Chiriqui has probably been experiencing crimes to one degree or another for many decades. That is the general nature of things. As populations grow and people do not know each other as a community, anonymous crimes become easier to perpetrate. In times of inflation, shortages, unemployment and general economic hard times, property crimes tend to increase. When there are significant disparities in wealth and possessions, the homes of the affluent become targets. It is not difficult to see that several of these conditions exist these days in Chiriqui.
I have heard of two different couples who experienced costly burglaries and who later decided to pack up and return to the United States. I remember musing about one of the couples and wondering what they would do if they came home to find their U.S. home burglarized, move to Panama again?
It is certainly upsetting and depressing to experience the theft of things that you worked and saved for, and even more disturbing if you are robbed at gunpoint and perhaps physically harmed. Beefing up the security of your home is definitely something to seriously consider.
But what about getting out of the Panamanian equivalent of Dodge? It is something that requires some very careful thought at any time, and particularly now as things are generally deteriorating in the United States.
Crimes of all kinds declined in the U.S. from 1980 or 1990 to 2009. Full reports are not available for later years. But with the increase in home foreclosures, unemployment, homelessness and inflation, crime, particularly burglaries and robberies, is due to rise again. At least 43 states have severe budget trouble. Some municipalities have declared bankruptcy and others are close. The federal government is beyond broke. It owes over $15 TRILLION dollars and has promised over $100 TRILLION more for Social Security and Medicare that it does not have a chance of covering. Yet it continues to borrow about forty cents of every dollar it spends, and it continues to spend over $2 BILLION per week on wars.
Any enterprise that wants more cash to continue operations looks for ways to squeeze more from its usual sources. Like Mafia dons who send out enforcers to smash up stores and break legs to make the point that the "protected" clients must pay up, the federal government and not a few state and local governments have decided that they need to show those cheeky citizens who is boss (and it ain't the people like the Constitution says).
I am including a lengthy article below for your consideration.
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If you have not been directly affected by any of the examples below, you are fortunate. But you are not immune, only fortunate. There may be a time when you are not so fortunate.
Please understand that this is not an "Obama thing." He's just another tool. It is an institutionalized change in the style of government which ignores the U.S. Constitution and basic human rights. It pervades governments at the federal, state and local levels and transcends administrations (to varying degrees). If you are anything above the level of an obedient cipher, you are the potential enemy.
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Twenty Examples of the Obama Administration's Assault on Domestic
Civil Liberties
The Obama administration has affirmed, continued and expanded almost
all of the draconian domestic civil liberties intrusions pioneered
under the Bush administration. Here are 20 examples of serious
assaults on the domestic rights to freedom of speech, freedom of
assembly, freedom of association, the right to privacy, the right
to a fair trial, freedom of religion and freedom of conscience
that have occurred since the Obama administration has assumed
power. Consider these and then decide if there is any fundamental
difference between the Bush presidency and the Obama presidency in
the area of domestic civil liberties.
Patriot Act
On May 27, 2011, President Obama, over widespread bipartisan
objections, approved a Congressional four-year extension of
controversial parts of the Patriot Act that were set to expire. In
March of 2010, Obama signed a similar extension of the Patriot Act
for one year. These provisions allow the government, with permission
from a special secret court, to seize records without the owner's
knowledge, conduct secret surveillance of suspicious people who
have no known ties to terrorist groups and to obtain secret roving
wiretaps on people.
Criminalization of Dissent and Militarization of the Police
Anyone who has gone to a peace or justice protest in recent years
has seen it - local police have been turned into SWAT teams, and
SWAT teams into heavily armored military. Officer Friendly or even
Officer Unfriendly has given way to police uniformed like soldiers
with SWAT shields, shin guards, heavy vests, military helmets,
visors and vastly increased firepower. Protest police sport ninja
turtle-like outfits and are accompanied by helicopters, special
tanks, and even sound-blasting vehicles first used in Iraq. Wireless
fingerprint scanners first used by troops in Iraq are now being
utilized by local police departments to check motorists. Facial
recognition software introduced in war zones is now being used in
Arizona and other jurisdictions. Drones just like the ones used in
Kosovo, Iraq and Afghanistan are being used along the Mexican and
Canadian borders. These activities continue to expand under the
Obama administration.
Wiretaps
Wiretaps for oral, electronic or wire communications, approved by
federal and state courts, are at an all-time high. Wiretaps in year
2010 were up 34 percent from 2009, according to the Administrative
Office of the US Courts.
Criminalization of Speech
Muslims in the US have been targeted by the Obama Department of
Justice (DOJ) for inflammatory things they said or published on
the Internet. First Amendment protection of freedom of speech,
most recently stated in a 1969 Supreme Court decision, Brandenberg
v. Ohio, says the government cannot punish inflammatory speech,
even if it advocates violence unless it is likely to incite or
produce such action. A Pakistani resident legally living in the US
was indicted by the DOJ in September 2011 for uploading a video on
YouTube. The DOJ said the video was supportive of terrorists even
though nothing on the video called for violence. In July 2011, the
DOJ indicted a former Penn State student for going onto web sites
and suggesting targets and for providing a link to an explosives
course already posted on the Internet.
Domestic Government Spying on Muslim Communities
In activities that offend freedom of religion, freedom of speech
and several other laws, the New York Police Department and the
CIA have partnered to conduct intelligence operations against
Muslim communities in New York and elsewhere. The CIA, which is
prohibited from spying on Americans, works with the police on
"human mapping," commonly known as racial and religious profiling
to spy on the Muslim community. Under the Obama administration,
The Associated Press reported in August 2011, informants known as
"mosque crawlers," monitor sermons, bookstores and cafes.
Top Secret America
In July 2010, The Washington Post released "Top Secret America," a
series of articles detailing the results of a two-year investigation
into the rapidly expanding world of homeland security, intelligence
and counterterrorism. It found 1,271 government organizations
and 1,931 private companies work on counterterrorism, homeland
security and intelligence at about 10,000 locations across the
US. Every single day, the National Security Agency intercepts and
stores more than 1.7 billion emails, phone calls, and other types
of communications. The FBI has a secret database named Guardian
that contains reports of suspicious activities filed from federal,
state and local law enforcement.
According to The Washington Post, Guardian contained 161,948 files
as of December 2009. From that database, there have been 103 full
investigations and at least five arrests, the FBI reported. The
Obama administration has done nothing to cut back on the secrecy.
Other Domestic Spying
There are at least 72 fusion centers across the US, which
collect local domestic police information and merge it into
multijurisdictional intelligence centers, according to recent report
by the ACLU. These centers share information from federal, state
and local law enforcement and some private companies to secretly
spy on Americans. These all continue to grow and flourish under
the Obama administration.
Abusive FBI Intelligence Operations
The Electronic Frontier Foundation documented thousands of
violations of the law by FBI intelligence operations from 2001 to
2008 and estimate that there are over 4000 such violations each
year. President Obama issued an executive order to strengthen the
Intelligence Oversight Board, an agency that is supposed to make
sure the FBI, the CIA, and other spy agencies are following the
law. No other changes have been noticed.
WikiLeaks
The publication of US diplomatic cables by WikiLeaks and then by
mainstream news outlets sparked condemnation by Obama administration
officials, who said the publication of accurate government documents
was nothing less than an attack on the United States. The attorney
general announced a criminal investigation and promised, "this is
not saber rattling." Government officials warned State Department
employees not to download the publicly available documents. A State
Department official and Columbia University officials warned students
that discussing WikiLeaks or linking documents to social networking
sites could jeopardize their chances of getting a government job,
a position that lasted several days until reversed by other Columbia
officials. At the time this was written, the Obama administration
continued to try to find ways to prosecute the publishers of
WikiLeaks.
Censorship of Books by the CIA
In 2011, the CIA demanded extensive cuts from a memoir by former
FBI agent Ali H. Soufan, in part because it made the agency look
bad. Soufan's book detailed the use of torture methods on captured
prisoners and mistakes that led to 9/11. Similarly, a 2011 book on
interrogation methods by former CIA agent Glenn Carle was subjected
to extensive black outs. The CIA under the Obama administration
continues its push for censorship.
Blocking Publication of Photos of US Soldiers Abusing Prisoners
In May 2009, President Obama reversed his position of three weeks
earlier and refused to release photos of US soldiers abusing
prisoners. In April 2009, the US Department of Defense told a
federal court that it would release the photos. The photos were
part of nearly 200 criminal investigations into abuses by soldiers.
Technological Spying
The Bay Area Transit System, in August 2011, hearing of rumors to
protest against fatal shootings by their police, shut down cell
service in four stations. Western companies sell email surveillance
software to repressive regimes in China, Libya and Syria to
use against protestors and human rights activists. Surveillance
cameras monitor residents in high-crime areas, street corners,
and other governmental buildings. Police department computers ask
for and receive daily lists from utility companies with addresses
and names of every home address in their area. Computers in police
cars scan every license plate of every car they drive by. The Obama
administration has made no serious effort to cut back these new
technologies of spying on citizens.
Use of "State Secrets" to Shield Government and Others From Review
When the Bush government was caught hiring private planes from a
Boeing subsidiary to transport people for torture to other countries,
the Bush administration successfully asked the federal trial court
to dismiss a case by detainees tortured because having a trial
would disclose "state secrets" and threaten national security. When
President Obama was elected, the state secrets defense was reaffirmed
in arguments before a federal appeals court. It continues to be a
mainstay of the Obama administration effort to cloak their actions
and the actions of the Bush administration in secrecy.
In another case, it became clear in 2005 that the Bush FBI was
avoiding the Fourth Amendment requirement to seek judicial warrants
to get telephone and Internet records by going directly to the
phone companies and asking for the records. The government and
the companies, among other methods of surveillance, set up secret
rooms where phone and Internet traffic could be monitored. In 2008,
the government granted the companies amnesty for violating the
privacy rights of their customers. Customers sued anyway. But the
Obama administration successfully argued to the district court,
among other defenses, that disclosure would expose state secrets
and should be dismissed. The case is now on appeal.
Material Support
The Obama administration successfully asked the US Supreme Court
not to apply the First Amendment and to allow the government to
criminalize humanitarian aid and legal activities of people providing
advice or support to foreign organizations, which are listed on the
government list as terrorist organizations. The material-support
law can now be read to penalize people who provide humanitarian
aid or human rights advocacy. The Obama administration solicitor
general argued to the court, "when you help Hezbollah build homes,
you are also helping Hezbollah build bombs." The court agreed with
the Obama argument that national security trumps free speech in
these circumstances.
Chicago Anti-War Grand Jury Investigation
In September 2010, FBI agents raided the homes of seven peace
activists in Chicago, Minneapolis and Grand Rapids, seizing
computers, cell phones, passports and records. More than 20 anti-war
activists were issued federal grand jury subpoenas and more were
questioned across the country. Some of those targeted were members
of local labor unions, others members of organizations like the Arab
American Action Network, the Columbia Action Network, the Twin Cities
Anti-War Campaign and the Freedom Road Socialist Organization. Many
were active internationally and visited resistance groups in Colombia
and Palestine. Subpoenas directed people to bring anything related
to trips to Colombia, Palestine, Jordan, Syria, Israel or the Middle
East. In 2011, the home of a Los Angeles activist was raided and
he was questioned about his connections with the September 2010
activists. All of these investigations are directed by the Obama
administration.
Punishing Whistleblowers
The Obama administration has prosecuted five whistleblowers under the
Espionage Act, more than all the other administrations in history
put together. They charged a National Security Agency adviser
with ten felonies under the Espionage Act for telling the press
that government eavesdroppers were wasting hundreds of millions of
dollars on misguided and failed projects. After their case collapsed,
the government, which was chastised by the federal judge as engaging
in unconscionable conduct, allowed him to plead to a misdemeanor
and walk. The administration has also prosecuted former members
of the CIA, the State Department and the FBI. They even tried to
subpoena a journalist and one of the lawyers for the whistleblowers.
Bradley Manning
Army Pvt. Bradley Manning is accused of leaking thousands of
government documents to WikiLeaks. These documents expose untold
numbers of lies by US government officials, wrongful killings
of civilians, policies to ignore torture in Iraq, information
about who is held at Guantanamo, cover-ups of drone strikes and
abuse of children and much more damaging information about US
malfeasance. Though Daniel Ellsberg and other whistleblowers say
Bradley is an American hero, the US government has jailed him and
is threatening him with charges of espionage, which may be punished
by the death penalty. For months, Manning was held in solitary
confinement and forced by guards to sleep naked. When asked about
how Manning was being held, President Obama personally defended the
conditions of his confinement saying he had been assured they were
appropriate and meeting our basic standards.
Solitary Confinement
At least 20,000 people are in solitary confinement in US jails and
prisons, some estimate several times that many. Despite the fact
that federal, state and local prisons and jails do not report actual
numbers, academic research estimates tens of thousands are kept in
cells for 23 to 24 hours a day in supermax units and prisons, in
lockdown, in security housing units, in "the hole" and in special
management units or administrative segregation. Human Rights Watch
reports that one-third to one-half of the prisoners in solitary
are likely mentally ill. In May 2006, the UN Committee on Torture
concluded that the United States should "review the regimen imposed
on detainees in supermax prisons, in particular, the practice of
prolonged isolation." The Obama administration has taken no steps
to cut back on the use of solitary confinement in federal, state
or local jails and prisons.
Special Administrative Measures
Special Administrative Measures (SAMS) are extra harsh conditions of
confinement imposed on prisoners (including pre-trial detainees) by
the attorney general. The US Bureau of Prisons imposes restrictions
on such segregation and isolation from all other prisoners, and
limitation or denial of contact with the outside world such as:
no visitors except attorneys, no contact with news media, no use of
phone, no correspondence, no contact with family, no communication
with guards, 24-hour video surveillance and monitoring. The DOJ
admitted in 2009 that several dozen prisoners, including several
pre-trial detainees, mostly Muslims, were kept incommunicado under
SAMS. If anything, the use of SAMS has increased under the Obama
administration.
These 20 concrete examples document a sustained assault on
domestic civil liberties in the United States under the Obama
administration. Rhetoric aside, how different has Obama been from
Bush in this area?
The above article by Bill Quigley.
I think I like my chances in Panama better.
Moving Mum to Panama
Here is an article that I read in the Panama Guide and it reminded me of when I first came to Panama with the goal in mind of bringing my Mom to a better place. Many people are retiring here not only to enjoy their last active years but also buying places to accommodate a live in at a later date when they want a full time care giver. It is a well thought out article and long but worth the read.
By Anonymous for Panama-Guide.com – We moved our mum to Panama last year. She just turned 90. In Los Angeles we chose the best nursing home we could find, still each nurse had 15 patients. The service was terrible and we were spending $6500 a month. Here, in Panama, we have two caregivers who split the week 24×7 , they do a brilliant job, exactly what she needs, and cost us $220 each a month plus taxes. No Typo! A bit more because we just gave them a $5 a week raise, to $56 a week, to also massage my mum every day for an hour. A lovely house is $1000 a month. Here is our story.
It is a long story, because it is not just about moving to Panama. It is about the process of caring for one’s parents, of which Panama is but an important chapter. Along the way we will visit all the usual issues. Problems with the parent, dealing with siblings, spousal relationships, trust fund issues, insurance issues, both medical and long-term care, wills, packing up the house, respite care, the caregiver’s physical and mental health. On top of that, we have all the issues of dealing with Panama. Immigration law, labor law, local culture, food, transportation, health care, internet access, banking and romance. And then we have the cross-border issues. Elder abuse, remote banking, multi-country inheritance law, cross-border insurance issues. It is a complicated puzzle. Very easy to make a mistake. (more)
For context, occasionally I will add in stories from the other members of my support group, Panama CareGivers. If you are just interested in Panama, feel free to skip to those later chapters. But I am sure those who are caring for a parent will choose to read the whole thing.
I have learned a lot in the process. Here are my simple rules of caregiving.
- Rule #1 Join a caregiver’s support group.
- Rule #2 You are the mature adult. Protect your parent from bad decisions.
- Rule #3 Email notification of large financial transactions by contract.
- Rule #4 Inheritance should at least partially depend on who provided care.
- Rule #5 It is their money, but it is also everyone else’s inheritance.
- Rule #6 Keep a close eye on your staff.
- Rule #7 Use Chinese Medicine to understand the aging process, Western medicine to understand disease processes.
- Rule #8 Physical Therapy is central to longevity and a healthy ending.
- Rule #9 Consider the caregiver’s emotional, and physical health in your decisions.
- Rule #10 There is a time to die.These are the rules I try to follow. I believe there is a path in life we have to follow, and our job is to discover that path. The rules above define the safe path through an emotional minefield. We can choose to wander off that path, or we can be forced off the path, but then we set off those land mines.For our family, it was the right decision to move my mum to Panama. It turns out that only a few of us have managed to move our parents to Panama, but given the current economic situation, a much larger number are interested in following in our footsteps. So I hope that this roadmap helps you avoid the landmines in your own journey.So let us start at the beginning.My mum had always planned for one of her kids to take care of her in her old age. She thought it was going to be my oldest brother. Historically, the oldest inherited everything and took care of the parents. She built an elderly accessible house for herself in New England where her oldest son could live with her. But he turned out to be financially and emotionally abusive, so that did not work out. Her next plan was to move to her childhood city of Los Angeles to be with her beloved middle son Matthew. But he was unhappily married and had no space for her. That left me,her youngest, available. I had recently gone through a nasty divorce, did not like being a nomadic consultant, so moved in with her.I kind of stumbled into the position. Having no idea what I was getting into. There was no road map to guide me. So this article includes a list of rules to guide you. My parents had not taken care of their parents, so there was no family experience to draw on. No parent’s maintenance manual. Sure my mum worked for the local council on aging, but I now believe she only saw the seriously dysfunctional and abusive families, if anything it made her more scared rather than teaching any lessons about healthy elder care.
Worse yet there was a mother who was manipulating me, so it was very hard to make the right decisions. We never sat down and discussed a long term plan. I tried to discuss it, but she would never share what she was thinking. Instead she manipulated the individual decisions. She came from a generation where women had no power. Instead she learned to manipulate people. I have never met a person better at it than her. She never trained me to recognize it and defend against it. I had to figure that out for myself. I am now very good at recognizing and defending against it, much to my ex’s chagrin.
I had no guidebook. I stumbled along. Only now do I understand the value of a support group. Rule #1 Join a caregivers support group!
Financial Issues
If it were not for money, everyone would stay home. So let us start here.
Our parents lived in the United States after World War II. It was a great time to make lots of money. They bought a house in 1963 for $30K, 7 acres, on the water, in New England. I do not even want to say how much it is now worth, but sadly mum made the first of many mistakes. They sold too early and built an accessible house for their retirement on the road. Lawsuits were filed both when they built the house, and when they sold the house in 2005. Still it was a lot money. While it is now no longer that much money in the US, the rule of thumb is that you are three times wealthier if you move to Panama. Of course it depends on the basket of goods you purchase. If you consume a lot of imported manufactured goods, drive a car, shop at the supermarket, smoke cigarettes, drink imported alcohol, buy inflated real estate, then the prices are the same as in the US. If not, if you take the bus, shop at the veggie market, consume lots of labor, rent an empty mansion, then you are way better off here.
There is a huge transition we make from being the child to being the parent. At a certain point in life, the kids judgement is just better. All the caregivers I talk to refer to this phenomenon. I think it is an important part of growing up. Mum did not want to sell her house, we saw the housing bubble, and her beloved son Matthew pushed her into selling. When we sold the house, I wanted us to buy gold, 1/3 of her portfolio, no matter what I did mum refused. I still thought of her as the senior adult and acquiesed. Instead she and my oldest brother John made the next big mistake, and bought stocks, without telling me, just before the market tanked in 2008. Such is life. We do not get to choose our family.
People do not talk much about money, but I hear a lot of stories of parents who made bad medical decisions. My theory is that the difference between children and adults is that children make decisions based on one issue, but mature adults are able to integrate multiple issues into their decision making. The scientific studies say that mature adults integrate both sides of their brain into decision making. Seniors lose that ability. Their decision making gets worse. You need to protect them from that. Rule #2. You are the mature adult. Protect your parent from bad decisions.
I had a lot of problems with the broker who allowed that her to purchase stock in 2008. He tried to sell us bank stocks before the banks blew up, and Real Estate Investment Trusts before the real estate market blew up. He bought highly speculative stocks with my brother without telling me. We had huge fights. He had to reverse some transactions. Finally he resigned and I could move her funds to Charles Schwab. When we asked them to trade in her account, sell her stocks and buy a global index fund, they appropriately refused to take on that legal risk. I love Charles Schwab. Even if they did not do what we needed. I trust them to follow the law. And they have filed suit against some of the too big to fail banks for manipulating interest rates downwards.
The original broker she had trusted to protect her had betrayed her. Rule # 3 is that once they need a caregiver, all large financial transactions should be emailed to the rest of the family members by contract. Putting up a mailing list is not that hard to do.
Finances are very strange in our family. Very strange in all families. Here is the problem. A person’s will is usually a static document. Worse, it is illegal to change it in favor of the caregiver, once the person needs a caregiver. So I do the work, yet my healthy, but useless older brother will get 1/3 of the inheritance. When I complained about this to another caregiver in our support group, she said in her case her brother gets ½, so I am doing well. I think it is a common problem. The incentive structure and feedback systems are all wrong and it exposes the caregiver/secretary to risk of lawsuits from the other parties. Since they inherit they have standing. I do the work, get paid nothing for it, and then am legally liable. Ridiculous! Rule #3 is that inheritance should, at least partially, be split according to the number of years of care each person provides. Anything else is an emotional disaster.
Packing Up Her House
As for me, I was divorced, out consulting, not happy so I moved in with my mother. Packed up her second house, and sold it in 2005, close to the peak of the market. She had lived in Westport for 40 years, so it took 3 months to pack up her house. Recycle things, return things, donate things, sort things, sell things. Others proposed just hiring someone to do it, but I am sure they would not have recognized my grandparents diaries in Polish, they would have been thrown out. So I am happy I did the work. My eldest brother did not help in the process. In fact after the sale closed, I had to go back to clean out his storage shed filled with garbage. It was so bad, it took 4 of us to do it. My other brother did come to help, for a day, caused lots of trouble, and in the process sold our most valuable antique, a very very old book, for a pittance. My dad was a rare book dealer,. Turns out it is very common for one child to do all the work, and the others to not help at all. Or to break something when they do help.
So we sold the house, and off we went to Hawaii and California. I wanted to go further afield. Mum was scared of the third world. First of all she did not want some third world woman catching. She had the money to live in the US, did not care about leaving money to others, in fact wanted to die broke. Little did she understand that off shore we would have had a way way better life. Fear is so strong in some people. So we spent way too much money in the US in Hawaii and Silicon Valley close to my kids. Although I did like the big Island! Rule #4. Sure it is their money, but it is also everyone else’s inheritance. You have to look at financial decisions from both perspectives, using both halves of your brain.
Lessons from my brother.
One day we got a phone call. My brother, Matthew, had a bicycle accident causing severe brain injury. We rushed off to Los Angeles to be by his bedside. My mother had always wanted to live in Los Angeles, I can’t stand the place. So it worked out perfectly for her, although it was not until much later that I realized what had happened. She got to choose where we lived without considering my concerns.
We spent a lot of time at my brother’s bedside. What I learned taking care of him, I later applied to my mother. Since I knew nothing about medicine, I was way out of my league. I needed a source of knowledge and expertise for how to interact with the hospital. I started a yahoo groups medical blog about his condition. What a great source of knowledge our friends had collectively. I would report what had happened, someone on the list would always have the right advice or question to ask. I recommend the process highly if your loved one has a medical emergency. Since eventually Yahoo Groups will disappear, I printed the blog out for his son’s 21 birthday present and will give it to him in 7 years when he turns 21. It came to about 4 inches of paper.
One of my friends said about taking care of my brother: “Never give up”. That is rule #6. The corollary is keep trying things until you find something that works. Here he was in bed, unable to move. We later found out physical therapy is very good, but at the time, we did not understand it, the insurance companies would not pay for it and my sister-in-law refused to allow us to pay for it, let alone pay for it herself. Something about losing Medical if there are private payments. Actually she withheld all insurance information and access to the doctors. And did not try anything to get him walking. Quite the reverse.
So we tried Chinese medicine. It worked brilliantly. Matthew could not move his arms, there were so stiff, they were even stiff for us to move. We brought the Chinese doctor in, brewed up large vats of herbs, like some scene out of Shakespeare. “Boil Boil Double and trouble.” Pretty soon his arms were moving. But that was not enough. I now understand that what he actually needed was physical therapy and chinese herbs together, but when we were able to provide the Chinese medicine, there was no physical therapy, and I did not then know enough to provide the physical therapy myself. Later when there was physical therapy, they would not allow Chinese herbs. To this day he is still stuck in bed.
Dealing with his wife was so hard. The wife has all the power. Refused to share information, doctor access, or decision making. While I hung out at my brother’s bedside powerless, she went off and worked. We tried everything that was within our limited power and knowledge.
I did learn a lot about caring for the sick. But I had not the medical authority to do what was necessary to get him walking. The family is supposed to fight with the hospital for better care. Instead we spent our time fighting the sister-in-law. And she had all the legal power. As for me, I was not able to protect my brother from his wife. If your wife does not love you, give medical power of attorney to someone else. Maybe I could have gotten him up and walking. She did not even try. At least I would have tried. My sister-in-law is going to rot in hell for what she did to him. I am pleased to say that she has already suffered enormously.
We fight so hard for our families life. I had no idea how passionate I was about my brother’s health, nor about my mother. I may dislike my mother, but I also love her deeply. Feelings for family are so strong.
When Matthew was first in the hospital I talked to the minister. I had a sense of spiritual connections between loved ones. The minister confirmed that. And said that the spiritual connections to others are all connected. Every time you lose someone, it brings to mind all the other losses of loved ones. That is why we fight so hard for the lives of our family. Because to lose them, is an injury to our spiritual bonds with them. It is an injury to ourselves.
Never give up, unless you have no legal authority! Eventually we gave up and went off to Panama for a while. Mum met and liked my friend Sandy, and liked Panama. That is why we were able to move here later. She had already visited Panama, and was comfortable with it, and Sandy. A year later, we found out that they were going to provide physical therapy to my brother, so we moved back to California to try again to help my brother.
Mum’s Aging.
Every person ages differently. My grandmother-in-law cooked her own meals every day of her life, and died in her sleep. Most people do not have such a graceful ending. I do not know what path your loved ones will take, I can only tell you the path my mother took. We all fall apart in different ways.
While we were attending to my brother’s bedside, my mother was getting older and weaker. A smelly room. Poop on the mattress. Rather than dealing with it, I kind of tuned it out. That cost us $1000. But dealing with an aging mum was just getting more and more depressing. I could not take it. As it got worse, I became so depressed that I was not able to get out of bed. At that point I realized it was time to make a transition. Move her to a nursing home. I could not handle it myself anymore. At that point there was no guilt. I had done all I could.
On Nursing Homes.
Since Matthew was in a nursing home, it was only natural to take my mother to the same nursing home. So my immediate family consisted of two people in adjacent nursing homes, mum was in assisted living, Matthew in skilled nursing. Talk about pitiful!
The food was terrible, so I bought my mum a small fridge and a microwave and kept it full of reasonable instant food from Trader Joes. Then one day at 12:50 I arrived and found her laying on the floor. A urinary tract infection is incredibly debilitating, and probably caused by their not changing her diapers regularly. I never liked that nursing home, but if they could not even do an inventory of their patients at lunch time forget it. We moved her to a far better nursing home, but then I had to visit two different places every day. Unbelievably, I could not get my sister-in-law to move my brother to the same place as my mother.
The new place was way better, but also not really good. We were fooled by the presentation. It turns out that you cannot really evaluate a nursing home by visiting it. What matters most is the process they execute, their quality of the care, the relationships between the patients and maybe the quality of the food. When you go and visit a nursing home you can see how nice the building is, how nice the room is and that is about it. The only important thing you can really evaluate is the food.
In this case the food was way too fattening. They said the residents liked it that way. Donuts, Bacon, greasy food. All kinds of junk. Sorry I do not have the records of how much weight my mother gained there, but here in Panama we are eating way healthier home cooked meals and she is losing weight.
This place already had a lovely lobby. They further remodelled it while we were there. They had recently been spending huge amounts of money making the place look better. Which is actually way cheaper than paying for good care, and helps more with the sales cycle.
This nursing home had remodeled the lobby to make it look great, and did their best to whisk the patients out of the lobby, not to be seen by new customers. It never ceased to amaze me that all their hundreds of customers spent most of their time by themselves in their bedrooms, only 10-20 could be seen at any one time in the public spaces. I now recognize that as a very bad sign. A clear measure of how good a nursing home is, but you have to be trained to spot it. The statistics to look for are how many patients are there, and how many are interacting in public spaces at any one time.
There is a reason the nursing homes make the lobbies look great, because they do need to focus on the sales cycle. An average nursing home stay is 1.5 years. Which means that every month you lose 5% of your customers, and have to replace them. Instead,I think, nursing homes should exercise their patients twice a day, Keep them alive for 3 years, and reduce the cost of new sales. But that is not what they choose to do. So ask how long patients live on average when you do visit. Ask if there is a required exercise class twice a day.
A great nursing home would have all the patients sitting in the lobby talking to each other. The best such environment, I ever saw was CNS in Bakersfield California. They treat brain injury survivors, such as my brother. Part of the organization has individual specialists doing specialized exercises with the patients. The other, later stage, better part of the organization, has all the more functional individuals, the first stage graduates, in a room interacting with each other. My brother got so much better there. This is a model all nursing homes should adopt, where the healthier patients interact with the older patients. It is good for both of them. Instead so many nursing homes isolate the patients in their bedrooms with no stimulation except television. So choose a nursing home based on percentage of patients in the lobby interacting with each other. Although I dare say most have few.
What we have done in Panama is we have created an environment where the family, but mostly the paid staff provide this kind of stimulation to my mother.
Since my mum was an emergency case, they gave her their only empty room. A lovely 2 bedroom suite on the top floor, far from everyone, with a great view. They only charged us for a studio. At first I lived elsewhere, and visited her every day. Later I would be gone from town half the time, then I would come and visit and stay with her. No one minded. As time went on, and she got sicker, I spent more and more time just living at my mum’s nursing home. No one seemed to notice or care. I was quiet and discrete. Everyone knew I was there, but no one said anything. It took two years for the CEO to notice and kick me out. It happened just when the front desk management changed to a more nazi manager. My girlfriend was asking way too many questions of the inmates and got noticed. O got rudely kicked out. I left, found a dirt cheap place to sleep, and came back to my nursing home office during the day time to keep an eye on my mum. I must be the only healthy person in history to have lived in a nursing home. It gave me great insights into how they actually function.
My being there was great for my mum. Those families that pay attention get better service. So few people visit their families in the nursing home. Check the sign in sheet to see the percentages. While most people get ignored we got way better service. Here is the schedule they agreed to for us.
Many patients get breakfast in their room. The patients often fall asleep, and they would come and take away the full tray, and leave her sleeping in her chair for hours. With me there, I made sure she ate, shooed away the staff who came too early to take her tray, and walked her back to bed. I did a lot of the work the nursing home should have been doing. But instead of getting a discount, they eventually raised the rent to the full price of the apartment. $5500 a month.
After breakfast she slept until her exercise nurse came at 10 am. She cycled for an hour, I made sure the exercise nurse brought her back for another hour’s nap. Then the regular staff came to take her down for lunch, brought her back for yet another hour’s nap. She then slept until exercise nurse came at 3pm, then waited an hour for dinner. After dinner, on those two nights a week when they had movies, I would wheel her up to the movie, at least they would bring her back to her room. If it was getting too late, when they were understaffed, I would go and get her.
Here in Panama she gets a movie every day. She sleeps less and exercises more.
That was her schedule when she left the nursing home to move to Panama. It had evolved over the years. The nursing home would have done none of that, it was only because I was there to push it, that they adapted to her needs. Once the schedule was set, even while I was gone, they maintained it. The problem with all nursing homes is that they do not execute the process that the patient needs, they just execute the same process for all clients. It was only because I was there all the time that they did at all what she needed.
Here in Panama, they do exactly what she needs. Every day we observe and adapt to her actual needs. The staff do this with minimal intervention on my part. In fact now, I get it wrong more often than right. And they tend to listen to me.
The dreaded WheelChair.
We will now back up a little bit to the time when she started using a wheelchair.
Our room was on the top floor and far end of one building. The cafeteria was in another building. Initially the nurses would walk my mum up and down every day. Remember she had just come from the other nursing home, and a debilitating Urinary tract infection. At first she got stronger, later as she got older she slowed down. Remember each nurse had 15 patients, and had not the time to be walking her, nor any motivation. Quite the reverse, the only reason they did not put her in a wheelchair right away, was because I was there to discourage it. But I was not there all the time.
There were times when I spent months in Los Angeles next to my families bedsides. There were times when I was gone, visiting my kids in Northern California. I would stay in Youth Hostels, and even lived in Yosemite Valley walk in campground for a few weeks. One day it snowed on my tent. That was fun. I would come and go. That seemed like a fair compromise between what my mother wanted and what I wanted.
I tried so hard to get my brother to walk. Eventually it was clear it was hopeless. Not only did I lack my sister-in-laws support, she actively got in the way. It is okay for my mother to be dying in a nursing home, but it hugely violates the natural order for my brother to be in that situation. Eventually I gave up in disgust, went off depressed to Canada for 3 months. On that trip, when I was not watching, is when my brother,John, bought the stocks just before the 2008 market crash. That is when the nursing home, put her in the wheelchair.
Once a person is in a wheelchair, things get much worse quickly. They do not walk. Their blood pressure goes up. They get vertigo, fall over break their hips, and go to the hospital. Only 50% come back from the hospital. The statistics say that if a patient walks less than ¼ mile they will be dead in less than 5 years, and the less they walk the sooner they are dead. Clearly exercise keeps the elderly alive.
Here in Panama we only use the wheelchair for outings. She walks all around the house, leaning on the staff.
This did not look good. Time to do something. For 40 years we had begged with mum to exercise. She never did. This time I insisted. Experiencing vertigo she was scared, and she complied. We hired a nurse to come and exercise my mum on an exercise bicycle. $12 an hour, first for one hour, then for two hours a day, 30 days a month , came to $760 a month. It worked great. Her blood pressure came down. By December she was starting to get up out of her wheel chair by herself. That is a wonderful thing, but of course the nursing home staff discouraged it. Time to move on.
Romance In Chile.
I thought it would be great to move to Chile. Mum seemed to think it was a good idea, so off I went to check out the country. Only much later did I understand she never wanted to go to Chile, but was trying to avoid the conflict. Send me off to get it out of my system. Who knows what her plan was. She did find a way to manipulate the decision.
Chile is such a wonderful country. This was January of 2010. My instincts and timing were great. They had just been accepted into the OECD, Organization of Economic Cooperation and Development. The 20 most industrialized countries in the world. The roads are brilliant, the buses are brand new Mercedes buses, with clean pillow covers. And yet they still have the third world vendors who walk onto the buses selling sweets, and newspapers. And salaries of about $300 a month. I love Chile. If we had bought a house there then it would have appreciated a lot.
Valparaiso was so good for my health. The health of caregivers often suffers so let me speak to this point. I thought we were moving to Valparaiso, so I went looking for a house to buy. . Six weeks walking up and down hills got my blood circulating like crazy. I am diabetic, the sugar clogs the arteries. Aerobic exercise cleans out the arteries, and made me so alive. As soon as my mum dies, off I go to hike the hills of the world, San Francisco, Valparaiso, Krakow and Turkey. In the meantime, I have been stuck in flat Los Angeles, and more recently in too hot Panama. My health has suffered accordingly.
Chile was also great for my love life. For reasons I do not understand the Panamanian women are not chasing me, but the Chileans were. I was divorced in 2000, quite happy being mostly single until 2010, but since then I have been keen to find a partner. I met my current “wife” on the flight back. She hugely supports my caring for my mother. She is also looking towards her old age and values my expertise in these matters. In contrast so many of the people in my support group have problems with their spouses not supporting their caregiving choices.
I am not sure why but the Panamanian women do not find me attractive,and I do not find them attractive. Sure you see a number of older gringos dating younger Panamanians. One old gringo with a wife also past her prime honestly said: “But I can’t afford an upgrade”. Another such couple we sat next to did not say a word to each other throughout dinner. I choose not such a relationship.
Columbian women are much more beautiful. A third friend found his wife on ColumbianSingles.com He has a child, she has a child, they have a child. It was the commercial attache to the Canadian consulate in Chile who told me that it was well known that: “if you go to Columbia single, you come back married. If you go there married, you come back single.” Meaning your wife divorces you for being unfaithful.
There was one Panamanian woman who did find me interesting. She sat down next to me on the bus. It was dark. She “fell asleep” leaned her head on my shoulder, her body close to mine. I really enjoyed it. My girlfriend who was sitting across the aisle was so angry at me! “But I did not do anything” I protested. “That is the problem” she replied.
My mum never wanted me to have a girlfriend. She worried that I would ignore her concerns and focus on the girlfriend. It is a legitimate concern, reinforced by my abusive elder brother’s behavior. When my eldest brother brought his russian wife and her daughter to live in her accessible house, it freaked her out. And for the longest time I was broken hearted from divorce, and did not really want to be involved with anyone. So that worked out. It is only in 2000 that I wanted a partner. And fortunately I managed to find an angel who not only approved of my taking care of my mother, but was hugely interested in the process of elder care for herself in her later years. It has worked out great. Except for mum who stares at her, wanting her to leave, clueless that if I am happier, mum is better taken care of.
Not everyone is so lucky. Many caregivers have problems with their spouses. While I am blessed with one who supports what I am doing others range from unhappy to ready to find an upgrade. I even heard of one case where the wife, a professionally trained nurse, wanted to take care of the mother-in-law, but the husband dumped his mother in a nursing home.
Two very sick years.
While I was gone in Chile, the nursing home threw out the exercise bicycle. Remember they prioritize the facility looking good over people’s health. And it was an old bike. They did not care if a lot of people were using it. My mother spent a few weeks without exercise, and no one told me. The exercise staff did not tell me. I called mum twice a week, but mum did not tell me. She just said come back soon, without telling me the reason. I should have called her nurse once a week.
Meanwhile in Chile I had not found a nursing home for her. I needed another week. By the time I returned to the US, she was a complete lump. And I was under the 3 week tax rule, I could not spend more than three weeks in the country, and still qualify for the $92,500 foreign earned income tax exclusion. I was so angry at her screwing up our move to Chile. At the time I did not understand that she had never wanted to go there. I was desperate to stay in the country less than 3 weeks. Fortunately I had met a Japanese woman on the airplane home, she invited me to her country. I bought my mum a new bicycle and off I went. Big Mistake.
Of course when I got back, mum was doing even worse. She had not been using the bicycle, she was quite catatonic. You have to keep an eye on your staff or they do the wrong thing. For one thing they just do not have my understanding of biology, physiology, and health maintenance. For the other thing, they just do not care. Probably I should have called them twice a week also. Rule #6 Keep a close eye on your staff. They do not love your parent.
I cannot describe it medically, but when I got back, there was the feel of death around her. It was terrible. Now she is older and weaker, and slowing down, but does not have that horrible sense of death about her. From January 2010, every time I would leave Los Angeles her health would go down hill. I was stuck in Los Angeles. I could leave and my mother would die, or I could stay and be depressed. I chose the later. I ended up finding a girlfriend I was not proud of. My diabetes was the worst ever. I did not take good care of my health, lost a front tooth, and needed 4 crowns altogether. It was a terrible time for me.
Now a wonderful panamanian dentist has now created the 4 crowns for me, $450 each. But I had to fire two very bad dentists before finding this one awesome one. He even had USB x-ray film, a technology none of my US dentists had. His dental processes are so different. He gives me wonderful time and attention, something often lacking in the US medical system.
It is amazing both how bad and how good the dentists are here. “This is Panama.” Rule #9 Consider the caregivers emotional, and physical health in your decisions.
Sadly I could not move my mum to Chile. First she did not want to go, and more importantly the elderly people who are moved against their will usually die quickly. It is called relocation trauma, it is an observed phenomenon. We were stuck. It was a terrible situation. I chose to stay and keep her alive. If you are reading this article, You would too.
Fortunately nature took its course. Mum kept getting weaker. Eventually she required two nurses at a time. The nursing home said she had to move out of assisted living, and into skilled nursing. Here we had this lovely two bedroom apartment far from everyone All very private. In skilled nursing it was small and crowded, and lots of nurses nearby. Worse yet it smelled, as do so many later stage nursing homes.
So we took mum to go and look at the place. There were all these zombies sitting at lunch. I was a bit naughty. I wheeled mum around so that she could look at their faces. She took one look, and said “Get me out of here”. We were free to leave Los Angeles. HURRAH! Out of the frying pan and into the fire!
By now my mum had been living in nursing homes almost 3 years, well past the expected 1.5 years. Her nursing home insurance had run out. That was another reason to move on.
Also she was getting much older. As they were getting ready to kick her out, one day she was not even able to stand. What to do?
Korean Medicine.
The lessons I learned taking care of my brother proved invaluable in taking care of my mother. There was a Korean student intern at the nursing home, and she had been offering a class in Chinese Herbal Medicine. I signed up for it, and had scheduled an appointment to visit the Jaseng center in Los Angeles. The doctor there was trained in both Chinese and Western Medicine.
Coincidentally the day before the appointment, mum was not able to stand up. They could not transfer her to her wheelchair. Big trouble. The whole structure we had set up would collapse instantly if she were bedridden. I physically helped the nurse for a day. Fortunately we had an appointment with the Korean doctor the next day, he gave her some medicine for her kidney chi. The following day she was standing up. Amazing! To this day she is dependent on her daily dose. Every time we reduce it, she fades. It is a bit hard bringing it into the country. And worse yet we have not found a local Chinese or Korean doctor we like to customize the prescription for her. Such specialized services are more available in the US.
Turns out Korean Medicine is even better than Chinese Medicine. . We met one Korean woman whose mother was completely cured of a stroke with Korean medicine. You see during the cultural revolution, Mao Tse Tung simplified Chinese medicine. But Korean medicine dates back thousands of years.
Western medicine and oriental medicine have very different models. Western Medicine is very reductionist down to the biochemistry level, and infectious processes. If you are in a car accident use a western doctor. Korean medicine is more strongly based on empirical observation. Their focus is on the health of the organs. It operates best on time scales of months. As you get older your chi expires. The kidney is the source of your chi. In fact my mother was always worried about her weight, never drank enough water, and that is hard on the kidneys. So her kidney chi is weak. And that is the source of all the other organ’s Chi.
The reason Chinese medicine is better than western medicine for elder care is that they have a superior model of the ageing process. They look at how the individual organs age. Rule #7 Use Chinese Medicine to understand and manage the aging process. Use western medicine to understand disease processes.
Anyhow mum was getting weaker, it was time for her to move to skilled nursing, she did not want to go there, so this time we were able to leave town.
So where should we go?
Thank god I had been working on relocation plans literally for the previous six months.
When I take a look at the world, I see the first world nations as highly desirable places to live. Canada, USA, Europe, Japan, New Zealand, Australia. Sadly wage rates for elder care are prohibitively expensive. A lot of the other countries are just too dangerous. No point listing them all. I walk a lot, getting hit over the head once ruins your whole life, as I found out with my brother Matthew. In the Americas the three safest places are Cuba, Panama, and Chile. Turns out Panama and Chile have the best internet access, Cuba the worst. Since I work on the internet that is important to me. While Americans are allowed to travel to Cuba, it turns out trading with the enemy act prohibits us from spending money there. For reasons based on her false notions, more than on reality of the country, mum refuses to go Chile. That left Panama in the Americas. But neither mum nor I was excited about the choice.
Looking at the broader world, the three “Third World Nations” that get my attention are South Korea, Chile and Turkey. I use the quotes because they are really first world countries with third world prices. All three of those have modern infrastuctures, way way better than the crumbling US infrastructures, and yet labor is typically $300 a month. Sadly asia is out, too alien for mum.
Mum always wanted to go to Turkey. And I speak Polish, so the plan was to go to Poland first, and from there I could travel to Turkey, set things up, and we could all go. Also as people get older, others watch for elder abuse. We even got visited by one such agent, thankfully mum passed the interview with flying colors. To avoid problems, The simple solution is to make decisions that all her family and friends agree to. Her friends all said that she always wanted to go to Turkey, so that was an acceptable legally defensible plan. It is good to be mindful of the law, even though the statues on elder abuse are hugely vague.
So we were planning on going to Poland then Turkey. We even bought tickets. Me, I am young at heart and male, I would have just packed my backpack, bought a copy of Lonely Planet guide and gone. But my mother is old and fragile, and with her I move much more cautiously. I asked everyone for their opinion, I even asked her Chinese Doctor for permission to travel. He cued us into the problems with travel. If she flies to Poland “she has a 70% chance of being uncomfortable!” He said in his broken English. “What ????” said my dear friend ZVI. “When I travel I have a hundred percent chance of being uncomfortable.” We later understood that what he meant is that she has a 70% chance of not surviving the transfer. Jet lag is so exhausting, even for the young. For the fragile elderly it is perhaps life threatening. Yes flying to Poland meant that she had health insurance when she arrived, and for the three months she is allowed to stay in the Schengen countries, but I would rather not take the risk of having her admitted to the hospital there.
Anyhow it was good advice. Sure I could move mum, but don’t go too far. I am male, naturally too aggressive, wanting to go far afield. The wise advice was to just go a short distance. And then it is easier for friends and family to visit, and for me to go back to visit my kids. So the first stop is Panama, who knows if we will ever leave for Chile or Turkey. Maybe we are stuck here.
MOVING TO PANAMA.
I could not have moved to Panama but for the help of my dear friend Sandy. I travel easily, but when dealing with my mother I made sure every detail is accounted for. I had a million questions. He answered them all. Health Insurance, banks, staffing, labor law, rental law, hospitals, dentists. You name it. I found a house to rent on the web, and asked him to go and inspect it. 5 bedroom mansion for $1000 a month. He liked it so much, he moved in with us, which worked out brilliantly. We had a local spanish speaking expat in our house. Another real estate agent highly recommended his deceased friends caregiver. Sandy set up the video conferencing interviews with a fluent translator. Same for the second interview. When people showed up late, he told me not to worry, “This is Panama. “ It is a phrase you will hear frequently. He set my expectations and standards for how things work here. I thank him enormously for providing a soft landing. But all good things come to an end. Eventually we outgrew him, tensions increased and we were both happy to part ways.
The interview felt more like she was interviewing us, than the other way around. She had a job, was happy and safe. We were the ones who had to perform. It is not like the US, where someone would take this job sight unseen. Here the employees have so much power. So much pride. They are not hungry.
I had the idea all wrong. I thought if they were making so little money, I can treat them like dirt. Actually they are quite wealthy at that income level. Sure they share a house with their family, and yes they borrow from each other frequently, such as when school starts. There is a tremendous social safety net. Free school, free breakfast and lunch in school. Free medical clinic here in the valley. The kids get a free laptop once a week. They get paid for a 13 months. They get a month’s vacation every year. Lots of other things I do not know about. But they are happy, and have their pride. They have tremendous pride. Which is one reason why they do not chase the foreigners romantically, because they would lose respect in their community. And it means that you have to treat your staff with respect. Sure the Panamanians treat their servants like dirt, but as the economy picks up, the staff also picks up and leaves.
Another reason they are financially well off is that they use a different basket of goods than we consume. They eat rice, beans and chicken all the time. There is a huge chicken farm near here. They have so many trucks going up there, the farm paid to repave the dirt road out to the farm. Basically I do not understand their lifestyle, but I know that I do not understand it. More importantly I listened to my friend Sandy on how to deal with them.
A big part of their compensation is living with us. They have a lovely house here. They sleep in the same room as mum, they feel safer that way. We have excellent food here. Some of the caregivers joke about the fat staff who eat too much, not that I have seen it. Their friends drop by to visit. They spend way too much on their cell phone bills. One of our staff had a romance with the gardener, at our first house but we have not seen him in a while.
On with the story. . We needed a second person, so our first person found an acquaintance to take the job. When our second employee did not show up for work one day, our first employee worked her shift, happy to get paid extra. When this happened a second time, I had her recruit a replacement for us. Paid her $80 for finding us our new second person. All is well.
We live in El Valle, three hours by bus $5.00 one way, from Panama city. It is the only inhabited caldera in a dormant volcano, anywhere in the world. It is higher here, and much cooler. Almost tolerable for those of us who come from nordic backgrounds. A lot of the wealthy Panamanians have houses here. That has two effects. First of all,it politically suppressed the high rises and golf courses found in so much of Panama. And secondly here and in another wealthy enclave, Isla Contradora they have free local hospitals. The service here is great, although their equipment is lacking. Labor rates are lower than in the capital, as are rental prices.
MEDICINE.
Well my mum had some minor problem recently, and just to learn the lay of the land, we rushed her to the local hospital. Wheeled her out into the street, and flagged a passing taxi. $1.50 for all of us one way. They even have an ambulance donated by Japan. This hospital is open 24×7, but I think the ambulance is not available on weekends. I think they have 4 doctors, of which 1 speaks english, one understands it and the other two do not. The service was free. FREE! We had to show our passports. Actually the service was excellent. Although their equipment is limited. There are other hospitals, and strong libel laws, so I need to be careful what I say. But most people here know what are the good hospitals, what are the bad hospitals, and which hospital is good, but nickels and dimes you to death. You just have to ask. There was also some story of an infectious disease in some of the hospitals, something like MRSA. But I am sure that is everywhere, not just in Panama. And of course it is worse in some hospitals, better in others.
Someday she may have a problem, and the local hospital should be able to solve it. Or maybe they have to rush her an hour down the hill to a larger place. And we are well aware of the risk that she may not make it to the life support systems they have there. But maybe it is better that way.
Actually my mother is on life support. Not the traditional tubes and ventilators we think of. She lives off the energy of her staff who literally keep her alive. Who now know how to do it so much better than I could.
A large part of elder care is keeping the body going. In Panama they are doing an great job with my mother. It is not just elder care that she is getting here, she is getting Physical therapy. They put her on an exercise bicycle twice a day. They play catch with her 15 minutes a day. Great for coordination. And since she does not throw the ball back very well, it is great exercise for the staff as well. She never liked a rocking chair, but they now put her in a hammock every day for an hour. Rule #8 Physical Therapy is central to longevity and a happy ending.
FOOD.
I am always hungry up here. I walk to the open air market every day and bring back as much food as I can carry for the three of us. It is great fresh vegetables, for not much money, 50 cents to a dollar a pound, and there is ground beef and chicken. The regular beef is too tough to chew, even for me, let alone mum who is losing her teeth. And that is about all there is up here. We have to cook everything from scratch. Yes there is processed food in the 5 chino stores, but it is mostly cheap, with high sugar content, and so we do not buy it. Instead we have this very healthy diet close to the earth. One market stall even grows food in the garden behind it.
And of course the best food in the market is on the weekends. That is when people drive up here, my American friend with the gorgeous Columbian wife shows up every Saturday, as do many others.
Is it organically grown? I think not. They do not care about chemicals. But they do care about money. So I believe that they use way less chemicals than American producers, and way more labor. Who knows for sure.
Since I am always hungry, I am a huge fan of desserts. I know every single dessert available anywhere in El Valle, and also many of the sources of dessert in Coronado and Panama. We even had an ice cream party up here. No sliced almonds anywhere in town, but I now know one family that stocks them in their freezer, and will lend in an emergency. That is a common trait. To know exactly what is available in which store, and to talk about it with others. It is so different from the US.
There is no cheese in town. Well almost none. Cream cheese is available. American cheese with plastic wrapping that I hate is everywhere. Occasionally we can find an Asiago in Centro Commercial. That is about it. For good cheeses we have to catch the bus an hour each way to Coronado. We have these two big shopping bags. And of course we are almost the only ones on the bus with groceries. The expats drive. The Panamanians shop locally.
We do get milk from the store. And fruit juices with sugar. Sugar free orange juice is available in Centro Commercial. A new bakery opened that distributes small bread rolls through the Chino stores. Delicious. There is an organic milk source in town. There is an organic farm, but I was not impressed.
We eat a lot of popcorn. The dutch butter is better than the local butter. You have to get the western herbs to flavor it from the big cities. Our spice rack is a precious commodity.
Forgive me for giving such boring details about what to buy where, but it is really how we think about food here. It is not that we drive to the super market and get what we want. We have to eat local produce. Locally grown. Everything else is a luxury. Very primitive really. So we are always thinking about food. I am sure our ancestors were the same way.
Next Year a big supermarket chain, El Rey is opening in town. I am kind of sorry to hear it.
INTERNET
Sometimes I work on the internet, so internet access is critical to me. Panama and Chile are the only two South and Central american countries with internet competition by law. In many other countries, such as Costa Rica internet and telephone is government controlled monopoly, so the service is intentionally bad. In Costa Rica they charge 10 cents a minute for phone calls. That is way too expensive for call center kinds of work. So skype makes sense, but hugely drains the government income. Accordingly the government blocks it, and internet telephony in Costa Rica, and many other countries is terrible. Maybe a VPN will get you around those problems, I am not sure. When we were in Costa Rica, VPN’s were not so readily available. In contrast, Panama and Chile have competitive networks, and one can get great service.
There are three internet service providers in El Valle. Strong libel laws here so I cannot tell you who has the better service, just ask anyone and they will know. Reportedly there is a third wireless provider in town.
It is so boring here in El Valle. We would go nuts if not for the local expat who has a lending library of DVD’s. Another friend of mine is much more high tech. He downloads movies off of bittorrent. He port forwards across his DSL modem, so he gets a movie in about two hours. Then he bought a openvpn VPN server, so that no one can track his IP address. Not that anyone cares in Panama. Finally he pops the downloaded movie on a USB stick which he then plays on a new High Def TV. Every night he cuddles up to his Panamanian wife, and watches some independent or foreign film with Spanish Subtitles. Not all gringos are that technically sophisticated of course. Some pay more attention to copyright law.
DEATH
Here is the final chapter, which I am not yet able to write since both my brother and mother are still alive. But I do know that death is a normal part of life. Rule #10 Like the song says. There is a time to die. One mother in our support group is in pain, and wants to die. The other day my mother lifted her other foot, so that it would get massaged next. She wants to live.
CONCLUSION
What do I think of Panama? My local Chinese doctor said it best. There is a certain energy in Panama. If it suits you, you are happy here. If not, you are not happy. No one follows the rules, no one even seems to know the rules. When asked what the rules are, everyone gives a different answer. My friend the libertarian loves it. Me, I prefer Chile. The rules there are well defined. Everyone knows them. If you do something wrong you get caught quickly, and released quickly. Here the rules have lots of different interpretations. Almost no bribery, just different interpretations. Panama is great for some, not so great for others. It all depends on who you are. Remember “This is Panama”
10 Commandments again.
So here are the 10 simple rules of eldercare repeated. .
- Rule #1 Join a caregiver’s support group.
- Rule #2 You are the mature adult. Protect your parent from bad decisions.
- Rule #3 Email notification of large financial transactions by contract.
- Rule #4 Inheritance should at least partially depend on who provided care.
- Rule #5 It is their money, but it is also everyone else’s inheritance.
- Rule #6 Keep a close eye on your staff.
- Rule #7 Use Chinese Medicine to understand the aging process. Western Medicine to understand disease processes.
- Rule #8 Physical Therapy is central to longevity and a healthy ending.
- Rule #9 Consider the caregiver’s emotional and physical health in your decisions.
- Rule #10 There is a time to die.
Thomas H. Brymer II
Replies
Do you mean like this? https://www.youtube.com/watch?v=PiblYasnzWE
I had copied and pasted the "Moving Mum" article into an email for my wife, an RN with considerable nursing home experience and for a lawyer friend who has a 90 year old mom. Later when I clicked "to post my comment about puting crime in Panama in perspective, it just showed up below the text I wrote. I have no idea how, and it was farther down on the page when I posted the comment so that I didn't see it. Pretty strange.
Susan and Pat,
Excellent comment.
The last line of the article I included with my most recent post says this: Sixteen percent of the country's 2 million prisoners suffer from mental illness.
Bob
Greg,
I'm a bit frustrated because I had written most of a reply when I inadvertently refreshed the forum page and lost all my work. I'll try to recapitulate.
I would appreciate your pointing out to me any THEORIES, uninformed or otherwise, in what I wrote in my brief reply to you.
I mention that there are 20,000 people in the U.S. in solitary confinement and expressed my doubt that all of those people need to be there for safety reasons. I cited the statistic of over 2.2 million people incarcerated in the U.S. and said that I can't conceive of our NEEDING to have that many people in jails and prisons. I cited two examples of people in solitary who did not need to be their for safety reasons (though I acknowledge that Manning probably needed some kind of secration for his OWN safety.
Then I provided two factual, non-theoretical statistical charts showing the magnitude of the prison population problem in the U.S.
The War on Drugs and the "Prison Industry" have a symbiotic relationship. In the 25 years after the Anti-Drug Act was passed the U.S. prison population increased from 300,000 to over 2,000,000.
The "Prison Industry" is unlike most other "industries" in that it is generally non-productive. Money is taken from citizens to pay for its operation. It provides non-productive jobs. The administration and security people in those jobs do not make cars, boats, toasters, washing machines or widgets of any kind. They just soak up money. There are also contractors who share the trough. I can allow that there is a need for some people in such jobs, but not the huge numbers. The "Prison Industry" is a big public jobs program. The prison industry is also a big private job program. Corrections Corporation of America (headquartered in my home town) opened its first prison in 1984. It now operates 60 prisons and is the largest private prison corporation in the country. A few years ago there were ten private companies in the same business as CCA. Now there are thirty. The private prison operators and the government prison operators receive almost all of their operating budget money from taxes on the public. To the extent that the revenues come from federal and state income taxes, only about half of the people who earn wages pay income taxes.
There are prison industries, but they do not usually contribute revenue to prison operating budgets. The federal prison industries UNICOR pays prisoners between 23 cents and $1.15 per hour, paying their staffs 75% of profits over material costs and the workers 25% of profits over material costs. If prisoners have fines or money judgments against them, 50% of their pay goes to those judgments, leaving them with 11 1/2 cents per hour to 57 1/2 cents per hour.
Have a look at this excerpt from a longer article:
There are approximately 2 million inmates in state, federal and private prisons throughout the country. According to California Prison Focus, "no other society in human history has imprisoned so many of its own citizens." The figures show that the United States has locked up more people than any other country: a half million more than China, which has a population five times greater than the U.S. Statistics reveal that the United States holds 25% of the world's prison population, but only 5% of the world's people. From less than 300,000 inmates in 1972, the jail population grew to 2 million by the year 2000. In 1990 it was one million. Ten years ago there were only five private prisons in the country, with a population of 2,000 inmates; now, there are 100, with 62,000 inmates. It is expected that by the coming decade, the number will hit 360,000, according to reports.
What has happened over the last 10 years? Why are there so many prisoners?
"The private contracting of prisoners for work fosters incentives to lock people up. Prisons depend on this income. Corporate stockholders who make money off prisoners' work lobby for longer sentences, in order to expand their workforce. The system feeds itself," says a study by the Progressive Labor Party, which accuses the prison industry of being "an imitation of Nazi Germany with respect to forced slave labor and concentration camps."
The prison industry complex is one of the fastest-growing industries in the United States and its investors are on Wall Street. "This multimillion-dollar industry has its own trade exhibitions, conventions, websites, and mail-order/Internet catalogs. It also has direct advertising campaigns, architecture companies, construction companies, investment houses on Wall Street, plumbing supply companies, food supply companies, armed security, and padded cells in a large variety of colors."
According to the Left Business Observer, the federal prison industry produces 100% of all military helmets, ammunition belts, bullet-proof vests, ID tags, shirts, pants, tents, bags, and canteens. Along with war supplies, prison workers supply 98% of the entire market for equipment assembly services; 93% of paints and paintbrushes; 92% of stove assembly; 46% of body armor; 36% of home appliances; 30% of headphones/microphones/speakers; and 21% of office furniture. Airplane parts, medical supplies, and much more: prisoners are even raising seeing-eye dogs for blind people.
CRIME GOES DOWN, JAIL POPULATION GOES UP
According to reports by human rights organizations, these are the factors that increase the profit potential for those who invest in the prison industry complex:
. Jailing persons convicted of non-violent crimes, and long prison sentences for possession of microscopic quantities of illegal drugs. Federal law stipulates five years' imprisonment without possibility of parole for possession of 5 grams of crack or 3.5 ounces of heroin, and 10 years for possession of less than 2 ounces of rock-cocaine or crack. A sentence of 5 years for cocaine powder requires possession of 500 grams - 100 times more than the quantity of rock cocaine for the same sentence. Most of those who use cocaine powder are white, middle-class or rich people, while mostly Blacks and Latinos use rock cocaine. In Texas, a person may be sentenced for up to two years' imprisonment for possessing 4 ounces of marijuana. Here in New York, the 1973 Nelson Rockefeller anti-drug law provides for a mandatory prison sentence of 15 years to life for possession of 4 ounces of any illegal drug.
. The passage in 13 states of the "three strikes" laws (life in prison after being convicted of three felonies), made it necessary to build 20 new federal prisons. One of the most disturbing cases resulting from this measure was that of a prisoner who for stealing a car and two bicycles received three 25-year sentences.
. Longer sentences.
. The passage of laws that require minimum sentencing, without regard for circumstances.
. A large expansion of work by prisoners creating profits that motivate the incarceration of more people for longer periods of time.
. More punishment of prisoners, so as to lengthen their sentences.
HISTORY OF PRISON LABOR IN THE UNITED STATES
Prison labor has its roots in slavery. After the 1861-1865 Civil War, a system of "hiring out prisoners" was introduced in order to continue the slavery tradition. Freed slaves were charged with not carrying out their sharecropping commitments (cultivating someone else's land in exchange for part of the harvest) or petty thievery - which were almost never proven - and were then "hired out" for cotton picking, working in mines and building railroads. From 1870 until 1910 in the state of Georgia, 88% of hired-out convicts were Black. In Alabama, 93% of "hired-out" miners were Black. In Mississippi, a huge prison farm similar to the old slave plantations replaced the system of hiring out convicts. The notorious Parchman plantation existed until 1972.
During the post-Civil War period, Jim Crow racial segregation laws were imposed on every state, with legal segregation in schools, housing, marriages and many other aspects of daily life. "Today, a new set of markedly racist laws is imposing slave labor and sweatshops on the criminal justice system, now known as the prison industry complex," comments the Left Business Observer.
Who is investing? At least 37 states have legalized the contracting of prison labor by private corporations that mount their operations inside state prisons. The list of such companies contains the cream of U.S. corporate society: IBM, Boeing, Motorola, Microsoft, AT&T, Wireless, Texas Instrument, Dell, Compaq, Honeywell, Hewlett-Packard, Nortel, Lucent Technologies, 3Com, Intel, Northern Telecom, TWA, Nordstrom's, Revlon, Macy's, Pierre Cardin, Target Stores, and many more. All of these businesses are excited about the economic boom generation by prison labor. Just between 1980 and 1994, profits went up from $392 million to $1.31 billion. Inmates in state penitentiaries generally receive the minimum wage for their work, but not all; in Colorado, they get about $2 per hour, well under the minimum. And in privately-run prisons, they receive as little as 17 cents per hour for a maximum of six hours a day, the equivalent of $20 per month. The highest-paying private prison is CCA in Tennessee, where prisoners receive 50 cents per hour for what they call "highly skilled positions." At those rates, it is no surprise that inmates find the pay in federal prisons to be very generous. There, they can earn $1.25 an hour and work eight hours a day, and sometimes overtime. They can send home $200-$300 per month.
Thanks to prison labor, the United States is once again an attractive location for investment in work that was designed for Third World labor markets. A company that operated a maquiladora (assembly plant in Mexico near the border) closed down its operations there and relocated to San Quentin State Prison in California. In Texas, a factory fired its 150 workers and contracted the services of prisoner-workers from the private Lockhart Texas prison, where circuit boards are assembled for companies like IBM and Compaq.
[Former] Oregon State Representative Kevin Mannix recently urged Nike to cut its production in Indonesia and bring it to his state, telling the shoe manufacturer that "there won't be any transportation costs; we're offering you competitive prison labor (here)."
PRIVATE PRISONS
The prison privatization boom began in the 1980s, under the governments of Ronald Reagan and Bush Sr., but reached its height in 1990 under William Clinton, when Wall Street stocks were selling like hotcakes. Clinton's program for cutting the federal workforce resulted in the Justice Departments contracting of private prison corporations for the incarceration of undocumented workers and high-security inmates.
Private prisons are the biggest business in the prison industry complex. About 18 corporations guard 10,000 prisoners in 27 states. The two largest are Correctional Corporation of America (CCA) and Wackenhut, which together control 75%. Private prisons receive a guaranteed amount of money for each prisoner, independent of what it costs to maintain each one. According to Russell Boraas, a private prison administrator in Virginia, "the secret to low operating costs is having a minimal number of guards for the maximum number of prisoners." The CCA has an ultra-modern prison in Lawrenceville, Virginia, where five guards on dayshift and two at night watch over 750 prisoners. In these prisons, inmates may get their sentences reduced for "good behavior," but for any infraction, they get 30 days added - which means more profits for CCA. According to a study of New Mexico prisons, it was found that CCA inmates lost "good behavior time" at a rate eight times higher than those in state prisons.
IMPORTING AND EXPORTING INMATES
Profits are so good that now there is a new business: importing inmates with long sentences, meaning the worst criminals. When a federal judge ruled that overcrowding in Texas prisons was cruel and unusual punishment, the CCA signed contracts with sheriffs in poor counties to build and run new jails and share the profits. According to a December 1998 Atlantic Monthly magazine article, this program was backed by investors from Merrill-Lynch, Shearson-Lehman, American Express and Allstate, and the operation was scattered all over rural Texas. That state's governor, Ann Richards, followed the example of Mario Cuomo in New York and built so many state prisons that the market became flooded, cutting into private prison profits.
After a law signed by Clinton in 1996 - ending court supervision and decisions - caused overcrowding and violent, unsafe conditions in federal prisons, private prison corporations in Texas began to contact other states whose prisons were overcrowded, offering "rent-a-cell" services in the CCA prisons located in small towns in Texas. The commission for a rent-a-cell salesman is $2.50 to $5.50 per day per bed. The county gets $1.50 for each prisoner.
STATISTICS
Ninety-seven percent of 125,000 federal inmates have been convicted of non-violent crimes. It is believed that more than half of the 623,000 inmates in municipal or county jails are innocent of the crimes they are accused of. Of these, the majority are awaiting trial. Two-thirds of the one million state prisoners have committed non-violent offenses. Sixteen percent of the country's 2 million prisoners suffer from mental illness.
In following thread I stumbled across this bit on "legal" traffic stops. Huffpost .
In my professional life, that was life before Panama, Pima Country AZ was a client. I spent time in the county jail as a contractor and with the Sheriffs dept. I remember on day with the "Mantis" group, the people who arranged and executed drug busts. The entire discussion of the day was who to raid based upon the amount of assets that could be seized. It was quite and education into the realities of law enforcement in the US.
It only enhanced what i knew from six months interning as a criminal prosecutor, there the Cty attorney has a hit list of people they wanted to nail. Som much for innocent until proven guilty. The lack of law enforcement here in Panama is frustrating but a breath of fresh air.
Mr. Meyer, your observations are proof-positive that it is time to decriminalize drug abuse.
The so-called "War on Drugs" has proven to be another half-witted attempt by ham-handed ignoramuses to confront issues about which they have little or no anthropological, humanistic, or cultural understanding. The billions of dollars that have been spent in inept and incompetent interdiction efforts have successfully ensured that the societal addictions to the "War on Drugs" and all the attendant toys and weaponry and detention facilities self-perpetuate the negative aspects of this most twisted of freak shows.
The "War on Drugs" will not and cannot ever be "won". It can only continue to be a horrible game with terrible social consequences. If some tweaker commits some heinous crime, then by all means chew him up. But if an addict can be successfully treated, then civilized society is blood and money leagues ahead of slamming some stupid stoner behind bars.
Greg:
I understand that there are prisoners who are dangerous enough to require solitary confinement and security measures like that. It is difficult to conceive that there are 20.000 of them (just as it is difficult to conceive that the U.S. NEEDS to incarcerate over 2.2 MILLION persons---more per capita than any other country in the world). SEE CHART BELOW
Do you think Bradley Manning was such a dangerous little puke that he required the treatment he received? I understand that because of the nature of his acts he may have needed to be isolated from the general population for safety reasons, but that did not required that he be kept naked.
Are you familiar with the Edgar Steele case? He has been kept in solitary confinement for much of his imprisonment. He is a mild-mannered attorney who was framed for trying to kill his wife (which even she does not believe). He is in prison because of his political and social stances and is being kept in solitary confinement "just because."
I'll have some of whatever it is that Ray is smoking. Jesus!
You can subtract 10,212 of those words which are in the "Moving Mum to Panama" article which somehow snuck into this thread.
Bob
Hang in there, Ray. The mother ship will be arriving any time now.
Bob, I would love to call you paranoid, however I believe that what you posted is happening, not just in the US but worldwide to one degree or another. The days of privacy are vanishing and bubbles of freedom shrinking. The main function of government is not to protect the people but the survive. Nothing new there, whether it be a King, a dictator or a republic governments use propaganda and repression to instill patriotism and bind their people to reality. The only reason Panama is better is it has fewer resources to do the same thing and that buys us time here.