Skyline’s 9th Annual Book Giveaway!

Collection:

Collection Box Location: Under stairs across from the Cascade Dining Room
Collection starts: October 22nd, Sunday
Collection ends: November 6th, Monday

Giveaway:

Date: November 7th, Tuesday
Time: 10am to 4:30pm
Place: Mt Baker Room

Link to Poster

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I don’t want CPR; will anyone listen?

By Jim deMaine

Special to The Seattle Times published Saturday September 23rd

I’m 85 years old and am in reasonably good health considering my age — mild hypertension, cured prostate cancer and macular degeneration. It’s been a wonderful life and I continue to enjoy friends and family, but if my heart stops, please don’t bare my chest and shock my heart trying to get it restarted. I don’t have some kind of death wish. I’m just trying to be realistic.

Now you’ve probably heard that Seattle leads the world in successful cardiac resuscitation. It’s true! If you happen to be quite a bit younger than I am, go into cardiac arrest with someone nearby who can start cardiopulmonary resuscitation while 911 is being called, your chance of survival may be as high as 55% (elsewhere in the country a 15% survival would be a good outcome). However, in my age group, it’s less than 5% chance of survival (only one in 20) — with a significant risk of brain damage, broken ribs and winding up in a nursing home.

I’ve expressed my wishes to my doctor for do not resuscitate or intubate orders, filled out an advance directive, completed portable orders for life sustaining treatment and talked at length with my designated durable power of attorney for health care.

So why might I, against my wishes, still be at risk of undergoing CPR? Well, picture me at an exciting Mariners game where suddenly I slump over with no pulse. My DPOA-HC is not present. My forms are in my apartment. Sustaining life is the norm for our community. Likely someone will step in and begin CPR and call for an automated external defibrillator. My wishes will be unknown. If I survive, waking up with a tube in my throat in an ICU is my nightmare.

So, what can I do? Very appropriately, 911 responders will do everything to save a life unless there is an explicit order/reason not to. In California and many other states, persons like me can obtain a certified DNR bracelet or medallion, which is covered in their legal codes. In Washington, we can wear a DNR bracelet or medallion but there is not a state or 911 policy addressing their use. When I talk to the medics, I find they vary quite a bit in their opinions about the utility of DNR bracelets/medallions — they haven’t received clear training about whether to honor the engraved DNR message. Oregon has a statewide registry of Physician Orders for Life Sustaining Treatment forms stored in an electronic database, so a 911 responder can immediately locate and act on one’s stated wishes. Washington has no such registry. Some will put their wishes on a wallet card, thumb drive or cellphone — but these are not easily found in an acute emergency.

I remain uncertain if my end-of-life wishes will be followed. This needs to change. We need to respect the wishes of persons like myself who are wearing a DNR bracelet. Basically, there are two things we need to do: First, we should have statewide policy to honor a DNR bracelet/medallion. Second, we need a statewide registry of POLST forms with a rapid retrieval mechanism for 911 responders.

Many elderly people like me want to leave this Earth in a natural way without CPR. Can we make the needed changes so that these wishes will be honored?

Jim deMaine is a retired pulmonary/critical care physician living in downtown Seattle. He is an author and clinical professor of medicine at the University of Washington.

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Resources for discussing and documenting end of life choices

Here are the references in the handout at the October 10th “Speaking of Dying” talk

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Slides from “Speaking of Dying Presentation”

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Here are the slides presented yesterday by Dr. Kate Brostoff. The full presentation will be on CareMerge within two weeks. Also these slides will be available on CareMerge under documents from the Health Care Committee.

As a reminder our chaplain Helen McPeak is available to meet with you individually or in small groups to discuss end of life issues. Forms are available from Sharon Redding RN and also from Helen. If you would like more one on one assistance Kate, Jim deMaine and Bob Wood are available to meet with you.

Posted in end of life, Health, Uncategorized | 2 Comments

Charles Feeney, Who Made a Fortune and Then Gave It Away, Dies at 92

After piling up billions in business, he pledged to donate almost all of his money to causes before he died. He succeeded, and then lived a more modest life.

By Robert D. McFadden in the NYT (thanks to Mike C.)

Charles F. Feeney, a pioneer of duty-free shops and a shrewd investor in technology start-ups who gave away nearly all of his $8 billion fortune to charity, much of it as quietly as he had made it, died on Monday in San Francisco. He was 92.

His death was announced by the Atlantic Philanthropies, a group of foundations he had started and funded since the early 1980s. He lived in a modest rented apartment in San Francisco.

In December 2016, with his donation of $7 million to his alma mater, Cornell University, for student community-service work, Mr. Feeney officially emptied the Atlantic Philanthropies’ accounts. It also fulfilled his pledge to give away virtually all of his wealth before he died, a rarity in the philanthropic world.

With what he called decent but unextravagant provisions made for his five adult children, Mr. Feeney said he retained about $2 million for himself, a small fraction of the billions he had amassed over six decades in business and given away over 35 years while often going to great lengths to conceal his identity, wealth and philanthropies.

“Chuck Feeney is a remarkable role model, and the ultimate example of giving while living,” his fellow billionaire Bill Gates told Forbes in 2012. Another of the world’s richest people, Warren Buffett, presented a Forbes 400 Lifetime Achievement Award to Mr. Feeney in 2014, calling him “my hero and Bill Gates’s hero — he should be everybody’s hero.”

Unlike philanthropists whose names are publicized, celebrated at banquets and emblazoned on building facades and museum wings, Mr. Feeney gave anonymously to universities, medical institutions, scientific endeavors, human rights groups, peace initiatives and scores of causes intended to improve lives in the United States, Vietnam, South Africa, Australia, Israel, Jordan and other lands. (continued)

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“Their Own Civil War”: Kim Schrier Talks about the Chaos in the House

By Joel Connelly

As colleagues savored soundbites on Sunday morning TV shows, a welcome opportunity came to hear out solid work-horse member of Congress who reaches across the aisle in the “other” Washington.  But U.S. Rep. Kim Schrier, D-Wash., did not bring any reassurance about a body that just ousted the Speaker it elected last January..

“Things are crazy right now,” said Schrier. Of the Republicans, who hold a narrow House majority: “They have their own civil war.” Of Speaker Kevin McCarthy, to get elected after 15 ballots: “He cut deals that would handicap him for his entire tenure.” When McCarthy had the opportunity to make Congress work: “He was down at Mar-a-Lago kissing the ring [of Donald Trump].”

The tail wagged the dog in the form of “20 to 25 crazies” of the far right. McCarthy “did not have to kowtow to them,” Schrier told an Eastside fundraiser. With a narrow 222-213 Republican majority, there was the option of reaching out to Democrats. McCarthy got a temporary budget fix earlier this year with the help of Democratic votes, then went on CBS’ Face the Nation to demean the Ds.

A modest use of intelligence might have yielded a different result. Just look, for a minute, at Washington’s delegation. Chaos is not on its agenda. “I went back there to get stuff done for Southwest Washington . . . I believe in bipartisanship,” newly elected Rep. Marie Gluesenkamp-Perez (MGP) told a recent town meeting in Tenino.

Rep. Derek Kilmer, D-Wash., spent four years chairing a bipartisan committee charged with improving internal operations of the House. Schrier has worked with Rep. Dan Newhouse, R-Wash., on the Yakima Basin Project. She pressed for the Inflation Reduction Act provision that capped insulin costs for diabetic seniors. MGP co-chairs the centrist Blue Dog Coalition, cosponsoring bipartisan legislation on issues ranging from forest management to farmers’ right-to-repair their equipment.

“He’s [McCarthy] shown he’d rather be held hostage by a bunch of weirdos than admit that he cannot lead the peoples’ house,” Gluesenkamp-Perez said after last week’s vote. In Rep. Kilmer’s words, McCarthy “weakened the institution by bending to extremists rather than collaborate across the aisle. He has inherited the chaos he has sown.”

Ahalf century ago, former Minnesota Sen. Eugene McCarthy quipped: “A moderate Republican is someone who gets to follow Richard Nixon into battle and shoot the wounded.” Spot-on observation, true in different form today. The Republican Party has grown insular and combative in the image of Donald Trump.

What of Republican colleagues who want to make government work? Some come from “red” districts, Schrier told donors. They are afraid of being “primaried” by MAGA voters. After all, six-term GOP Rep. Jamie Herrera Beutler lost to Trump-endorsed Joe Kent in last year’s primary, with Kent then losing to MGP.

Trump has his candidate for House Speaker, Ohio’s strident GOP Rep. Jim Jordan, and the ex-president may show up when House Republicans caucus on Tuesday. Jordan chairs the House panel launching an impeachment “investigation” against President Biden. Even House Majority Leader Steve Scalise is seen as more collegial, said Schrier, even though Scalise once described himself as “David Duke without the baggage.” (Duke, a fellow Louisiana politician, is a former Grand Dragon of the Ku Klux Klan.)

Self-described GOP moderates have spurned joining with Democrats to elect a new Speaker. Instead, they blame D’s for casting votes for McCarthy’s downfall. But what reason did Democrats have to rescue the maladroit McCarthy? “He has been completely partisan, refusing to work with Democrats at every turn to appease MAGA Republicans in Congress,” said Rep. Adam Smith, D-Wash., who chaired a collegial House Armed Services Committee when Democrats ran the House.

In the meantime, crises mount. Shutdown looms. The federal government is funded only until November 17. The Republican right has long resisted legislation to deal with the immigration crisis, even when a bipartisan bill passed the U.S. Senate by a 68-30 vote.

“Now Ukraine funding is hanging in the balance, and we have a war thrust on Israel,” lamented Schrier. “Now, at a precarious moment, we have chaos in the House.” She noted the political right’s loud lip service to Israel, adding: “If we can’t get aid to Israel, all this wrapping in the Israeli flag while also associating with anti-Semites will go for naught.”

What a difference time makes. Democratic Speaker Tom Foley, D-Wash., used to have fiery House floor debates with GOP Rep. Henry Hyde over the Reagan administration’s push for U.S. assistance to the Contra guerillas in Nicaragua. When done, the two big Irishmen would stroll arm in arm from the chamber.

As House Speaker, Nancy Pelosi had to work with a 221-214 Democratic majority, yet the House passed major Infrastructure legislation, the CHIPS act to bolster U.S. manufacture of microchips, and the Inflation Reduction Act with its major investment in green energy.

“We’re the ones who govern,” said Schrier. The “crazies”, as she put it, stand willing to “blow up the country.”

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Sigh!

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In states without Medicaid

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As you get your COVID vaccine, thank these two scientists

Thanks to Ed M.

Yesterday, the 2023 Nobel Prize Winners for Physiology or Medicine went to Drew Weissman and Katalin Karikó for their discoveries in the biotechnology behind our Covid-19 mRNA vaccines. 

Behind the amazing story of perseverance and collaborative spirit (it’s a fascinating story) is an absolutely revolutionary scientific discovery. 

Here is the problem they solved, how we leveraged it for the pandemic, and the far-reaching implications.

The problem

In 1961, we discovered RNA in living things. RNA is a string of letters that gives our cells instructions on how to function. (continued)

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Amazing early photographs reborn

Now with added colour! Early photographs reborn – in pictures
From seaside bathers to the Moulin Rouge in Paris, these images from the early 20th century have been revitalised with the latest colour technology. Thanks to Bob P.

Read in The Guardian: https://apple.news/ANVqtrEM9REq5iE2Y65UShg

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What They Don’t Tell You About Getting Old

By Roger Rosenblatt in the NYT – thanks to Tim and Tony for sending this along

Mr. Rosenblatt is the author of several novels and memoirs, including “Cataract Blues: Running the Keyboard.”

I recently turned 83, and while there are many joys to getting older, getting out of taxis is not one of them.

What you don’t want to do is get your left foot caught under the front right seat before you try to swing your right foot toward the door; otherwise, you’ll topple over while attempting to pay the fare, possibly injuring your ankle, and causing the maneuver to go even more slowly. If you make it past the taxi door, there is still the one-foot jump to the street. You’re old. You could fall. Happens all the time.

And that’s when it’s just you in the taxi. If some other old person is with you — a friend, a spouse — there’s a real possibility of never getting out of the vehicle. You might live out the rest of your days in the back seat, watching Dick Cavett do real estate ads on a loop.

“Old People Getting Out of Taxis.” I was thinking of making a film with that title, if I knew how to make a film. Figure it would run four hours. I asked an actor friend, also old, if he’d star in it. His response: “If I can get out of my chair.”

It’s no joke, old age. It just looks funny. Mel Brooks latched on to this in his 1977 film “High Anxiety” with Professor Lilloman (pronounced “little old man”), a stock character who moves at a turtle’s pace, mumbles and whines as he goes, equally irritated and irritating.

I used to find the professor a lot funnier than I do now. Slow? Merely to rise to my feet in a restaurant takes so much angling and fulcrum searching, the waitstaff takes bets on whether I will do it at all.

Old age isn’t what the books promised it would be. Literature is littered with old people for whom the years have brought some combination of wisdom, serenity, authority and power — King Lear, the ageless priest in Shangri-La, Miss Marple, Mr. Chips, Mrs. Chips (I made that up), Dickens’s Aged P, crazy Mrs. Danvers. In fiction, old folks are usually impressive and in control. In life, something less.

I can’t think of anyone who has come to me for wisdom, serenity, authority or power. People do come to sell me life insurance for $9 a month and medicines such as Prevagen, which is advertised on TV as making one sharper and improving one’s memory. Of course, that is beneficial only to those who have more things they wish to remember than to forget.

One thing I need to remember is which day for which doctor. Two years ago, my wife and I moved back to New York City after 24 years of living by the sea. The city is safer, we thought — just in case we may ever need to be near medical facilities. Since our move, not a day has passed without one of us seeing a doctor, arranging to see one or thinking or talking about seeing one.

On one day last week, I had a vascular sonogram in the morning, consulted my ophthalmologist in the afternoon, made an appointment with a retina specialist, spoke to my primary care physician about test results and put off my dentist. As a result of such activities, my vocabulary has increased. I now can say “occlusion” — and mean it. Has anyone seen my oximeter?

Activities such as getting out of a taxi are not only degrading and humiliating; they take so much effort, they simply make you tired. You may reasonably say, “Why not take the subway?” I would, except for the two hours needed to get up and down the stairs. Still, it’s all a matter of adjustment. It took me three or four years of taxi rides to finally admit to myself that I’m old.

Old. Even the word sounds like a sigh of surrender.

I wrote a book called “Rules for Aging” 25 years ago, when I used to leap in and out of taxis like a deer, if you can picture such a thing. The rules were less about aging than about living generally, one of the first being “Nobody’s thinking about you.”

In old age that’s true in spades. And that’s another of aging’s unnerving surprises. You disappear from the culture, or rather, it disappears from you. Young women and men shown on TV as world famous, you’ve never heard of. New idioms leave you baffled. You are Rip Van Winkle without having fallen asleep.

To be sure, old age has compensations. Grandchildren. Their company is delightful, partly because they think you have something useful to impart, if you could remember to impart it. Waitresses tend to treat you sweetly. Doormen and maintenance crews show respect. And there are positive or harmless activities for the over the hill. Women take up watercolors and form book clubs. Men find loud if pointless camaraderie in diners and on village benches all over the country. Hey, old-timer.

While here in the city, we hail taxis. And cringe to see whether the one we have hailed is a normal car, for normal people, or one of those sliding, clanging door jobs that require a forklift for entry. I’m not exaggerating — much.

My point is: Who ever expected to spend time wondering if Madison Beer is a beverage honoring a founding father? Who ever expected that one’s social circle would consist of Marie, who does blood work, and an M.R.I. technician named Lou? Who ever expected that getting out of a taxi would be so momentous an issue that one is a bundle of nerves planning exit strategies halfway through the ride? Who ever expected old age?

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The danger of debates

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We the People – democracy threatened

Commentary by Heather Cox Richardson – thanks to Pam P.

In Tempe, Arizona, today, President Joe Biden spoke at the dedication ceremony for a new library, named for the late Arizona senator John McCain, who died in 2018. Biden used the opportunity not only to honor his friend, but to emphasize the themes of democracy and to call out those who are threatening to overturn it. While Biden has made the defense of American democracy central to his presidency, he has never been clearer or more impassioned than he was today. 

Biden recalled that when McCain was dying, he wrote a farewell letter to the nation that he had served in both war and peace. “We are citizens of the world’s greatest republic, a nation of ideals, not blood and soil,” McCain wrote. “Americans never quit…. We never hide from history. We make history.”

Biden reiterated the point he makes often: that the United States is the only nation founded on an idea, articulated in the Declaration of Independence, that we are all created equal and have the right to be treated equally before the law. While “[w]e’ve never fully lived up to that idea,” he said, “we’ve never walked away from it.” Now, though, our faith in that principle is in doubt. 

“[H]istory has brought us to a new time of testing,” Biden said. “[A]ll of us are being asked right now: What will we do to maintain our democracy? Will we, as John wrote, never quit? Will we not hide from history, but make history? Will we put partisanship aside and put country first? I say we must and we will. We will. But it’s not easy.”

Biden laid out exactly what democracy means: “Democracy means rule of the people, not rule of monarchs, not rule of the monied, not rule of the mighty. Regardless of party, that means respecting free and fair elections; accepting the outcome, win or lose. It means you can’t love your country only when you win.”

“Democracy means rejecting and repudiating political violence,” he said. “Regardless of party, such violence is never, never, never acceptable in America. It’s undemocratic, and it must never be normalized to advance political power.”

“Today,” he warned, “democracy is…at risk.” Our political institutions, our Constitution, and “the very character of our nation” are threatened. “Democracy is maintained by adhering to the Constitution and the march to perfecting our union…by protecting and expanding rights with each successive generation.” “For centuries, the American Constitution has been a model for the world,” but in the past few years, he noted, the institutions of our democracy—the judiciary, the legislature, the executive” have been damaged in the eyes of the American people, and even the eyes of the world, by attacks from within.

“I’m here to tell you,” Biden said: “We lose these institutions of our government at our own peril…. Democracy is not a partisan issue. It’s an American issue.”

“[T]here is something dangerous happening in America now,” Biden said. “There is an extremist movement that does not share the basic beliefs in our democracy: the MAGA Movement.” After high praise for his Republican friend McCain, and recollections of working with Republicans to pass bipartisan legislation throughout his career, Biden made it clear that he does not believe “every Republican,” or even “a majority of Republicans” adheres to the MAGA extremist ideology. But, he said:

“[T]here is no question that today’s Republican Party is driven and intimidated by MAGA Republican extremists. Their extreme agenda, if carried out, would fundamentally alter the institutions of American democracy as we know it.”

The MAGA Republicans, Biden said, are openly “attacking the free press as the enemy of the people, attacking the rule of law as an impediment, fomenting voter suppression and election subversion.” They are “banning books and burying history.” “Extremists in Congress [are] more determined to shut down the government, to burn the place down than to let the people’s business be done.” They are attacking the military—the strongest military in the history of the world—as being “weak and ‘woke’.”

They are “pushing a notion the defeated former President expressed when he was in office and believes applies only to him: This president is above the law, with no limits on power. Trump says the Constitution gave him…’the right to do whatever he wants as President.’ I’ve never even heard a president say that in jest. Not guided by the Constitution or by common service and decency toward our fellow Americans but by vengeance and vindictiveness.”

Biden accurately recounted the plans Trump has announced for a second term: expand presidential power, put federal agencies under the president’s thumb, get rid of the nonpartisan civil service and fill positions with loyalists. Biden quoted MAGA Republicans: “I am your retribution,” “slitting throats” of civil servants, “We must destroy the FBI,” calling the Chairman of the Joint Chiefs of Staff a “traitor” and suggesting he should be executed. These extremists, he said, are “the controlling element of the House Republican Party.”

“This is the United States of America,” Biden said. “Did you ever think you’d hear leaders of political parties in the United States of America speak like that? Seizing power, concentrating power, attempting to abuse power, purging and packing key institutions, spewing conspiracy theories, spreading lies for profit and power to divide America in every way, inciting violence against those who risk their lives to keep America safe, weaponizing against the very soul of who we are as Americans.”

“The MAGA extremists across the country have made it clear where they stand,” Biden said. “So, the challenge for the rest of America—for the majority of Americans—is to make clear where we stand. Do we still believe in the Constitution? Do we believe in…basic decency and respect? The whole country should honestly ask itself…what it wants and understand the threats to our democracy.”

Biden knew his own answers: 

“I believe very strongly that the defining feature of our democracy is our Constitution.

“I believe in the separation of powers and checks and balances, that debate and disagreement do not lead to disunion.

“I believe in free and fair elections and the peaceful transfer of power.

“I believe there is no place in America…for political violence. We have to denounce hate, not embolden it.

“Across the aisle, across the country, I see fellow Americans, not mortal enemies. We’re a great nation because we’re a good people who believe in honor, decency, and respect.”

Pointing to the fact that the majority of the money appropriated for the Bipartisan Infrastructure Law has gone to Republican-dominated states, he added: “I believe every president should be a president for all Americans” and should “use the Office of the President to unite the nation.”

The job of a president, he said, is to “deliver light, not heat; to make sure democracy delivers for everyone; to know we’re a nation of unlimited possibilities, of wisdom and decency—a nation focused on the future.”

“We’ve faced some tough times in recent years, and I am proud of the progress we made as a country,” Biden said, “But the real credit doesn’t go to me and my administration…. The real heroes of the story are you, the American people.” Now, he said, “I’m asking you that regardless whether you’re a Democrat, Republican, or independent, put the preservation of our democracy before everything else. Put our country first…. We can’t take democracy for granted.” 

“Democracies don’t have to die at the end of a rifle,” Biden said. “They can die when people are silent, when they fail to stand up or condemn the threats to democracy, when people are willing to give away that which is most precious to them because they feel frustrated, disillusioned, tired, alienated.” 

“I get it,” Biden said. But “[f]or all its faults…, American democracy remains the best…[path] forward to prosperity, possibilities, progress, fair play, equality.” He urged people not to sit on the sidelines, but “to build coalitions and community, to remind ourselves there is a clear majority of us who believe in our democracy and are ready to protect it.”

“So,” he said, “let’s never quit. Let’s never hide from history. Let’s make history.” If we do that, he said, “[w]e’ll have proved, through all its imperfections, America is still a place of possibilities, a beacon for the world, a promise realized—where the power forever resides with ‘We the People.’” “That’s our soul. That’s who we truly are. That’s who we must always be.”

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Memory Hub news

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Freeway Park free event

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Dementia and spirituality — and more

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Not in our back yard – I hope!

Thanks to Pam P.

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I don’t want CPR; will anyone listen?

Ed note: For more about advance care planning for serious illness, please attend a special showing on October 10th at 3 PM in the MBR of the documentary “Speaking of Dying” ; followed by discussion and Q&A with Kate Brostoff, Jim deMaine and Sharon Redding.

By Jim deMaine – Special to The Seattle Times 9/23/23

I’m 85 years old and am in reasonably good health considering my age — mild hypertension, cured prostate cancer and macular degeneration. It’s been a wonderful life and I continue to enjoy friends and family, but if my heart stops, please don’t bare my chest and shock my heart trying to get it restarted. I don’t have some kind of death wish. I’m just trying to be realistic.

Now you’ve probably heard that Seattle leads the world in successful cardiac resuscitation. It’s true! If you happen to be quite a bit younger than I am, go into cardiac arrest with someone nearby who can start cardiopulmonary resuscitation while 911 is being called, your chance of survival may be as high as 55% (elsewhere in the country a 15% survival would be a good outcome). However, in my age group, it’s less than 5% chance of survival (only one in 20) — with a significant risk of brain damage, broken ribs and winding up in a nursing home.

I’ve expressed my wishes to my doctor for do not resuscitate or intubate orders, filled out an advance directive, completed portable orders for life sustaining treatment and talked at length with my designated durable power of attorney for health care.

So why might I, against my wishes, still be at risk of undergoing CPR? Well, picture me at an exciting Mariners game where suddenly I slump over with no pulse. My DPOA-HC is not present. My forms are in my apartment. Sustaining life is the norm for our community. Likely someone will step in and begin CPR and call for an automated external defibrillator. My wishes will be unknown. If I survive, waking up with a tube in my throat in an ICU is my nightmare.

So, what can I do? Very appropriately, 911 responders will do everything to save a life unless there is an explicit order/reason not to. In California and many other states, persons like me can obtain a certified DNR bracelet or medallion, which is covered in their legal codes. In Washington, we can wear a DNR bracelet or medallion but there is not a state or 911 policy addressing their use. When I talk to the medics, I find they vary quite a bit in their opinions about the utility of DNR bracelets/medallions — they haven’t received clear training about whether to honor the engraved DNR message. Oregon has a statewide registry of Physician Orders for Life Sustaining Treatment forms stored in an electronic database, so a 911 responder can immediately locate and act on one’s stated wishes. Washington has no such registry. Some will put their wishes on a wallet card, thumb drive or cellphone — but these are not easily found in an acute emergency.

I remain uncertain if my end-of-life wishes will be followed. This needs to change. We need to respect the wishes of persons like myself who are wearing a DNR bracelet. Basically, there are two things we need to do: First, we should have statewide policy to honor a DNR bracelet/medallion. Second, we need a statewide registry of POLST forms with a rapid retrieval mechanism for 911 responders.

Many elderly people like me want to leave this Earth in a natural way without CPR. Can we make the needed changes so that these wishes will be honored?

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Pa. to register voters automatically, Gov. Shapiro announces

FILE – Pennsylvania Gov. Josh Shapiro (AP Photo/Matt Rourke, File)AP

By Amy Worden | aworden@pennlive.com (thanks to Pam P.)

Gov. Josh Shapiro on Tuesday announced that Pennsylvania will become the 24th state to implement automatic voter registration.

In an interview on MSNBC’s Morning Joe, Shapiro said everyone who goes to the Department of Motor Vehicles to get a new or renewed driver’s license will be automatically registered to vote, unless the individual chooses to opt out.

“It’s a safe, secure, streamlined way to get them to register and participate in our democracy,” said Shapiro, speaking on National Voter Registration Day.

Shapiro said there are 1.7 million Pennsylvanians who are eligible to vote but are not registered. He said Secretary of State Al Schmidt estimated there would be tens of thousands of new registrants in the first year.

Shapiro said he has spent his career fighting for the right to vote and that he was “proud” to fulfill a campaign promise.

There are 8.6 million registered voters in Pennsylvania, according to information from the Department of State. More than 10 million Pennsylvanians out of 13 million total are at least 18 years old, the minimum legal age to vote, according to U.S. Census figures.

States have been required to offer voter registration at driver’s license centers since Congress passed the National Voter Registration Act in 1993.

A 2021 study by researchers from the Public Policy Institute of California, the University of Southern California and the University of California-Berkeley found that automatic voter registration increased registration in states where it was in effect, and boosted the number of people actually voting by more than 1%.

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Fact upon fact

Thanks to Bob P.

Pearls Before Swine Comic Strip for September 22, 2023

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A voice not so small

Thanks to Ed M. – thoughts from a friend

“You say the little efforts that I make will do no good; they never will prevail to tip the hovering scale where justice hands in the balance.  I don’t ever think I thought they would, but I am prejudiced beyond debate in favor of my right to choose which side shall feel the stubborn ounces of my weight.”                Bonaro W. Overstreet

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How to Change Your Mind-Set About Aging

by Holly Burns in the NYT – thanks to Put B.

At a pool party this summer, Johnnie Cooper climbed onto the diving board, executed a perfect dive and then joined a raucous game of Marco Polo. The occasion? Her 90th birthday.

“I’ve always looked forward to this age,” said Ms. Cooper, who lives in Huntsville, Ala., and is retired from the U.S. Army Aviation and Missile Command. “You no longer have a lot of the struggles you had. There’s a lot more peace.”

Her enthusiasm for getting older could be part of the reason she has lived such a long, rich life. While everyone’s experience with aging is different, experts are increasingly finding that having a positive mind-set is associated with aging well.

A decades-long study of 660 people published in 2002 showed that those with positive beliefs around getting older lived seven and a half years longer than those who felt negatively about it. Since then, research has found that a positive mind-set toward aging is associated with lower blood pressure, a generally longer and healthier life and a reduced risk of developing dementia. Research also shows that people with a more positive perception of aging are more likely to take preventive health measures — like exercising — which, in turn, may help them live longer.

You can’t stop the march of time, but you don’t have to dread it. Here are some ways to help shift your thinking.

From the crotchety neighbor to the clueless Luddite, negative stereotypes of aging are everywhere. Taking in negative beliefs about aging can affect our view of the process — and our health, said Becca Levy, a professor of epidemiology at Yale and the author of “Breaking the Age Code: How Your Age Beliefs Determine How Long and Well You Live.” A 2009 study, for example, found that people in their 30s who held negative stereotypes of aging were significantly more likely to experience a cardiovascular event, like a heart attack or stroke, later in life than those with positive ones.

To change your negative age beliefs, you first need to become more aware of them, Dr. Levy said. Try a week of “age belief journaling,” in which you write down every portrayal of an older person — whether in a movie, on social media or in a conversation. Then question if that portrayal was negative or positive, and whether the person could have been presented differently. Simply identifying the sources of your conceptions about aging can help you gain some distance from negative ideas.

“People can strengthen their positive age beliefs at any age,” Dr. Levy said. In one 2014 study, 100 adults — with an average age of 81 — who were exposed to positive images of aging showed both improved perceptions of aging and improved physical function.

If you associate aging with only loss or limitation, “you’re not getting the full picture of what it means to age,” said Regina Koepp, a psychologist who specializes in aging. Instead, she said, “shift your attention — look around for role models, see who’s doing it well.”

That “doesn’t have to be a person who’s 90 diving off a diving board,” Dr. Koepp said. It might just be someone who attends a yoga class every week or volunteers for a cause.

Dr. Levy recommends coming up with five older people who have done something you deem impressive or have a quality that you admire, whether it’s falling in love later in life, showing devotion to helping others or maintaining a commitment to physical fitness.

Research suggests that optimistic women are more likely to live past 90 than less optimistic women, regardless of race or ethnicity. But thinking more positively about aging doesn’t mean papering over real concerns with happy thoughts — or using phrases like “You haven’t aged!” as a compliment.

“The platitudes don’t work — we’ve heard them, they’re trite, they’re tone-deaf,” said Melinda Ginne, 74, a psychologist in the San Francisco Bay Area who specializes in aging.

Instead, try to look at the honest reality with optimism. If you’re feeling deflated that your tennis game isn’t as strong in your 70s as it once was, Dr. Ginne said, remind yourself: “No, I can’t play tennis like I did when I was 50, and I can only play for 10 minutes. But I can still play.”

To feel more positive about aging, Dr. Koepp said, examine what worries you have about the process and then reflect on how troubling those concerns actually are.

For example, Dr. Koepp, 47, has been having an issue with her left hip. “I’ll say I’m old because I feel stiff and creaky,” she said. “But then I think, Well, my right hip isn’t stiff and creaky, and it’s the same age.”

The point is that while getting older may be contributing to her hip pain, she said, it’s not the only factor. “But we conflate age and disability, and I think that scares people,” she said.

Focus on what you’re gaining, too. Research has shown, for example, that emotional well-being generally increases with age, and certain aspects of cognition, like conflict resolution, often improve in later life.

With time, “we’re likely to develop more resilience,” Dr. Koepp said. Successful aging doesn’t mean you won’t get sick, encounter loss or require care at some point, she said. And no one said that changing any mind-set is easy. But if you can, she added, it may allow you to see yourself more clearly “as a person with lived experience and wisdom” as you age.

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                          Ponderings of Peanuts

Thanks to Mary Jane F.

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Standing Up Floating Across the Roof of the World

ByArt Thiel in the Post Alley Newsletter

Drive east from Seattle on I-90 and take a left at Missoula, MT. Head due north for about 1,700 miles. Then, theoretically, you could dip the front wheels into the Arctic Ocean’s once-mysterious Northwest Passage, right where Karl Kruger concluded an astonishing two weeks this summer. 

Except you can’t drive there from here. Or anywhere.

Roads dwindle in the north of Canada, from asphalt to sealcoat to gravel to chuck-holed hardpan to tundra. Above the Arctic Circle, only airplanes, boats and barges penetrate the isolation of most of the Inuit villages scattered randomly along the Passage. The fabled sea lane that is the shortest way for ships to reach Asia from Europe was first crossed by Norwegian explorer Roald Amundsen in 1906. Took him three years. But it wasn’t until 2007 and the changing climate that the first ships crossed without an icebreaker.

The map shows Kruger’s 2022 starting point at Tuktoyaktuk, near Alaska. More than 900 miles later, he finished 2023 at Kugluktuk.

Summer months in the Passage these days have some commercial traffic, inspiring global energy companies to wonder about oil, gas and rare earth minerals. Also inspired are rival militaries looking for a strategic edge, including China, which has no frozen coastline but operates two icebreakers and is building a third. Russia has seven, with three under construction. The U.S. has two, and the 47-year-old cutter based in Seattle, the Polar Star, spends much of its time in Antarctica. The ship in 2021 was the first U.S. surface vessel to visit the Arctic since 1982.

Also sharing the Passage are a few, non-native smaller craft — tour boats, sailboats, kayaks — and one stand-up paddleboard.

It is the preferred conveyance for Karl Kruger, 51, a graduate of Western Washington University, an Orcas Island resident and an ambitious adventurer. The board is a custom expedition version that carries 400 intimately curated pounds, including captain. What vessel and crew lack in tonnage they make up in gumption.

Because he has a passion for the Arctic and a capacity for epic endurance, Kruger came upon a novel way to experience both. Over the past two summers, through some of Earth’s most remote wilderness, he has paddled west to east atop the Arctic Ocean nearly 1,000 miles.

Alone. (Continued)

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Octopuses used in research could receive same protections as monkeys

Thanks to Mike C.

A giant Pacific octopus (Enteroctopus dofleini) is weighed and tagged by a biologist.Credit: Fred Bavendam/Minden Pictures/Alamy

Cephalopods such as octopuses and squid could soon receive the same legal protection as mice and monkeys do when they are used in research. On 7 September, the US National Institutes of Health (NIH) asked for feedback on proposed guidelines that, for the first time in the United States, would require research projects involving cephalopods to be approved by an ethics board before receiving federal funding.

“A growing body of evidence demonstrates that cephalopods possess many of the requisite biological mechanisms for the perception of pain,” the NIH wrote on its website. Furthermore, cephalopods have advanced learning and cognitive abilities, and seem to respond to anaesthesia in a similar way to mammals, it said. But the agency noted that because cephalopod brains are so different from those of mammals, defining what ethical research should look like will require further study.

The US Public Health Service (PHS) sets guidelines for the use of animals in science for both the NIH and the National Science Foundation, defining animals as any vertebrate. Before a research project receives federal funds, scientists must obtain approval from their institutions’ ethics boards, which evaluate protocols to ensure compliance with PHS standards.

A welcome move

But there are no such restrictions around the humane treatment of invertebrates — animals with no backbone that include insects, worms and cephalopods. Late last year, members of the US House of Representatives and US Senate sent letters to the NIH and PHS, asking that research policies redefine ‘animal’ to include cephalopods. The amendment now proposed by the NIH would require institutions’ ethics committees to evaluate cephalopod research.European directive gets its tentacles into octopus research

“We are really happy to see NIH proposing this guidance,” says Catharine Krebs, a medical-research specialist at the animal-rights non-profit organization Physicians Committee for Responsible Medicine in Washington DC. Krebs says that the NIH proposal isn’t perfect — in her view, individual ethics committees often apply rules inconsistently and her organization would ultimately like to see cephalopods left out of research entirely. “But we’re counting this as a win,” she says.

Cephalopod researchers also welcome the move. Although the number of federally funded scientists studying cephalopods in laboratories is small, it is growing, because researchers who previously used other model animals, such as mice, have become interested in studying the basic biology of the cephalopod nervous system. “It’s hard for me to see how this will be a hindrance,” says Clifton Ragsdale, an octopus biologist at the University of Chicago in Illinois. “Things that are good for animal welfare are also good for the quality of research.”

Concerns remain

But Robyn Crook, a marine biologist at San Francisco State University in California, says the issue is complicated — because so little is known about cephalopod biology, many scientists don’t know how to ensure the animals’ welfare. For instance, researchers know that opioid drugs suppress pain in mice, but no one knows whether pain receptors in different cephalopod species respond in the same way. Without understanding that, Crook says, it’s hard to tell whether an anaesthetic has dulled an animal’s pain or has simply relaxed the animal’s muscles so that it can’t pull away when poked. Crook’s group has been comparing several painkillers in bobtail squid, but Crook says that they haven’t had much luck figuring out which drugs are the most effective, despite testing hundreds of animals. “Ninety per cent of what we tried was inconclusive,” she says.

Crook hopes that the NIH will provide funding for researchers to study questions such as this specifically to improve cephalopod welfare in the laboratory.Duck! Octopuses caught on camera throwing things at each other

The NIH acknowledges the gaps in understanding of cephalopod biology. In a statement to Nature, the agency said that certain aspects of cephalopod research, such as pain perception and species-specific husbandry, are still being studied. “Applying the PHS policy to cephalopods is challenging at this time,” the NIH wrote. However, it added, several of the PHS guidelines on the use of animals in research can already be applied. These include requirements that research be performed only if it advances scientific knowledge and benefits society, that investigators use as few animals as possible and that discomfort is minimized.

International guidelines

Outside the United States, researchers have already begun to address such issues. In some countries, including the United Kingdom, Switzerland, Norway, Canada, Australia and New Zealand, ethical approval is required for certain types of cephalopod research. Graziano Fiorito, a marine biologist at the Anton Dohrn Zoological Station in Naples, Italy, led an international team of scientists earlier this year to develop recommendations for housing, care and management of cephalopods in research. The advice included specifications for water quality, animal density, anaesthesia and humane euthanasia.

The European Commission is expected to adopt the list of minimum requirements into law around the end of the year and to institute a training certification across the European Union, says Fiorito. Currently, each European country has its own laws for cephalopod research. He hopes that the PHS will end up adopting similar guidelines so as to standardize cephalopod care around the world. “I think that it is very good that the United States will start moving toward standardization.”

The NIH is gathering feedback on the proposal until 22 December, but it does not yet have a date at which the guidelines will be instituted.

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