The Aging of America-The Need for More Nurses and Nursing Aides

Four Decades ago, when I was in my 40's, I happened to visit a nursing home in Chicago, Illinois. I was shocked and depressed to see so many senior citizens in need of assistance just to cope up with their daily activities. This feeling comes again every day when I visits Macrine in the skilled nursing and rehabilitation hospital where she had check in since the 19th of May. The ratio of the elderly patients for rehab to home health aides/nurses per shift is about 1 to 20. In this rehab hospital that Macrine is staying, the aides are primarily members of the minorities populations-(non white)-Hispanic, Asian, black, Filipino, Chinese and Indian Americans. According to the stats they are poorly paid. Thus the care of the elderly is compromised because the aides are overworked and too many patients to take care of. Underpaid and without a strong union, home health aides make an average wage of about $23,000, according to the New York Times’ Binyamin Appelbaum. "Instead of white men who make stuff, the group is increasingly made up of minority women who serve people,” he writes. Indeed, immigrants account for almost a third of the in-home health-care workforce, and one in five of them are undocumented, by one estimate.

A rapidly growing elderly population might be the most important yet inevitable feature of the country’s economic future. Why aren’t voters hearing more about it? Here's an excerpt about how the Aging Population is changing America( see reference below). It mentioned the need for home health aides/nurses and rise in health care spending.

"Does the inevitable aging of America carry obvious public-policy recommendations? The need for home health aides should factor into the conversation about immigration, yet I have heard nothing on the campaign trail about how the fastest growing occupations in the U.S. currently relies on a steady supply of immigrants. The rise in health-care spending for the elderly will force debates about the most humane and affordable way to care for those who need it. The next presidents may not serve as grand architects of public health policy, as Obama did. Rather they may have to serve as tinkerers and handymen, making targeted fixes to keep the house from falling apart.

"As Americans live longer, poor and middle class retirees will need more savings. The U.S. government could discuss an expansion of Social Security for the poorest, or new ways to force—or “nudge”—even low-income Americans to save enough money to last their extended lifetimes".

Do you agree? Let me hear from you!

Reference: https://www.theatlantic.com/business/archive/2016/10/aging-america/503177/

My Second Review of HCR ManorCare of Citrus Heights, California

This is our 3rd time ( for Macrine) to check in at ManorCare for post rehabilitation after hospitalization. We saw familiar faces ( nurses and aides) as well as supervisors. We were welcome just like we were all related. The nursing staff is about 30% Filipino-Americans, 50% Indian-Americans and the rest have Hispanic and Other Asians ancestry. They are caring and compassionate with a few exceptions especially on the supervisory staff who appeared to be overworked and tired most of the time. The Medical doctors are either Indian or Filipino Americans. Most of the nursing staff are part-time employees. I am rating our stay this time as Good.

Once in a while ( especially during Change of Shift), you have to wait for more than 10 minutes to get a response from your HELP BUTTON. I have heard of patients shouting for Help with no one responding for more than 10 minutes. Otherwise I am happy with our care especially the physical therapy we are receiving for 6 days.

Manor Care is a 162 beds nursing skilled and rehabilitation facility located on Upland Way in Citrus Heights, CA. The standard rooms are double occupancy. There are 10 rooms for private patients who pays additional rent of $60 per day because it is not covered by Medicare unless the patient has an infectious decease. The facility is very clean with beautiful landscaping and has a NO SMOKING policy. ManorCare provides individualized post-hospital skilled nursing care in a comfortable environment. Its clinical and therapy teams are experienced in providing specialized care focused on the patient needs, interests and ability. For detailed information on ManorCare of Citrus Heights read the following:

https://www.nursinghomesite.com/MANORCARE_HEALTH_SERVICES_%28CITRUS_HEIGHTS%29_CITRUS_HEIGHTS_CA

For the latest financial news on HCR ManorCare read the following:

https://www.reuters.com/article/us-hcrmanorcare-bankruptcy-quality-care/hcr-manorcare-files-for-bankruptcy-with-7-1-billion-in-debt-idUSKBN1GH2BU

Personal Note: David III and I are sending our gratitude and thanks to the following: Jean Maeda Jambalos for her hospital visit and flowers, Dinah and Ditas for their telephone calls, Sister Guia, Merlet Perlas, Genny Mendosa-Nieva, John Ocampo, Mark Richards, Eleanor Sabalbaro, Alma Sosa and Antonio Marques Sans for their FB messages of concern and hopes for a rapid recovery. Last but not least to Mele Tonga our compassionate and caring care giver.

Abuse of the Elderly in Nursing Homes and Other Facilities

Two weeks ago ( May 15) Macrine was hospitalized for severe bladder and kidney infections which completely immobilized her-a complete metabolic shut down. Luckily in four days her infection was cured via IV antibiotics, but her movement had been restricted and needed several weeks of rehabilitation. We again checked in at Manor Care ( our 3rd time in two years)- a well rated rehabilitation hospital near us. We have been here in Manor Care for almost a week and Macrine is showing improvement with physical and occupational therapies daily. However, she could barely stand and now starting to talk, but still has no appetite and constipated. She is taking a stool softener twice a day, but her bowel movement is still abnormal. I stayed with her overnight to be sure she is taking fluids and not dehydrated and will not fall on her bed when she wakes up and panic if there is no one around. We have a private room ( ADDITIONAL FEE from own account) which is not covered by my insurance. We also hired a private care giver ) at my own personal expense to be around Macrine during the day, so I could get some sleep and be ready for my night duties.

This past week, I have been observing that at the night shift, there is a lot of opportunity for abuse by male attendants, if the nursing aides are abusive both physically and sexually to the senior patients. Thus I did some Internet search and here's some statistics on abuse of the elderly in nursing homes and other facilities in the US for your information. According to the best estimates, about 1-2 million U.S. citizens 65 years of age or older have been mistreated, exploited or injured by a caregiver. For more details on this subject read:

https://www.nursinghomeabusecenter.com/elder-abuse/statistics/

Are You Ready for the Big One in California?

Shake Potential Map of California( From: https://www.shakeout.org/california/sandiego/)

I am talking about Earthquakes here in California! Recent earthquakes in Alaska and in Southern California ( Channel Islands) would indicate the Big One is coming. We do not know when, but based on historical statistics it probably would occur soon. So are you Prepared for the Big One?

If you resides in the Fault zone ( see map), I suggest be prepared now. There are information in the Internet of what you need to have and what to do in case the Big One comes. Here's the site: https://www.calacademy.org/explore-science/how-to-prepare-for-an-earthquake

Here's also the latest information of things to know about earthquakes for your information and reading pleasure.

https://www.vox.com/energy-and-environment/2017/9/21/16339522/8-things-to-know-about-earthquakes-alaska

Note: When I was a child growing up in Iloilo City, Philippines, I experienced the Jaro Earthquake ( magnitude 7) which destroyed the cathedral steeple and dozens of other buildings in the city. I also experienced the La Loma Earthquake in 1989, when we still residing in Pinole, California. (https://en.wikipedia.org/wiki/1989_Loma_Prieta_earthquake).

Both earthquakes were scary and an experience I will never forget.

What An Hour of Whole Body Massage Can Do for Your Body and Spirit

Three weeks ago, Macrine and I had a one hour each of whole body massage by Mark Richards (http://www.sacramentocmt.com/).

I can still remember how relax I was and my whole body was ache-free. Prior to the massage my back aches and my leg muscles were cramping. Mark starts massaging your back. Then your foot and legs ( Left and Right). This is followed by both your arms and fingers. The massage ends with your neck and shoulder. To me the most enjoyable part of the massage is my two feet. Now I know why the ancient Chinese tradition of Foot Massage was very popular during the Middle ages.

Macrine and I had this luxury of a once a month home service whole body massage. We highly recommend Mark for his massage services. He can vary the pressure of his massages at your request. The cost incurred and dent from our budget is not small but the pleasure/benefits we received is worth every penny of it.

Here's are two videos of a deep tissue foot and leg massage and a whole body traditional massage from wikihow.com.

https://www.youtube.com/watch?v=h5Vcixxpwvg

https://www.youtube.com/watch?v=h5Vcixxpwvg

Two of Macrine's Relatives are Millionaires

Macrine and I have four relatives residing here in Northern California. Two are Millionaires(in Paper) now because they decided to purchase a house in Palo Alto and Mountain View, a few years ago.

The other two of our other relatives living in Sacramento and Benecia are now close to being Millionaires also if we consider the estimated value of their residences based on the estimates of Zillow.com as of today.

Macrine and I are the poorest based on the estimate of our residence as of today, although in terms of area ( square footage), our home is second in size and first in lot size.

Let me start with our residence. We purchased our home in June, 2003. It has 4BR and 2.5 baths and a swimming pool with 2,200 sq. ft of living space with almost 0.5 acre corner lot. We recarpeted and painted the whole house and replaced all kitchen appliances after our purchase. The purchase price in 2003 was $370,000. Today Zestimate is only $479,785. If my math is right this is only about 1.8% increase in value annually. I am still happy the estimated value did not decreased.

A family relative purchased her house in April 2001 for $234,500. It is located in the Fabulous Forty's Sacramento District- area of expensive homes. It is a small house with only 2 BR and 1 Bathroom and only has 1,379 sq. foot living space area. Last month she added a 500 sq foot deck. The Zestimate today is $750,000.

Another family relative and his wife moved their residence from Walnut Creek to Benecia in 2015. After selling their 4BR, 3BA house with swimming pool for $1 Million in 2015, they moved to a slightly bigger house in Benecia. They paid $799,000 for a 4BR, 3.5 Bathrooms house with 2866 sq.ft living space. Zillow estimate today is $890,224.

Macrine's family relative purchased a house in Palo Alto in the early 1990's. It has only 1,647 sq.ft of living space, 3BR and 2BA. This year she added a 400 sq ft. annex (a bedroom and a bathroom). She has the whole kitchen area also remodeled and the garage enclosed as another bedroom. I am not sure how much was the original price but I believe it was about $510,000. Today the house has now 5BR, 3BA and a living space of 2000 sq. ft. Would you believe the Zestimate today is $3,137,207!

Last but not least example is Macrine's another family relative purchase of a house in Mountain View. She and her Hubby purchased a 4BR, 3BA home with 1850 sq. foot in 2009 for $1,060,000. They remodeled the kitchen and dining area and add another small bedroom last year. Today Zestimate is $2,462,091.

This article ( blog) confirms the following statement that in buying a home the three most important things to consider are: Location, Location, and Location!

Note: The actual purchase price of most homes could vary from Plus or Minus 10% of the Zestimate depending on the supply and demand on a particular location and time of sale. In some location in Northern California such as San Francisco, some homes will sell over 10% of asking price/estimate.

Here's the latest predictions for the housing market for 2018 in Northern California.

https://www.mercurynews.com/2017/12/12/no-housing-bubble-in-sight-and-other-predictions-for-2018/

Housing Market in San Francisco Getting Out of Control

Two weeks ago, my sister-in-law a resident of Palo Alto visited us. During her visit she told us of the experiences of her daughter and son-in-law who had been searching for a home in the city for the last 4 months. Both her daughter and son-in-law work in the City by the Bay(SFO). Ideally they want to purchase a home within biking distance to the place where they work. Her son-in-law works for Google, and her daughter has a private practice as a Registered Social Worker and Counsellor.

Their original plan was to purchase a 2-bedroom, one bath house within biking distance to Google. They found one and offered $150,000 more than the asking price. They were out bided. According to the their real estate agent there were 6 other clients who put bids on the property.

This experience made them change their plan and searched for a 1 bedroom, one bath home. They found one and again bid $150,000 over the asking price. Again they were out bided. There were more than a dozen clients who bided for that home my sister in-law emphasized. Today they have stopped their search and hope that their landlord will not increased their rental soon. This illustrates that the Demand is more than the Supply, thus the skyrocketing prices.

I found two recent articles on the Internet on this subject. I am posting it for your reference and reading pleasure.

1. http://www.businessinsider.com/why-housing-is-so-expensive-in-san-francisco-2014-4

2. https://www.mysanantonio.com/technology/businessinsider/article/San-Francisco-housing-is-so-expensive-that-12729885.

Here's a video comparing the Housing Situation in New York City and the City by the Bay: https://www.youtube.com/watch?v=hU0LtQO8GnI

Final Note: My grand daughter working in San Francisco is renting a 2BR condo in a high rise building within walking distance to her office at EERO. She pays $4000 a month, but shares the rent with a condo mate, otherwise she will not be able to afford it.

Future Blog: Two millionaires in my wife's family because of real estate in the right location!

Life in the Philippines versus Life in the United States-An Update

I woke up late this morning very tired but lucky I am alive. My 83.5 aging years is catching up on me and punishing me with aches and pains. However when I recall how lucky Macrine and I to afford two homes, it reminded me to post the following blog with the Trump/Duterte update. Forgive me my dear readers all over the world, but I can not stop writing about our Beach House and Conference Hall in the Philippines on this day of our 61st Wedding Anniversary, May 8, 2018. Today is also the 57th birthday of our oldest daughter-Dinah! Happy Birthday, Dinah!



If you have been following my blogs, you probably know we called ourselves snowbirds. We have a retirement home in the Philippines, but our primary residence is in Northern California. The following are some photos showing the differences and similarities between our two lifestyles. Since pictures are worth more than a thousand words, all you will read are labels and short description of the photos. Enjoy my photos:




The first photo is our ranch style home in the Philippines and the second is our home in Northern California. Both houses are ranch style( one floor) about the same size( 2,700 sq.ft). The major difference is the construction and style. Our retirement house in the Philippines has two patios ( balconies) both in Front and in the Back. It has also a long driveway and the whole property gated.




Our backyard in Marinduque versus our backyard in Northern California. We have no swimming pool in Marinduque, but the backyard leads to our beach house and Conference Hall, only a few meters from the Amoingon beach-of Western Marinduque.



The first photo is our side yard in the Philippines versus our side yard in Northern California. I have two ground orchids here in US but have more than 50 non-terrestial orchids in my gardens in the Philippines.





The first photo is the twin orchids in my front yard in the Philippines versus the yellow orchid in my yard in Northern California


My jack fruit tree in the Philippines versus my lemon tree in Northern California. I have several other fruit trees in the Philippines, including mangoes, avocados, citrus trees, guayabanos, star-apple and cashew trees.




My PC in the Philippines versus my PC in Northern California. My PC in US has a much bigger monitor (48"").

Last but not least is Party time: We prepared the same food in both homes. We enjoyed both Pinoy as well a American dishes.




The first photo is in northern California with salad and Dungeness crab, versus filipino cuisine of Marinduque.

Our friends often asked us which abode do we prefer. Our answer is always the same- both places. Marinduque is excellent during winter time and Northern California is excellent during spring, summer and Fall.

As an addenda here's a comparison of Duterte and Trump:

https://www.bloomberg.com/news/articles/2016-11-15/trump-duterte-bromance-no-slam-dunk-as-manila-warms-to-china
https://www.quora.com/What-are-the-similarities-between-President-Trump-and-President-Duterte

Our Neighbor's Home Estate Sale and our Coming 61st Wedding Anniversary

Yesterday, I went to our next door neighbor's House Estate Sale. This was an event that reminded me of my younger days when bargain hunting was one of my recreation. This event also reminded me of our coming 61st wedding anniversary this coming May 8 ( Tuesday). Let me explain.

Our neighbors are also in their mid-80's. I have never met the wife. However her husband have been a good neighbor. Five years ago, he volunteered to mow my front yard, because he was bored and saw that my yard needs some mowing. When I offered to pay him the standard fee of $25 he refused. Since then I have seen him only two to three times walking on the side walk with a blank stare on his face. I once waved at him but he appeared not to recognize me.

Yesterday when I woke up David III was gone. I thought he went to work. Thirty minutes later he was home with boxes of tools, paper products and dozens of boxes of bric-a brac ( storage bins etc..). He told me our neighbor had a Garage and House Sale ( Everything in the House including furniture, Garden tools etc.. are For Sale). Thousands of items are scattered all over the house including the back and side yards and of course in the driveway.

I told David III to watch his Mom for a while so I can attend the Sale. There were so many people in the house, our whole street was lined with parked cars and Vans. I stayed for about 15 minutes, purchased 4 garden books, 2 pruners, some live plants, fertilizers, and an ash tray for $10. David III purchased $100 worth of goodies.

I asked one of the ladies managing the sale what happened. She told me the lady of the house died last year. Moreover, the old man ( the one who mowed my lawn for free) is showing signs of Dementia. Their children decided to sent him to a nursing home and now is preparing the house for sale. It is a beautiful 3 bedroom 2 bath home beautifully landscaped with a jacussi and hot tub. The lady I talked to was one of the three daughters of the couple. She told me her parents had been married for 60 years( last year) and will be 61 years this year. What a coincidence?

While looking at the thousands of items scattered all over the house ( Inside and Outside) reminded me of all the things Macrine and I had accumulated also for the last 61 years of our married life. The same event will probably happened when both of us are incapacitated. As a memory of our neighbor, I purchased one of his WELCOME yard sign and placed it my front yard.

Now back to our coming 61st wedding anniversary. We have not planned a party. Macrine, David III and I will just probably have dinner at Red Lobster and order our favorite dishes- Lobster, Shrimps and Dungeness Crab and of course wine( Johanesberg Reisling).

Time Management Skills-Post Retirement Activities

There are several excellent articles on time management skills in the Internet. I have practiced several of these skills( goals, priorities, planning) before my retirement as a first line supervisor in my job as Chemistry Team Leader at the US Food and Drug Administration.

As a team leader, I was responsible for prioritizing, assigning and assuring the technical accuracy of all of Chemistry, Manufacturing and Controls (CMC) issues for all New Drug Applications (NDA) submitted to the Division of Anti-Infective Drugs. My responsibilities required that I used time management skills in order to achieve the goals of my job as A Chemistry Team Leader.

This article( blog) is my personal experiences as a retired Senior Citizen and as a Primary Care Giver to a loved one suffering from the ravages of Parkinson Disease.

Let me show you my time management on a daily basis and perhaps you can learn a lesson specially if you are a disorganized person. If you felt that many things you have to do are not accomplished, its time to think about time management. To me the two most important skills to remember are goal setting and priorities. Here are some examples:

1. I love blogging and playing computer games(Bridge and Mahjong). I can only do this when my wife is resting or sleeping. Our whole house is wired so I can monitor her while I am doing my computer activities.

2. When my wife takes a nap, I also take a nap with her, watch TV or do my personal needs/activities.

3. My son lives with us, but has a full time job. However on his day off, she watches her MOM for a few hours. That is the time when I do my grocery shopping, banking, hair cut and other personal needs-Bath and Shower, a little gardening and paying bills.

4. I cooked only two or three times a week. Most of our meals are ordered and delivered from Munchery and from the Pinoy store or from the nearby restaurants. We are lucky that we can afford this luxury.

5. Last but not least, I always take time for a break and rest. It is important that you take care of yourself first so you can do your job well as a Primary Care Giver.

For more details on time management skills read the following:

https://www.coachingpositiveperformance.com/17-essential-time-management-skills/

Personal Note: We are lucky to afford the services of a cleaning lady twice a month and a gardener on a weekly basis. My son takes care of the swimming pool and minor repairs of our house as well as do all the long distance and night driving.