Do we really know what we are doing?

The people are jumping on the bandwagon.
The cash for clunkers. So many doing the
trade in... some are a little disappointed, but
others thrilled.

Those who are a little disappointed are the ones
who thought they would get a trade in as well as
the government's cash for their clunkers. Being these
vehicles can't be sold, there is no trade in value.

Their idea of clunkers and mine sure is different.
Cadillac's, SUV's and etc. better than any car
I have owned.

I have seen on the news some of the ones that
are heading for the junk yard in Spokane. I had hoped
the parts would be used and not smashed. I know they
are seizing up the engines so they never will run again.
But will they totally smash the car.. The answer I have
been told is yes. They are turned in to 5"x5" squares.

So I have to ask, do we know what we are doing? There
will be few and far between, used cars for those without
money to buy new.

We already ran into that point two years ago, of not being
able to buy a box for a truck my grandson owned. Why?
because the price of metal was out of sight. And the yards
were smashing cars as fast as they could get them in.
Meaning anything older than 2003 was gone. So no parts.

What will happen to those of us in the $20,000 or less income
bracket who won't be able to buy a used car or truck?

I guess my signature at the end of my emails serves me well.


He is a wise man who does not grieve for the things
which he has not, but rejoices for those which he has.
~Epictetus

Where does it say, killing granny????

I am truly sorry for such a long post today. But I feel
it is important. There are some of you out there who
has gotten the scare tactic email... either says Obama
trying to kill Granny, or look at page 425, Obama
killing off the elderly. So here you are, page 425 for
you to read for yourself.... and tell me where it says it
is going to kill anyone. Then go the bottom and see
what it means in common language. If the governement
one gets to be too much for you.. scroll down to the
lower part and I will tell you what it means.

Page 425

1 ‘‘(FF) advance care planning consultation (as
2 defined in subsection (hhh)(1));’’; and
3 (B) by adding at the end the following new
4 subsection:
5 ‘‘Advance Care Planning Consultation
6 ‘‘(hhh)(1) Subject to paragraphs (3) and (4), the
7 term ‘advance care planning consultation’ means a con
8 sultation between the individual and a practitioner de
9 scribed in paragraph (2) regarding advance care planning,
10 if, subject to paragraph (3), the individual involved has
11 not had such a consultation within the last 5 years. Such
12 consultation shall include the following:
13 ‘‘(A) An explanation by the practitioner of ad
14 vance care planning, including key questions and
15 considerations, important steps, and suggested peo
16 ple to talk to.
17 ‘‘(B) An explanation by the practitioner of ad
18 vance directives, including living wills and durable
19 powers of attorney, and their uses.
20 ‘‘(C) An explanation by the practitioner of the
21 role and responsibilities of a health care proxy.
22 ‘‘(D) The provision by the practitioner of a list
23 of national and State-specific resources to assist con
24 sumers and their families with advance care plan
25 ning, including the national toll-free hotline, the ad-
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426
1 vance care planning clearinghouses, and State legal
2 service organizations (including those funded
3 through the Older Americans Act of 1965).
4 ‘‘(E) An explanation by the practitioner of the
5 continuum of end-of-life services and supports avail
6 able, including palliative care and hospice, and bene
7 fits for such services and supports that are available
8 under this title.
9 ‘‘(F)(i) Subject to clause (ii), an explanation of
10 orders regarding life sustaining treatment or similar
11 orders, which shall include—
12 ‘‘(I) the reasons why the development of
13 such an order is beneficial to the individual and
14 the individual’s family and the reasons why
15 such an order should be updated periodically as
16 the health of the individual changes;
17 ‘‘(II) the information needed for an indi
18 vidual or legal surrogate to make informed deci
19 sions regarding the completion of such an
20 order; and
21 ‘‘(III) the identification of resources that
22 an individual may use to determine the require
23 ments of the State in which such individual re
24 sides so that the treatment wishes of that indi
25 vidual will be carried out if the individual is un-
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427
1 able to communicate those wishes, including re
2 quirements regarding the designation of a sur
3 rogate decisionmaker (also known as a health
4 care proxy).
5 ‘‘(ii) The Secretary shall limit the requirement
6 for explanations under clause (i) to consultations
7 furnished in a State—
8 ‘‘(I) in which all legal barriers have been
9 addressed for enabling orders for life sustaining
10 treatment to constitute a set of medical orders
11 respected across all care settings; and
12 ‘‘(II) that has in effect a program for or
13 ders for life sustaining treatment described in
14 clause (iii).
15 ‘‘(iii) A program for orders for life sustaining
16 treatment for a States described in this clause is a
17 program that—
18 ‘‘(I) ensures such orders are standardized
19 and uniquely identifiable throughout the State;
20 ‘‘(II) distributes or makes accessible such
21 orders to physicians and other health profes
22 sionals that (acting within the scope of the pro
23 fessional’s authority under State law) may sign
24 orders for life sustaining treatment;
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428
1 ‘‘(III) provides training for health care
2 professionals across the continuum of care
3 about the goals and use of orders for life sus
4 taining treatment; and
5 ‘‘(IV) is guided by a coalition of stake
6 holders includes representatives from emergency
7 medical services, emergency department physi
8 cians or nurses, state long-term care associa
9 tion, state medical association, state surveyors,
10 agency responsible for senior services, state de
11 partment of health, state hospital association,
12 home health association, state bar association,
13 and state hospice association.
14 ‘‘(2) A practitioner described in this paragraph is—
15 ‘‘(A) a physician (as defined in subsection
16 (r)(1)); and
17 ‘‘(B) a nurse practitioner or physician’s assist
18 ant who has the authority under State law to sign
19 orders for life sustaining treatments.
20 ‘‘(3)(A) An initial preventive physical examination
21 under subsection (WW), including any related discussion
22 during such examination, shall not be considered an ad
23 vance care planning consultation for purposes of applying
24 the 5-year limitation under paragraph (1).
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429
1 ‘‘(B) An advance care planning consultation with re
2 spect to an individual may be conducted more frequently
3 than provided under paragraph (1) if there is a significant
4 change in the health condition of the individual, including
5 diagnosis of a chronic, progressive, life-limiting disease, a
6 life-threatening or terminal diagnosis or life-threatening
7 injury, or upon admission to a skilled nursing facility, a
8 long-term care facility (as defined by the Secretary), or
9 a hospice program.
10 ‘‘(4) A consultation under this subsection may in
11 clude the formulation of an order regarding life sustaining
12 treatment or a similar order.
13 ‘‘(5)(A) For purposes of this section, the term ‘order
14 regarding life sustaining treatment’ means, with respect
15 to an individual, an actionable medical order relating to
16 the treatment of that individual that—
17 ‘‘(i) is signed and dated by a physician (as de
18 fined in subsection (r)(1)) or another health care
19 professional (as specified by the Secretary and who
20 is acting within the scope of the professional’s au
21 thority under State law in signing such an order, in
22 cluding a nurse practitioner or physician assistant)
23 and is in a form that permits it to stay with the in
24 dividual and be followed by health care professionals
25 and providers across the continuum of care;
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430
1 ‘‘(ii) effectively communicates the individual’s
2 preferences regarding life sustaining treatment, in
3cluding an indication of the treatment and care de
4 sired by the individual;
5 ‘‘(iii) is uniquely identifiable and standardized
6 within a given locality, region, or State (as identified
7 by the Secretary); and
8 ‘‘(iv) may incorporate any advance directive (as
9 defined in section 1866(f)(3)) if executed by the in10
dividual.
11 ‘‘(B) The level of treatment indicated under subpara
12 graph (A)(ii) may range from an indication for full treat
13 ment to an indication to limit some or all or specified
14 interventions. Such indicated levels of treatment may in
15 clude indications respecting, among other items—
16 ‘‘(i) the intensity of medical intervention if the
17 patient is pulse less, apneic, or has serious cardiac
18 or pulmonary problems;
19 ‘‘(ii) the individual’s desire regarding transfer
20 to a hospital or remaining at the current care set21
ting;
22 ‘‘(iii) the use of antibiotics; and
23 ‘‘(iv) the use of artificially administered nutri24
tion and hydration.’’.
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431
1 (2) PAYMENT.—Section 1848(j)(3) of such Act
2 (42 U.S.C. 1395w-4(j)(3)) is amended by inserting
3 ‘‘(2)(FF),’’ after ‘‘(2)(EE),’’.
4 (3) FREQUENCY LIMITATION.—Section 1862(a)
5 of such Act (42 U.S.C. 1395y(a)) is amended—
6 (A) in paragraph (1)—
7 (i) in subparagraph (N), by striking
8 ‘‘and’’ at the end;
9 (ii) in subparagraph (O) by striking
10 the semicolon at the end and inserting ‘‘,
11 and’’; and
12 (iii) by adding at the end the fol
13 lowing new subparagraph:
14 ‘‘(P) in the case of advance care planning
15 consultations (as defined in section
16 1861(hhh)(1)), which are performed more fre
17 quently than is covered under such section;’’;
18 and
19 (B) in paragraph (7), by striking ‘‘or (K)’’
20 and inserting ‘‘(K), or (P)’’.
21 (4) EFFECTIVE DATE.—The amendments made
22 by this subsection shall apply to consultations fur
23 nished on or after January 1, 2011.
24 (b) EXPANSION OF PHYSICIAN QUALITY REPORTING
25 INITIATIVE FOR END OF LIFE CARE.—
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432
1 (1) PHYSICIAN’S QUALITY REPORTING INITIA
2 TIVE.—Section 1848(k)(2) of the Social Security Act
3 (42 U.S.C. 1395w–4(k)(2)) is amended by adding at
4 the end the following new paragraphs:
5 ‘‘(3) PHYSICIAN’S QUALITY REPORTING INITIA
6 TIVE.—
7 ‘‘(A) IN GENERAL.—For purposes of re
8 porting data on quality measures for covered
9 professional services furnished during 2011 and
10 any subsequent year, to the extent that meas
11 ures are available, the Secretary shall include
12 quality measures on end of life care and
13 advanced care planning that have been adopted or
14 endorsed by a consensus-based organization, if
15 appropriate. Such measures shall measure both
16 the creation of and adherence to orders for life
17 sustaining treatment.
18 ‘‘(B) PROPOSED SET OF MEASURES.— The
19 Secretary shall publish in the Federal Register
20 proposed quality measures on end of life care
21 and advanced care planning that the Secretary
22 determines are described in subparagraph (A)
23 and would be appropriate for eligible professionals to use
to submit data to the Secretary.
25 The Secretary shall provide for a period of comment on such
set of measures before finalizing such proposed measures.’’.


This only means IF you want to talk to your doctor about advance care planning...Medicare will pay for one session with your Dr.
Every 5 years... Which by the way, you are charged for it right now....
anyone who has worked in the health voc. like myself.... would have telling
you to do this... I did it years ago.. about 10 years ago, I have a living will written... I sent a copy to my kids and said if you have any problems with this...let's talk about it now... not fighting with your siblings while I am half dead in a bed, that I don't want to be in anymore. None of them wrote back... some of them did mention to me on the phone they did not have a problem with this. My doctor has a copy of it...


So yes, YOU SHOULD BE TALKING ABOUT IT NOW.. I don't care if you are
only 31 years old... Look what happen to Terri S. in Florida...
heck the whole nation got in on that one... So..
those who are reading the scare emails about how they want to kill granny....
it is based on lies... and this is what it says...
NOT YOU HAVE TO.. but YOU CAN.. IF YOU CHOSE... to talk to your doc.
and Medicare will pay for it..if you are 65, otherwise it is
you paying for it. Or you can go to the local stationary/office
supply store and pay $6.50 like I did.. and fill in the blanks yourself.
I don't know about you..but I sure don't want the hospital getting rich
off of my body... by testing it for everything they can think of...
I want to control ..... I don't want to be laying in bed for 5 years
on a tube feeding, not knowing anyone.

So chose for yourself... put on your big boy/girl pants and
take care of business and stop listen to every yahoo
who tries to tell you about the boogie man coming.

Where are they now???

Now that there is pipl, people search and so many others...out there,
have you Googled or Binged or any of the other searches to find some
one, who you have lost track of over the years?

I tried over the weekend to find such a person. We were foster sisters.
My parents took her in for a short time. She wasn't getting along
with her foster parents and we had been friends for about 3 years.
Many of years of pretending so many things. Pretending we were
putting on a show for which we collected a nickel, only to have to
give it back to the complainers. lol... We protected the neighborhood,
with our special badges and we even had the old school guard type
thing that we put on. It was a white sash that went around your
waist and over your shoulder and held together by the badge.
It was all pretend.

I think Gloria was 14 when she came to our house. My folks had to
go thru all kinds of stuff to get her. Talks with our minister, fire
dept. came to the house to check it out, and police report. But
finally she moved in. She and Mom got along fabulously. They had
art and horses in common. They were best friends. And I became
the "middle child".

The middle child gets blamed for everything. The middle child is
just the right age. See the older child would never do xxxx because
they were too old to do such things. Too mature... And of course the
baby of the family, well, they would never dream of doing such a thing
and would be too small. So the MIDDLE CHILD did it. No matter what
it was. So I was not in the best of favor for a while. That is when I
became mostly a Daddy's girl. He was my protector.

But then Gloria came up with a dandy idea. I was a freshman in high
school and she was in the 10th grade. And she said we could have lots
of fun, skipping school. It went great. We went fishing. (we borrowed
a boat), it went so well, we skipped the next day. And the next...
THEN THE BOOM CAME.. As I was sitting there innocently eating
my breakfast, my mother asked how school had been the past couple
days. I keep my head down, as my face reads like a truth machine.
Fine, I said. That open the door to the tornado called mom. I won't
bored you with the details, but the long and short of it, I became
friends with the strap, I was grounded for the rest of my life, and
Gloria was gone. Which was sad.

So over the weekend, I decided to find my friend, as there were some
great times between those years. So I printed in her name time after
time. I tried her maiden name, as I didn't know her married name.
She had gotten married in Texas, and then divorced. And then moved
to New York. Mom had gotten a letter from her, as she was wanting
to know where I lived. But Mom decided for me, that no good would
come from this... so she waited a few years to tell me.. of course the
letter was gone.

So here we are in the land of computers, where they say you can
find just about anyone. So I printed in her name. Gloria L. Rich.
born in Chepachet, R.I. in November of 1938 or 39. I think she
was just 6 months older than I. Because it seem like I was the same
age as she was for a few months. So that would make it 1939. Just
not positive... so used both years... but nothing came up. There are
zillions of Gloria Rich's but not with the L. The couple that did have the
L were not from New York or R.I. or Texas and not her age.

You know for $40 I could have looked up more... but I am a cheap skate.
And besides I don't trust those sites anyway. So..Gloria L. Rich who was
born in Chepachet, R. I. if you find this blog before I die.. let me know. I
will be able to tell you what town you lived in Texas, and you can tell me
what your youngest sister's name is. I lost contact with her, when she
married and went to Germany with her husband. Also you can tell me
the name of the old foster parents that your sister stayed with. As I know
the answers to these questions..

Maybe if I couldn't find you, you can find me...

Have you ever wonder what happen to a friend from your childhood?

Ah, the good old days....not

Remember when we use to have these...
They rotated back and forth. And if you
were lucky they were quiet. If it was old,
then you had a click noise from the blades
hitting the protection screen.

How did we survive those days? I know
it was awful lot when it was summer, as
my bedroom was upstairs near the attic.
You could barely stand a sheet on you.
Yet we thought we had it made if we had
the fan up in our room.... because that wasn't
the case most of the time. I think mom and dad
had two.. a big one and a small one.

I say this as I sit next to our window AC. With
another one kicking in around 7 p.m. in the bedroom,
leaving our room 62 by the time we go to bed.

You can't get there from here....

This is the cement grinder being unloaded, laying it down today..next is the sealer..

You can't get there from here

Seems to be the word of the day or week.
Not only is my road being done but about
1/3 of the streets are being done.

Also we have several projects around town
being done. So as I went to the post office
the other day, I was detoured 4 times.
I left the post office and headed to the
highway, and came back in on my road.

Today, I am suppose to go somewhere at
10am. And usually when they are working on
the roads, they are done with my section by
9 ...9:30am ....then they bring back the equipment
about 3, as it is stored at the end of our dead end
street. So hope I can get out in in 45 minutes.

In our neighborhood

For 11 years we have wanted to have it...

7 years ago we were promised it...

And finally this year, this week coming...

we get paved roads.... here is the beginning

of the equipment. First they dig up the road

itself... as you can see from the road..

Tomorrow they will spread shredded concrete.

Then a sealer after that has been placed in the

two days. And then next week.. we get the black Gold.

Life summed up in a bag

You know how they say that your life
and possessions are in a yard sale with
in 7 days of your death...Well, your paper
work doesn't do so well either.

After 9 years, the King and I went thru
the 2 drawer file cabinet we had his mother's
papers in. It took 2 hours of going thru and
figuring out what to keep and what to throw.

We had done a quick number on them years
ago, and then left them in the file cabinet.
The cabinet has been moved from room to
room. And we decided yesterday was the
day to deal with it all.

After shredding 3 bags of papers, and
deciding do we keep the cards, the
cards from the flowers, and other papers
dealing with the funeral. We ended up
with one white zip bag that the funeral
home gave us with the book. And several
envelopes with pictures in them to send to
different family members.

78 years summed up in one bag.

My Clematis Runneth Over

As you can see, I have not rode my bike for a couple weeks.

The deep purple one is 10 years old.

The light purple that has bigger flowers is 8 years old. This year they are smaller, in the past they have been at least 8 inches across.

And behind the basket of the bike is a red one that is 2 years old.

How old you want to be?

There seems to be another drug that is
trying to make it to the market. Called
Resveratrol. Suppose to get you added
years.

But I got to ask you. Just how many
more years do you want pass, say 80?
And what guarantee do you have it will
be quality life? To me it would be better
to have a good healthy life until you go.

Something is not good about messing
with God's plan. I just want to be healthy
until it is time. And hope and pray it isn't
Alzheimer's.

How long to you want to live? 80? 100?

Health Care Plan

I don't have the answer for what we can have.
What we all can afford. Or how to do it. But one
thing for sure... we need something done.

The biggest drawn down on our health facilities
is the illegal immigrants. Like it or not, it is the
truth. When ever you have a major group of people
who can not pay. Who do not pay taxes to support
the system, who seem to get away with a free
medical services that our own citizens don't get,
it is bound to be a huge burden.

Health care should be equal for all. No matter
what your position is in life. Straight across the
board. Millionaire or homeless. Elderly, or children
But how do you pay for it. That is the major question.
Maybe we could do it like the French. They charge
$2.00 more for their gas. Which affords
them health care for $10 a visit. Hospitals $20.

There is abuse on both sides of the alley here. Be it
Doctors or patient's. We all have seen the shows on
television. The investigation of doctors who have done
poor job of healing. The scene of the Dr. jumping in his
Hummer or what ever and driving off, without a word.
There are records in each state of malpractice.

But on the other side you have patient's who have sued
for the smallest of things. Some times even when the
patient didn't follow directions and blamed it on the
Dr. There are records of many court battles. So the
blame lays on both sides.

Then you have Dr. who stack the deck, by ordering
unneeded procedures. We were a victim of a small
bit ourselves not too long ago. The King doesn't have
insurance, so we have to pay cash. So when it is an
extra lab, it hurts our budget greatly. The Dr's who
walk into a nursing home and stand at the door way
of the dining room, and call each of his patients and
ask how they are doing.. then have the nurse write
down that he visited them. At $35 a name. It was his
monthly visit, paid for by Medicare. Or about 6 years
ago in Florida where a 99 year old woman was taken
to the hospital to die, and they ran 4 major test on
her before she died on Sunday.

And then you have the ER addicts. Who run down
there for the smallest of things. Things like colds,
that you and I stay home and drink fluids and take aspirin.
Or made up things, to get attention. Or chose to have
unneeded operations. Like the mother who wants to have
liposuction on her 3 year old daughter. AND the Dr. is
thinking about it! The rest of us know this is baby fat
that will be run off of her in a year or so, naturally.

So where do we find the sanity in all of this? Is it even
possible? How to you change people's habits? How
do you fight greed? On both sides?

And who is held hostage in all of this? You and I.
Those of us who play by the rules. Who hate to go
to the doctor or the hospital. So when we go, we are
really sick.

I wish Obama well. I wish Congress well. If only they
would stop fighting and find the real answer for the
citizens of American, no matter what their status is.