our loved ones to the very end. The hope that, when this
significant, precious time with our loved ones was over, we
would be the better for it, that our lives would reflect
everything we had learned from this experience.
support group helped me be the kind of daughter that I had
always wanted to be. For that, I would always be grateful. My
hope is that anyone with a loved one who is living with
dementia would take the opportunity to join a support group
and receive the same understanding, compassion and help that
was made available to me.
criminals have become increasingly sophisticated, and all
financial services firms are ripe targets for frauds. In 2016,
the FBI’s Internet Crime Complaint Center received almost
300,000 complaints for almost $1.3 billion in losses.
Read more by clicking the link http://bit.ly/2EtuEuk
you are the caregiver of someone with Parkinson’s disease
(PD), you are likely well aware of the common motor symptoms
associated with the condition, like tremors. However, you may
not be aware that non-motor symptoms (those unrelated to
physical movement), such as psychosis, commonly develop as the
disease progresses. These symptoms should not be overlooked.
is Parkinson’s Disease Psychosis?
PD progresses, up to 40 percent of the approximately one
million Americans living with the illness will develop
psychotic symptoms, primarily hallucinations, but also
delusions. These symptoms can be an indication of Parkinson’s
disease psychosis (PDP), but unfortunately, many patients are
not diagnosed. Sometimes, the symptoms of PDP are misdiagnosed
as a co-morbid condition. Other times, patients and their
families may not be comfortable sharing the symptoms with
their physician team.
definitions can vary, the term psychosis generally means “loss
of reality testing.” Psychotic symptoms may be brought on by
infections, typically bladder or pneumonia, but are often
caused by medications. These are usually the ones used in
treating PD, but other medications, particularly narcotic pain
medications and many of the drugs used to treat an overactive
bladder, may cause symptoms as well. When infections have been
ruled out and no other medication has been identified as
causing the psychosis, then the most likely culprits are the
PD medications. It’s also possible that PDP might be a
naturally occurring complication as the disease progresses.
are a couple of things to keep in mind here. One is that the
symptoms may begin even though PD medications have been
constant over several months, or even years. The problem may
not necessarily be triggered by an increase in PD medications.
The reason that a stable medication regimen can begin causing
hallucinations is that the PD is always progressing, making
patients more sensitive to possible drug side effects. The
second principle to keep in mind is that it may not be one
drug that is the cause, but the combination of all the PD
PD patients have occasional, or not so occasional, symptoms
that are often seen in people who lose their ability to
separate reality from fantasy. These are most commonly
hallucinations, which are false perceptions in one of our
special senses (vision, hearing, taste and touch). For
example, it’s quite common for patients to report seeing other
people, often children, who are sitting or standing in the
room, ignoring them. Another commonly cited experience is that
a patient who is watching TV or reading a book notices two
strangers sitting on a sofa talking to each other, but they
make no noise. The patient talks to them, and they ignore him.
When he gets up to approach them, they disappear. A few days
later, this happens again, and after one or two episodes, the
patient no longer pays attention or tries to contact them.
These types of hallucinations tend to occur more at night than
during the day and are usually the same each time.
of the images may be entertaining, but usually are just a
little bit annoying. The hallucinations may look real, appear
to be black and white, fuzzy or sharp and sometimes, the
people may look somewhat odd, like cartoons.
hallucinations, or hearing things that are not there, are
about half as common as visual hallucinations, and they tend
to be less distinct than the visual hallucinations. Patients
may hear a radio in another room, a party going on across the
street or voices talking in the hallway. Less common are
tactile hallucinations (e.g., feeling things on the skin),
olfactory (e.g., smelling an aroma not detectable to others)
and taste hallucinations.
Types of Hallucinations
addition to persistent or repeated visual hallucinations, a PD
patient might also see a fleeting image out of the corner of
their eyes, like a cat or a shadow passing by, but when they
turn to look, there isn’t anything there. Sometimes they see
slight flashes of light, which are very much like reflections
off their eyeglasses.
type of experience is called a “presence hallucination,” which
is not really a hallucination. With a presence hallucination,
patients have a strong feeling of another person, or an
animal, being behind them or to the side, but when they turn
around, there isn’t anything. This feeling usually isn’t
scary, as the patient doesn’t feel they’re about to be
attacked. However, this is a strong feeling – something most
people have experienced on occasion – but in this case, it’s
experienced more frequently and more strongly.
are false, irrational beliefs. In PDP, delusions are more
bothersome, but less common. Also, in PDP, the delusions tend
to be fairly similar from one patient to the next and are
usually paranoid in nature. For example, a patient might be
positive that his spouse has been attacked and is in need of
assistance. Or, a spouse may be irrationally convinced that
their partner is committing adultery.
after a 20-year battle with PD, Susan’s father, Gary, passed
away in April 2014 at the age of 74. Because Susan resides in
Las Vegas, her mother, Marjorie, was her father’s primary
caregiver in Iowa. Susan stayed actively involved by providing
her mom with emotional support, particularly in later years
when her father developed PDP.
and her mother believe that Gary’s PDP started after a
hospital stay resulted in changes to his medication doses. At
that time, Gary began to experience strange and disturbing
delusions, often in relation to his wife’s safety. For
example, on several occasions, he called the police, convinced
that “weirdoes” had entered the house to sexually assault
Marjorie. He once even drove himself to the police station to
report the perceived crime. Also disturbing, Gary would see
kittens frolicking and then get upset when he thought he saw
them die because he “forgot” to feed them. Other
hallucinations included seeing strangers in his bed or with
him in the shower. Despite telling Gary that his visions were
not real, Susan and Marjorie often could not convince him of
mother was emotionally exhausted and stressed from caring for
Gary, whom she had been married to for 48 years. The idea of
seeking more help for him was overwhelming, given the time she
already gave to physical therapy and day-to-day care. Her life
already revolved around Gary’s illness. Susan tried to
encourage her mother to speak to her physicians about Gary’s
visions, but her mother was embarrassed. On the other hand,
both also wished the physicians had asked if these symptoms
Impact on Caregivers
Susan’s story demonstrates, PDP is difficult for both the
patient and their caregivers, particularly because it is
impossible to convince someone who is experiencing delusions
regarding the truth of their circumstances. Logic does not
fact, accusations of spousal infidelity are often the “last
straw” and when caregivers find caring for their loved one too
overwhelming. One of the major problems in dealing with PDP is
that the patient and the family often try to hide the problem
– the patient for fear of being thought “crazy” and the
caregiver due to embarrassment. The reality is that when a PD
patient has psychotic symptoms, his or her mental abilities
will be otherwise normal. The patient may not be disoriented,
can still balance their checkbook and recall everything
they’re supposed to know. When hallucinations or delusions
occur, the treating doctor should be notified. No irreversible
harm will occur if treatment is delayed, but it is unlikely
the problem will go away on its own.
don’t always need to be treated. If these symptoms often don’t
bother the patient, then they don’t need immediate attention,
but they should always be monitored. Yet, hallucinations also
indicate toxicity, hence PD medications cannot be increased
without worsening of the hallucinations, and therefore,
physicians may limit treatment. When the psychotic symptoms
require treatment, the doctor may first reduce PD medications,
and when these cannot be further reduced, they may prescribe
quetiapine or clozapine, the only currently available
antipsychotic drugs that do not worsen mobility in people with
PD. When these drugs are successful, then the PD medications
can be increased, if needed, to better control PD motor
Your Loved One and Yourself
is also associated with increased caregiver stress and burden,
nursing home placement and increased morbidity and mortality.
But, your loved one is certainly not alone in living with PDP,
and an effective management plan can improve the complication.
Seek out the support that he or she needs, but also make sure
that you are getting the emotional care you personally need in
order to be an effective advocate for your loved one.
for Energy Investors: The World Economic Forum, the Institute of Electrical and Electronics
Engineers, the MIT Technology Review, prestigious national
laboratories, and a
slew of other experts are buzzing about this new element that
the energy industry. Early investors are already reaping the
benefits. Are you in?
- The U.S. has seen the installation of
around 700 megawatts of
over the last several
- The total is only 0.06% of U.S.
capacity. But the storage market is starting to gain
- As of now, there is another 69 MW of
capacity planned for
OKE) announced plans to spend $1.4 billion on a new
pipeline from the
Rocky Mountain region. The 900-mile Elk Creek Pipeline would
carry 240,000 bpd
of unfractionated NGLs from Montana to Kansas, and is
expected to be completed
by the end of 2019.
- Credit Suisse says it’s time to buy oilfield services stocks. “The oilfield services
sector - after suffering the sharpest decline in history
followed by the
sharpest recovery - is back to what appears to be at least a
run of somewhat normal growth,” Credit Suisse analyst James
- Nymex futures for natural gas fell back
after the cold
snap. Spot prices in New York and New England have spiked to
levels, but the problem is pipeline capacity not a shortage
of natural gas.
Nymex gas is still trading below $3/MMbtu.
January 9, 2018
Oil has held onto the strong gains from last week, despite
some choppy trading.
As of early trading on Tuesday, Brent was sitting at roughly
$68 per barrel and
WTI at $62. Brent is not far from the key psychological
threshold of $70, a
level that hasn’t been hit since 2014 during the beginning
of the market downturn.
worries about oil
prices moving too high.Iran’s oil minister said that OPEC does
not want oil to rise
any more than it already has so as not to spark a shale
drilling boom. “Members
of the Organization of the Petroleum Exporting Countries are
not keen on
increased Brent crude prices above $60 a barrel because of
Bijan Namdar Zanganeh said in comments on the ministry’s news agency Shana.
plunge. Earnings for supertankers
that move oil around the
world fell by more than half in 2017, in large part because
of the OPEC cuts.
Fewer shipments came at a time when the shipping industry
brought new capacity
online, crushing their day rates. “These cuts reduced the
number of cargoes
from the Middle East to Asia significantly at a time when a
large amount of
newly-built vessels are being delivered,” Olivier Jakob,
managing director at
Petromatrix GmbH, told Bloomberg. Earnings per day fell to $17,794 on
average in 2017, the
lowest figure since 2009. The poor conditions for the oil
tanker industry are
set to continue this year, with capacity expected to expand
by another 4
percent at a time when OPEC will continue to hold back
to subsidize coal and nuclear.FERC, the powerful energy regulator
U.S., rejected a proposal from the Department of
Energy to prop up aging
coal and nuclear power plants. The logic behind the proposal
was to reward
power plants that provide “resilience” to the grid. That is,
the proposed rule
change would have led to a premium for plants that held a
90-day supply of fuel
on site – a definition only met by coal and nuclear plants.
FERC rejected the
proposal, and instead asked grid operators to come up with
ideas to improve
resilience. The rejection is a blow to the coal and nuclear
industry, as well
as the Trump administration, which supported the proposal.
oil tanker burns
for a third day.An Iranian oil tanker collided with a
Chinese freight ship in
the East China Sea, and the fire on the tanker raged for a
third day. Poor
weather hindered rescue efforts on Tuesday. The tanker has
been leaking condensate,
an ultra-light crude oil that is volatile, raising fears
that the tanker would
explode. “We can’t grasp the level of oil contamination at
this moment. The
cargo is still on fire, so it is hard to figure out if oil
is being spilled,”
Park Sung-dong, an official from South Korea’s Ministry of
Fisheries, told Reuters.
Nigeria. Nigeria has suffered through several weeks of fuel
shortages. Despite producing
nearly 1.8 million barrels of oil per day, the poor state of
sector means that the country has to import most of its
refined fuel. On top of
that, regulated fuel prices mean that refiners struggle to
turn a profit.
funds continued to
step up bullish bets.Major investors increased their net length on WTI and Brent
futures at the start of
the year, breaking new records in the extent of their
bullishness. The positioning
is a testament to the optimism surrounding the trajectory of
oil prices, but it
also continues to heighten the risk of a correction to the
production sinks again. Venezuela’s
oil output fell by another 100,000 bpd in December, dipping to just 1.7 mb/d, the
lowest level since 2002, according to S&P Global Platts.
The drop off is
steeper than prior monthly losses, and raise fears of an
accelerated decline in
2018. S&P Platts says that Venezuela "has been suffering
spiraling economic, political and humanitarian crisis, with
state oil company
PDVSA short of funds, personnel and equipment, and suffering
sanctions that restrict its financing."
oilfield services companies are planning public offerings
this year after
putting plans on ice in 2017. Expectations of higher oil
prices and higher
spending from drillers makes 2018 more opportune for going
public. Reuters reports that Liberty Oilfield Services,
services company, recently filed to raise $160 million by
selling 10.7 million
shares. If that offering goes well, more IPOs will likely
plans focus on shale.
Shell (NYSE: RDS.A) will increasingly
rely on shale
production going forward, according to an FT interview with the oil major’s CEO. Ben van
Beurden told the FT that
Shell will invest in chemicals, electricity and biofuels in
the years ahead, a
variety of sectors that will act as a hedge against a
regime on carbon emissions. As for oil, Shell will focus on
in the U.S., Canada and Argentina. Shell has been late to
the shale game, but
van Beurden says its declining cost of production combined
with the rebound in
oil prices means that “you will see a tremendous amount of
growth” in cash
1/12 Medical Insurance Board
applies for life insurance, they go through the underwriting
process. It is
during this process the insurer determines how risky the
proposed insured is to
insure based on things like current health, health
record, and the insureds history located in the MIB. No MIB
does not stand for
MEN IN BLACK, the popular movie franchise with Will Smith.
Although the codes
can seem as alien as some of the characters in the movie.
The MIB (Medical
information bureau) is just one of the many tools in an
underwriter’s tool box
to check the risk of the current applicant. The MIB helps
by checking past records to uncover such things as
errors, omissions or
possible misrepresentations made on insurance
to see if you’re an undocumented extraterrestrial trying to
get life insurance
on Earth. (That’s the last Men in Black joke, I promise,
underwriters use the MIB to verify information so that when
they’re setting an
insureds rate class there is a checks and balance system to
make sure no
essential information is missing. It also aids the
underwriter in being sure
that what an applicant has disclosed on a current
application is consistent
with previous applications.
The MIB was
in 1902 with a sole goal of working with life insurance
companies to combat and
hopefully prevent fraud. They do this by compiling
information from previous
applications that an insured has applied for such as life,
or LTC applications. With that said, a client will not
have an MIB file
if this is the first time they have applied for insurance.
It’s important to
note that MIB information is just one part of the larger
puzzle that an
underwriter puts together. Decisions are not based solely on
the MIB report;
instead, they use it to help develop and verify the medical
during the time of application.
information such as (but not limited to) the date of any
medical impairments, when the impairment was diagnosed,
types of treatment, and
where the medical history came from. What does all this mean
for an applicant?
As an example, let’s say Mr. Smith applies for life
insurance and through the
medical exam the underwriter finds out that Mr. Smith has
undergone surgery to
remove a previous melanoma. The underwriter rates Mr. Smith
and he decides
against accepting the current application. Six months go by
and Mrs. Smith
demands that her husband take out a policy. Mr. Smith
applies with another
company in hopes of obtaining a better rate and “omits” his
prior history of
melanoma. The current underwriter would learn from the MIB
that the surgery
occurred and when it was performed, and how the information
was obtained (PHI,
exam or APS). The underwriter can then ask for further
information so that they
could rate Mr. Smith accordingly.
such as the MIB the insurer can help to combat fraud that
could in the future
drive up rates. Moral of the story, it is best to be as
honest as possible.
While underwriters are not the Men in black (I know I
promised, I couldn’t help
myself) they can and usually will find out if the applicant
has history that
has not been disclosed. Properly rating an applicant helps
to keep costs in
check which is good for both insurers and customers alike.
what biologists call the pivot temperature, turtles hatch as a
mixture of males and females. For green sea turtles, this
temperature is 29.3 degrees Celsius (85 Fahrenheit).
A few degrees below 29.3 C, all the sea
turtles are born male. Heat up the eggs and only
females are born.
transitional range, from 100 percent males to 100 percent
females, spans a very narrow band of only a couple of degrees.
estimate sand temperatures, study authors used
historical sea and air temperatures in the breeding
grounds between 1960 and 2016. By the 1990s, the sand
temperature estimates were consistently higher than the
EFM- that is 1990- indicating that
global warming was causing problems even then, Can we fix it?
No. By 2050 and another 1.5 billion people, a plague will kill
most of us. Then the sea turtles take over
fiduciary rule is in an odd sort of limbo. Despite being
seemingly dead from a rule-making point-of-view, it is still
very much alive as a practical rule that needs to be abided by
even if it is not in full force. But is still surprising to
learn, especially given all the hype over the rule’s possible
dissolution, that 42% of all advisor-held US assets under
management are now subject to the fiduciary rule. That
figure is up from what would have been 24% in 2005 and 33% in
2010. The growth has come from the large number of firms
seeking to grow their fee-based managed account programs.
and 2016, the National Retirement Risk Index (NRRI)
improved modestly, dropping from 52% to 50% of
working-age households, according to the Center for
Retirement Research (CRR) at Boston College. The
NRRI measures the percentage of households at
risk of having insufficient income to maintain
their pre-retirement standard of living. The
CRR says between 2013 and 2016, both equity and
house prices increased sharply, serving to reduce
the NRRI. According to the CRR, there were three
main factors increasing the share of households at
risk for inadequate income in retirement—the rise in
Social Security’s Full Retirement Age (FRA), the
decline in interest rates, and new reverse mortgage
rules. All groups of households experienced an
improvement in risk, except middle-age and
middle-income households, due in part to more
non-mortgage borrowing. Read more >
"At some point in the next several years,
environmental risk is going to magnify in importance in
asset pricing processes. Environmental risk (do we call
it e*) will enter asset pricing models right alongside
the interest rate. For example, rising insurance
rates and the evaporation of certain types of coverage in
certain regions will affect asset prices
dramatically. A lesson from the earliest days of
capitalism and the rise of maritime insurance on long
distance sea trade can be re-stated: no insurance, no
large scale, globe-girdling capitalism. So what
insurance costs may be the largest question in the next
decade. And who has it and who doesn't. (If you
can't insure Florida, just what is going to be in
Florida?) The amount of insurance in force may
become a companion measurement to GDP for measuring
national economic weight. Just how will the world be
insured in 2030? That will also say something about
banking? (Will uninsured collateral trigger the next
banking crisis?) Look for footnotes in corporate financial
reports describing insurance coverage and future access to
is giving up
on discovering new drugs for Alzheimer's and Parkinson's
diseases, abandoning costly efforts to find effective
treatments for the disorders.
working more than 30 hours a week while also caring for an
elderly relative will receive a daily stipend of up to $70
to offset elder care costs, per the new law. The money
can be used on anything that helps the caregiver meet his or
her responsibilities without having to sacrifice work. That
can include adult day care, chore services, home-delivered
meals, homemaker services, personal care, respite care or
EFM- didn't have any insight to
funding or total costs but is a major step in the right
than half the world's robots live in Asia, mostly China,
(Global Robotics}. The world robot population reached nearly
300,000 in 2016, based on the most recent numbers available,
and HSBC estimates their population will grow to 414,000 by
2019. Currently, robot unit growth is running at 15% per year.
is the world’s largest market for industrial robots,
accounting for about 30% of global demand. This growth story
is being driven by powerful macro forces – higher wage bills,
an ageing population, and supportive government policy ... We
estimate robot production in China rose by 58% in 2017 alone,
including the production of lower-tier robotics automation
demand has cut the robot world into two halves: China is the
dominant buyer of robots globally, while Japan and Europe are
the superior suppliers of machines. "Our conclusion is clear –
the superior technology of Japanese and European companies is
the decisive factor for winning the majority of the new
business, which requires ever-greater levels of precision.
Chinese robot makers remain strong in the low-to-medium
segment of the market – e-commerce driven logistics is a good
example – but competition is increasing all the time.
The rise of HFT means that ordinary investors
buying or selling stocks, bonds, exchange traded funds or
futures are likely to be transacting with an algorithm on the
other side. But the bonanza has now ended. Trading firms are
struggling to wring profits from the incremental millisecond.
Subdued volumes and reduced volatility have shrunken the size
of the pie. Exchanges have ratcheted up market data and
technology costs for customers. In 2017, aggregate revenues for
HFT companies from trading US stocks was set to fall below $1bn
for the first time since at least the financial crisis, down
from $7.2bn in 2009
Why We Never Think Alone
By Steven Sloman and Philip Fernbach
Illustrated. 296 pp. Riverhead Books. $28.
In “The Knowledge Illusion,” the
cognitive scientists Steven Sloman and Philip Fernbach
hammer another nail into the coffin of the rational
individual. From the 17th century to the 20th century,
Western thought depicted individual human beings as
independent rational agents, and consequently made
these mythical creatures the basis of modern society.
Democracy is founded on the idea that the voter knows
best, free market capitalism believes the customer is
always right, and modern education tries to teach
students to think for themselves.
Over the last few decades,
the ideal of the rational individual has been
attacked from all sides. Postcolonial and
feminist thinkers challenged it as a chauvinistic
Western fantasy, glorifying the autonomy and power of
white men. Behavioral economists and evolutionary
psychologists have demonstrated that most human
decisions are based on emotional reactions and
heuristic shortcuts rather than rational analysis, and
that while our emotions and heuristics were perhaps
suitable for dealing with the African savanna in the
Stone Age, they are woefully inadequate for dealing
with the urban jungle of the silicon age.
Sloman and Fernbach take this
argument further, positing that not just rationality
but the very idea of individual thinking is a myth. Humans
rarely think for themselves.
two reports on
home hospice came out — one from Politico
and one from Kaiser
Health News. According to their investigations, the
hospice system, which began idealistically in the 1970s, is
stretched thin and falling short of its original mission.
News discovered there had been 3,200 complaints against
hospice agencies across the country in the past five years
more than a
million Medicare patients go into hospice care every
year, so the complaints are in the minority. Mr. Banach told
me he’s worried that drawing attention to what he called the
“salacious” stories of failed hospice care means more families
will turn to less holistic, less humane end-of-life care. That
could be true. But then, should there be more transparency
early on? Should the hospice reps explain that in most cases,
someone will rush to your loved one’s side in a crisis, but
sometimes the agency just doesn’t get the timing and the
As the number of
hospice providers grows, does that model provide too
great an incentive to understaff nighttime and weekend shifts?
The solution may have to come from consumer advocacy and
better regulation from Medicare itself.
government-sponsored website called Hospice
Compare will soon include ratings of different agencies
what has become an increasingly common business arrangement,
owners of nursing homes outsource a wide variety of goods and
services to companies in which they have a financial interest
or that they control. Nearly three-quarters of nursing homes
in the United States — more than 11,000 — have such business
dealings, known as related party transactions, according to an
analysis of nursing home financial records by Kaiser Health
News. Some homes even contract out basic functions like
management or rent their own building from a sister
corporation, saying it is an efficient way of running their
businesses and can help minimize taxes.
arrangements offer an additional advantage: Owners can arrange
highly favorable contracts in which their nursing homes pay
more than they might in a competitive market. Owners then
siphon off higher profits, which are not recorded on the
nursing home’s accounts.
Why exercise should not be a New
1/9: I find it hard to think 3% GDP
can be maintained but right now we are doing it
and retail sales grab the spotlight over the next two days,
with data set to show that producer prices, a key measure of
industrial inflation, rose 0.2 per cent in December on the
previous month. That is expected to take the year-on-year
reading to 3 per cent. (FT
Global warming I do not care if they blame humans (I don't
know the percentage caused by us) but we have to figure
out a way to live in the next 30 years, Do I think we will make
the inroads necessary? Not a bleeding chance.
on the state you reside in, there are
two ways your assets could be divided:
1. Community property:
Marital assets — and
debts incurred by either spouse during the marriage —
are divided 50/50. However, separate property (anything held
in only one spouse's name, including property owned before
marriage, given as a gift, or inherited) is not taken into
account. The states that observe this law are Arizona,
California, Idaho, Louisiana, Nevada, New Mexico, Texas,
Washington, and Wisconsin. Residents of
Alaska can opt-in to a community property agreement.
2. Equitable distribution:
Marital assets (not including separate property) are
divided "fairly" at a judge's discretion, taking into
account each person's earning potential or income, financial
needs, and personal assets.
1/5: FINRA arbitration claims
1/3:This is just a drop in the
bucket. Where does the other 7 billion come from?? This is not
uncommon with hundreds of other city and state budget. Then we
have the Federal budget deficit which supposedly will drop to
manageable levels with the new tax cut. Won't work. The
government will avoid bankruptcy but more cities will have to
since the 2018 market will not be as strong as 2017
issued $1.01 billion in pension obligation bonds to
help reduce the city's $8.2 billion in unfunded
markets are born on pessimism, grow on skepticism, mature
on optimism and die on euphoria.”
1 in 10 young adults — and 1 in 30 adolescents
— have experienced homelessness in the past year. Researchers
say the spike is largely because of low wages, a pricier
rental market and family instability.
and many did not get a high school diploma. There is little
upside to this. They are going to be stuck for life.
some best practices foremployersto
help their employees be financially secure so they may
retire on time: Consider adoptingretirementprograms
with features that help employees retire on time. Provide
education to help employees proactively make informed
home values to slow. The Post's Kathy
Orton and Aaron Gregg: "The steady increase in
housing prices in many of the nation’s priciest markets,
including the Washington region, is expected to slow in
coming years, analysts say, as the Republican tax law
begins to reshape a major part of the U.S.
economy... Economists and housing experts broadly
agree the changes will slow price increases in expensive
housing markets — though nobody expects housing values to
decline, given the overall strength of the economy and the
fact that there are relatively few houses for sale in top
EFM- but I wonder just what the increase will be. Our country
runs on home construction. A rise in interest rates should not
hurt too much since any increase in mortgage payments would be
minimal. However, emotionally, it could impact buyers if they
wanted/needed a floating rate.
is a web-based distributed ledger of all transactions/datasets
that have ever been executed. It is constantly growing as
‘completed’ blocks are added to the blockchain in a linear,
chronological order, with a new set of recordings/entries. It
allows participants in a business network to see the system of
ledger technology (DLT) makes it easier to create cost-ef
cient business networks where virtually anything of value can
be tracked and traded, without requiring a central point of
control. A blockchain’s integrity hinges on strong
cryptography with emphasis on verifying any new information
being added. Once information is added to the distributed
ledger, it can no longer be changed – which is why it’s called
likelihood of a vital employee incurring a disability is 8
times greater than death before retirement age.
clients need to know about Key Person Replacement Insurance
Business Clients need a New Year’s reminder of how many ways
their business could suffer from a key employee’s total
of revenue and profit generated by the key employee could be
of the business when clients withhold or delay their
business until the impact of the employee’s disability is
of management skill and experience, especially in a business
without management depth
expenses associated with recruiting, hiring, and training a
employer pays the premium and is the owner of the policy
insuring the key employee in the event of total disability.
If the Key Employee becomes
totally disabled, the employer can receive benefits after 90
days, tax free. These benefits can be used at the
discretion of the business. Common uses usually include
bridging the lost revenue gap, training a replacement, and
filling temporary staffing needs. The benefits cannot be
assigned to the employee. The maximum amount available is
based on a calculation of 150% of the employee’s monthly
can be paid in either in a lump sum after 365 days or paid in
monthly installments after 90 days for 12 month.
have nightmares that the military is chasing me," says a
12-year-old who fled Myanmar. For hundreds of thousands like
her, the horror isn't over
of the year- “Alternative facts are not facts; they’re
falsehoods.”“The use of ‘alternative facts,set the stage for
allowing America to have two contradictory narratives to exist
side by side. This only accelerated the divide in this
12/31: Do you think the powers in
China knew about this????
are pouring into the beleaguered child welfare system.
12/31: Next of CMS 2019 Actuarial Value Calculator Methodology
25 pages. "The [Actuarial
Value (AV) Calculator (XLSM)] represents
an empirical estimate of the AV calculated in a manner that
provides a close approximation to the actual average spending
by a wide range of consumers in a standard population. This
document is meant to detail the specific methodologies used in
the AV calculation. This document is revised from the 2018
version to incorporate updates in the 2019 version." Centers
Medicare & Medicaid Services [CMS], U.S. Department of
Health and Human Services [HHS]
in six Americans lives in what the group calls “economically
distressed communities” that are “increasingly alienated from
the benefits of the modern economy.” Such communities have
high shares of poverty, many housing vacancies, a large
proportion of adults without a high-school diploma, high
joblessness, and a lower median income than the rest of the
state in which they are located. They also lost jobs and
businesses between 2011 and 2015.
“The lack of construction in coastal cities has forced people
who are marginally educated and low-income to move inland,”
12/31: Look at the increase for
CMS Announces Marketplace Enrollment, Actuarial Value
Calculator, and Medical Loss Ratios
"Despite all of the changes that [HHS] has proposed in its
2018 payment notice, HHS decided not to make major changes in
the actuarial value calculator for 2019. It will increase
claims costs projections for 2019, with a 5.4 percent
increase for medical costs and an 11.5 percent increase for
drug costs. The calculator also reflects increased
out-of-pocket limits for 2019, which will be set finally by
the payment notice but are projected for purposes of the
calculator to be $8,000."
12/29:Basically, don't get sick
12/29: Say what you want about the
great growth et al but recognize you CANNOT accept risk this
latest debt level is up 3.5% month-over-month. The November
data gives us an additional sense of recent investor behavior
12/28: Truck and railroad tonnage
gives you an idea how good the economy may be doing
New Evidence on the Demand for Advice Within
"Demand for advice on asset allocations and income planning
increased four-fold among study participants after online
advice tools were introduced.... Demand tends to be higher
among plan contributors than non-contributors and is
significantly higher among contributors with web access."
Steps to Help Seniors See the
Need for Home Modifications
are questions caregivers face on a daily basis. How do
we balance between too much and too little care? How do
we balance what we think needs to be done with what
might be most helpful?
family members and other caregivers often sabotage
well-intended efforts to help their loved ones simply
because they haven’t thought about answers to basic
questions. And when it comes to recommending changes in
someone’s home, the balancing act can be particularly
acute. This is a place where someone has lived all his
life, where she feels comfortable, where he feels safe.
The fact is, however, that while most people say they
want to live in their homes as long as possible, most
are not designed to allow them to age successfully in
not just the ill, but the “well elderly” who experience
the effects of aging. Aging affects vision, mobility,
dexterity and endurance. Arthritis or other degenerative
diseases may make it difficult to do the things one used
to do. This usually translates into some very real and
practical problems at home. The three most common
problems are: getting in and out of the house; using the
bathroom; and going up and down the stairs. Because most
people are unaware that simple home modifications can
alleviate these problems, many develop coping strategies
to stay in their homes, but put them at risk for
accidents or injury.
approaching the possibility of home modifications can be
sensitive, the right preparation and understanding can
make all the difference. It’s a fact of life. As people
age, their bodies change and they may have difficulty
performing certain daily activities because of physical
and cognitive limitations. So the house that was once
perfect for them may not be anymore. Consider this, when
couples have their first child they make changes around
the home. But very few realize that as they get older
they also need to make changes to make the home more
appropriate for this stage as well.
an occupational therapist who works in a county office
in aging, I see attempts at this balancing act on a
daily basis. Some successful. Some not. But all well
intended. While an occupational therapist has
specialized skills and expertise to match an environment
to a person’s abilities, there are simple steps family
caregivers can use.
Investigate and Raise Awareness
best first step, even before you raise the home
modification issue with your loved one, is to build a
list of helpful resources for yourself. If you’ve ever
tried to find particular products or home contractors
for general work, you know how difficult this process
can be. Who do you trust? What is the right price? Who
have others used before?
investigating resources can be the biggest obstacle a
person faces when considering home modifications,
becoming aware of different products and services can
really help to facilitate this process. Subscribing to a
catalogue that carries home modification products is a
good idea and can easily be found by conducting a quick
“Google” search on the subject. If you find something
you think might be immediately useful, try introducing
the idea of change in the form of a gift, like a new
bathmat with non-skid backing. Or, if some regular home
maintenance is already being performed, include
handrails, if necessary, as part of that project.
resources, like area agencies on aging, can be
enormously helpful and are good places to start. These
agencies may be knowledgeable about products and local
services that can help with home modifications and offer
referrals on aging resources – both subsidized and
private. Sometimes, resources may be in your own
back yard. Neighbors and friends who have successfully
adopted changes can be great role models
a professional who specializes in aging is the best
person to provide a complete assessment, there certainly
are things caregivers can begin to do that will be
enormously helpful when a professional is brought
observe and look out for any changes in the home and
with the person. As you look around the home, ask
yourself if the environment has changed in any way. Is
it clean? Is anything broken? Is there food in the
kitchen? Has the laundry been done? As for the person,
have you noticed whether they are forgetting things? Are
medications being taken? Are bills being paid? It’s good
to keep an eye out for any kind of change in typical,
are things you can learn from observing. There are also
things you can learn by asking. You might not always get
a complete response, but you will have started the
dialogue and reinforced your efforts in raising
kinds of things are you having difficulty doing at
are you not doing now that you used to be able to do,
or that you still want to do?
are the reasons you don’t do those things?
feel unsafe and which are you unable to do?
important to problem-solve together. If you strongly
impose your own ideas, they run the risk of being
ignored. Approach the subject by letting your family
members know that you are concerned about their health
and safety and assure them that you don’t assume that
getting older means self-awareness and understanding are
Consult a Professional
truth is, no matter how prepared you might be, no matter
what kind of approach you take, you should count on a
certain amount of resistance to your offer of help. A
soft, patient approach is key, but in the end, it may
not be all that is required.
occupational therapist can match an environment to a
person’s abilities so they can do what they want and
need to do at home. The occupational therapist’s unique,
three-pronged approach – looking at the person, the task
and the environment – results in an individualized
assessment that matches a person’s physical and
cognitive abilities to the features of the physical
environment allowing them to do what they want and need
to do. It enables people to live what they consider to
be full and meaningful lives.
be honest, while utilizing the resources of an
occupational therapist may provide enormous benefit to
your loved one, it also relieves an enormous amount of
pressure from the caregiver. The external professional
can come in and ask questions in a way that produces the
kind of responses that help lead to the development of
an action plan.
OT can walk into the home and immediately begin to
identify what a person is doing well and can emphasize
the person’s success. For example, she might say, “I
notice you have cleared everything out which really
helps in preventing falls. Are there other areas that
you would like to focus on?”
occupational therapist can take the blame off of the
person and put it on the environment – it’s not you –
it’s the home. Explaining that most houses were built
when people’s life expectancies were not nearly as long
really rings true for some.
process of change
essential to recognize and think about changes before
they are needed rather than waiting for a crisis
situation that may force a person to be removed from a
home. Advanced planning empowers the person to make
changes for themselves rather than have someone else
step in. Often, it you wait until a crisis, individuals
will resist even more.
change and the adoption of new behaviors to occur
slowly. The process usually takes several steps
the planning stage, consider the Home Modification
Strategies recently released from the American
Occupational Therapy Association (see sidebar). This
resource offers a room-by-room guide of things to look
for and changes to consider in the home.
his famous graduation speech turned book, Dr. Seuss
reminds us in Oh
the Places You’ll Go, to:
with care and great tact / And remember that Life’s a
Great Balancing Act / Just never forget to be dexterous
and deft / And never mix up your right foot with your
is a great balancing act, but not an impossible one.
Through awareness, education, planning and action, you
can help your loved ones fulfill their desire to remain
in their homes for as long as possible
Saudi Arabia wants to increase oil production and that
could drive the prices down- so too the number of rigs.
reaches highest level in November. OPEC’s
resolve looks stronger than ever. In the run up to the
late-November decision to extend the production cuts
through the end of 2018, the group posted its best
compliance rate with the agreed upon production cuts
yet. OPEC reported a
122-percent compliance rate
in November, a figure that bodes well as the group
seeks to keep those curbs in place for another year.
supports gradual, managed exit from OPEC cuts.
In another bit of news that
bolsters the OPEC deal, Russian energy minister
Alexander Novak said that Russia supports a gradual
exit from the production cuts, reducing the risk of
a messy conclusion and return to full production.
oil minister sees market balanced in first
quarter. Iraq’s oil
minister Jabar al-Luaibi said that he was optimistic that the oil market would reach a balance in the
first quarter of 2018, which will be accompanied by
higher oil prices. His comments are some of the most
bullish out there among OPEC members, most of which
see such an event unfolding in the second half of
strategists predict lower prices ahead.
While Iraq’s oil minister voiced optimism, a group
of energy analysts told CNBC that there is more risk
to oil on the downside as we head into the New Year
because of rising U.S. production at a time when
speculative moves in the futures market have become
a little too bullish. "While we could easily see an
escalation of tensions in the Middle East, in the
absence of that, optimism is probably misplaced for
up to six months,” Harry Colvin, director and senior
economist at Longview Economics, told CNBC. “Everybody seems to be facing the same way over oil at the minute and
it's when this happens that you need to be
in China teleported
properties of light particles
called photons from the ground into outer space for
the first time this year, using mirrors and lasers. It
was a huge success for quantum physicists, who say the
finding could completely change how we move energy and
information around the world.
looks set to leapfrog
Britain and France next year to become the world's
fifth-largest economy in dollar terms, according to a
report by the Center for Economics and Business
Research. India's ascent is part of a trend that will
see Asian economies increasingly dominate the top 10
largest economies over the next 15 years. CEBR also
predicted that China will overtake the U.S. as the
world's No.1 economy in 2032
I said back in the early 90s that the Japanese economy
would strengthen and retain its prominence. Didn't
happen and I simply gave up any use. Maybe now?
Japanese economy is
moving closer toward the central bank's 2% inflation
target, though only gradually, offering some hope that
a steady economic recovery will gradually drive up
prices. Core consumer prices rose for the eleventh
straight month in November, climbing 0.9% from a year
earlier, while Japan's unemployment rate fell further
and household spending rose faster than expected.
Lots of things look different when
you step into a small Green House nursing home.
The bright living and dining
space, filled with holiday baubles at this season. The
adjacent open kitchen, where the staff is making lunch.
The private bedrooms and baths. The lack of long stark
corridors, medication carts and other reminders of
I was visiting the Green
House Homes at Green Hill, a continuing care
facility in West Orange, N.J. Dorothy Bagli, who’s 91,
showed me her room, looking out onto the garden and
filled with artwork from home and photos of her
grandchildren. (Her son, it turned out, is a
reporter at The Times.)
“I’ve gotten to know most of the
people that live here,” she said — an easier task when
there are only 10 residents.
“It’s very intimate,” agreed
Eleanor Leonardis, who declined to give her age and is
recuperating from a nasty fall. “It feels a lot like
thing that struck me most was a man sitting alone at the
communal table, having his breakfast oatmeal — at noon.
The staff knows that he doesn’t like getting up or
eating early in t
conventional nursing homes, aides have to hustle
residents out of bed, help them dress, escort them to
the dining room by whatever time breakfast is served,
and then perhaps whisk them off for physical therapy.
These facilities struggle to provide even a smidgen of
Here, physical therapists come to
the Green House Homes. If they find a resident still
asleep, they come back later.
The Green House Project, which in
2003 opened its first small nursing homes in Tupelo,
Miss., counts just 242 licensed homes in 32 states to
date, with 150 more in
various stages of planning or construction. (Next
up: Bartlett, Tenn.; Lima, Ohio; and Little Rock, Ark.)
That’s a droplet in the bucket of the nation’s more than
15,000 nursing homes.
But few aspects of aging generate
quite so much anticipatory horror as nursing homes, and
so Green Houses have attracted disproportionate
attention, including media
They seem to embody change. “The
numbers are still modest, but it truly is a different
model of care,” said Sheryl Zimmerman, a gerontologist
and health services researcher at the University of
North Carolina at Chapel Hill.
What wasn’t clear, until Dr.
Zimmerman and a team of researchers around the country
undertook the most comprehensive research to date on
Green Houses, was how good a job these newcomers do.
“Does this model work?” she asked. “Is it sustainable
The group’s study of nearly 100
Green Houses compared to standard nursing homes, funded
by a $2 million grant from Robert Wood Johnson
Foundation and published in the journal Health Services
Research, showed that Green Houses don’t
fulfill all their goals and promises.
“control over the rhythms of the day” represents a
pillar of Green House life, as one of its brochures
declares, the researchers found that about a third of
the homes didn’t allow residents to decide when they
awakened, and most restricted when residents could bathe
or shower. Compared to conventional nursing homes, Green
Houses also are far less likely to offer formal
But overall, the studies,
incorporating nine years of data, add up to a positive
report card. “Compared to traditional nursing homes, no
doubt about it,” said Dr. Zimmerman. “It’s a preferable
model of care.”
Among the reasons:
* Green Houses practice what’s
called “consistent assignment,” meaning that the same
aides care for the same few residents. “People know you.
They know your likes and dislikes,” Dr. Zimmerman said.
“There’s more trust and familiarity. Relationships
aide (in Green House lingo, a shahbaz) who knows
residents well is also better able to spot health
problems early on. “Because aides were in closer and
more consistent contact, they were more aware of changes
in residents’ conditions,” Dr. Zimmerman said.
A Green House shahbaz spends many
more hours on patient care: an average 4.2 hours per
resident per day, compared with 2.2 hours in
conventional nursing homes. (At Green Houses, that
includes tasks like preparing meals and doing laundry.)
* Compared to residents in
traditional nursing homes, Green House residents fared
better on three of eight federal inspection criteria,
and did equally well on the others.
* Though Green Houses are
expensive to build (including a $200,000 payment to the
nonprofit Green House Project for training, design and
support), with 8 percent higher operating costs than
standard nursing homes, they save Medicare 30 percent
per resident per year. (They charge residents or their
insurers somewhat more than regular nursing homes,
Developers also seem able to adapt
them for particular populations. They’ve built Green
Houses for assisted living, for veterans, for a public
housing agency, for people with dementia and multiple
Houses incorporate hospice care, too. “We try very hard
to say, ‘This is home for life,’” said Susan Ryan,
senior director of the Green House Project.
She’s troubled by how slowly the
model has spread, partly because of complex state
regulations and financial obstacles.
only modest progress toward that goal, Ms. Grant
said. Perhaps one function of the Green House model,
then, is to point the way.
“There are many elements of it
that could be done by other nursing homes,” Ms. Grant
said. “There are ways to break down the size and make
nursing homes smaller,” with workers consistently
assigned to a group of residents. Facilities could be
redesigned to offer private rooms; they could give
residents more say over their routines.
At Green Hill (disclosure: my late
father lived there for a year and a half, though not in
a Green House), Dorothy Bagli’s family has discussed
whether to move her into the facility’s traditional
nursing home, which costs slightly less.
But Jeanne Jenusaitis, one of her
12 children, thinks the small scale of the Green House
suits her mother, along with aides who know and
understand her. Wouldn’t her mother, who has dementia,
get disoriented trying to find her way through the long
nursing home corridors? Would there be a staff person
always in sight to assuage her fears?
Her Green House, Ms. Jenusaitis
said, “is so much more nonclinical. She likes that
feeling of home.”
For caregivers of elderly or disabled
individuals, routine and specialized medical
care can be overwhelming. Communication with
physicians, nurses, technicians, pharmacists and
office personnel is essential to ensuring that
your family member receives the best health care
available. Here are several guidelines to ensure
the safety and good health of those being cared
for by family members:
a written log of illnesses, symptoms and
medications. This list should be taken to all
appointments and shared with the doctor. Do not
rely on memory. Oftentimes, several doctors are
treating one patient and each may not have the
most recent medications, etc.
a primary care physician who can assist with
coordinating medical care. A family doctor
serves as the central point of contact.
copies of insurance cards and claims processing
information. Take this information with you to
a power of attorney if necessary to provide you
with the legal authority to make informed
decisions regarding the patient.
the Health Claims Arbitration Office or local
courthouse to review your state’s defendant index.
Consumers can conduct their own research to
determine if a physician has been disciplined or
had claims filed. Although the index does not
provide detailed information about claims,
consumers can determine if a specific physician
has a history of claims.
resources are available when researching doctors and
other medical providers:
an advocate for the patient—ask
questions, request additional information—be a part
of the process.
participating in a caregivers support group.
Support groups offer caregivers an opportunity to
discuss their experiences in a setting that is
empathetic and understanding.
time for yourself by asking for
assistance from other family members and friends.
Mental and physical exhaustion can lead to poor
judgment and apathy.
request information pertaining to prescription
medications including side effects and
interactions with other medicines you or your loved
one may be taking
The BEA's Personal Consumption
Expenditures Chain-type Price Index for November, released
this morning, shows that core inflation remains below the
Federal Reserve's 2% long-term target at 1.48%. The most
recent Core Consumer Price Index release, also data through
November, is higher at 1.71%. The Fed is on record as using
Core PCE data as its primary inflation gauge.
12/26: I gave up doing any
investing in South America. It was one mess after another and
the corruption was horrid. Here is a powder keg about to get
abuse that has become a defining feature of
American life is increasingly emerging in Mexico
as well, posing a daunting challenge for health
officials and feeding the country’s soaring
are much more likely to die when they turn 62 years
old, probably from retiring
Most Americans become eligible for Social Security benefits
when they turn 62 years old. Comparing death rates of those
who have just turned 62 with those who are almost 62, Maria
Fitzpatrick of Cornell and Timothy Moore of the University
of Melbourne find that mortality increases by 1.5 percent in
the month people turn 62, and the effect is greater
among men. This jump in mortality at age 62 was not observed
prior to 1962, the year that the Social Security eligibility
age was lowered to 62. The authors find that the demographic
subgroups with the largest increases in mortality at age 62
are those most likely to retire then, including unmarried
males and males with little education. Further, the primary
drivers of the increased mortality at 62—more deaths from
traffic accidents and lung-related conditions—are causes of
death that have previously been linked to losing a job
life expectancy at birth declined for the second consecutive
year in 2016, fueled by a staggering 21 percent rise in
the death rate from drug overdoses, the Centers for Disease
Control and Prevention reported Thursday.
The United States has not seen two years of declining life
expectancy since 1962 and 1963, when influenza caused an
inordinate number of deaths. In 1993, there was a one-year
drop during the worst of the AIDS epidemic
12/20: Employer-sponsored medical plan costs expected to rise 8.4
BY KATIE KUEHNER-HEBERT Costs for employer sponsored-medical plans in 2018 are
likely to rise 8.4 percent – nearly triple the projected
rate of inflation, as global risk factors such as high
blood pressure, physical inactivity and obesity increase,
according to Aon’s report, “2018 Global Medical Trend
For 2018, the gap between the average medical trend rate and
the average general inflation rate is expected to modestly
decrease to 5.3 percentage points from the corresponding 5.4
figure in 2017. The average nominal medical trend rate is
expected to increase 0.2 percentage points: For 2018, the
global average medical trend rate was 8.4 percent and the
average general inflation rate was 3.1 percent. In 2017, the
global average medical trend rate was 8.2 percent and the
average general inflation rate was 2.8 percent.
“Aon expects further medical cost escalation due to
global population aging, overall declining health, poor
lifestyle habits becoming pervasive in emerging countries,
continuing cost shifting from social programs, and
increasing utilization of employer-sponsored plans,”
the authors write.
if you’re not a caregiver, the threat of the holidays being
right around the corner strikes instant fear, terror and
major stress into the hearts of almost everyone. However,
there is hope for caregivers to enjoy the holiday season and
still make it a special time for their loved one as well.
The key is to pace yourself, as well as to help your loved
one do the same, so that neither of you will feel completely
drained, depressed or overwhelmed, especially during such a
special time of year. Here are some suggestions that may
help you both survive the holidays:
not to schedule too many social events, one right after
another. It's better to miss out on a few holiday events
than to end up with yourself or a loved getting too
exhausted, which could lead to health problems for both of
you. Remember, when it comes to holiday events, it's the
quality, not the quantity, that counts.
sure that your loved one gets a chance to have some quiet
time away from all the noise, stress, and chaos that is a
natural part of the holidays. It’s best to spend some quiet
time together, so that you both get a chance to unwind from
you end up traveling away from home for the holidays, make
sure to begin packing way in advance so that you’ll have
everything needed for the person you’re caring for, as well
as for yourself. Make lists and check them often prior to
leaving home. Remember to have any refills on medications
done early. If you’re traveling by car, remember to break up
the car trip with a stopover at a park or at a favorite
restaurant so that your loved one can get some fresh air and
feel less confined.
out for holiday burnout in the person you’re caring for, by
taking note of unusual irritability, tiredness, or even
boisterousness, depending upon their condition. Also, be
aware of possible holiday burnout in yourself.
the end of the holidays, you may notice some post-holiday
blues creeping into the mood of your loved one. It’s best to
try and get them back into their regular, daily routines as
quickly as possible, but do it gradually so that it’s not
too much of a shock.
is always required as a caregiver, but even more patience is
required during the holidays, and in order to keep yourself
from stressing out too much or becoming too exhausted, it’s
important to try and keep your own, personal holiday
schedule under control. This doesn’t mean to deprive
yourself of social events that you’d like to attend for
yourself, but know what your limits are, know that it’s okay
to reduce your holiday commitments down to only a few, and
don’t feel guilty about telling someone “no” when asked to
participate in yet another holiday function.
online whenever possible. A growing number of major
retailers have cyberspace shops offering a variety of goods
that can be purchased without ever leaving your home.
shopping is another option if you don't want to spend hours
fighting the crowds at the mall.
the same gift for as many people as possible on your list.
If you find a gift book that would be perfect for all of
your favorite friends, pick up a half-dozen copies. You
don’t always have to get everyone you know something
your shopping time as efficiently as you can, by creating
and carrying a business-card sized list of gift ideas in
your wallet, along with a list of gifts you've already
gotten. These lists will help you from spending so much
money, and will also help you not buy so many unnecessary
Your Loved One
it’s the holiday season, try to maintain the daily routine
you and your loved one are used to doing.
before an official gathering, continually speak about the
people who will be coming to visit, or who you’ll be
visiting, so that the person you’re caring for will begin to
start looking forward to some social time.
seasonal music around the house, and serve their favorite,
the person observe but don’t try to force them into any
activity beyond their cognitive capacity. Have them do a
repetitive task, such as folding napkins or cracking nuts,
that will help keep them calm.
it’s possible, have them help bake cookies, or decorate the
tree. If they don’t want to, let them stay as an observer.
to the onset of any behavioral problems during a holiday
gathering, prepare distractions such as a family album to
draw the person's attention away from their problem.
also a good idea to prepare your visitors for how your loved
one may react during the gathering, and what to expect from
their condition. This way, it won’t be shock if relatives
and friends haven’t seen them for a while.
sure to prepare friends and relatives regarding the
condition of your loved one, especially if they haven’t seen
them in quite a while. The behavior or condition of the
person you’re caring for may come as quite a shock, so it’s
best that everyone is informed ahead of time so that
everyone is at ease and relaxed during a holiday visit.
focus on how the holidays “used” to be, but focus instead on
what a wonderful gift it is to have your loved one with you
for yet another holiday season. The top-two priorities for
you during this time of year is maintaining health and
happiness, for the person you care for and for yourself as
well. If you can, go ahead and by yourself a gift, something
you’ve had your eye on for quite a while. Try to take time
off from other obligations and responsibilities in order to
re-energize during this season.
smaller gatherings; this will help reduce the noise and
stress level for you both. It’s okay to set limits, and make
sure that everyone in the family, as well as friends,
understand what you need as a caregiver during this time.
Don’t be afraid to ask for help, and to delegate holiday
tasks among family and friends. Don’t spread yourself too
thin by volunteering to help others. It’s okay to say no,
and when you do, make it short and simple, and don’t
apologize; it should be abundantly clear as to why you can’t
do something, until you actually have extra time on your
hands (and when is that really going to happen?). Hopefully,
family and friends will want to know what you want or need
for the holidays for yourself. Definitely put respite at the
top of your list as what you’d like to receive the most.
day at the spa - a day of massages, facials, manicures and
pedicures would be a perfect gift. Caregivers are often so
busy meeting everyone else's needs that they overlook their
own needs. A service that is totally self-indulgent is a
rarity to someone who normally thinks of others first.
card for streaming movies - this is a great way for
you to catch up on some of the movies you may have missed at
the theaters. Ask for some microwave popcorn, traditional
movie candies, and may be even a new set of pajamas to go
along with the gift card, all perfect for upholding the true
tradition of home theater viewing.
certificate for a clothing boutique - the wardrobe of a
caregiver generally consists of wash and wear clothing (for
obvious reasons), so having the opportunity to shop for an
outfit that is something other than cotton is a fun splurge.
good for an entire day off from caregiving duties - do
anything you want to do, and don’t necessarily have the day
planned and structured for you, so you can experience some
certificate for a bookstore or online bookseller - this is a
great gift because a new title by your favorite author can
always take you to another place when you need to get away.
coupon good for a night out on the town, including a gift
certificate to a favorite restaurant, along with someone to
watch your loved one could add up to a wonderful evening.
All eight indexes on our world
watch list have posted gains for 2017 through December 18.
The top performer thus far is Hong Kong's Hang Seng with a
gain of 32.04%, followed by India's BSE SENSEX at 26.34%. In
third is our own S&P 500 with 20.16%.
worksheet to determine how much in unnecessary income
taxes you are paying
They indicate that the results are emailed but since you
phone number is required you might be called by an
agent of something.
12/20: Washington Post"
The national debt is poised to explode by more than
$1 trillion, and there is no realistic scenario in which
these tax cuts generate enough economic growth to pay
for themselves. Some Republicans
will cite this hole that they’re creating to call for cuts
to popular entitlement programs next year. This could
aggravate many of Trump’s core supporters, which is why
they are unlikely to happen.
Conversations about older men
dating and marrying young girls have left many Americans
surprised, especially in the wake of allegations that
Alabama Republican Senate candidate Roy Moore dated
teenage girls while he was in his 30s.
But few may know that
child marriage has a long and vibrant history in the US.
In the last 15 years,
more than 207,000
minors have become legally wed in the United
States, many marrying below the age of consent to sex in
my day- Drop a nuclear bomb on the city of your choice.
Great for bars. Estimate the
number of casualties for a fee beer
expectancy for women in the US has stalled, leaving American
females at the bottom of the list of the wealthiest nations.
US life expectancy is now the lowest among ... high-income
nations, the discrepancy is especially stark for women,"
said the CRR. In 1960, American women were likely to be
among the longest-living females in the world. But that
trend reversed itself in the 1980s, and today their life
expectancy lags two-and-a-half years behind women in other
CRR had another surprising finding. Even though women have
had, and still do have, longer life spans than men, that gap
is narrowing. It's now is only four to five years,
compared to the nine or 10 years for previous generations
CRR looked at retirement-age Americans and based its study
on expected life span from age 65 on. But the factors that
make both men and women -- but particularly women -- die
younger than they should are already in place when they're
in their 30s and 40s.
despite the ongoing criticism of the US health care system
relative to socialized medicine in other developed
countries, this nation's erratic health care doesn't seem to
be a significant factor, according to the CRR. "These
differences probably have had little impact," it said.
the study indicated that the fault lies within ourselves.
The CRR said diseases associated with smoking and obesity,
such as lung cancer and diabetes, have contributed to the
decline in women's life spans relative to other countries.
"If US patterns had matched those of its peer countries, US
life expectancy would have exceeded the average until very
CRR said the life expectancy gap between the US and other
countries was "surprising" given that we spend more money on
health care than any other nation in the world. And the US
is doing better than most other nations at "aggressive
treatment" of cancer and heart disease. But where the US
fails is in obesity, which causes stroke, and lung cancer,
which is often caused by smoking. US women were found to
have smoked a lot
12/18: Dementia- this is why you
cannot depend on taking care of a patient who has "lost their
in about 2003 or so. I was working
for the Memphis police department.
Another officer and I got
dispatched to a call where a
homeowner woke up and found
someone in his house and that he
had an axe.
got there and were met by an
elderly man in his night clothes
holding a double-bladed axe with a
red stain on the blade. As I
secured the weapon the old man
said he woke up and found someone
in his bedroom so he went out and
got the axe and hit them with it.
partner and I exchanged looks
because there is no way an
intruder would stay put while the
old man went and got an axe.
the old man hit us with the
comment that the intruder was dead
in the bedroom. My partner, who
had previous military experience
and served overseas in Iraq, went
to the bedroom to check.
heard a chirp and then my partner
got on the radio requesting for
EMT. He told dispatch there was an
elderly lady lying on the floor
next to the bed who was alive and
hurt bad yet unresponsive.
this time the old man told me
about his wife whom he lived with
and who was asleep in the bedroom.
third officer got there about the
same time as the paramedics and
assisted me in detaining the old
went back in to check the scene
and see about my partner. As I
entered the bedroom, the
paramedics began lifting the lady
to put her on a stretcher. The
sight was gruesome and I don't
feel like sharing the details. My
partner called out “just hold on,
from this lady a grandmotherly
voice called out, “Don't worry,
baby. I'm okay”. At this my
partner, a hardened war vet,
nearly fainted. A paramedic had to
help keep him on his feet. It
amazed me that such an frail
old-looking woman, who had such
injuries, would assure my partner.
lady was transported to the
hospital and I remained on the
scene with the old man. He kept
saying how he woke up to find a
stranger in his home. It got even
worse when he asked to see his
wife. It was almost like he had no
idea of what was going on and
didn't see her get carted out to
his kids made the scene. From them
I learned that the man had been
diagnosed with advanced dementia
the day before and they were going
to start some type of treatment
the next day. They were so mad at
themselves that they had waited.
was a somber time for us all.
best as the family and I could
figure out was that apparently the
old man woke up in the middle of
the night. Didn't recognize his
wife of 30+ years sleeping next to
him. He then went and got the axe.
found out a lot later that the
tough old lady survived and her
husband had to be put in an
assisted living/care home
12/17: North Korea was
'invited to a sitdown with Tillerson with no strings
attached. Then the invitation was changed to North Korea
has to earn its place to a negotiation. If North Korea was
remotely rational it would say the initial invitation
was grossly mishandled. An irrational North Korea would say we
Well it was stupid, childless and
we looked like fools. North Korea may slow down its nuclear
focus for awhile and just focus on germ warfare. They still
win the negotiations. China must step in soon ot a lot
of lives may be lost to gross arrogance and stupidity.
I am not confident with Trump/ On
the other hand neither Bush nor Obama did anything so this
mess is beyond normal reasoning.
a new study by Hendrik Bessembinder, a finance professor at
Arizona State University. He looked at U.S. stock
performance over the 90 years through December 2016.
startling discovery: The market’s entire 90-year gain, over
and above Treasury bills, could be attributed to just 1,092
companies, equal to 4% of all stocks. The other 96%
collectively matched T-bills.
half the wealth created over this 90-year stretch can be
explained by just 90 stocks, including Exxon, Mobil, Apple,
Microsoft, GE and IBM. That’s a mere 0.36% of the stocks
that traded during this period. Most of the other 25,000
listed companies weren’t nearly so impressive: Stocks
typically stuck around for just 7½ years—and a majority lost
money during their usually brief life.
other words, if you had picked just one or two stocks, the
odds suggest you would have got your head handed to you.
most recent analysis found that, over the past 15 years,
just 7% of large-cap U.S. stock funds outpaced the S&P
500-stock index, 6% of mid-cap funds beat the S&P MidCap
400 and 6% of small-cap funds outshone the S&P SmallCap
600. The 15-year results for bond funds and international
stock funds were almost as grim.
provider network administrator somewhere in the country is
trying to set up a nursing home network aimed issuers of
private long-term care insurance (LTCI) and their
statewide nursing home network would offer people covered by
"participating payors" rate discounts.
private LTCI providers could by participating payors.
network organizers told HHS OIG they would open the
network to any willing nursing home care provider in a
state that earned a quality rating of 3 stars or higher on
the Centers for Medicare and Medicaid Services Nursing
Home Compare website, if the facility agreed to give a
participating payor's insureds a minimum discount on use
of a semiprivate room.
This figure includes an increase of 274,000 people over the
last three months. At the end of the third quarter of the
fiscal year, these nearly 5 million defaulters represent
22% of all Americans who were required to pay federal
the presence of a systematic preference for independent
living at old age which we refer as “institutionalization
aversion” (IA). Given that IA is not observable from
revealed preferences, we draw on a survey experiment to
elicit individuals’ willingness to pay (WTP) to avoid
institutionalization (e.g., in a nursing home), using a
double-bounded referendum WTP format. Our results suggest
robust evidence of IA and reveal a willingness to pay of
up to 16% of respondent’s (individuals over fifty-five
years of age) average income. We find that estimates of
the willingness to pay to avoid institutionalization (or
€292 at the time of the study) exceed the amount
respondents are willing to pay for home health care at old
age in the event of a mild impairment (€222). WTP
estimates vary with income, age and especially,
respondents’ housing conditions. Finally, we test the
sensitivity of our estimates to anchoring effects and