Sometimes there are more questions than answers.

Posted on December 31, 2020December 31, 2020

This month, I had the opportunity to work with several low-income older adults regarding changes they wanted to make in their living situations. We read a lot in the newspapers about the need for “affordable” housing in Napa … but, this is usually for working adults, or people with families. There is another crisis in our reality, that is virtually ignored by our political icons, and that is the desperation of aging people, needing care due to physical/cognitive decline, and having no place to live. The “no place” to live is strictly due to income. They are living on Social Security alone, squeaking by every month … but, then it comes time for more care, and there is no place to go and no one to take care of them.

Our In-Home Support Services system, which is paid for by Medi-Cal, and provided by Napa County, is going through a severe shortage of choreworkers. The pay offered to the choreworkees is very low, and many of them are driving in from Solano County because they can’t afford to live here. We have older people who qualify for choreworker support, but are unable to find anyone to take on the job. The IHSS system is not enough.

Some believe that the skilled nursing facilities will be a final home when circumstances gets desperate. Only for a few. Cognitive decline is not a medical reason for admission, on Medi-Cal, to a nursing home. A broken hip, or recovery from pneumonia is … but, they only want you for the first 21 days covered by Medicare. Then, the discharge planners are looking to send you back home.

I cannot tell you how many calls I have gotten this year from panicked family members asking for a “place” where mom can go because she can no longer manage alone at home. And, her income is $1,300 a month.

Napa County desperately needs a non-profit, publically supported assisted living center for low-income aging people in cognitive and physical decline. The time to have one is now. The planning should have happened a year ago. I asked our community for support, holding a very public meeting on what we can do to help make this happen. Many showed up for the first meeting, by the third meeting there were only four of us sitting around the table. We tabled the idea, not enough support.

As I retire next month from Share the Care, I leave with the regret that I am leaving people behind that need more help at home, and there is no program/service in our community that is currently able to help. Caring for older people is not a job for volunteers. We tried that. Share the Care started as a volunteer program, and we discovered that while people are well-meaning in intent, there is a reality of being there for another on a daily basis.

Today, I have one woman who, with Lewy Body Dementia, has been living alone for five months in anxiety and fear, wondering what is going to happen to her? I frankly told her that I didn’t know … there is no place to go and she can’t afford anyone to care for her. There are no friends or family, either.

In another situation, a man fell, breaking six ribs and was hospitalized. He wants to return to his apartment, but without care, he had to go to the nursing home. He will be there for about three weeks, and then be sent back home. Except there still won’t be anyone to care for him … which is why he fell in the first place. Also, no family or friends on the horizon.

Sometimes there are more questions than answers when it come to us figuring out how to care for each other. Share the Care is a start in our community, but it truly needs to grow to meet an even greater need. The new executive director will be starting the job on January 25.

Pandemic Stress

Posted on November 28, 2020November 30, 2020

The unraveling of status quo started a few months ago. What was deemed “manageable” by many older people confined at home, has begun to fray. Social isolation is taking a toll. Without witnesses and social support, strokes are undetected, forgetfulness progresses into full blown dementia and fear has moved into full paranoia that anyone could cause an illness or even death.

In the beginning, when Share the Care talked to people about how they were doing in the pandemic, most pointed to their food supplies and told us they were doing “fine.”

But, now, nine months later … that “fine” has taken another turn. The “fine” might now mean that instead of making dinner, they’re drinking an Ensure. Or, they’ve fallen and even though a face is torn and bruised, it doesn’t merit a trip to the emergency room or even doctor’s office. Or, watching TV all day is the only conversation heard, or believed to be true. Curtains and shades are shut all day. And, trips to the bank, grocery store or church, have stopped altogether. As the number of COVID cases continue to mount throughout the country, the toll we are paying with our humanity and lack of the ability to care and comfort each other is a huge tear in our fabric of compassion for each other.

The goal now is to stay out of hospitals and nursing homes. Or, if there is no choice, to be able to discharge home as soon as possible.

Doctors are increasingly reliant on telehealth for diagnosis. Or, just order bloodwork and read the labs. But the problem is older people who are often forgetful and not able to tell an accurate story about their conditions, are being increasingly abandoned by a health care system that has moved into a technological future unavailable to many of them.

A woman going blind with macular degeneration calls me asking if I can help her legally kill herself. In her 90’s, she cannot bear the thought of no longer being able to read. Already having lost most of her hearing, and physical bearing, the loss of eyesight is the last straw. She asks to die, because no one has offered hope. Share the Care hooks her up to the Earl Baum Center in Santa Rosa, where she learns about glasses and other devices that can help with her vision. It’s reading that she misses the most, and we find her a reader who will visit several times a week and read, out loud, from a favorite book. Talk of suicide has stopped. She has found a little of what she was looking for, care and hope.

Without human connection, depression can only deepen. One man tells me there’s nothing to do all day but watch TV. He’s bored. His body aches, walking is difficult. He asks me over and over, “What am I to do all day? There’s nothing.” He drives to Safeway, just to see some people. A diabetic, he pays no heed to doctor’s orders as he eats an apple pie straight out of the aluminum pie pan. His legs, he tells me, hurt so bad that he doesn’t get out of his chair very much. Not even to use the bathroom. His chair is surrounded by open jars of urine. He promises to empty them once I leave. But the truth is, it doesn’t matter to him whether they’re empty or full, whether he’s dressed or in a robe, or what is on the TV sitting just four feet away. His doctor has ordered a pill for depression, but he says he doesn’t really need to take it. He’s sure he’s “okay.”

Exercise is walking to the mailbox, entertainment is a game of solitaire, and today’s meal is delivered in a plastic purple bag from Meals on Wheels. Phones ring, but aren’t answered, “It’s just another marketer,” and no one can remember when they had a moment of recent joy.

This Thanksgiving month, so many of us will be celebrating alone. Families are told not to get together, people are encouraged to depend on screens for touch and we are all trying to protect each other from the disease that has stopped us all in time.

Share the Care can help some, but not enough. We could use more volunteers. More people to be involved. Let us know what you can do. We’ll find you a place to belong. Even when this pandemic is over, life will have been altered for many. Let’s be there for them.

Women of a Certain Age

Posted on October 19, 2020October 19, 2020

I go on Medicare November 1. I am mostly worried that doctors will not provide me with the care that I will need over time. I know that old women do not get the attention or ear of their mostly male doctors. I know because for the past forty years, I’ve been taking older women to doctors and have watched as they have been methodically dismissed, unexamined or otherwise not heard.

I was reminded of this today, when I took a 73-year-old woman to a new doctor for the first time. The visit was less than 10 minutes, and I was reminded how little doctors delve into the realities of older people with lots of chronic problems.

This woman needed me to go into the doctor’s office with her, because she is unable to remember her own history. She also has trouble word finding, forming sentences and is forgetful from moment-to-moment. She knows it’s happening, but doesn’t recall when it started. And, it’s frustrating her to no end. She keeps asking, “What is going to happen to me?”

A widow with no family. she has no support. I did find a a woman in Oakland who knew her years ago, and when I called her, she told me that she hadn’t seen her in years, but occasionally they do talk over the phone. Her friend believes it was 7-8 months ago when her words became jumbled and conversations changed. “She was different.”

Socially isolated and COVID afraid, “something” happened, and there is no medical record of it, anywhere.

She did tell me that one night she panicked, and called 911. The ambulance took her to the hospital, where she was given a prescription for fungal cream, “the kind you’d get for athlete’s foot.” Except, there was nothing wrong with her feet.

So, by the time she called Share the Care, all she knew was that she needed “HELP!” But, she couldn’t articulate why.

Today’s doctor wouldn’t let me in the examining room. She asked that I accompany her, but he said COVID restricted the number of people in the room. I explained to the nurse that this woman has a cognitive problem, and is not a good historian. I went outside to wait. Ten minutes passed. I also wanted to tell him what I’d observed over the last month of visiting her.

When I returned to the waiting room, the receptionist opened the window and told me that the appointment was over, and that she needed to return in two weeks. A blood test had been ordered.

That’s all.

I asked to speak to the doctor. I watched her hesitate. I insisted that I speak to the doctor. He told me he had examined her. I asked again, “Examined?” I asked whether he looked at her skin? There was a rash all over her trunk. I asked whether he’d notice that she cognitive deficits. I asked about her body pain. And whether she had mentioned her high anxiety and low depressions. He reiterated, “I am the doctor.” That’s when I asked him whether he saw her medications, which were still in my purse. He took them from me and went into his office. Apparently, he didn’t.

The exam wasn’t anything I would settle on for myself at any stage in my life.

But, if I am not able to advocate or pursue my own medical care, who is going to do so for me?

He called for her to return to the examination room. This time she was in there a little longer, and he made two referrals to two specialists. But, he didn’t return to talk to me about what he’d found or thought about her condition.

On the car ride home, I asked her what she talked about with the doctor. She said she didn’t know. That she told him that she hurt, but that was about all. “I kept asking for you to come into the room, but that doctor wouldn’t let you,” she said.

I told her that the doctor had ordered a fasting blood test. We’d go together in a few days to get one. She asked what they were looking for … I answered, “I don’t know, one of the things could be diabetes.”

“Oh,” she said. “I already have diabetes. I used to take medication for it. But I don’t have the pills anymore.”

There is so much more to talk to the doctor about, so many unanswered questions.
We do not have a board-certified geriatric physician in Napa county. Not a single one. And yet we have thousands of geriatric patients.

That’s what I worry about the most. The perfunctory ten minute visit that works for me today, because I’m still mentally able to understand and research my own care regime, will not work for me in my 80’s, when I forget, can’t explain things or hurt all over with no explanation.

And, who will be the doctor there to listen or care?

Truths About Aging We’d Rather Not Face

Posted on September 29, 2020September 29, 2020

Life gets harder. By the time a person reaches 80, they’ve had many losses and experiences that have shocked them into the reality of frailty and vulnerability. And, without tools or information on how to manage all this emotional pain, many older people become estranged, isolated and depressed.

Share the Care visits were initially stopped during the COVID shelter in place order. We called and talked to many older adults, and you know what we learned? That life isn’t much different for them, with or without COVID. Many hardly ever leave their house, nor entertain many visitors anyway. In several cases, life with COVID even got better because children took their parents in to live with them during the crisis. And, another thing that happened with COVID: They got more food. Keeping people fed became a priority in our community, and so deliveries of free groceries became a priority of many human service programs.

So, while they were being showered with cans of fruit cocktail and bags of rice and beans, no one was actually looking into their kitchens or refrigerators to find out what was really happening to all this abundance. And, when Share the Care started making visits again, what we found was canned food and rotting produce left in bags and boxes on the kitchen floor.

Most older people living alone do not cook. A pre-made, home delivered meal might get heated up in the microwave, but very often it gets placed in the freezer for “later.” We’ve opened freezers stacked with meals going back several months.

Older people like food that is very sweet, or very salty. When asked what they’d like for a meal treat, we hear MacDonald’s or Wendy’s. And, it’s a hamburger, french fries and a coke that bring happiness. Even for those with diabetes or other chronic illnesses where diet makes a difference. And, one meal a day seems to be the norm, with some light snacking in-between. But the best thing would be for someone to come over, cook a meal together, and dine. Spending time in conversation is the true value of the meal. Dropping off groceries and meals doesn’t nourish the battered soul.

Many older people rely on mood altering substances to get through the day. Whether it’s alcohol, an anti-depressant or opiates, we see it often enough to recognize the impact it has on our medical system, as people physically deteriorate and become more frail over time.

We can put in all kinds of safety devices in the home, but someone falling down because they’ve had three glasses of wine, or are taking three different medications with dizzying side effects, is beyond our capacity to manage.

Sometimes older people want to die, they’ve had enough loss and trauma and are asking for mercy in having it all stop. We offer help, we have in-home counseling available through Mentis, and more often than not, it’s turned down. No matter how bad someone might feel in the day-to-day, being labeled with a “mental” problem is worse.

People who seem to suffer the most are those without family or meaningful relationships. In one case, a woman had all four of her children die, and is now caring for a husband with dementia. In another situation, a 97 year old woman, losing her eyesight, is saying her life will be unbearable is she is unable to read.

Share the Care offers help, but it’s not always accepted. Walkers and canes are placed against walls, driving continues even though their license has been suspended and medication doses are missed and forgotten.

We have a proliferation of senior services offering help in our community…but, the truth is, how does one navigate a life process where loss is the dominating factor? Social workers, nurses, aides and caregivers are strapped for time, where time is needed most. It’s also true that professionals can never replace the connection of family and friends.
Sitting with the tears of recent widows, the laments of those estranged from adult children and the fears of illnesses without cures, brings up fear of aging. No one wants to suffer a continuous string of loss. But, that is a reality of age. It is a truth.

And, so the loneliness of COVID, well … it wasn’t so bad for the older folks. That’s normal. As one woman told me, “I’m used to being alone. Sometimes I don’t see another person for a whole week. My daughter lives in Minnesota, she calls every Sunday.”

The smallest bit of help can sometimes make the biggest impact. If you can help us, please do.

Posted on August 12, 2020August 12, 2020

COVID-19 has shocked us into a new reality. For those over age 65, the last five months have proven particularly challenging. Not only are we asked to shelter in place, but if there’s a fall or other healthcare crisis, we worry about not only going to the hospital, but how quickly we can return home. We might need to avoid moving into congregate care facilities, and many families are looking at alternative arrangements at home.

We at Share the Care have been giving away hundreds of pieces of medical equipment and home health supplies while working with families to modify their homes so older loved ones can be safe at home. We have installed grab bars, built ramps, fixed rails, made home safety assessments and countless recommendations. We’ve helped find caregivers, complete forms, advocate for care and mostly guided our community along the safest path for caring for someone at home.

But we need to raise money, about $10,000, to stay open through the rest of the year. As a nonprofit, we’ve been hit hard with an increased demand for services and shrinking opportunities for fundraising.

This month we were invited to join the Travis Credit Union Foundation’s Community Funding Initiative. This means that Travis Credit Union will match every dollar you donate to Share the Care. What a wonderful gift for all of us! Your money will go twice as far! The Travis Credit Union fund will match up to $20,000.

You can go online to tcufund.org, choose Share the Care Napa Valley under the section for Napa County and donate directly on their website today through September 30th.

Share the Care is a 501 (c) 3 nonprofit agency. Many people calling us don’t drive anymore, or can’t get out of the house without help. Some can’t afford to pay their bills. Others have to move and have no one to help them. We aren’t limited to any one service, and we certainly can’t do everything. But, we know that the smallest bit of help can sometimes make the biggest impact. If you can help us, please do.

If you can’t go online, you can send in a check to:
Share the Care
3205 Montclair Ave.
Napa, CA 94558

Thank you.

Yvonne Baginski, Executive Director
Share the Care Napa Valley

Share The Care Napa Valley Grows into New Role During Covid Crisis

Posted on July 30, 2020July 30, 2020

People don’t want to go into nursing homes, or any congregate living situation right now. And, who can blame them? As COVID sweeps through facilities, it is impossible to keep everyone safe. Staying home might be a better alternative. To stay home, people need to be outfitted with the right supplies and equipment. We know, because lots of people have been showing up at the front porch every day.

Just this last month, we have given away more than 35 walkers, commodes and wheelchairs. And, countless underpads, adult diapers, wound care supplies, etc. Everything is free. We are overflowing with colostomy, urostomy and ostomy supplies … every brand and number. If you need anything, check with us, first.

Our Stop Falls Napa Valley program is going strong. We send out an Occupational Therapist, Robin Stearns, to make a home safety assessment, and then follow her instructions with grab bars, ramps, railings and other modifications made by our licensed handyman, Bob Waldear. Anyone can make a referral to this program: Call us at 492-3198.

The home environment is important for the health and safety of our older people, and Share the Care also can help with downsizing, organizing and moving. Share the Care can also help find caregivers and other ancillary services. Director, Yvonne Baginski, has over 35 years experience in advocacy, planning and consulting on long-term care strategies for families. She spends a lot of time on the phone working through problems and finding solutions. And, if she can’t help, she’ll find someone who can.

Our volunteer program has been discontinued. This isn’t a great time to be going into people’s homes, nor taking anyone out on rides. We are happy to talk on the phone, or make an assessment masked and outdoors.

Right now, on the 3205 Montclair Ave front porch, we have lots of free masks, too. Thanks to Liz Allesio, and her mask-making sewists, we are able give away masks without charge to anyone in need. Along with masks, we frequently get clothing and household items dropped off … so, if you drop by the porch, you’ll be surprised by what you might find.

Who Will Care For Me When I No Longer Can?

Posted on April 9, 2019April 12, 2019

A Special Presentation by Yvonne Baginski on May 20, 2019

My dad died on March 18. He died alone. An unknown caregiver at his side, in an assisted living apartment he had moved into just three weeks earlier. He died in pain. He suffered.

I wish it was different. But he wanted to live his life his own way. And, at the end, his way was no longer working well. So, when his children came to help, he argued, resisted and refused to believe the reality that he was old, frail and dying.

He was 90 years old. A Holocaust survivor, he trusted no one. A Ph.D biochemist, he knew more than any doctor. He filled his cupboard with vitamins, minerals and supplements. They were his hedge against his body breaking down from cancer and the cells multiplying into his bones.

There is an irony of having a daughter whose lifelong work has been working with aging people at end of life, and never wanting her advice or any interpretation of her knowledge. I am that daughter.

In the end, his final words to me were: “you’re going to die, too.”

He is right.

But I am not wishing my life ends differently. I am making sure it does.

I am talking to my family. Instructing my children. And, making sure that all documents are organized, accurate and up to date. I have documented what to do if I lose cognitive ability, I have talked with family about possibilities, and most of all, I am making sure that what I wish will not impede or destroy the lives of those I love. At least not much. I have to face the fact that not everything is under my control.

One day, I know that I will not be able to drive. I suspect, too, that my mind will continue to decline and that those few words I can’t remember every so often, will become sentences, paragraphs and eventually pages of reality I can no longer understand. If I get cancer or heart disease, I might have to make decisions about treatment and longevity of suffering. But mostly, I have to face the reality that I will not be living into my 80’s and 90’s in the same condition that I am in my 60’s. That is so.

Of course I also worry about the money. How much my preferences will cost, whether the money will run out, and will there be anything left to pass on to my children?

I am no different than you.

But, maybe I have more knowledge, or understanding of what it’s like in the last part of life. I have walked that path with over one thousand people in my lifetime.

That’s why I created Share the Care Napa Valley. I know that there are many people like my dad. People who haven’t planned, or thought of, or even realized that one day they will be struggling with a set of circumstances brought on my aging, disease and fraility. And, that’s the time when a family member calls Share the Care and asks for help.

On Monday, May 20 from 10 a.m. to noon, Share the Care will be hosting an event that can help all of us make plans, or at least think of, what we might want to happen in the last part of our lives. “Who Will Care for Me If I No Longer Can?” will be an information and resource event held at the Napa Elks Lodge, 2840 Soscol Ave. Tickets are just $10 at the door. That ticket is an investment for the knowledge of what you need to do to make it better for not just yourself, but everyone else in your life.

But knowledge isn’t everything. There is also the ability to act on it.

I know because my dad, refused to act. He truly believed that the right combination of supplements would make him immortal. Or, at least give him another year or two of life.

The sad part was that his intention of not wanting to be a burden to his children only intensified as he went from hospital to nursing home, and then to assisted living.

We knew that he always wanted to be in his own home. But, he got caught in the “system of care” that is now a standard practice for old people who are hospitalized after a fall. It is automatic. And, without a voice or an advocate, people believe what they’re told by discharge planners and case manager is their only option for care.

There are other options. But they must be planned for and discussed far in advance. Come, learn more. It’s not just about dying…it’s about living the way you want in the last part of your life.

See you there.

Yvonne Baginski, Director, Share the Care Napa Valley

Your Turn: Many ways to make life better for seniors

Posted on January 16, 2019January 22, 2019

Jan 16, 2019 : Original article in the Napa Register.

Napans are great at reacting and helping during emergencies. A fire, an accident, a one-for-all effort brings in responses from just about every facet of society. There is a heart glow in helping and being of service in the company of others with an agreed upon goal. Stories of courage and self-sacrifice abound, and we have many whose photos grace magazine and newspaper stories on their efforts in making life better for those with less. We pack boxes for troops, raise money with crab dinners, have clothes drives for fire victims and so on.

It feels good to help someone else. That’s a basic tenet of humanity, and most religions. Serving is of service to both the giver and receiver. And, I am willing to bet that most of us “give” something at one time or another. Or, at least believe we do.

The greater challenge, I believe, might be of serving in every day life. It is in the slog of day-in and day-out existence that many of us ignore or set aside the idea of service as we survive work, commuting, deadlines and family pressures. Time is of the essence and it seems that most of us have less than ever before. I have found a solution…and that is integrating service and life into a seamless existence.

Is anyone else feeling that “time is running out?” I am. I have entered my last third of life, and I am wondering how much, or whether it’s possible, to make any change at all before I too, leave this planet. I want to leave it a better place, with hope for my children and grandchildren to live good, satisfactory lives where they, too, can be of service to humanity.

My life work has been in the field of aging. Frankly, it’s been difficult. People often as me how I can continue, in what they might believe, is such depressing work … and the reality of impending death and suffering keeps many away. But, I don’t look at the work, I look at the people. Each of them individually, with lives, purpose and meaning. And, it’s not their history but their present life that is of interest and concern. I believe in the value of life as a harbinger of our humanity and service to each other.

I look at 2019, and wonder whether there is hope for making life better for people who are struggling with age, infirmity, poverty and chronic illness and now, increasingly so, dementia. As a society, as a culture, there are major changes that must occur. This week, I visited three people, all over the age 90, living alone and trying to with increasing infirmity. One asked me whether I meet many people over age 90 … and I smiled with the reality of not only do I meet many, but increasingly more.

Here are a few of my suggestions to build a better community for aging people in Napa County:

1. Eliminate automated phone systems. They don’t work for people who have trouble hearing, understanding or following conversations. We need real people to answer phones and respond questions.
2. Develop a community-supported residential care home where older people, who are low income, with dementia, can safely live. Right now, people are “aging in place,” because of no choice…but, we don’t leave 6-year-old children home alone, and we cannot continue to leave people with advanced dementia home alone.
3. Fix the lumps and bumps on sidewalks so people can safely walk in their neighborhoods.
4. A moratorium on rent increases for people over age 62 and on SSI, (monthly income $970) living in mobile home parks and senior retirement apartment buildings.
5. Increased re-use of medical equipment and supplies to stop waste.
6. Build nature spots, bird and butterfly sanctuaries with clear paths and sitting areas in all health care facilities, retirement homes, etc. Gardens, too.
7. Talk to neighbors, become a good neighbor.
8. And, when neighbors and friends are hospitalized or moved to an assisted living or nursing home…visit them. As often as possible.
9. Volunteer with Share the Care Napa Valley, CAN-V, Napa Ombudsman Program, Molly’s Angels or other services working with the older population. Become involved in how people are cared for in our community.
10. (This one is empty, for you to fill in. Send me an email and let me know what you think we need to do to make Napa Valley a better place to age: sharethecarenv@gmail.com

Yvonne Baginski is the newly-elected Senator for the California Senior Legislature representing Napa and Solano Counties. She is also the Director of Share the Care Napa Valley. Her front porch is a well-recognized Napa Valley tradition for distributing and collecting medical equipment and home health supplies. She can be reached at 707-491-3198.

Yvonne Baginski, Director of Share the Care Napa Valley, wins Jefferson Award!

DONATE through December 31st!

A Special Presentation by Yvonne Baginski on May 20, 2019

Jan 16, 2019 : Original article in the Napa Register.