43,273 indigent senior citizens in Caraga get social pension

By Alexander Lopez

BUTUAN CITY—The Department of Social Welfare and Development in the Caraga Region (DSWD 13) has

provided 43,273 indigent senior citizens with their social pensions during the first three months of this year.

In a statement on Monday, the agency said the beneficiaries form part of their Social Pension for Indigent Senior Citizens Program (SocPen).

“The agency vows to continue to carry out its services to the poor, vulnerable, and disadvantaged,” the

DSWD 13 said, adding that the payout for the SocPen program will continue to complete the first semester of this year.

For this year, 58.3 percent of the 184,700 target beneficiaries under the program in the region are women, according to the agency. The SocPen is considered an additional financial assistance of the government to indigent senior citizens in the amount of P500 per month. The assistance aims to augment the daily subsistence of indigent senior citizens, especially for their medical needs. PNA

In nursing homes, impoverished residents live final days on pennies

By Matt Sedensky AP National Writer

PHILADELPHIA—New pants to replace Alex Morisey’s tattered khakis will have to wait.

There’s no cash left for sugar-free cookies either. Even at the month’s start, the budget is so bare that Fixodent is a luxury. Now, halfway through it, things are so tight that even a Diet Pepsi is a stretch.

“How many years do I have left?” asks 82-year-old Morisey, who lives in a Philadelphia nursing home. “I want to live those as well as I can. But to some degree, you lose your dignity.”

Across the US, hundreds of thousands of nursing home residents are locked in a wretched bind: Driven into poverty, forced to hand over all income and left to live on a stipend as low as $30 a month.

In a long-term care system that subjects some of society’s frailest to daily indignities, Medicaid’s personal needs allowance, as the stipend is called, is among the most ubiquitous, yet least known.

Nearly two-thirds of American nursing home residents have their care paid for by Medicaid and, in exchange, all Social Security, pension and other income they would receive is instead rerouted to go toward their bill. The personal needs allowance is meant to pay for anything not provided by the home, from a phone to clothes and shoes to a birthday present for a grandchild.

One problem: Congress hasn’t raised the allowance in decades.

“It’s really one of the most humiliating things for them,” says Sam Brooks, an attorney for The National Consumer Voice for Quality Long-Term Care, which advocates for nursing home residents and has urged an increase in the allowance.

“It can really be a point of shame.”

Especially when an individual has no close relatives or no one able to financially help, the allowance can breed striking need. When Marla Carter visits her mother-inlaw at a nursing home in Owensboro, Kentucky, the scene feels more 19th-century poorhouse than modern-day America. With just a $40 allowance, residents are dressed in ill-fitting hand-me-downs or hospital gowns that drape open. Some have no socks or shoes. Basic supplies run low. Many don’t even have a pen to write with.

“That’s what was so surprising to us,” Carter says, “the poverty.”

She was so horrified that she and her husband started a nonprofit, Faithful Friends Kentucky, to distribute items to area nursing home residents. Among the things most warmly received are Kleenex tissues, because facilities often stock scratchy generics and even those can be hard to come by.

“You bring a soda or a toothbrush and they’ll get so excited,” she says.

“It’s so sad to me.”

Medicaid was created in 1965 as part of the Great Society programs of Lyndon B. Johnson. A 1972 amendment established the personal needs allowance, set at a minimum of $25 monthly. Unlike other benefits like Social Security, cost-of-living increases were not built into personal needs allowance rules.

Had it been linked to inflation, it would be about $180 today. But Congress has raised the minimum rate only once, to $30, in 1987. It has remained there ever since.

Some politicians have tried to fix the problem, including Rep. Jennifer Wexton, a Democrat from Vir - ginia who in 2019 introduced a bill to raise the minimum allowance to $60 and cement annual increases tied to those for Social Security. It didn’t even get a hearing.

“I was shocked,” Wexton says. “It’s about dignity for these people.”

Medicaid is jointly administered between individual states and the federal government and, faced with federal inaction, states have taken it upon themselves to raise allowances. Even so, most remain low. A majority of states—28—have allowances of $50 or less, according to a state-bystate survey by the American Council on Aging. Just five states grant residents $100 or more each month, including Alaska, which stands alone in offering $200 monthly, the maximum under federal law. Four states —Alabama, Illinois, North Carolina and South Carolina—remain at the $30 minimum. Despite such paltry allotments, some facilities have been cited for not telling residents they were entitled to an allowance at all, for failing to provide the money, or for spending the funds without their permission. And though federal regulations outline a host of items that are to be provided to nursing home residents, many find themselves unable to use the cheap items facilities offer, spending their allowance on replacements for institutional-grade soap that makes them dry and itchy, tissues that feel like something out of a bus terminal bathroom, razors that leave a face nicked and bleeding and denture adhesives that seem incapable of keeping false teeth in place.

Some homes skirt the rules, making residents pay for things like diapers or haircuts that are supposed to be included.

“As soon as I get it, it’s gone,” says Chris Hackney, a 74-year-old resident of a nursing home in Durham, North Carolina, who spends his $30 monthly allowance on body wash, toothpaste, deodorant and some items his facility used to provide but has cut back on, wipes and diapers. “Think of the prices of everything that tripled and quadrupled. And the money hasn’t gone up any.”

Hackney, a retired appliance technician who has used a wheelchair since a motorcycle accident nine years ago, has a daughter who pays his cell phone and a church that sends care packages. But even a modest boost to the allowance, Hackney says, would mean a ton.

“It would change so many lives in here,” he says.

Doctors and the art of the narrative MY SIXTY-ZEN’S WORTH

ments because they’ve heard that prescriptive medicines are bad for the liver.

By Nick Tayag

If the waiting at the anteroom takes long, the stories veer towards their families. Disputes with their children or with their spouses, in-laws or their neighbors. Dealing with a separated daughter with an autistic child. Problem spouses with toxic habits.

I can fill several notebooks of this stuff to help me conjure ideas for my various narrative writing projects.

But then at one point I thought, shouldn’t the doctor be the one listening to this? Shouldn’t a physician strive to know as much as he can about his patient’s lives to have a better handle on how to treat him? Someone should be recording their stories and come up with a body literature made available to students and practicing doctors.

Sure we are impressed with all the technology of diagnosing and treating diseases.

But the human aspect is mostly set aside. What happened to “the art” side of healing?

rocket science, just simple common-sense logic.

In novels and films, there is such a thing as back-story. It is a set of events preceding and leading up to the present scene. It provides some missing details that help complete our understanding of the character in the film or novel and explain, for instance, why he behaves the way he does.

Many doctors don’t have the slightest interest to seek out the back-stories. They seem to forget that humans, unlike animals, can talk. Patients can tell doctors a lot about themselves (their peculiarities, their idiosyncracies, their limitations) that can help solve health problems in a way that is more enlightened and customtailored to each patient’s respective situation and habits.

pass more than just medical charts and diagnostic results.

Too bad the scientific evidence of the healing power of the narrative is sparse. NBM is not yet widely incorporated in clinical practice. More research is needed in this field of inquiry.

While the jury is still out on the subject, I believe there is much to explore in the possible links and synergies between medicine and the humanities. What roles can drama, poetry, fiction, biography and cinema play in reflecting and influencing good practice?

ness, doctor and patient, society and the human spirit, men and women, love and fate, aging, and death and grieving.

I also highly recommend the works of A.J. Cronin, a Scottish physician and novelist. His novella “Country Doctor” and his autobiography “Adventures in Two Worlds” are a must read for prospective doctors.

WHEN I accompany my wife to her cardiologist for her regular checkups, we would usually find ourselves in the company of other patients in the anteroom. We all wait silently for our turn to be called to get inside the doctor’s clinic.

However, my wife is a good trigger person. One casual question to the person beside her and a conversation starts. At first, it comes in trickles, and then it swells to an unstoppable torrent. Overhearing the thread, others would add to the exchange.

Human nature being what it is, people are normally predisposed to talk about themselves. What ails them, their age, their families, their problems and other ordinary details of their lives. I stay quiet but my ears are acutely tuned in to the chitchat because I’m on a constant lookout for materials for my think pieces.

One problem that crops up in every conversation is never having enough money to afford doctors’ fees and buy medicines. The other issue is health illiteracy.

Some say that they’ve stopped taking their medicines because they already were feeling well. Others say they sometimes resort to organic supple -

More and more young doctors are data-driven. Without even knowing the financial situation of the patient, the doctor writes an order for diagnostic test after another. X-rays, MRI, CT scan, blood chemistry tests. They cost. But the patient is left with no choice; the whole prognosis is based on those results. How about organic alternatives? Perish the thought. Most doctors trained in Western medicine would scoff at the idea.

But why not listen first before prescribing? This is a question I ask after so many years of going to doctors’ clinics. It’s not even

This is why I believe we must add the study of the humanities in medical schools. Future doctors need to read literature and become adept in the use of narrative art as a tool in the healing process. In short, the doctor must learn to develop insights into human nature, learn to read human beings better. This needs intuition and empathy, which I think every human being is gifted with. One sage calls it “knowing from the heart.”

This is why I am all for the growing interest in narrative-based medicine (NBM), first used by Rita Charon in 2000 to describe “the capacity to recognize, absorb, metabolize, interpret, and be moved by stories of illness.” In a nutshell, narrative medicine draws on the study of art and literature to enhance students’ listening and observation skills and to expand their view of patients to encom-

Take for instance a painting. A doctor who learns to appreciate a piece of artwork would be much more open to listen to people’s stories. If you gaze at visual works of art such as paintings of people by the French Impressionists, Caravaggio, Norman Rockwell or Fernando Amorsolo, they reveal stories that you don’t get just by a casual glance. It can teach a doctor that by being attentive to details, one gets to see the whole story, as if there is an ongoing dialogue between the painting and the viewer, facilitated by the artist.

The narrative-based approach shifts the doctor’s focus to the need to understand first before the need to problem solve. Thus, the patient-doctor relationship is strengthened and the patient’s needs and concerns are addressed more effectively and with better results.

A good way to start learning the narrative art is to read the literary works of Anton Chekhov, a Russian doctor who was also a writer. Many of his short stories are not only good read per se, but they also deal with themes of health and ill-

One physician who read Chekov was moved to write: “It was not only important but essential. Nowhere else in the medical curriculum did they confront and discuss the wide array of human concerns raised by Chekhov (and by our patients)—the deep and painful thoughts and feelings aroused by illness and death, the capriciousness of fate, the unexpected dignity in suffering, the power of simple acts of kindness, and the haunting desires and ambitions we discover in ourselves, sometimes at the worst of times.”

To any doctor who reads this, don’t just listen with your stethoscope to the beat of your patient’s heart or the condition of his lungs. Offer a listening heart. Everybody needs someone to listen to them. Scratch the surface of a physically suffering patient, and underneath there’s usually a spiritually wounded human being who is thirsting for the caring presence of other people. More than just the medicines, just being there totally with the patient can be the most essential thing every doctor can offer suffering humanity.

As a Buddhist sage once asked: who is available to you? To whom are you available? These to me should be the measure of a meaningful practice of the healing arts.